Author name: Dr. Kalyani Ingale

May 2025 has been a dynamic month for women’s health, with the Pune Obstetrics and Gynaecological Society (POGS) dedicating its focus to the rapidly progressing science of infertility management. The “Womb & Wellness” chronicle for May served as a comprehensive guide, offering in-depth insights into the latest advancements and protocols in fertility treatments. This month’s events and discussions underscore POGS’s commitment to empowering both healthcare professionals and couples navigating the often-challenging journey of conception. May Highlights: Learning, Support, and Medicolegal Preparedness POGS orchestrated a series of impactful events throughout May, fostering continuous learning and community support: • AMOGS CME with POGS (15th May): This academic event, held at Hotel Ramee Grand, brought together approximately 100 delegates to discuss crucial topics in maternal healthcare. Dr. Vinay Thorat presented an overview of “Yellow Alert: Liver Dysfunction in Pregnancy,” while Dr. Jagdish Hiremath shed light on “Anti-Coagulants & Pregnancy,” covering their indications, contraindications, and best practices for safe maternal and fetal outcomes. • Nurses Training Program (16th May): In association with AMOGS and Chandrapur Obgyn society, POGS organized an online webinar to celebrate International Nurses Day. The program, themed “Surakshit Matrutva Abhiyan” (Safe Motherhood Campaign), featured lectures on Antenatal Care, Labour, Postpartum period, and Lactation by experts like Dr. Shilpa Kshirsagar, Dr. Uma Wankhede, and Dr. Girija Wagh from Pune. It also included practical drills on neonatal resuscitation and PPH (Postpartum Haemorrhage), attended by around 100 nurses. • POGS Medicolegal Masterclass (18th May): Held at Dr. Nitu Mandke IMA Hall, this highly anticipated masterclass focused on “Better to prepare and prevent than repair and repent”. With over 150 registrations, it addressed pressing medicolegal concerns, including MTP (Medical Termination of Pregnancy) and POCSO (Protection of Children from Sexual Offences). Sessions covered the legalities of sterilization operations, hysterectomy audit, indemnity insurance, and the critical distinction between criminal and civil negligence. Experts also discussed handling medical emergencies, referrals, ethics, and the crucial examination of victims of sexual abuse. Advancing Infertility Treatment: Key Insights from May’s Chronicle The core of May’s “Womb & Wellness” issue delved into several critical areas of infertility treatment, offering valuable updates for practitioners: • Factors Influencing Ovarian Response in POSEIDON Women: The POSEIDON (Patient-Oriented Strategies Encompassing Individualized Oocyte Number) criteria are vital for classifying women with poor ovarian response (POR). The issue highlighted Follicular Output Rate (FORT) and Follicle-to-Oocyte Index (FOI) as key predictors of ovarian resistance to gonadotropin stimulation. Low FORT (approx. 30%) can indicate hypores-ponse, while high values (approx. 80%) signify adequate response, influencing the adjustment of ovarian stimulation protocols. FOI assesses the combined effectiveness of ovarian stimulation, oocyte maturation triggering, and retrieval procedures, helping identify unexpected hypo-responders. • The Impact of Pre-IVF Weight Loss in Obese Women: Obesity significantly affects reproductive health, contributing to anovulation, irregular cycles, and poor gamete/embryo quality. The chronicle emphasized that even a modest weight loss (5–10% of body weight) before IVF can improve ovulation, enhance gamete and embryo quality, increase IVF success rates, and reduce the risk of obstetric complications like gestational diabetes and preeclampsia. Medical and nutritional strategies, physical activity, and psychological support are crucial components of this pre-IVF preparation. • Individualized Gonadotropin Dosing in ICSI Cycles: The evolution of Individualized Controlled Ovarian Stimulation (ICOS) aims to tailor treatment to each woman’s unique characteristics, maximizing pregnancy chances while minimizing risks. The article stressed the importance of Antral Follicle Count (AFC) and Anti-Müllerian Hormone (AMH) as reliable ovarian reserve markers to guide the starting dose of gonadotropins for hyper-, normo-, and poor responders. This individualization is crucial in the era of embryo vitrification to achieve higher cumulative pregnancy rates. • Newer Advances in Treating Thin Endometrium: A thin endometrium (defined as <7 mm or <8 mm) negatively impacts implantation rates in ART. The issue explored various treatment strategies, including hysteroscopy to correct structural issues (e.g., in dysmorphic uteri or Asherman’s syndrome). Pharmacological options like extended estrogen administration, Growth Hormone (GH), and tamoxifen were discussed. Regenerative medicine, using intrauterine infusions of growth factors like Granulocyte Colony-Stimulating Factor (G-CSF) and Platelet-Rich Plasma (PRP), as well as Mesenchymal Stem Cells (MSCs), are emerging as promising new therapies for endometrial regeneration and improved receptivity. • The ART Act 2021 – An Overview: This crucial legislation regulates Assisted Reproductive Technology (ART) clinics and banks in India to ensure ethical practices and safeguard patient rights. The Act mandates registration of clinics, sets eligibility criteria for commissioning parties (single women or married couples with specific age limits) and donors, and prohibits sex-selective services. It also requires insurance coverage for oocyte donors and confers biological child rights to children born through ART. Challenges in its implementation, such as privacy concerns, lack of donor counseling, and finding suitable donors, were also highlighted. Staying Connected and Empowered with the POGS App To ensure all members remain at the forefront of these advancements, POGS continues to promote its brand-new POGS App. Launched on Android and iOS, this state-of-the-art mobile application centralises all POGS-related information, offering seamless new member and conference registration, monthly quizzes, and a digital library with newsletters, videos, and past lecture recordings. Conclusion May 2025 has powerfully demonstrated POGS’s dedication to infertility management and the advancement of women’s reproductive health. Through expert-led discussions, training programs, and comprehensive articles on novel treatments and regulatory frameworks, POGS continues to equip medical professionals with the tools and knowledge necessary to provide the highest standard of care. This commitment ensures that couples facing infertility receive the best possible support and access to cutting-edge solutions, ultimately fostering hope and enhancing the journey to parenthood.

August 2025 has been a month of profound reflection and forward-thinking for the Pune Obstetrics and Gynaecological Society (POGS), with the latest “Womb & Wellness” issue (Issue 5) dedicating its focus to Research Methodology and Medical Education. These foundational pillars are critical for advancing women’s health and ensuring that future generations of healthcare professionals are not only competent but also compassionate and evidence-driven. A Month of Academic Brilliance and Community Engagement POGS continued its vibrant schedule of events, blending academic excellence with impactful community outreach: • PG Conference, “The Bull’s Eye” (26th–27th July): This national online conference, a brainchild of POGS President Dr. Manish Machave, successfully engaged postgraduate students across India with enriching sessions on exam strategies, clinical pearls, and interactive discussions covering obstetric and gynaecological topics. • Amrutpan Programme on Breastfeeding (1st August): Led by Dr. Vaishali Korde Nayak, this program raised awareness about the importance of breastfeeding, aligning with World Breastfeeding Week. • Infertility Masterclass (3rd August): Coordinated by Dr. Manjiri Valsangkar, with contributions from Dr. Sandhya Meshram, Dr. Nilesh Balkawade, and Dr. Samidha Dalvi, this stellar event provided clinical depth for daily fertility practice. • POGS Outreach Program in Hadapsar (7th August): Efficiently led by Dr. Vaibhav Dangat, Dr. Mrinmayee Dharmadhikari, and Dr. Kalyani Ingale, this initiative expanded academic excellence to the community. • POGS Pink Conclave (13th August): Steered by Dr. Kalyani Ingale in collaboration with Abbott, this elegant conclave focused on vital women’s health concerns with practical updates. • Breastcon 360 at Lonavala (23rd–24th August): Convened by Dr. Charulata Bapaye, this upcoming holistic breast health conference promises further insights. Honouring a Legacy in Medical Education: Late Dr. Aparna Shrotri This August issue is dedicated to the memory of Dr. (Mrs.) Aparna Nishikant Shrotri, a retired Professor of Obstetrics & Gynaecology at B. J. Medical College, Pune. Her exemplary leadership in medical education, clinical practice, and women’s health promotion, coupled with her prolific authorship of 57 research papers and impactful books like “Surgical Principles in Obstetrics and Gynaecology” and “सुरि्षित प्रसूती” (Safe Motherhood), has left an indelible mark on India’s medical community. She was remembered as a “lighthouse of knowledge” and a “mother divine, friend, philosopher and guide” by her students and colleagues. The Core of August’s Theme: Research and Medical Education The month’s central theme emphasises that “Research methodology is the structured process through which scientific inquiry is conducted” and forms the “foundation for understanding diseases, testing interventions, and improving patient outcomes”. This directly links to the editorial’s focus on Medical Education, recognising that “a doctor is a student until he dies”. Revolutionising Learning: The Evolution of Medical Education in India Medical education in India has undergone a profound evolution, from ancient Ayurvedic traditions to a modern, highly regulated biomedical framework under the National Medical Commission (NMC). The shift towards Competency-Based Medical Education (CBME), implemented since 2019, aims to produce holistic Indian Medical Graduates who excel as clinicians, leaders, communicators, professionals, and lifelong learners. Key components of CBME include: • Foundation Course: An initial one-month orientation. • Early Clinical Exposure (ECE): To correlate basic sciences with clinical application. • Integrated Teaching-Learning: Bridging theory and practice across disciplines. • Skill Development: Emphasis on psychomotor, affective, and communication skills through mandatory and desirable skill lists. • Electives: Options for self-directed learning and critical thinking. • Attitude, Ethics, and Communication (AETCOM) Modules: Equipping students with crucial soft skills, empathy, and professional conduct, which can significantly enhance patient care. • Structured and Formative Assessments: Reducing subjectivity and providing continuous feedback. • Log Book Maintenance: Tracking acquired competencies. • Medical Humanities and Family Adoption Program: Fostering holistic development and community understanding. Despite these advancements, challenges remain, including faculty training gaps, infrastructure disparities, increased workload, and the “failure to fail” phenomenon. Preparing for MS OBGYN Exams and Dissertation Writing The August issue offers invaluable guidance for postgraduate students, particularly for the often “anxiety-inducing” “Recent Advances” paper (Paper IV) in the MS Obstetrics and Gynaecology theory exam. Students are encouraged to stay updated through standard journals, guideline portals (FOGSI, ACOG, RCOG, WHO), and CME events, building a “Recent Advances Notebook”. Key topics in obstetrics, gynaecology, and public health are outlined, from NIPT and fetal therapy to robotic surgery and targeted cancer therapies. Detailed guidelines for Dissertation Writing emphasise identifying relevant, feasible, and ethical topics, structuring the dissertation (from title page to references), and the crucial role of research methodology and statistical analysis. Time management and effective writing styles are also crucial for a significant academic achievement. Recommendations for selecting dissertation topics align with current practices, research gaps, and local relevance. The Transformative Power of Simulation and AI in Medical Education Modern medical education is increasingly embracing Simulation-Based Medical Education (SBME) to replicate real-world clinical experiences safely and interactively. Originating from aviation, SBME offers structured, repeatable learning, a safe space for error, and feedback-driven growth, particularly vital in high-acuity fields like obstetrics and gynaecology for emergency drills and surgical skills workshops. Multidisciplinary simulation, such as the PROMPT course, enhances team coordination and communication, improving patient outcomes. Artificial Intelligence (AI) is emerging as another game-changer, revolutionising curriculum planning, teaching-learning, skills acquisition, assessment, and research. AI offers: • Personalised, Adaptive Learning: Tailoring content to individual student needs. • Enhanced Simulation: Creating dynamic scenarios and providing detailed feedback on psychomotor, decision-making, and communication skills. • Content Curation and Knowledge Management: Efficiently analysing medical literature and generating educational materials. • Objective Assessment: Automating repetitive tasks and tracking longitudinal performance. In OBGYN, AI can identify curriculum gaps, forecast workforce needs, and improve training for procedures like ultrasound and surgery, ultimately leading to better patient outcomes. The Art of Communication in Healthcare Beyond technical skills, effective communication is the “lifeline of healthcare”. Dr. Dilip Walke’s insights, garnered over 35 years of practice, highlight its importance in building trust with patients and families, managing emergencies, explaining complications, and fostering strong inter-team collaboration. Good communication acts as a “preventive medicine for mistrust,” crucial for both patient preparedness and medicolegal safety. Guidelines for preparing professional presentations also stress clear, organised structure,

April has marked a critical turning point in women’s health and obstetric care, with the Pune Obstetrics and Gynaecological Society (POGS) dedicating its efforts to tackling one of the most significant challenges in maternal health: haemorrhage. The inaugural issue of The POGS Chronicle, “Womb & Wellness,” for April 2025, served as a powerful declaration of POGS’s renewed commitment to scientific excellence, community outreach, and safeguarding the lives of expectant mothers. A New Era for POGS: Leadership, Learning, and Digital Innovation April saw the formal installation of the new POGS team for 2025-26, with Dr. Manish Machave taking the helm as President. This month also celebrated the momentous launch of the brand-new POGS App, an innovative mobile application now available on both Android and iOS. This app centralises all POGS-related information, offering seamless member and conference registration, monthly quizzes, a digital library, and recordings of past lectures, making it easier than ever for members to stay connected and engaged in advancing women’s health. “Code RED”: A Life-Saving Conference on Haemorrhage Management The highlight of April was the 40th Installation Conference “Code RED,” held from 18th to 20th April 2025. This critical gathering focused intensely on haemorrhages and haematological disorders in obstetrics and gynaecology, bringing together leading physicians and specialists to share cutting-edge insights and life-saving protocols. Key sessions included: • Blood and Blood Products Workshop: Day 1 commenced with scientific deliberations and brainstorming panel discussions on the prudent use of blood and blood products in obstetric emergencies. • Keynote Addresses and Orations: The conference featured insightful talks by senior faculties, including two orations: “The Extraordinary You” by Dr. Pankaj Desai and “Every drop of blood counts” by Dr. Parag Biniwale, emphasising the prevention of Postpartum Haemorrhage (PPH). • Medicolegal Moot Court Room: An innovative session that simulated legal proceedings in cases of medical negligence, offering invaluable insights into the legal aspects of obstetric care. • Simulation-Based Obstetric Emergency Workshop: This interactive workshop, conducted by Dr. Rajendra Patil and Dr. Jui Lagoo and their team, provided hands-on training for critical obstetric emergencies, demonstrating POGS’s commitment to practical skill enhancement. The “Code RED” conference underlined the importance of early recognition, prevention, and effective management strategies to improve patient outcomes and reduce maternal mortality caused by excessive haemorrhage. Empowering Nurses: “Surakshit Matrutva Abhiyan” Furthering its commitment to community engagement and safe motherhood, POGS, in association with AMOGS, conducted a Nurses Training Program on 22nd April 2025. Held at the MG Auditorium, BJGMC, Pune, this program aimed to enhance clinical knowledge and skills in maternal and neonatal care, recognising nurses as the crucial 24-hour point of contact for patients. The training included: • Lectures on Antenatal Care, Labour Guide, Postpartum Care, and Lactation. • Hands-on drills for Eclampsia Management, Postpartum Hemorrhage (PPH), Adult Resuscitation, and Neonatal Resuscitation. This initiative underscores POGS’s holistic approach to maternal safety by equipping all healthcare providers with essential skills. Deep Dive into Maternal Haemorrhage and Related Conditions The April issue of “Womb & Wellness” provided comprehensive articles covering various aspects of obstetric and gynaecological haemorrhage, a significant cause of maternal morbidity and mortality. • Recurrent Pregnancy Loss (RPL): Detailed investigations and management strategies for couples experiencing two or more failed pregnancies were presented, covering genetic, anatomical, endocrine, and immunological factors, as well as the role of anti-phospholipid antibody syndrome. • Eclampsia Management: Discussions focused on the prevention and management of eclampsia, a life-threatening condition involving convulsions in hypertensive pregnant women, including the crucial role of magnesium sulphate and emergency protocols. • Postpartum Haemorrhage (PPH): Both medical and surgical management of PPH were extensively covered, from uterotonic agents like oxytocin and tranexamic acid to surgical interventions such as uterine artery ligation and Cesarean hysterectomy, emphasising prompt resuscitation and multidisciplinary approaches. • Antepartum Haemorrhage (APH): An overview of bleeding from or into the genital tract after 20 weeks of gestation, with a focus on conditions like placenta praevia and placental abruption, their diagnosis, and management. • Cesarean Hysterectomy in Obstetric Care: A case review and lessons learned from managing complex cases like placenta percreta, highlighting the necessity of a multidisciplinary team and thorough preparedness in tertiary care centres. These detailed articles serve as invaluable resources for practitioners, reinforcing the importance of evidence-based practices and proactive management in preventing adverse maternal outcomes. POGS: Committed to a Safer Future for Mothers POGS’s initiatives in April demonstrate a profound dedication to “POGS FOR HER” – safeguarding its members and striving for the betterment of women’s health. By focusing on critical areas like haemorrhage management, recurrent pregnancy loss, and eclampsia, POGS is actively working towards reducing maternal mortality and morbidity.

July has been a pivotal month for women’s health and gynaecological advancements, with a strong emphasis on Urogynaecology and Pelvic Floor & Vaginal Surgeries. The latest issue of The POGS Chronicle, “Womb & Wellness,” illuminates these critical areas, highlighting how innovative techniques and educational initiatives are transforming patient care. The Pune Obstetrics and Gynaecological Society (POGS) has been at the forefront, fostering continuous learning and bringing together experts to address conditions that significantly impact a woman’s quality of life. July Highlights: A Month of Learning and Outreach POGS and its collaborators hosted several significant events in July, demonstrating a robust commitment to academic excellence and community engagement: • Swasth Nari Abhiyan Yatra (2nd July): This FOGSI Presidential initiative reached Pune, bringing crucial Breast and Cervical Cancer Awareness to healthcare professionals. The CME fostered dialogue and education, with esteemed faculty discussing screening for breast cancer and managing abnormal PAP smears. • A-Z Masterclass on Colposcopy (6th July): Held at SKN Medical College, this masterclass provided in-depth training on colposcopy, a vital procedure for cervical health. • POGS-MIMER Endoscopy Masterclass & EAGLE Project (10th–11th July): MIMER Medical College, in collaboration with POGS and IAGE, hosted its Annual Endoscopy Masterclass. This flagship event, part of the EAGLE (Every Aspiring Gynaecologist Learns Endoscopy) project under FOGSI President Dr. Sunita Tandulwadkar, is dedicated to mentoring and training gynaecologists in minimally invasive surgical techniques. • POGS Outreach CME – Manchar (24th July): Extending academic reach to the community, this outreach program featured talks by eminent speakers and highlighted upcoming POGS events, encouraging members to utilize the new POGS App for updates. • National Online PG Conference, “The Bull’s Eye” (26th–27th July): This brainchild of POGS President Dr. Manish Machave was designed as an online conference to reach OBGY postgraduate students nationwide. It focused on uncommon yet significant topics crucial for MS, DNB, and CPS exams, covering obstetric topics on the first day and gynaecological topics on the second. The Core of July’s Theme: Pelvic Floor and Vaginal Health Urogynaecology, a specialised field combining gynaecology and urology, focuses on diagnosing and treating pelvic floor disorders like urinary incontinence and pelvic organ prolapse. Damage to the pelvic floor muscles can severely compromise bladder, rectum, and sexual functions, leading to significant distress. Understanding the Perineum and Pelvic Floor A deep dive into perineal anatomy is crucial for successful vaginal surgeries. The perineum comprises the urogenital and anal triangles, with layers of skin, subcutaneous tissue, superficial and deep spaces housing structures like the clitoris, muscles (ischiocavernosus, bulbocavernosus), and glands. The Pudendal nerve and vessels play a vital role in the perineum’s sensory and motor functions and blood supply. The pelvic floor, a complex structure of muscles and connective tissues (including the levator ani muscles, perineal membrane, and perineal body), provides essential support to pelvic organs and helps manage intra-abdominal pressure. Damage to these supports can lead to conditions like cystocele and rectocele. Advanced Surgical Techniques and Therapies This month’s discussions highlighted several key advancements: 1. Redefining Non-Descent Vaginal Hysterectomy (NDVH): NDVH is a scarless, minimally invasive procedure for uterus removal. This technique offers superior peri-operative outcomes, including shorter operative times, less blood loss, lower complication rates, and quicker recovery, especially benefiting obese, elderly, or medically debilitated patients. Innovations like uterine morcellation and modified lithotomy address traditional challenges of large uterine size and limited visualisation. The SLOPE score is used for objective patient selection, guiding surgical planning and optimising outcomes. 2. Sacrospinous Ligament Fixation (SSLF): A standard surgical method for pelvic organ prolapse, particularly vaginal vault prolapse, SSLF involves anchoring the vaginal apex to the sacrospinous ligament using native tissue techniques. While highly effective, surgeons must be aware of potential complications such as buttock pain, neuropathic pain, or hemorrhage. 3. PRP Therapy in Recurrent Vaginitis and Vaginal Atrophy: Platelet-Rich Plasma (PRP) therapy offers a cutting-edge, non-hormonal solution by injecting the patient’s own platelets. It promotes tissue regeneration through growth factors (PDGF, VEGF, TGF-β, EGF), aiming to rejuvenate vaginal mucosa, reduce infections, and alleviate symptoms like dryness and itching. This OPD-based treatment is autologous, safe for hormone-sensitive patients, and boasts high patient satisfaction. 4. Managing Perineal Tears: Perineal tears, common during childbirth, are classified by severity (First to Fourth Degree, with Third and Fourth degrees termed Obstetric Anal Sphincter Injuries – OASIS). Predisposing factors include nulliparity, large birth weight, and instrumental delivery. Prevention involves mediolateral episiotomy and perineal massage. For repair, techniques like the Warren Flap or Noble’s operation are used, with the Martius Graft being a valuable option for rectal buttonhole tears or rectovaginal fistulas to enhance healing and reinforcement. Staying Connected with POGS To ensure continuous access to the latest medical knowledge and event information, POGS has launched its state-of-the-art mobile application, available on both Android and iOS. This POGS App centralises all POGS-related information, offering seamless new member and conference registration, monthly quizzes, and a digital library with newsletters, videos, and past lecture recordings. Conclusion July 2025 has truly underscored POGS’s dedication to advancing Urogynaecology and Pelvic Floor Health. Through a series of impactful conferences, masterclasses, and comprehensive articles, the society has equipped healthcare professionals with the knowledge and skills necessary to provide optimal care in these critical areas. By championing minimally invasive techniques and innovative therapies like PRP, POGS continues its mission to uplift women’s well-being and ensure a healthier future.

  Advancements in Gynaecological Surgery: How Minimally Invasive Techniques are Revolutionising Women’s Health & Fertility The field of gynaecology has witnessed remarkable transformations, leading to significant improvements in women’s health and wellness. The latest issue of The POGS Chronicle, “Womb & Wellness,” highlights these sophisticate d medical and technical advances, particularly in minimally invasive gynaecological surgery. These innovations are not only enhancing diagno stic accuracy but also making treatments safer, faster, and more effective. The Dawn of a New Era: Understanding Gynaecological Endoscopy   The desire to peer into the human body is as old as recorded history, with early descriptions of endoscopic  examinations dating back to Hippocrates in Greece (460-375 BC), who referenced a rectal speculum. A three-bladed vaginal speculum, similar to modern instruments, was even found in Pompeii’s ruins from 70 AD. Fast forward to the 20th century, and pioneers like Raoul Palmer performed the first gynaecological laparoscopy in 1944, and Kurt Semm developed automatic insufflators in the 1960s, profoundly shaping the development of what he termed “Pelviscopy”. Today, gynaecological endoscopy has blossomed into a fine art, combining science and skill. These sophisticated procedures, encompassing both laparoscopy (abdominal approach) and hysteroscopy (uterine cavity approach), offer significant advantages over traditional open abdominal surgery. Benefits include superb clear visualisation, reduced incidence of adhesions, minimal trauma, lower complication rates, rapid recovery, shorter hospital stays, and cosmetically better outcomes with less scarring. Empowering Fertility: Key Endoscopic Surgeries for Conception For many couples struggling with subfertility – defined as the failure to achieve clinical pregnancy after 12 months or more of regular unprotected intercourse – endoscopic surgeries offer hope by correcting structural or pathological causes. Laparoscopic Fertility Enhancing Surgeries: Laparoscopic Myomectomy: Uterine fibroids, common benign tumours, can impair fertility by distorting the endometrial cavity or interfering with embryo transport. Laparoscopic myomectomy provides a minimally invasive alternative to laparotomy for removing various types of fibroids, leading to faster recovery and fewer postoperative adhesions. Laparoscopic Tubal Surgeries: Tubal disease or damage to the fallopian tubes accounts for 25-35% of infertility cases. Laparoscopic procedures like tubal cannulation for proximal blockages, salpingectomy for severe hydrosalpinx, or tubotubal reanastomosis for sterilisation reversal, aim to restore tubal patency and improve conception chances. Laparoscopic Adhesiolysis: Pelvic adhesions, often caused by inflammation or previous surgery, can distort anatomy and impede gamete and embryo transport. Laparoscopic adhesiolysis restores normal anatomy, improving pregnancy outcomes. Endometriosis Management: Endometriosis, a chronic inflammatory cond ition, affects up to 50% of infertile women. Laparoscopy is the gold standard for diagnosis and treatment, helping to manage adhesions and improve fertility. Laparoscopic Ovarian Drilling: For women with Polycystic Ovarian Syndrome (PCOS) who are resistant to ovulation induction drugs, laparoscopic ovarian drilling can induce ovulation and achieve high pregnancy rates by making the ovaries more receptive to lower-dose stimulation. Hysteroscopic Fertility Enhancing Surgeries: Uterine abnormalities contribute significantly to infertility, and hysteroscopy allows for precise interventions within the uterine cavity. Hysteroscopic Myomectomy: Submucous myomas (fibroids projecting into the uterine cavity) can be resected transcervically using operative hysteroscopy, improving pregnancy rates in infertile women. Hysteroscopic Tubal Cannulation: For proximal tubal blockages, hysteroscopic cannulation can restore patency and increase pregnancy rates, offering an alternative to IVF in some cases. Hysteroscopy for Metroplasty in Septate Uterus: A uterine septum, the most common congenital uterine anomaly, is associated with recurrent pregnancy loss. Hysteroscopic metroplasty significantly improves reproductive outcomes by incising the septum. Hysteroscopy for Intrauterine Adhesions (Asherman’s Syndrome): Adhesions within the uterine cavity, often caused by curettage, can impair reproduction. Hysteroscopic adhesiolysis is the main treatment, improving pregnancy and live birth rates. Hysteroscopic Polypectomy: Endometrial polyps, localised hyperplastic overgrowths, can be effectively resected hysteroscopically, improving fertility and pregnancy rates regardless of their size or number. Beyond Fertility: Other Minimally Invasive Gynaecological Procedures Minimally invasive techniques extend to a broad range of gynaecological conditions: Total Laparoscopic Hysterectomy (TLH): This procedure involves removing the uterus through small abdominal incisions, offering proven benefits over abdominal or vaginal hysterectomy, including quicker recovery. Laparoscopic Management of Adnexal Masses: Adnexal masses (growths near the uterus, ovaries, or fallopian tubes) can range from benign cysts to malignant tumours. Laparoscopy provides a safe and effective approach for diagnostic evaluation, removal of benign masses, and even staging in early-stage malignancies, offering reduced pain and shorter hospital stays. Special care is taken during specimen retrieval using endoscopic bags to prevent spillage and preserve oncological safety. Addressing Ectopic Pregnancies: Both tubal and scar pregnancies (implantation in a previous caesarean section scar) are life-threatening conditions. Minimally invasive surgical management, such as salpingostomy or salpingectomy for tubal pregnancies, or hysteroscopic/laparoscopic resection for scar pregnancies, is crucial for prompt treatment and maternal health. The Technology Behind the Precision: Energy Sources in Endoscopy The success of modern gynaecological endoscopy relies heavily on advanced energy sources for cutting, coagulation, and dissection. Electrosurgical Energy: This includes monopolar and bipolar systems. Bipolar energy is often preferred in hysteroscopy as it allows the use of normal saline, reducing systemic risks and providing effective cutting and coagulation with lower thermal injury. In laparoscopy, advanced bipolar systems like LigaSure offer superior vessel sealing with reduced thermal spread. Ultrasonic Energy: Devices like the Harmonic Scalpel use high-frequency ultrasonic vibrations to simultaneously cut and coagulate tissues at lower operating temperatures, leading to minimal lateral thermal spread, reduced smoke, and precise dissection. Hybrid Energy Systems: Newer devices, such as Thunderbeat, integrate both advanced bipolar and ultrasonically generated frictional heat energy into one instrument, further improving surgical efficiency and versatility. These innovations are meticulously chosen by surgeons based on the specific procedure and desired outcome, ensuring optimal results while minimising complications. POGS: Advancing Women’s Health Through Education & Innovation Organisations like the Pune Obstetrics and Gynaecological Society (POGS) are at the forefront of these advancements. POGS demonstrates a strong commitment to education and engagement through cutting-edge webinars, masterclasses on medicolegal issues, and initiatives like Menstrual Hygiene Day. Furthermore, POGS has launched a brand-new POGS App, available on Android and iOS, designed to centralise all POGS-related information. This state-of-the-art mobile application offers seamless new member and conference registration, monthly quizzes,