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5. Appropriate counselling should be given to patient who seeks contraceptive
and sterility procedures together with their failure rates. 6.
Patients who are menopausal should be fully counselled prior to commencement of treatment together with the associated side effects
7. At the menorrhagia clinic, patients should be counselled about various
options available including medical and surgical techniques 8.
Counselling for adolescents should be handled by the subspecialist or by a qualified and credentialed counsellor for adolescent
Measurable elements for 19.3.2
1. Patient must have diagnosis made once seen by subspecialist
2. All fellows in Reproductive Medicine must discuss management of patients
3. Appropriate counselling must be done and documented
4. Initial counselling must be done by subspecialist
5. Patient must countersign appropriate counselling documents
Evidence of continuous monitoring of above standards and remediable actions taken Std: 100
19.3.3 Standard
The therapeutic range of surgical and non surgical techniques for the management of patients with fertility and reproductive endocrinology problems must be made
available to ensure that patients receive not only appropriate but timely therapy.
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Intent of 19.3.3
1. This RM subspecialist is responsible for grooming hisher team to ensure
the smooth running of the clinics, ward, daycare facilities and the operating theatres. This should include the following :-
a. Fertility Clinic and ART Centre
b. Family Planning Clinic
c. Menopause Clinic
d. Sexual Dysfunction Andrology Clinic
e. Menorrhagia Clinic
f. Paediatric and Adolescent Gynaecology Clinic Combined Clinic
g. Minimal access and Reproductive Surgery
h. Robotic Surgery
2. Consultative services should be available in the areas of medical endocrinology,
paediatric endocrinology and genetics. There should be mutually complementary active and continuing interaction between these groups.
It is essential that another subspecialist with special interest and expertise in the management of male infertility be available. This person should also
provide formal education for consultative care for male infertility patients. 3.
Ambulatory facilities, including ultrasound and Doppler imaging, must be available to ensure the presence of high quality care for women. The operating
rooms must be equipped for endoscopic, ablative and microsurgical procedures.
Measurable elements for 19.3.3
1. The Reproductive Medicine team has to ensure that medical treatment in the
first line of management unless otherwise indicated.
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2. Patient undergoing ART must be discussed, protocol planned and appropriate
appointment date for ART given 3.
Multidisciplinary team approach should be displayed 4.
Patient for surgical management should be discussed prior to intervention being carried out
5. Appropriate equipments and facilities must be available with service records
intact and updated.
Evidence of continuous monitoring of above standards and remediable actions taken Std: 100
19.4 FERTILITY CLINIC 19.4.1 Standard
Patient shall be seen in the Reproductive Clinic on an appointment basis.
Intent of 19.4.1
1. All patients seen in the Gynaecology Clinic or referred to that clinic will be
given an appointment at the Fertility Clinic to see the Fertility Counsellor within two weeks.
2. The appointment will have a date and time and the patient would be advised
to bring along her spouse and this process will take about an hour. 3.
Those fees as per the Medical Order 1982 would be charged.
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Measurable Elements of 19.4.1
1. To ensure that all patient that require assessment for Fertility Care seen in
this manner 2.
Explanation that they have to be seen as a couple 3.
Explanation that it would take one hour 4.
Aware of the fees payment
19.4.2 Standard
At the fertility clinic the patient’s first appointment will be the fertility counsellor. The specialist clinic shall provide services for all cases that have been referred from
the general gynaecology clinic with sub-fertility requiring counselling and assisted reproduction.
Intent of 19.4.2
1. The Fertility counsellor would be a qualified staff nurse with training in
counselling and would take a health history of the couple and fills up the blue and pink fertility forms.
2. The fertility counsellor would also gave out the investigation forms and
discuss initial modes of treatment. She would subsequently give an appointment to see the doctor within 4 weeks.
3. The Fertility counsellor would explain why bloods, semen analysis and
hysterosalphingogram HSG are required. The Fertility counsellor would also informs the patient that HSG is done after her menses and an appointment
is taken at the Radiology Clinic.
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