Training curriculum and evaluation for IFS ART Fellowship program

  1. Objectives
  2. Syllabus Theory
  3. Scope of practical training
  4. Recommended books and journals
  1. Objectives
  2. At the end of one year the fellow should be
  3. Confident in handling infertility patients, work up, decision making, ultrasound, stimulation protocols, monitoring and troubleshooting.
  4. Understand the operative and laboratory aspects of ART procedures
  5. Understand the role of endoscopy in infertility management
  6. Understand the problems of ART pregnancies
  7. Medico-legal, ethical and management issues related to ART
  8. Have exposure to research methodology in ART

Note – This training does not include hands on in IVF laboratory, endoscopy and ART pregnancy management

  1. Syllabus
  1. Basic Sciences
  1. Female anatomy - Uterus, Cervix & Fallopian tubes
  2. Congenital anomalies.
  3. Cervix & cervical canal – function & structural anomalies
  4. Structure & function of fallopian tubes ( Lecture 1)
  5. Physiology & Endocrinology of the menstrual cycle
  6. Neroendocrine control of menstrual cycle
  7. Folliculogenesis- Hormonal, Autocrine & paracrine regulators of follicular growth
  8. Ovulation & Luteal phase.
  9. Endometrial changes during MC
  10. Window of implantation – factors governing implantation. (Lecture 2)
  11. Anatomy & Physiology of male reproduction
  12. Anatomy & anatomical abnormalities – testes, epididymis, vas
  13. Spermatogenesis
  14. Hormonal control of spermatogenesis
  15. Fertilization – sperm changes leading to fertilization, contribution of male genome to the embryo.
  16. Ejaculation – physiology and abnormality
  17. Molecular Biology and genetics
  18. genetics and epigenetics in infertility
  19. basics of genetics and transmission of genetic diseases
  20. role of ART in genetic disease
  21. Cell division
  22. Single gene disorders: recessive and dominant
  23. Sex-linked disorders
  24. Late-onset disorders and disease susceptibilities
  25. Chromosome rearrangements: Robertsonian reciprocal translocations and their consequences
  26. Aneuploidy, sporadic aneuploidy and important aneuploidy syndromes (e.g. Edwards, Turner Patau).
  27. Counselling for inherited disorders

B.Infertility management

  1. Evaluation & Management of female factor
  2. Importance of detailed history & physical examination
  3. Investigations – Biochemical, hormonal, ultrasound, Ovulation tests, Tubal evaluation, Luteal phase progesterone. Role of PCT, Cervical hostility tests, EB
  4. Importance of viral marker screening, Pap’s smear, HPV, mammography.
  5. Endoscopic evaluation – role of Laparoscopy & Hysteroscopy, indications& complications
  6. Ovarian reserve markers.
  7. Endocrine disorders affecting ovulation – thyroid , Hyper Prolactinaemia adrenal
  8. Primary & Secondary amenorrhoea
  9. Polycystic ovarian syndrome
  10. Hirsuitism - androgen disorders
  11. Endometriosis
  12. Fibroids & infertility
  13. Ovarian tumors
  14. Chronic pelvic inflammation & Genital Koch’s
  15. Luteal phase defect
  16. Immune system involvement & Thrombophilia’s
  17. Genetic evaluation

5Evaluation & Management of Male factor

  1. History & physical examination
  2. Semen analysis & morphology & tests for sperm function. Role of DNA fragmentation
  3. Role of ultrasound
  4. OAT & Azoospermia , Retrograde ejaculation
  5. Endocrine evaluation & role of endocrine abnormalities leading to MF.
  6. Impact of Infection in semen
  7. Genetic testing & immune factors – Karyotyping, Y deletions
  8. Varicocele - role in infertility & management.
  9. Medical & Surgical treatments for MF.

C ART

6Intrauterine Insemination

  1. Indications, Ovarian stimulation, Monitoring, Trigger Timing of IUI, LPS
  2. Sperm preparation techniques
  3. Procedure of IUI, Post IUI precautions

7Assisted Conception

  1. Indications & indications for IVF/ ICSI, Pre- IVF investigations.
  2. Ovarian stimulation protocols
  3. Agonist & Antagonist Protocols, ICOS –
  4. Management of Poor Responders
  5. Use of Agonist & HCG as ovulation trigger.
  6. Luteal Phase support in ART cycles.
  7. Monitoring – ultrasound & hormonal, Importance of Pre-ovulatory P
  8. FET
  1. Complication of COS – OHSS
  2. Oocyte retrieval & ET techniques and complications
  3. Techniques to Improve IVF results
  4. Recurrent implantation failure

D Embryology Lab

  1. Quality assurance & Quality controlS
  2. How to set up a laboratory – detailing of equipment, layout, cleaning etc.
  3. Sperm preparation for IVF & ICSI – Ejaculate, Epididymal aspiration, testicular biopsy/aspiration, micro-tesa
  4. IVF / ICSI procedure
  5. Embryo culture systems
  6. Assessment of Fertilization & Embryo development
  7. Advanced lab procedures - Assisted Hatching, BET, IMSI
  8. Preimplantation genetic diagnosis – procedure & indications
  9. Oocyte & embryo cryopreservation

E Medicolegal and ethical aspects

  1. Third Party Reproduction
  2. Oocyte donation
  3. Embryo donation
  4. Surrogacy
  1. Ethical & medico-legal aspects aspects of infertility management- ICMR guidelines

F Miscellaneous

  • Biostatics & Data management.
  • Fertility preservation – Social & Onco- fertility.
  • Monitoring & treatment of early pregnancy after ART treatment
  1. Practical Training
  • Adequate hands on to develop skills in performing ultrasound in management of all types of infertility problems
  • At least one month of laboratory posting with hands on in sperm preparation techniques. Adequate understanding of all laboratory procedures, equipments, inventories, decision making and troubleshooting.
  • Adequate exposure to ovum pickup and embryo transfer
  • Exposure to endoscopy and ART pregnancy management
  1. Recommended books and journals
  1. Journals
  2. Fertility and sterility
  3. Human reproduction
  4. Human reproduction update
  5. Reprod Biomed outline
  1. ART
  2. David Garden
  3. Vergese
  4. Pankaj Talwar
  5. Altus
  6. Frozen Life
  1. Infertility Management
  2. Kamini Rao
  1. Ultrasound
  1. Endoscopy
  1. ICMR guidelines