Andrological Dysfunction (SLS320)

10 credits

Aim of this module

This module will provide the trainee with knowledge and understanding of the causes, diagnosis and treatment of both male and female infertility and wider aspects of andrological dysfunction. They will understand the psychosocial aspects of male and female infertility and how to support men and women referred for investigation. They will also understand the role of regulation and accreditation in diagnosing and treating infertility and the legislatory quality management aspects of licensed treatments. They will apply their understanding of the interrelationship of the different problems to potential outcomes; the diagnostic and therapeutic modalities available for conditions beyond the field of subfertility and the impact of infertility on the male, their partner, extended family and friends.

 

  1. Plan and optimally time andrological investigations.
  2. Review a series of case notes to link the cause of male sexual dysfunction, endocrine dysfunction and/or genital tract pathologies with the suggested treatment plan and produce an interpretive report of the investigations.
  3. Review a series of case notes and recommend treatment pathways, including options based upon clinical presentation.
  4. Perform a risk assessment and audit in a diagnostic setting, analysing the findings and presenting a report with recommendations.
Number Work-based learning outcome Title Knowledge
1 1

Plan and optimally time andrological investigations exercising their own professional judgement.

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2 1

Perform witness checks during a procedure to meet regulatory and good practice requirements.

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3 1

Review the required consents appropriate for a variety of diagnostic testing and different treatments.

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4 1

Follow the appropriate guidelines for incident reporting.

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5 2,3

Review case notes to link the results from semen analysis to fertility prognosis and produce an interpretive report of the investigations.

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6 2,3

Review case notes to link the cause of male sexual dysfunction with the suggested treatment plan and produce an interpretive report of the investigations.

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7 2,3

Review case notes to link the cause of male endocrine dysfunction with the suggested treatment plan and produce an interpretive report of the investigations.

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8 2,3

Review case notes to assist diagnosis of male genital tract pathologies and design/confirm a suggested treatment plan.

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9 4

Perform a risk assessment for screening for sexually transmitted infections.

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10 4

Perform an audit for an endocrine diagnostic laboratory procedure related to this module.

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11 4

Analyse the data, present a report and discuss and implement recommendations.

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You must complete
2 Case-based discussion(s)
2 of the following DOPS / OCEs
Assessment Title Type
Perform identity checks with a patient having a procedure meeting regulatory and good practice requirements DOPS
Perform witness checks during a procedure meeting regulatory and good practice requirements DOPS
Review the required consents and what is appropriate for a variety of diagnostic testing, including for endocrine and STI tests DOPS
Perform a blood endocrine assay for a male patient DOPS
Perform a witnessing audit DOPS
Perform a risk assessment DOPS
Discuss a male patient case where endocrine diagnosis has been indicated at an MDT, include discussion of endocrine markers beyond testosterone. OCE
Discuss subsequent pathways for a patient with male sexual dysfunction / spinal cord injury / psychosexual issues in an appropriate MDT or specialist clinic team meeting. OCE
Discuss male patient experience/needs either at a group or individual level within a service. OCE
Present and evaluate to colleagues an array of treatment options for men beyond simple assisted conception (e.g. varicocele surgery / vibratory stimulation for anejaculation / etc). OCE
Discuss the impact of STI diagnosis on the individual and the couple. OCE

Important information

The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.

Learning Outcomes

  1. Discuss the diagnosis and causes of male and female infertility and critically evaluate treatment options.
  2. Discuss and appraise the causes, pathological changes, diagnosis and treatment of male infertility and sexual dysfunction.
  3. Discuss and critically evaluate medical and surgical treatment options and appropriate Assisted Reproductive Technology (ART) open to the male with andrological dysfunction.
  4. Explain and critically evaluate the current accreditation requirements for laboratories performing semen analysis.
  5. Examine the current statutory and regulatory requirements of fertility treatments and professional codes of practice.
  6. Explain and critically analyse the principles and practice of quality management and validation.
  7. Discuss the linkages between the reproductive science laboratory and other clinical specialisms in the investigation of male and female infertility and patient care.

Indicative Content

Male and Female Infertility

  • Investigation of the infertile male, including specialist andrology testing including endocrine and laboratory

 Causes of Male Infertility and Sexual Dysfunction

The need to be empathetic and sensitive when considering issues of male infertility and sexual dysfunction should be paramount to all learning in the academic and work-based setting and should be considered alongside all causes and cases listed below: 

  • Endocrine deficiencies
  • Obstructions
  • Genetic and chromosomal disorders
  • Autoimmunity
  • Varicocele
  • Spinal Cord Injury
  • Psychosexual issues including:
    • disturbances of desire
    • arousal
    • erectile dysfunction
  • Ejaculatory and orgasmic dysfunctions, including retrograde ejaculation
  • Male sexual dysfunction including:
    • disorders of sexual development
    • hypogonadism
    • male ageing and other conditions from puberty to senescence
  • Male genital tract pathologies including:
    • Infections and their consequences
    • inflammations
    • sexually and non-sexually transmitted
  • Cancer and conditions, the treatment of which affect male fertility
  • Genetic and chromosomal disorders
  • Overview of the causes of female infertility including:
    • endocrine disorders
    • genetic and chromosomal disorders
    • tubal disorders
    • endometriosis

Medical and surgical treatment options

  • Non-pharmacological, pharmacological and surgical treatment options for male infertility and sexual dysfunction including mode of action, evidence base and the reasons why they are used in different clinical situations
  • Non-medical and non-surgical options (including expectant management and psychological interventions) and the evidence supporting these
  • Treatment options for female infertility
  • Patient involvement in treatment decisions
  • Financial considerations in treatment choices

 Regulation and Accreditation requirements including quality management

  • The Human Fertilisation and Embryology Act and Code of Practice
  • Legislation and regulatory mechanisms in the UK compared with those both within and outside the EU
  • Accrediting organisations, e.g. the United Kingdom Accreditation Service and the Royal College of Pathology
  • Licensing for both treatment and research in the UK
  • Social and ethical responsibilities of a Clinical Scientist working in Andrology
  • The limits of the concept of confidentiality
  • Quality management system within a diagnostic laboratory (e.g. ISO615189) and treatment centre (e.g ISO9001), including audit requirements.
  • Quality control tests routinely employed in the andrology laboratory including internal and external quality control, CE-marking and bioassays
  • Validation and verification of equipment and processes
  • Statistical analysis, uncertainty and quality control charts for diagnostic Andrology.
  • Principles of information governance and be aware of the safe and effective use of health and social care information