Infertility Training

One-day certificate course:

• Basic evaluation of an Infertile couple
• Counseling of an infertile couple
• Ovulation Induction Protocols
• Oral ovulogens, Gonadotrophins, Agonists
• Antagonists, Insulin sensitizers, aromatase inhibitors.
• Ovulation study in ultrasound
• Role of ultrasound for IUI practice.
• The ultrasound-based decision on stimulation protocols
• Ultrasound for decision making on a trigger
• Optimizing IUI & technique
• Medical management of male infertility
• Setting up of IUI Lab
• Semen preparation techniques
• Live demonstration of various methods of IUI
• Hands-on semen preparation

Program Highlights:

The course consists of an extensive theoretical and practical training on infertility related ultrasound, clinical aspects of IUI, Lab aspects of IUI, Laboratory techniques and protocols of IVF embryology, and clinical aspects of IVF and ICSI. The training also includes. The course has been designed to satisfy the need for the complete training in IVF and infertility, but it can also be divided according to the candidate’s special needs for only ultrasound or ultrasound and IUI.

Day 1 Wednesday 9.30 AM to 3.30 PM (Ultrasound in Infertility)

• 9.30-12.00: Live demos and case to case discussion.
• 12.00-1.00: Systematic transvaginal scan technique- b mode and Doppler image.
• 1.00-1.45: Lunch
• 1.45–3.30: Congenital uterine anomalies, Acquired uterine anomalies

Day 2 Thursday 9.30 AM to 3.30 PM (Ultrasound in Infertility)

• 9.30-12.00: Live demos and case to case discussion.
• 12.00-1.00: Role of ultrasound in PCOS.
• 1.00-1.45: Lunch
• 1.45–3.30: Baseline scan and deciding the stimulation protocols for IUI and IVF

In PCOS, Preovulatory Scan and deciding the time of hCG and time of IUI, Luteal phase assessment ,prevention and management of OHSS.

Day 3 Friday 9.30 AM to 3.30 PM (Ultrasound in Infertility)

• 9.30-12.00: Live demos and case to case discussion.
• 12.00-1.00: Differential diagnosis of adnexal lesions related to infertility.
• 1.00-1.45: Lunch
• 1.45-3.30: Tubal assessment, Ectopic pregnancy- diagnosis and management, summary and queries.

Day 4 Saturday 10:00 AM to 4:00 PM (Andrology – Preparation & Practical IUI)

• 10.30 – 12.45: Lab Setup and IUI Preparation Techniques hands on.
• 12.45- 1.30: Lunch.
• 1.45 – 3.30: Ovulation induction, Optimizing IUI, Medical Management in Male Infertility.

Day 5 Sunday – Holiday

Day 6 Monday 10.00 AM to 4.00 PM (Embryology)

• 10.30 – 12.30: IVF Lab Introduction + live demos ovum picks up.
• 12.30- 1.15: Ovum Pick up Theory.
• 1.15- 2.00: Lunch.
• 2.00 – 4.00: Stimulation Protocol for IVF, Role of Agonist & Antagonist, LH in IVF stimulation.

Day 7 Tuesday 10.00 AM to 4.00 PM

• 10.30 – 12.30: Basic Embryology
• 12.30- 1.15: Embryo Transfer Theory.
• 1.15- 2.00: Lunch
• 2.00 – 4.00: Implantation Failure.

Day 8 Wednesday 10.00 AM to 4.00 PM

• 10.30 – 12.30: Embryology essentials presentation and observing embryos.
• 12.30- 1.15: Fetal reduction Theory.
• 1.15- 2.00: Lunch.
• 2.00 – 4.00: Semen Analysis, Surgical Management of Male Infertility.

Day 9 Thursday 10.00 AM to 4.00 PM

• 10.30 – 12.30: Advanced techniques presentation + live demos of embryos transfers.
• 12.30- 1.15: Endometriosis.
• 1.15- 2.00: Lunch.
• 2.00 – 4.00: RPL, Counseling, Controversies in IVF.

Curriculum for the observership course in Infertility & IVF- 3 month

• What is Infertility
• Anatomy of the female genital tract
• Hormones in reproduction:
  • Role of Estrogen
  • Role of Progesterone
  • Role of FSH
  • Role of LH
• Role of AMH
• Pituitary hypothalamic ovarian axis
• Patient counseling
• Physiology of Ovulation
• Causes of Infertility – diagnosis
• Anovulation – definition
  • Types
  • Causes
  • Treatment of each
• Polycystic 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

Uterine causes of infertility

• Congenital uterine anomalies:
  • Diagnosis
  • Treatment of strategies
• Uterine pathologies and fertility prognosis

Tubal cause of Infertility

• Diagnosis
• Management

Cervical causes of Infertility

• What is the importance
• Does it exist in the 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
• Optimizing results

Male factors of Infertility

• Anatomy of the male reproductive tract
• Hormonal assessment
• Normal semen parameters
• Abnormal semen parameters
• Causes of oligoasthenospermia & teratozoospermia
• Treating abnormal sperm parameters
• Medical management of male infertility

IVF – In-vitro Fertilization

• Clinical aspects
• Anesthesia
• 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

Setting up IUI & IVF Laboratory

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

Curriculum for the fellowship course in Infertility & IVF- 6 months

• 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
• Hypothalamo Pituitary Ovarian Axis
• Patient counseling
• 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 the 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 – Intrauterine insemination

• Indication
• Success rates – present results
• Optimizing results

Male factors of Infertility

• Spermatogenesis – physiology
• Anatomy of the 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, Varicocoelectomy, surgical techniques for obstructive azoospermia
• Medical management of male infertility
• The genetic factor of male infertility

IVF – In-vitro Fertilization

• Clinical aspects
• Anesthesia
• 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
• Newer methods – mitochondrial transfer
  • Stem cell in infertility
  • Ovarian regenesis
  • Endometrial regenesis
  • PRP
  • GCSF

Setting up IUI & IVF Laboratory

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