Arri Coomarasamy

STUDY QUESTION: What is the effect of progesterone administered via vaginal oil capsules versus pessaries, on clinical outcomes, when used for luteal phase support (LPS) in ART? SUMMARY ANSWER: Our study findings indicate a higher live bir…

Mid-trimester pregnancy loss (MTL), defined as a pregnancy loss occurring between 14 + 0 and 21 + 6 weeks of gestation, causes significant physical and emotional distress to women and presents clinical challenges to healthcare professionals…

Theoretical skills Have a thorough understanding of the epidemiology, pathophysiology and clinical characteristics of adenomyosis Be aware of the diagnostic modality and diagnostic features of adenomyosis Understand the impact of adenomyosi…

BACKGROUND: Controlled ovarian stimulation (COS) is an essential step in most assisted conception cycles. Different treatment combinations (termed protocols) exist in COS, yet there is no consensus on their relative effectiveness and safety…

This chapter addresses some of ‘Knowledge Area 11 – Subfertility’ from the MRCOG Syllabus and Knowledge Requirements for Core Curriculum 2019. Demonstrate appropriate knowledge, skills and attitudes in relation to subfertility, including an…

This chapter addresses some of the topics included in ‘Knowledge Area 11 – Subfertility’, from the MRCOG Syllabus and Knowledge Requirements for Core Curriculum 2019. Demonstrating appropriate knowledge, skills and attitudes in relation to …

Abstract Study question What is the impact of adenomyosis and its phenotypes on spectrum of outcomes ranging from conception to birth? Summary answer Adenomyosis has a negative impact on implantation with reduced clinical pregnancy and live…

BackgroundTubal ectopic pregnancies can cause significant morbidity or even death. Current treatment is with methotrexate or surgery. However, methotrexate treatment can fail in approximately 30% of women. Gefitinib, an epidermal growth fac…

This chapter includes clinical cases, background, evidence-based practical management options, preventive measures and key-point summaries of adenomyosis. Adenomyosis can coexist with fibroids, making the symptoms worse. With advances in im…

BACKGROUND: Most women undergoing assisted reproduction treatment will reach the stage of embryo transfer (ET), but the proportion of embryos that can be successfully implanted after ET has remained small since the mid-1990s. Human chorioni…

STUDY QUESTION: Is serum vitamin D associated with live birth rates in women undergoing ART? SUMMARY ANSWER: Women undergoing ART who are replete in vitamin D have a higher live birth rate than women who are vitamin D deficient or insuffic…

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This chapter addresses the management of bladder injuries in open surgery. Risk factors for bladder injury include obesity, inadequate incision, large pelvic masses, congenital abnormalities, endometriosis, extensive pelvic dissection, blee…

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Sub-endometrial junctional zone peristalsis is increased by ovarian stimulation and traumatic embryo transfer, and is linked with decreased implantation and pregnancy rates in assisted reproduction treatments. Various agents have been used …

Unexpected large uteri are common; they are often due to fibroids, the incidence of which is up to 25% of all women. All patients should have a menstrual history taken and a pregnancy test performed before any operation, particularly if int…

This chapter addresses ureteric injury in open surgery, citing case studies that help in the management of ureteric injury in laparoscopic surgery. Risk factors for ureteric injury include an enlarged uterus, previous pelvic surgery, ovaria…