VOLUME 118, ISSUE 6, P1036-1043
Authors:
Alan H. Decherney, M.D., Marja Brolinson, M.D., Grace Whiteley, D.O., Richard S. Legro, M.D., Nanette Santoro, M.D.
Abstract:
PRO: The “E” is Turning into A “G”
CON: The reproductive endocrinologist is dead. Long live the reproductive endocrinologist
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We need Andrology - A- to replace E- Endocrinology in REI.
Infertility is a couple problem. A competent practitioner of Infertility should have good working knowledge of Male and Female Infertility. Unfortunately, the experience and exposure of most of the Fellows in Reproductive Endocrinology and Infertility to Reproductive Andrology is very limited. It is essential that REI Fellows are trained in Reproductive Andrology. They must be trained in clinical evaluation of an Infertile male, relevant investigations and Spermatozoa Retrieval Techniques, if not in surgical correction of Obstructive Azoospermia
Therefore, I feel REI should be RAI- Reproductive Andrology and Infertility. All our Fellows are trained in Andrology and Reproductive Sciences and take care of the couple as a unit
Professor Dr Pandiyan Natarajan.
Chief Consultant in Andrology and Reproductive Sciences,
Apollo 24/7, NOVA IVF FERTILITY,
Chettinad Super Speciality Hospital (Retired)
Professor Emeritus, The Tamil Nadu Dr MGR Medical University.
Dear Sir/Madam:
We read with great interest the recent article by Decherney et al. debating the responsibility of reproductive endocrinologists in tackling the ever mounting complexity of genetics in the fertility clinic. We agree with both the pro and con side that while there is great potential in the power of genetics to improve fertility care, the level of training necessary to adequately educate patients about genetic testing choices and empower them in proper decision-making is a mountain casting a ever-larger shadow on reproductive endocrinologists. While the authors debate the role of reproductive endocrinologists in accomplishing this feat, there was surprisingly little reference to the role of a genetic counselor in this task. Genetic counselors are to be found not only at carrier screening or preimplantation genetic testing (PGT) labs, but increasingly in fertility clinics, each with a unique set of roles and responsibilities (1). Our in-clinic roles alongside REIs complement and enhance their care given our specialized training in genetic testing, genetic technologies, and empowering and assisting patients in their decision-making. This, in turn, reduces the burden many physicians feel at tackling conversations surrounding reproductive genetics (2). Between 2018 and 2021 alone there was a 32% growth in genetic counselors reporting their area of specialization as infertility and PGT(3)(4). While we welcome any reproductive endocrinologist who pursues a reproductive genetics fellowship to join us in our roles as genetics experts, it also behooves the field to recognize the resources currently available to them. As we submit this letter on Genetic Counselor Awareness Day, we implore our reproductive medicine colleagues to invite us to the table and collaborate in the spirit of working toward a common goal: building the families our patients so fervently desire.
Respectfully,
The Executive Board of ASRM’s Genetic Counseling Professional Group