Infertility, Treatment and Role of Regulation

Module details

Title

Infertility, Treatment and Role of Regulation

Type

Specialist

Module code

SLS327

Credits

10

Requirement

Compulsory

Aim of this module

This module will provide the trainee with knowledge and understanding of the causes and treatment options for male and female infertility and the approach to managing the infertile couple. They will understand the role of regulation in treating infertility and become familiar with legislatory quality management aspects of licensed treatments.

Competencies

#	Learning outcome	Competency	Action
# 1	Learning outcome 1	Competency Review case notes to link the cause of infertility with the suggested treatment plan and produce an interpretive report of the investigations.	Action View
# 2	Learning outcome 1	Competency Plan and optimally time a thaw/warming cycle within a natural or hormone replacement therapy (HRT) cycle.	Action View
# 3	Learning outcome 2	Competency Perform witness checks during a procedure to meet Human Fertilisation and Embryology Authority (HFEA) requirements.	Action View
# 4	Learning outcome 2	Competency Review the required consents appropriate for a variety of treatment cycles, including those involving donated gametes.	Action View
# 5	Learning outcome 3	Competency Perform quality assurance and quality control tasks within the laboratory.	Action View
# 6	Learning outcome 3	Competency Perform and report a risk assessment for one procedure performed in your laboratory.	Action View
# 7	Learning outcome 2,3	Competency Follow the appropriate guidelines for incident reporting within the centre.	Action View
# 8	Learning outcome 2	Competency Minimise risks and hazards in compliance with health and safety policies.	Action View

Assessments

You must complete:

• 2 case-based discussion(s)
• 2 of the following DOPS/ OCEs:

Peform an EQR	DOPS
Undertake a NEQAS submission for both sperm and embryos	DOPS
Perform QC checks on a specific piece of equipment	DOPS
Examine consents in the patients notes for appropriateness and accuracy for the selected treatment	DOPS
Perform an audit	DOPS
Perform a risk assessment	DOPS
Complete an incident report form through your internal system	DOPS
Perform a health and safety audit	DOPS
Perform a witnessing audit	DOPS
Perform a COSHH assessment	DOPS
Review a patient notes to plan when embryos should be thawed rewarmed within the frozen embryo replacement cycle, discuss and confirm the thaw plan with the patient.	OCE

Learning outcomes

1. Suggest a patient’s pathway, including treatment options and stimulation regimens based on clinical presentation.
2. Perform procedures within the statutory and regulatory framework.
3. Perform quality management tasks.

Learning outcomes

1. Discuss the causes and diagnosis of male and female infertility.
2. Discuss and justify the treatment options for male and female infertility.
3. Describe different ovarian stimulation regimens, including the endocrine and physiological responses.
4. Explain and critically evaluate the statutory and regulatory requirements of fertility treatments and professional codes of practice.
5. Explain and evaluate the principles and practice of quality management and validation.
6. Discuss the linkages between the reproductive science laboratory and other clinical specialisms in the investigation of male and female infertility and patient care.

Indicative content

• Investigation of the infertile male, including specialist andrology testing
• Causes of male infertility, including endocrine deficiencies, obstructions, genetic and chromosomal disorders, autoimmunity, varicocele
• Treatment options for male infertility
• Investigation of the infertile female
• Causes of female infertility, including endocrine disorders, genetic and chromosomal disorders, tubal disorders, endometriosis
• Treatment options for female infertility
• In-vivo oocyte development and ovarian stimulation regimens, including mechanism of actions of antagonists and agonists
• Endocrine and physiological response to ovarian stimulation
• Luteal endocrinology
• Outcomes of ART treatment
• The Human Fertilisation and Embryology Act and Code of Practice
• Legislation and regulatory mechanisms in the UK compared with those both within and outside the EU
• Governing bodies and accrediting organisations
• Licensing for both treatment and research in the UK
• Social and ethical responsibilities of a clinical embryologist
• Quality control tests routinely employed in the ART lab – mouse embryo bioassay and sperm survival tests
• Quality management system within an (in-vitro fertilisation) IVF centre
• Validation of equipment and processes

Activities

• Attend clinical appointments to gain experience of the clinical presentation of male and female infertility (with the permission of patients). Evaluate your experience in terms of both the clinical presentation and patient experience/needs and discuss with your supervisor.
• Attend clinical appointments to gain experience and review the range of treatment options for the infertile couple (with the permission of the patient). This may include attendance at initial medical consultation, nurse consultation or follow-up consultation within the clinical setting of the assisted conception unit.
• Shadow at least one patient pathway to gain experience of the endocrine and physiological responses to different ovarian stimulation regimens and discuss the clinical situations in which each would be used, the monitoring undertaken and patient safety considerations.
• Attend multidisciplinary team meetings to participate in case discussion to review a wide range of clinical cases.
• Select one case discussion and review in more detail, following patient progress and actual/potential outcomes, to include the clinical presentation, options considered, treatment provided and patient engagement and experience in the process.
• Attend multidisciplinary team meetings to gain experience and describe the partnership between the reproductive science laboratory and other clinical specialisms in the investigation of infertility, for example Clinical Genetics.

 

• Become familiar with the laboratory quality management system and perform examination and other audits as part of the laboratory accreditation process (applies as appropriate to all specialist modules).