FNB Reproductive Medicine: Admissions, Medical Colleges, Fees, Eligibility criteria details

Basic Sciences

1. Anatomy: Comprehensive knowledge of the pelvis's regional anatomy, including female and male reproductive organs. Detailed knowledge of gross anatomy of the hypothalamus, pituitary, and adrenal glands. Comprehensive knowledge of the histology of the genital tract and endocrine glands related to reproduction. Detailed knowledge of cell structure about function.

2. Physiology: Comprehensive knowledge of human physiology with particular reference to the female and male reproductive systems.

3. Genetics and molecular biology: Detailed knowledge of sexual differentiation and common inherited disorders. Knowledge of the principles of inheritance of chromosomal and genetic disorders. Detailed knowledge of chromosomal abnormalities involve in reproduction.

4. Embryology: Comprehensive knowledge of gametogenesis, fertilization, and early embryo development. Comprehensive knowledge of the development of the reproductive organs and abnormalities associated with them. Knowledge of common fetal malformations.

5. Pathology: Detailed knowledge of the cytopathology and histology of the female and male reproductive tract.

6. Biochemistry: Knowledge of the metabolism and function of neurotransmitters, receptors, and autocrine and paracrine factors.

7. Biophysics: Knowledge of the physical principles and biological effects on reproductive organs of heat, sound, and electromagnetic radiation, understanding of the principles of laser, isotopes, X-rays, ultrasound, and magnetic resonance imaging.

8. Immunology: Detailed Knowledge of immune mechanisms and the principles of reproductive immunology

9. Pharmacology: Comprehensive knowledge of the properties, pharmacodynamics, actions, interactions, and hazards of pharmacological agents

which are used in reproductive medicine and particularly compounds that could have a deleterious effect on the reproductive tract and adverse epigenetic influence.

Clinical Sciences

1. Infertility: Comprehensive knowledge of epidemiology, causes, investigations, and management of female and male infertility.

2. Endocrinology: Comprehensive knowledge of gynecological and andrological endocrinology including its applications in reproductive medicine.

3. Reproductive Genetics: Detailed knowledge of genetic disorders related to female and male reproduction (infertility, recurrent abortions, etc).

4. Pediatric and adolescence: Detailed knowledge of normal and abnormal sexual development and specific disorders affecting young females and males and adolescents

5. Disorders of menstruation: Comprehensive knowledge of normal menstruation and the pathophysiology of menstrual disorders, their investigations, and management

6. Andrology: Comprehensive knowledge of normal and abnormal spermatogenesis, as well as of testicular, epididymal and accessory sex glands pathophysiology. Comprehensive knowledge of erection and ejaculation, as well as their physiopathology. Detailed knowledge of endocrine changes in spermatogenesis, monogram, and sperm function tests.

7. Andrology laboratory: Semen analysis, processing of semen for various procedures – intrauterine insemination, IVF/ICSI, processing samples of testicular/epididymal sperms for ICSI.

8. Assisted reproductive technology: Evolution of different technologies in ART. Controlled ovarian stimulation, oocyte retrieval, and embryo transfer techniques.

Comprehensive knowledge of endocrine therapy, especially ovarian stimulation and its complications. Comprehensive understanding of the ART: insemination, IVF,

ICSI. Comprehensive knowledge of gamete and embryo donation. Comprehensive knowledge of pre-implantation genetic diagnostic techniques

9. Embryology laboratory: Culture media, oocyte identification, insemination, fertilization and cleavage check, blastocyst culture, embryo hatching, techniques of intra-cytoplasmic sperm injection, cryopreservation, and its principles. Semen freezing /embryo freezing/oocyte freezing with slow freeze techniques or vitrification.

10. Comprehensive knowledge of reproductive surgery and competence in common fertility-enhancing endoscopic and open surgeries.

11. Ultrasound: Detailed knowledge and competence in ultrasound in all aspects:-

a) Pelvic ultrasound in women and ability to diagnose pathological conditions

of the female genital tract

b) Scrotal ultrasound

c) Follicle monitoring

d) Ultrasound-guided invasive procedures.

12. Statistics and epidemiology: Detailed knowledge of statistical analysis. Collection of data in reproductive medicine as well as the knowledge of calculating the effectiveness of infertility treatments. Detailed knowledge of setting up and interpreting clinical trials. Knowledge of evidence-based medicine about human reproduction as well as the knowledge of meta-analysis or guidelines on diagnosis or management of various conditions given by important medical bodies such as RCOG, ASRM, ESHREE, or Cochrane.

13. Psychosomatic: Knowledge of psychosexual and stress-related disorders.

Detailed knowledge of the psychopathology and management of psychosexual disorders, and the influence of stress conditions such as ejaculation disorders, impotence, and vaginismus.

14. Ethics and law: Detailed knowledge of ethical and national legal issues involved in reproductive medicine and ART and the resources required in providing adequate health care in hospitals and the wider community.

Detailed Syllabus

A. Basic & Applied Sciences:

• Basic Anatomy and physiology of the male and female reproductive system

• Applied Pharmacology, Biochemistry, and Pathology of the male and female reproductive system

• Physiology: Menstrual cycle/ovulation

• Endocrinology: Relevant to human reproduction – hypothalamic-pituitary ovarian hormones.

Ovarian Hormones: Structure, Biosynthesis, Function, Mechanism of Action, and

Laboratory Diagnosis. Knowledge of autocrine and paracrine hormones.

• Endocrine disturbances affecting reproduction such as thyroid and adrenal function. Physiologic and Pathophysiologic Alterations of the Neuroendocrine

Components of the Reproductive Axis

• Normal puberty and pubertal disorders.

• Polycystic ovary syndrome and other hyperandrogenic states

• Abnormal Uterine Bleeding

• Disorders of Sex Development

• Reproductive Immunology and Its Disorders

• Ultra-sonography in reproductive medicine

• Endoscopic surgery, both Hysteroscopy and Laparoscopy

• Diagnosis of male and female infertility

• Ovulation Induction

• Monitoring of Ovulation

• Intrauterine insemination

• Controlled Ovarian Stimulation

• Embryology: Gametogenesis and fertilization

• Genetics: Nomenclature / Basic principle / Pre-implantation genetic diagnosis

• Laboratory equipment – handling and maintenance, record keeping, quality control, and quality assurance

• Andrology: Spermatogenesis.

• Andrology laboratory: Semen analysis and sperm function tests

• Infertility: Broad outlines of causes of male and female infertility. Workup of the male and female partner.

• Assisted reproductive technology: Evolution and different technologies

• Processing sperm for various procedures –for intrauterine insemination, IVF,

ICSI

• Processing samples of testicular / Epididymal sperms

• Embryology Laboratory

• Culture media

• Egg Identification

• Insemination

• Normal/abnormal Fertilization and cleavage check.

• Blastocyst culture

• Embryo hatching

• Techniques of intra-cytoplasmic sperm injection

• Cryopreservation

Principles of cryopreservation

• Semen freezing/oocyte freezing/ embryo freezing

• Slow freeze techniques/vitrification

• Ovum pick-up and embryo transfer

• Safety issues in ART including OHSS and multiple pregnancies

• Embryology lab quality control and maintenance

• Exposure to laboratory techniques in ART

• Storage and use of gametes

• Basics of reproductive genetics

B. Genetic history and counseling

C. Pre-implantation genetic diagnosis

D. Pre-implantation genetic screening

E. Endometrial Receptivity assay

F. Ethical principles in ART

After completion of the course, the reproductive medicine specialist will be proficient in the following areas of learning:

1. Operative gynecological open surgery, minimally invasive surgery, and microsurgery for pelvic resurrection.

• Proficient in the practice of microsurgical principles as applied to the treatment of tubal disease, especially distal tubal obstruction, proximal tubal re-canalization, and mid-tubal obstruction by the end-to-end anastomosis.

• Proficient in principles and practice of diagnostic and operative laparoscopy for conditions like ovarian cystectomy/ resection and desiccation of endometriosis /myomectomy and repair of tubal blocks and adhesiolysis etc.

• Proficient in the principles and practice of diagnostic and operative hysteroscopy for conditions causing infertility like removal of foreign body, polyps, IUCD, biopsy, septum resection, adhesiolysis, cannulation of tubal

ostium and myomectomy for sub-mucous fibroid.

• A clear understanding of the principles of the reconstructive surgery as applied to Mullerian duct abnormalities – vaginoplasty for vaginal agenesis, or unification of bicornuate uterus.

2. Reproductive endocrinology and its management.

3. Proficient in the etiology, pathophysiology, diagnosis, and management of common gynecological problems related to infertility like – fibroids/endometriosis / pelvic infections /ectopic pregnancy and management of high-order pregnancy.

4. Expertise in the use of ovulation-inducing agents and hormonal control of the menstrual cycle and controlled ovarian stimulation.

5. Follicular recruitment and oocyte retrieval procedure.

6. Understand and be able to manage OHSS.

7. Trans Vaginal Ultrasonography with particular reference to follicular monitoring and early pregnancy scanning.

8. Andrology: Semen analysis and semen preparation

9. Laboratory Technology: Familiarity with ART laboratory equipment,

maintenance and troubleshooting.

10. Oocyte identification and grading, embryo grading, micromanipulation, cell culture, freezing techniques, etc

11. Medico-legal and ethical aspects

A. Third-Party Reproduction

a. Oocyte donation

b. Embryo donation

c. Sperm donation

d. Surrogacy

B. Ethical & medico-legal aspects of infertility management- ICMR guidelines

12. Miscellaneous

• Biostatics & Data management.

• Fertility preservation – Social & Onco- fertility.

• Monitoring & treatment of early pregnancy after ART treatment

• Research Methodology

• Medical statistics

• Writing and presenting a paper

Suggested minimal requirements:

Assist 10 Proximal cornual block

• Perform 05 Tubal re-canalization procedures

• Minimally Invasive Assist 20 diagnostic laparoscopies

• Assist 20 operative laparoscopies

• Perform 10 diagnostic laparoscopies

• Perform 10 operative laparoscopies

• Andrology Assist 20 PESA, TESA, TESE of testis

• Perform 5 PESA, TESA, TESE testis

• IVF Assist 25 Oocyte retrieval

• Perform 10 Oocyte retrieval

• Laboratory Observe 20 semen analyses & 20 sperm preparation

• Perform 10 semen analysis & 10 sperm wash procedures

• Follow up 5 cases of IVF & 5 ICSI retrieval to embryo transfer (written records)

Counseling sessions

Observed 10 sessions & Performed 25 sessions

1. Reproductive anatomy and physiology of the male and the female.

2. Reproductive endocrinology.

3. Gametogenesis.

4. Fertilization in vivo.

5. Implantation and early embryogenesis.

6. Pathology of infertility - Causes of infertility namely the ovarian, tubal, uterine,

male factors, the pathology that reduces fertility namely endometriosis, fibroid,

adenomyosis uterine anomaly, etc.

7. Approach to investigate and diagnose sub-fertility.

8. Clinical decision-making and choice of treatment.

9. Pharmacology - Pharmacological effects of the various drugs including the pharmacokinetics and pharmacodynamics of the commonly used drugs.

Prostaglandins and Other Lipid Mediators in Reproductive Medicine

10. Clinical Embryology.

• Principles and practice of semen analysis and cryopreservation of semen.

• Cytology of mammalian and human oocytes to identify stages of oocyte maturation accurately.

• All aspects of embryology including developmental.

• Cell biological techniques used in cell and tissue culture.

Molecular biology and genetics of human reproduction.

• Micromanipulation of sperm and oocytes for carrying out ICSI and single-cell

biopsies of embryos for preimplantation genetic diagnosis.

• Principles and functioning of all the equipment used in the laboratory.

• In vitro fertilization of oocytes after processing the gametes.

• Principles and practice of embryo freezing.

11. Anesthesia during the ART procedure.

12. Complication of an ART procedure.

13. Ovulation induction during IUI and IVF procedures.

14. Ultrasound and other imaging modalities in infertility.

15. Fundamental of the surgical procedures namely laparoscopy, hysteroscopy, etc.

16. Pre-conception evaluation and counseling.

17. Administration setting up the ART unit, quality control, and assurance, creating a protocol for management, and organizing and coordinating clinical meetings.

18. Research and audit.

19. Counseling of the infertile couple Implicative, therapeutic, ethical, and social.

20. Teaching.

21. Clinical andrology.

Topics to be included in all subjects:

• Biostatistics, Research Methodology and Clinical Epidemiology

• Ethics

• Medico-legal aspects relevant to the discipline

• Health Policy issues as may apply to the discipline 

Career Options

After completing FNB Reproductive Medicine, candidates will get employment opportunities in Government and the Private sector.

In the Government sector, candidates have various options to choose from which include Junior research fellow, Teaching at academic medical centers, and Consultants.

While in the Private sector, the options are Fellow (Reproductive Medicine), Junior research fellow, Senior Research fellow (Reproductive Medicine), and Consultants.

Frequently Asked Questions (FAQs) –FNB Reproductive Medicine Course /FNB in Reproductive Medicine Course

Answer: The full form of FNB is a Fellow of National board.

Answer: FNB in Reproductive Medicine or Fellow of National Board (FNB)/Fellow of National Board - Post Doctoral (FNB-PD) Reproductive Medicine is a post-doctoral fellowship program for doctors in India that is done by them after completion of their postgraduate medical degree course.

Answer: FNB in Reproductive Medicine is a doctoral fellowship program of two years.

Answer: The candidate must have a postgraduate medical degree in DNB/MD/MS Obst. & Gynaecology from any college/university recognized by the Medical Council of India (Now NMC)/NBE. The feeder qualification mentioned here is as of 2022. For any further changes to the prerequisite requirement please refer to the NBE website.

Answer: FNB Reproductive Medicine offers candidates various employment opportunities and career prospects.

Answer: The FNB Reproductive Medicine candidate’s average salary is between Rs.10 lakh to Rs. 15 lakh per annum depending on the experience.

Answer: Yes, the candidate can teach in a medical college/hospital after completing the fellowship.