Postgraduate Obstetrics, Gynecology, Infertility and Clinical Endocrinology

by R Rajan

This book Postgraduate Reproductive Endocrinology emphasis was given to physiology, applied chemistry of hormones and fundamentals of endocrine management of gynecological disorders and fertility problems. The minimally invasive and minimally access endoscopic operative procedures make therapeutic options quite attractive in terms of safety, comfort, quick relief, minimal hospitalization, early ambulance and early return to work. So, much so, both diagnosis and surgical treatment and cure are completed on the day of initial visit, and if desired without hospitalization. In no other branch of medicine this unique combination has excelled as has been witnessed in infertility practice. What has been a series of investigations performed over a protracted period of time and a lengthy and frustrating therapeutic options including laparotomy correction of pelvic factors, has today proved to be as simple as sonographic evaluation and endoscopic corrective procedures on the day of first visit to the clinic. This “one-day” protocol is quite “couple friendly” and ensures higher pregnancy rate over an average period of 6 months. Repeat clinic visits, frequent follow-up studies and unnecessary iatrogenic procedures such as IUI could be avoided for the benefit of the couple. Those failing to achieve the desired results within 6 months to 1 year could resort to alternate measures which includes ART. In the practice of gynecology, sonographic diagnosis could be confirmed by the clinician, particularly when that condition is being treated by operative endoscopy. This sonographic and endoscopic correlation is of paramount importance in gaining experience and correcting mistakes, and particularly the young readers are advised to meticulously follow this principle. With this educative value in mind, the author has placed a lot of illustrative photographs of ultrasound and laparoscopy findings of the same patients. Application of many concepts discussed in various chapters should depend on the situations in which the particular clinician is working, and the clinicians must critically view many of the opinions of the author and take whichever is found suitable for them in their clinical management.

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