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Knowledge Area 11 – Subfertility

Capability in practice (CiP)

  • 1: The doctor is able to apply medical knowledge, clinical skills and professional values for the provision of high-quality and safe patient-centred care
  • 6: The doctor takes an active role in helping self and others to develop
  • 11: The doctor is competent in recognising, assessing and managing non-emergency gynaecology and early pregnancy care

 

Summary Knowledge Requirements

PART 1 MRCOG

  • Epidemiology of subfertility and treatment
  • Anatomy, development, function and cell biology of the organs of the male and female reproductive tracts in the context of their relevance to fertility and its disorders
  • How to interpret results of investigations commonly performed as part of the investigation of subfertility

PART 2 MRCOG

  • Demonstrate appropriate knowledge, skills and attitudes in relation to subfertility, including an understanding of the epidemiology, aetiology, pathogenesis, clinical treatment and prognosis of all aspects of male and female fertility problems.
  • Have knowledge of indications, limitations and interpretation of relative investigations and treatments in relation to both males and females, including disorders of development and endometriosis
  • Have broad-based knowledge of assisted reproductive technologies, including ovulation induction, in vitro fertilisation, intracytoplasmic sperm injection, gamete donation and surrogacy, and the legal and ethical implications of these procedures

PART 3 MRCOG

  • Demonstrate appropriate knowledge, skills and attitudes in relation to subfertility, including an understanding of the epidemiology, aetiology, pathogenesis, clinical treatment and prognosis of all aspects of male and female fertility problems.
  • Have broad-based knowledge of assisted reproductive technologies, including ovulation induction, in vitro fertilisation, intracytoplasmic sperm injection, gamete donation and surrogacy, and the legal and ethical implications of these procedures

 

Detailed Knowledge Requirements

  • Epidemiology, aetiology, pathogenesis, clinical features, treatment and prognosis of male and female subfertility
  • Indications, limitations and interpretation of investigations: endocrine measurements (male and female), semen analysis, ultrasound, other imaging techniques, genetic analysis, operative procedures
  • Indications, techniques, limitations and complications of surgery in relation to: male and female subfertility, endometriosis, developmental disorders
  • Indications, limitations and complications of assisted reproductive techniques: Ovulation induction, IVF & ICSI, Gamete Donation
  • Legal and ethical issues
  • Able to describe the natural history of conditions that run a chronic course
  • Have knowledge of long-term management plans for chronic conditions
  • Epidemiology, aetiology, pathogenesis, clinical features, treatment and prognosis of Male and female subfertility: Female (ovulatory disorders, tubal disorders, endometriosis, cervical & uterine factors, genetic & developmental disorders), Male (structural, endocrine, pharmacological, infectious, lifestyle, genetic), Unexplained infertility, Long term sequelae of cancer treatment, Sterilisation regret
  • Indications, limitations and interpretation of investigative techniques: Semen analysis, Endocrine assessment, Assessment of ovulation, Assessment of the sub-fertile male, Amenorrhoea & oligomenorrhoea, Polycystic ovary syndrome, Hyperprolacinaemia, Thyroid/adrenal function, Gonadal failure, Genetic analysis, Chromosome analysis e.g. sex chromosome abnormalities, Genetic abnormities e.g. cystic fibrosis
  • Operative investigative procedures: Diagnostic laparoscopy, Diagnostic hysteroscopy
  • Indications, limitations, techniques and complications of: Ovulation induction (clomifene, gonadotropins, gonadotrophin-release hormone), Other medical interventions (e.g. metformin, dopaminergic drugs), Intrauterine insemnination, In vitro fertilisation, Intracytoplasmic sperm injection, Surgical sperm recovery
  • Legal and ethical issues: Human Fertilisation and Embryology Act, Welfare of the child, Embryo storage, Gamete donation, Surrogacy
  • Indications, limitations and complications of surgery in relation to male and female Infertility: Reversal of sterilisation and vasectomy, Adhesiolysis, Salpingostomy, Surgical management of endometriosis, Ovarian diathermy, Myomectomy, Hysteroscopic surgery, Varicocoele