All Course: Long Term fellowship Program

• What is Infertility
• Embryology of female genital tract
• Anatomy of female Genital tract
• Hormones in reproduction:
  • Role of Estrogen
  • Role of Progesterone
  • Role of FSH
  • Role of LH
  • Role of AMH
• Pituitary hypothallamo ovarian axis
• Patient counselling
• Physiology of Ovulation
• Causes of Infertility – diagnosis
• Anovulation – definition
  • Types
  • Causes
  • Treatment of each
• Polycytsic ovarian diseases – pathophysiology
  • Diagnosis in adolescent & in adult
  • Hormonal parameter
  • Ultrasound
  • Metabolic component
  • Management strategies – depending on the aim of treatment
  • 2018 ESHRE consensus and guidelines for diagnosis and treatment of PCOS
• Poor Ovarian reserve
  • Causes
  • Bologna criteria
  • Diagnosis
  • Management strategies
  • Assessment of ovarian reserve – different tests accuracy
  • Practical importance

Uterine causes of infertility

• Congenital uterine anomalies:
  • diagnosis
  • Treatment of strategies
  • Outcome of pregnancy
• Uterine pathologies and fertility prognosis

Tubal cause of Infertility

• Causes
• Diagnosis
• Pregnancy prognosis
• Management

Cervical causes of Infertility

• What is the importance
• Does it exist in presence of ART?

Ovulation induction methods For IUI /For IVF

• Oral ovulogens
• Different gonadotrophin protocols
• Role of down regulators
• Agonist/ Antagonist
• Role of LH in ovulation Induction
• Role of progesterone in ovulation induction
• Luteal phase assessment
  • Abnormal luteal phase
  • Causes
  • Management
• Ovulation Trigger – hCG/agonist

Implantation:

• Physiology of implantation
• Causes of implantation failure
• Recurrent implantation failure
• Investigations & diagnosis
• Management strategies
• New endometrial receptivity tests

IUI – Intra uterine insemination

• Indication
• Success rates – present results
• Optimising results

Male factors of Infertility

• Spermatogenesis – physiology
• Anatomy of male reproductive tract
• Hormonal assessment
• Normal semen parameters
• Abnormal semen parameters
• Causes of oligoasthenospermia & teratozoospermia
• Treating abnormal sperm parameters
• Surgical treatment of male Infertility – PESA/TESA, Varicoccoelectomy, surgical techniques for obstructive azoospermia
• Medical management of male infertility
• Genetic factor of male infertility

IVF – In vitro Fertilization

• Clinical aspects
• Anaesthesia
• Ovum pickup
  • Method
  • Variation
  • Complication
• Embryo Transfer
  • Method
  • Alternatives – mock transfer, catheter types, ultrasound guidance
  • Change in results
  • Complication

Embryology aspects of IVF

• Embryo development
• Gamete handling techniques
• IVF
• ICSI
• Assisted Hatching
• IMSI
• Segmentation of IVF
• Genetics in Infertility
• Role of stem cells in reproduction
• Newer methods – mitochondrial transfer
  • Stem cell in infertility
  • Ovarian regenesis
  • Endometrial regenesis
  • PRP
  • GCSF

Setting up IUI Laboratory

• Setting up IVF laboratory – about the instruments – choices
• Maintenance of the IVF & IUI lab equipment
• Cleansing of IUI lab/IVF lab – maintenance
• Role of Ultrasound in Infertility Management
  • For dose decision
  • For trigger , Timing of IUI
  • Luteal phase assessment
• Ovarian hyper stimulation syndrome
  • Diagnosis
  • Monitoring
  • Treatment protocols

This is an online and onsite module, online module is available from Jaypee Brothers (Diginerve) link.

This is a lecture series of 25 lectures which will be available to one candidate for the defined time. During this time or after that onsite module of two weeks is available, which will include Hands-on and/or simulator training, lectures on clinical embryological and ultrasound aspects of IVF and live demos with case to case discussion on Ultrasound

Online Module

will consists of following lectures

1. Understand the baseline scoring system and its application in planning stimulation protocols.
2. Pretrigger scan, the intricacies of the time of trigger in IUI and IVF.
3. Luteal phase scan
4. Mullerian duct abnormalities.
5. Endometrial pathologies
6. Myometrial pathologies
7. Adnexal lesions and impact on treatment planning in ART.
8. Tubal assessment by ultrasound.
9. Ultrasound in PCOS
10. Ovum pickup technique
11. Embryo transfer- finer touch
12. Sonoendocrinology
13. Physiology of ovulation induction
14. Assessing ovarian reserve
15. Gonadotrophins in ART
16. Role of CC and Letrozole in new era.
17. Ovulation induction in hypogonadotrophic hypogonadism
18. Luteal phase support
19. Optimizing success in ART
20. Impact of thyroid and Prolactin abnormalities in ART
21. Recurrent pregnancy loss
22. Status of pregenetic diagnosis
23. Thin endometrium
24. Management of azoospermia
25. Managing OHSS

Onsite Module

2 weeks Hands-on training schedule

Day- 1, Monday

• Demonstration of Basic Ultrasound, Basics of Doppler settings and technique.

Day-2, Tuesday

• Case to case discussion with live demos on uterine abnormalities, adnexal lesions, and follicular monitoring.

Day-3, Wednesday

• Case to case discussion on Follicular monitoring, baseline scan and the decision of stimulation protocol, luteal phase problems and US diagnosis of PCO.

Day-4, Thursday

• Andrology-preparation & Practical IUI
• Ultrasound scan on simulation
• Hands-on training in lab setup and IUI preparation techniques

Day-5, Friday

• Case wise discussion and live demos on scan
• IVF lab introduction with live demos and hands-on in lab techniques during ovum pick-up
• Theory and simulator training in ovum pick-up

Day-6, Saturday

• Basic Embryology+Gamete handling
• Simulator training in ovum pick-up
• Simulator training in ovum pick-up and embryo transfer

Day-7 Week off ,Sunday

Day-8, Monday

• Embryology essentials presentation and observing embryos
• Ultrasound scan on simulation

Day-9, Tuesday

• Live demos and case to case discussions
• Live demos and hands-on in embryo transfers (lab techniques)

Day-10, Wednesday

• Stimulation Protocol for IVF (finer points) including role of agonist and antagonist, LH in IVF simulation & dealing with poor ovarian reserve.
• Embryo transfer simulation

Day-11, Thursday

• Case to case discussion
• Early pregnancy assessment (Normal and Abnormal)

Day-12, Friday

• Live demos of ultrasound and case to case discussion
• Live demos of SSG & HyCoSy
• Live demos of Sonohysterography
• Ectopic pregnancy diagnosis and management

Day-13, Saturday

• Lab exposure, simulator sessions on ovum pick-up and embryo transfers, query solving.

Day-14 Week off, Sunday

Note: This is an overview of the program, which is likely to change according to the number of patients, complexity of cases and the discussion that follows.