Kugajeevan Vigneswaran

• King's College Hospital NHS Foundation Trust

Study question How are fertility clinics in England distributed and has this changed over time? Does clinic size, geography and local deprivation level influence live birth rates? Summary answer A clinic’s size, urban/rural environment and local deprivation level shows no statistically significant impact on a clinic’s live birth rates. What is kn...

Study question How accurate, credible, reliable and readable is online information obtained from social media content in relation to the diagnosis and management of fertility problems? Summary answer Information available on social media regarding infertility often uses language that is inappropriate for a lay audience and lacks sufficient accurac...

Confidently tackle the MRCOG Part 1 exam with this comprehensively updated revision guide, reflecting the latest changes to the curriculum and question format. Edited by experienced examiners and written by course lecturers, the full syllabus is summarised using their extensive knowledge of the exam. Topics covered include the anatomy of the pelvic...

Study question What is the relative effectiveness and safety of final oocyte maturation trigger protocols in women undergoing in vitro fertilisation (IVF) treatment? Summary answer OHSS rate was lowest with GnRH agonist trigger and no difference in LBR was observed comparing various trigger protocols in normal, high and poor responders. What is k...

Key content Androgen therapy can improve sexual wellbeing, libido and sexual arousal in postmenopausal women through its effect on the central nervous system. Testosterone levels gradually decline throughout a woman’s lifespan and testosterone therapy may be useful for menopausal women with sexual dysfunction, in whom estrogen therapy alone has bee...

This authoritative textbook provides a much-needed guide for postgraduate trainees preparing for the European Board and College of Obstetrics and Gynaecology (EBCOG) Fellowship examination. Published in association with EBCOG, it fully addresses the competencies defined by the EBCOG curriculum and builds the clinical practice related to these compe...

Menopause is a major life event that can affect women in several ways. Its onset marks the end of the reproductive life cycle, and its impact can be both short and long term. The menopause is often a gradual process, preceded by a transitional period known as the perimenopause. The average age of the menopause in the UK is 51. The clinical manifest...

The association between socioeconomic status and fertility is a subject that has received much attention. Yet, little is known as to whether the socioeconomic status has an impact on the outcomes of fertility treatment. This systematic review aims to assess any possible relationship between socioeconomic deprivation and treatment outcomes. A databa...

This chapter includes clinical cases, background, evidence‐based practical management options, preventive measures and key‐point summaries of uterine fibroids. Uterine fibroids are the most common benign tumours found in women of reproductive age. Approximately 5‐10% of women with infertility have fibroids; however, it is only in 2‐3% women that fi...

This chapter includes clinical cases, background, evidence‐based practical management options, preventive measures, key‐point summaries of uterine artery embolization (UAE) and answers to questions patients ask. UAE has become a widely accepted alternative to myomectomy, as an equally efficacious uterus‐sparing procedure, with approximately 25,000...

An authoritative account of the causes of infertility that fully explores the clinical assessment of patients and covers the decision-making behind treatment options. The content follows the MRCOG syllabus as well as delving deeper into subjects covered by the RCOG Advanced Training Skills Modules (ATSMs), leaving readers well prepared for their ex...

Background: The saltatory pattern (SP) has been defined by guidelines as a uniformly increased bandwidth of >25 beats per min lasting for 30 min. However, previous research suggest that it is very unusual to observe such a “uniform” increase in the bandwidth persisting for >30 min. Baseline fetal heart rate variability (FHRV) on cardiotocography re...

Background Endometrial scratching (with the use of a pipelle biopsy) is a technique proposed to facilitate embryo implantation and increase the probability of pregnancy in women undergoing in vitro fertilization (IVF). Methods We conducted a pragmatic, multicenter, open-label, randomized, controlled trial. Eligible women were undergoing IVF (fresh...

The precise impact of fibroids, which are the most common benign gynaecological tumours in women, on reproductive function and infertility is unknown. The need to treat submucosal fibroids is widely accepted, but fibroids in other locations and sizes continue to present a clinical conundrum. This article examines the mechanisms by which fibroids af...