Fellowship in Andrology and Men’s Health

2. Department of Andrology, Manipal Andrology and Reproductive Services (MARS), Manipal Hospital, BANGALORE. (Affiliated to Manipal University) Fellowship in Andrology and Men’s Health Andrology & Men’s Health is a field of medicine which deals with the problems related to male health, male infertility problems, specific diseases of male reproductive system and and urologic problems with particular reference to males. The program is intended to train doctors in the critical aspects of Laboratory Andrology and a wholesome training in Clinical Andrology.

3. OBJECTIVES • To provide professional experience in Andrology and Men’s health with Post Graduate knowledge to understand and study the causes of male infertility, erectile function and dysfunction and biological causes of aging in men. • The modern management of male reproduction, means health and sexual health requires an in-depth knowledge not only of surgery but also of imaging, biopsy techniques, pathology, endocrinology, radiology and basic science. • The special focus of this specialty is on the study of male infertility, andrology laboratory and surgical procedures, Erection and ejaculatory processes and their surgical approaches, problems in aging men and biological processes of aging, embryological procedures and ART lab maintenance as pertaining to Assisted Reproductive Technology (ART).

4. COURSE CONTENTS Clinical • History taking, clinical examination, understanding semen analysis and deduction of critical aspects for clinical management • Investigation procedure in male infertility • Advanced sperm factors affecting fertility • Genetics in infertility • Sperm function tests & seminal fluid analysis • Sperm Morphology: Kruger criteria & Computer assisted morphology analysis • Quality control in Andrology lab • Semen Banking / Cryopreservation

5. Course Contents contd.. • Immunological infertility • Testicular Tissue – histology • TESA sample processing/freezing • Selection of patients for ART / IUI • Complications in ART • PESA, MESA, TESA, TESE and their preparation • Selection of healthy sperm for ICSI • Microsurgical Varicocele ligation • Electroejaculation • TUR – Ejaculatory ducts • VVA • VEA

6. Course Contents contd.. • Counseling in ART • Setting up of an ART clinic & organizational aspects • Understanding of the classification and evaluation of erectile dysfunction • Knowledge of the indications, techniques, and complications of radiographic evaluation of the arterial supply of the penis • Understanding of the basic techniques of testicular biopsy, evaluation and tissue processing, recognition of basic testicular pathology, and knowledge of pathologic prognostic factors • Ability to counsel patients on treatment options for therapy for erectile dysfunction and reproductive health abnormalities

7. Course Contents contd.. • Evaluation of erectile dysfunction and reproductive dysfunction in an office based setting – including visual sexual stimulation • Understanding of the indications, complications, techniques, and results of Priapism • Understanding of the indications, results and basic biology of vibratory therapy and stimulation mechanisms and prostatic massage • Understanding of the biology, evaluation and treatment of local therapies to the penis – VCD, Self Inj, ICI, MUSE, Gels • Understanding of the indications, complications, techniques, and treatment options in aging

8. Course Contents contd.. Andrology – Embryology • Basic Cell Biology • Basics of semen analysis, sperm motility, morphological assessment, identification of leucocytes and contaminants • Fertilization and early embryo development • Embryo culture • Sperm Analysis and processing • Micromanipulation • Cryopreservation of sperm – various methods

9. Course Contents contd.. • Implantation • Oocyte/Embryo cryopreservation and Vitrification • Ethics and regulations in ART • Cloning – principles and ethics • Stem Cells • ART Laboratory setup and maintenance • Data recording / statistics

10. OUTCOME • Methodical investigation of problems leading to infertility, aging and erectile function in men, including female sexual dysfunction • Categorizing them according to clinical condition • Conducting necessary investigations and diagnostic procedures • Trans rectal / doppler ultrasound examination for study of testis, prostate and seminal vesicles for evaluation of the pathopysiological processes of testicular, seminal, ejaculatory dysfunction • Bio Chemical assays of reproductive hormones in serum. • Display detailed knowledge and understanding of human Gamete Biology and Molecular perspective

11. Outcome contd.. • Critical evaluation of new advances in Biotechnology • Acquire ability to establish and IVF Centre • Conductive Quality Control procedures that are essential to the reliable operations of a IVF clinic • To familiarize oneself with the technique or handling Male and Female Gametes use in IVF / ICSI etc • Competence in In Vitro Culture techniques used for Gametes and Embryos • To be capable of Andrology laboratory procedures – semen analysis, sperm processing, donor semen banking, motility enhancers for sperm, cryopreservation of Gametes, Embryos and Tissues for later use in human infertility treatment

12. Outcome contd.. • Reasonably predict the viability of an Embryo prior to its transfer in IVF • Achieve/demonstrate skills for Micromanipulation Procedures as in Intra Cytoplasmic Sperm Injection required for clinical ART • Display some knowledge about the techniques used for Karyotyping (e.g. Lymphocyte cultures, amniotic fluid, cell culture etc.,) • Understand the ethical implications of ART and Cloning • Develop adequate skills in report writing, oral and visual presentations • Basic use of computers, data analysis and record maintenance

13. ADMISSION & FEES • Duration: The course is spread over 12 months/2 semesters including 80 hours of Theory and Practicals. • Eligibility criteria: MS (Gen Surgery) / MD (Ob/Gyn) / MCH (Urology) • Intake: The program academic year starts in January. We admit a maximum of 2 students per year. • Program admission fee:

14. SELECTION CRITERIA

15. ASSESSMENT Paper 1 – Andrology, Erectile dysfunction, Ejaculatory function, Semenology and ART laboratory for 100 marks including Theory, Practicals and viva voce. Paper 2 – Men’s Health, Aging, Endocrinology and Therapeutics for 100 marks including Theory, Practicals and viva voce. Passing Criteria - Minimum 50% marks in Internal, theory and practical evaluation.