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To determine knowledge retention 1 year after training for intrapartum emergencies.Training was undertaken in 6 hospitals and the Bristol Medical Simulation Centre, UK, between November 2004 and March 2005. Participants (22 junior and 23 senior doctors, 47 junior and 48 senior midwives) were randomly recruited from participating hospitals and underwent practical training at their local hospital or simulation center with or without additional teamwork training. The primary outcome was change in factual knowledge over time, as assessed by a 185-question multiple-choice questionnaire before and after training.Mean scores at 6 (97.6 ± 23.0; n = 107) and 12 (98.2 ± 21.6; n = 98) months remained higher than those before training (79.6 ± 21.9, n = 140; both P0.001), but were slightly lower than those immediately after training (101.0 ± 21.3, n = 133; P0.001 and P = 0.007, respectively). The type of training had no effect on retention of knowledge.Training was associated with sustained retention of factual knowledge of obstetric emergencies care for at least 1 year. The decay in knowledge was small compared with the original gain in knowledge. Neither training location nor inclusion of teamwork training affected knowledge retention. Annual training seemed to be satisfactory for all staff groups.

Opinion remains divided as to whether finding endometriotic lesions in the absence of adhesions has an adverse effect on the likelihood of conception.This was a retrospective study of 192 fully investigated infertile couples, followed up for up to 3 years following laparoscopy. Women studied were ovulating,40 old years and their partners had normal sperm parameters. All 117 women with unexplained infertility and 75 with minimal/mild endometriosis without adhesive disease were managed conservatively.Women with endometriosis were found to have a lower probability of pregnancy compared with women with unexplained infertility (36% versus 55%; P0.05). Other factors adversely associated with pregnancy were primary infertility, smoking and longer duration (3 years) of infertility. However, the effects of duration of infertility and primary infertility were not observed to be statistically significant for women with endometriosis.The findings, although undertaken in a select population undergoing laparoscopy, suggest the likelihood of pregnancy is reduced in infertile women with minimal/mild endometriosis compared with those infertile women with a normal pelvis. Duration of infertility and a previous history of pregnancy are important in predicting the likelihood of pregnancy in women with no obvious cause for their infertility (unexplained), whilst the relationship may be more complex in women with minor endometriosis

A pilot study was designed to examine whether the outcome of embryo transfer in women with a hydrosalpinx might be improved by surgical drainage of the hydrosalpinx at the time of oocyte collection for in-vitro fertilization treatment. A comparative, controlled but retrospective analysis of the results was performed of all women with infective tubal damage aged

We report the safe use of levonorgestrel hormone releasing intra uterine system (Mirena®) as a contraceptive in egg donors during a treatment cycle. In the first case report, a 29-year-old egg donor using the Mirena coil for contraception and two egg recipients, aged 41 years and 32 years respectively underwent standard IVF treatment, oocyte retrieval in the egg donor and in vitro fertilization followed by embryo transfer in the recipient. The outcome of IVF cycle using donor eggs was satisfactory with successful pregnancy in the egg recipient. The second case involved a 34-year-old egg donor using the Mirena coil and a 44-year-old recipient. Our findings suggest that egg donors can safely use the (Mirena®) as a contraceptive device during treatment, without compromising follicular development and oocyte quality.

A skeleton quality manual has been prepared by collaboration between the British Fertility Society, Association of Clinical Embryologists and the Human Fertilisation and Embryology Authority (HFEA). A quality manual is a fundamental part of the quality management system (QMS) and is designed to encompass the ethos of clinical governance including education and training, clinical audit, clinical effectiveness, research and development, openness and risk management. It is mandatory for fertility clinics licensed by the HFEA in the UK to have a QMS in place to enable continual improvement of service. This manual is a tool that Centres can adapt to reflect their own service provision. The aim is to provide a skeleton to compliment or develop a Centre’s QMS. The aims of each section describe what the outcome should be and practical examples have been given. The examples are not exhaustive, and Centres should develop their own standard operating procedures (SOPs) to support the quality manual. Where possible, the aims and examples within the manual have been mapped to the relevant HFEA standard licence conditions included in the 8th HFEA code of practice (CoP). Examples suggest where implementation of quality standards outlined in this manual might be mapped to compliance with some HFEA standard licence conditions. Users should be aware that not all requirements of standard licence conditions or of the 1990 Human Fertilisation and Embryology Act (as amended) or HFEA Directions are mapped to this manual. Implementing a QMS on the basis of this manual would not mean that a Centre would be fully compliant with all HFEA requirements. HFEA standard licence conditions in this template are denoted by the letter T and a number, and these references are linked to a list of HFEA standard licence conditions appended at the end of the document. A standard licence condition highlighted in bold indicates that it has been mapped to the quality manual template. This should help Centres comply with mandatory HFEA requirements. The manual and the activities undertaken in implementing the manual can form part of the evidence of compliance shared with the HFEA in the course of an inspection.