After a prolonged period of virtual learning, one of the most anticipated fertility education programs – Kamini Rao IVF Training made its return with Medline Academics in 2022. The five-day course brought together healthcare professionals eager to deepen their understanding of reproductive medicine and fertility care through an immersive, in-person learning experience. As medical education continues to evolve, the return of in-person training serves as a reminder that some of the most valuable learning happens through direct interaction, shared experiences, and real-time discussion. For professionals working in fertility and reproductive healthcare, gatherings like these remain an important part of continuous growth and development. It's one of the longest courses being run and has done very well in terms of its reviews.
The field of reproductive medicine is evolving rapidly, making continuous learning essential for fertility specialists, gynaecologists, embryologists, and healthcare professionals. Choosing the right training institute can make a significant difference in both clinical expertise and career growth. This is where Medline Academics has earned its reputation as one of the leading names in fertility education. What sets Medline Academics apart is its emphasis on practical learning. Rather than relying solely on classroom lectures, the programs encourage critical thinking, case-based discussions, and evidence-based decision-making. This approach helps healthcare professionals gain the confidence needed to manage complex fertility cases and improve patient outcomes. For aspiring fertility specialists and practicing clinicians looking to enhance their expertise, Medline Academics continues to be regarded by many professionals as the Online infertility courses in India, offering a strong foundation for lifelong learning and professional development in reproductive medicine.
One of the commonest things which we often try to do is improve the clinical care that you are able to give and also equally improve the outcomes, improve the chance of pregnancy. We also explore the alternative regimes of when you increase the dose, when you use the step-up regimes, how you decide on which protocols to use in trying to make these treatments affordable to your patients. Equally, when do you extend the doses? And all these minor changes which have come over the past five to 10 years, that's what will help you to learn. We also concentrate on the first stage of assisted reproduction, IUI treatments, how to improve IUI treatments, how to use tablets, injections, as well as combining both of these, the use of ovarian drilling, how do we treat polycystic ovaries as well as hypo-hypo conditions? Can we change that? Can we improve the outcomes in those cases? We will talk an entire day on looking at your IVF protocols.
And what we're not going to tell you is we're not going to give you three or four protocols. What we're going to explore is how do we get to understanding what protocol we use? How do we decide based on the Goody triangle and the antral follicle count, the AMH, the relationship, the changing of the antral follicle count, how do we decide at what dose do we start this stimulation? How do we alter stimulation? What do we know by FSS threshold? What do we know by LH ceiling? Can we manage stimulation better? I know many of you all will be doing IVF. And what we are trying to see is can we explore and make you think a bit more differently? Can we use oral agents and test the stimulation? Can we try and save patients money as well as can we change the outcome? We also look at the difficult cases.
What happens with PCOS stimulation? How can we prevent ovarian hypo stimulation? But equally, how do we get more mature eggs? How do we avoid the risk of having immature eggs and having a poor stimulation? Challenging issues such as poor responders and using that new concept of changing the antral follicle, trying to find out how you can help some poor responders by just thinking a bit more differently. Finally, we look at thin endometrial. What can we do different? What can we understand and how can we change our protocols? With Sachin, we explore the challenges that are presented in the subcontinent, where drugs are different, where stimulation regimes are different, where women respond differently.
We also look at fibroids, how to remove fibroids, which fibroids to remove and which fibroids to leave behind. We explore the complex issue of adenomyosis and its implications on fertility treatments and assessment. We also will be discussing between eight to ten cases where we'll be asking you your opinions, but also we'll be able to tell you what is going on and what is changing in those discussions.
It's important for you to know so that you can try and change the results, but equally offer different treatments. You can troubleshoot your laboratory. You can learn about procedures which embryologists are doing, but equally go back and tell the embryologist, I need to have quality controls.
Look at audit and traceability. These are things which we want to inculcate in you so that that type of quality control helps you to improve your labs. Often we say we learn everything.
No, but we want to make you start thinking a bit differently. It's that thinking process once changed, you'll enjoy the phenomenal part of reproductive medicine. Remember the limited spaces.
So, if you've been pregnant, breastfeeding or on hormonal contraceptive, these numbers potentially could be lower than they really are. Not that you're out of eggs, just they're being suppressed. And when more time has passed, those things will improve.
Just important facts to note. But everybody's going to run out of eggs at some point. Start with the most you're ever going to have.
You will run out. That's called menopause. We're trying to see where you are on the spectrum.
And that's important because we might intervene more aggressively or do things different if you have a lower egg count. Importantly, lower egg counts are not associated with infertility, meaning your body doesn't care if you've got five or 20 eggs outside the vault. Your body is made that in natural fertility cycles, you're going to ovulate one.
However, what is important and what does matter is that the fewer eggs you have, the less time you have to grow your family and the higher risk of having a cycle cancelled with IVF, the more cycles you're going to need to get to the same outcome because you can only get the eggs that are outside the vault to grow with IVF. IVF success is totally determined by how old you are and how many eggs you have. And the more, the merrier, especially at a younger age.
So, when you're coming in to do IVF, what I'm trying to evaluate is how many eggs do you have and think about your entire infertility picture. What is bringing you here? Do you have PCOS? Do you have endometriosis? Do you have other autoimmune disease? And those details are important when I'm trying to pick your protocol. Now, the protocol is the combination of medications that we are going to use to try to get all of the eggs to grow.
And I will be very honest with you that there are clinics out there that will use the same protocol for every patient, no matter what. And even if you use this protocol and you didn't respond well, they'll use the same protocol again. So you have to be an advocate for your own health.
You have a limited amount of time to get the job done. You've got to know what you're looking for. You've got to know how to judge or gauge if things are going as expected.
Typically you expect oestrogen levels of around 150 to 200 picogrammes per mature egg in an IDF cycle. And we're adjusting medications along the way. Now, the mature range of eggs for the average person is going to be about 15 to 20 millimetres.
So that's important. What's your oestrogen? What's your egg range? You can trigger somebody in an antagonist cycle with either Lupron or HCG because they bind to the same receptor. Can't use Lupron in somebody who has FHA or functional hypothalamic amenorrhoea because it requires the brain to work.
Essentially what it does is it flares the brain to send out a lot of natural LH and that is the surge versus giving you HCG, which is binds to the LH receptor. The reason why we like to give Lupron is that I can push you further, get more eggs, get your oestrogen higher and decrease the risk of ovarian hyper stimulation, which is something that is created or caused when you have a high number of eggs and a high oestrogen. I have a whole video on it.
OHSS is real. It's something to be scared of, but it happens so much rarer now. And specifically, if you're doing a Lupron trigger, we really don't have to worry about it.
And a lot of synchronisation issues just based on the nature of the protocol. If you have a really high egg count, that probably matters less. We don't need 50 eggs, but if you don't have as many, every egg matters more.
Sometimes you can get that synchronicity improved by leading them with suppression like oestrogen or the birth control pill. And the reason why is that oestrogen stops the brain from sending out FSH. Therefore those follicles that come out of the vault don't see any FSH and then they're hungrier.
So they respond and grow together better. I use the bad analogy. If we can imagine normally you've got a nest of baby birds, mama bird brings one worm, the biggest bird's going to get the worm and grow.
And that's what happens normally. We're trying to override that process when we do IVF. So if I starve all the birds for a little bit of time and don't feed them, and then I come in with a tray of worms for all the birds, now all the birds can grow together and they're going to be happy and they're all going to get big and fat.
That's what IVF is. So that's what we're trying to do. But I like to starve the birds first and get a better response in most people.
Otherwise, you have some Lupron protocols. Lupron protocol can be used as a suppressant and that can either be used in the luteal phase or overlapping with birth control pills. It can be continued through the stimulation or it can be halted or stopped because Lupron lasts as a suppressant for up to 12 days.
Lupron is giving subcutaneously and it is what we call a GnRH agonist. GnRH is secreted from the hypothalamus and it controls the release of FSH and LH from the pituitary gland. If I give an agonist, what it actually does is upregulates all of your FSH and LH, but then the pituitary gland is empty and it has none and you're down regulated.
As a leading IVF Hospital in Bangalore - Dr. Kamini Rao Hospitals, the hospital is committed to offering comprehensive fertility solutions tailored to the unique needs of every individual and couple. From initial fertility assessments and diagnostic services to advanced assisted reproductive technologies, patients receive personalized care at every stage of their treatment journey. In addition to advanced technology, emphasis is placed on individualized treatment planning. Every fertility journey is different, and treatment protocols are carefully designed based on a patient's medical history, fertility profile, and reproductive goals. This personalized approach helps optimize outcomes while ensuring patients receive care that is appropriate for their specific needs.