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ART Inspection Form - CBE

The document provides details of an inspection of an Assisted Reproductive Technology Center. It includes information on infrastructure, facilities, staffing, procedures performed, and equipment available at the center. The inspection found that the center met the necessary requirements to be satisfactory.

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Chandrasree
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26 views

ART Inspection Form - CBE

The document provides details of an inspection of an Assisted Reproductive Technology Center. It includes information on infrastructure, facilities, staffing, procedures performed, and equipment available at the center. The inspection found that the center met the necessary requirements to be satisfactory.

Uploaded by

Chandrasree
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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INSPECTION FORM FOR ACCREDITATION

Speciality : Assisted Reproductive Technology Center (IVF Unit)


Check List
(To be filled by the Inspector)
Date of Inspection : 16.05.2019
Name of the Inspectors:
Pathologist :Dr.N.Geetha.,MD(OG),
Professor of OBG,
Department of OBG,
CMCH, Coimbatore.
Gynecologist : Dr.S.Kalyani.,MD(Path),
Associate Professor,
Department of Pathology,
Coimbatore Medical College,
Coimbatore.

Part I – General Information

Name and address of the Institution : SUDHA WOMEN, CHILD CARE &
FERTILITY CENTER (A UNIT OF
SUDHA HOSPITALS)
410, Bharathiyar Road,
New Siddhapudur,
Coimbatore – 641044

Fax/ Phone/e-mail : 0422 4270373 , 9952419307


sudhainfertility @gmail.com
Type of Hospital : Partnership / Women Care & Fertility
Center
Year Established : 2016

Number of Years offering this Specialty: 3

Total Number of Beds in the Hospital : 50

Total number of indoor admission per year in the last three years:
2016-17 : 777
2017 -18 : 903
2018- 19 : 2216

1
Total number of indoor admissions per year in the specialty in the last three years:
2016 – 17 : 275
2017 - 18 : 324
2018 - 19: 645

Number of Out Patient attendance per year in the last three years:
2016 - 17 : 9323
2017 -18 : 12233
2018-19 : 13230

PART – II
Specific information about Assisted Reproductive Technology Centre (IVF Unit)
Faculty
Director /Head of the Department/ Division Head
Name : Dr. S. Dhanbagyam
Qualification : M.D (O&G), ART
Years practicing in the specialty / sub specialty : 25 YEARS
Other members in the specialty:
Name Qualification Years of Full Time Part time Remarks
Experience number of
hours /
week
As
Annexure - I

Support Staff (in other specialties)


Name Qualification Years of Full Time Part time Remarks
Experience number of
hours / week
As
Annexure -II

2
Infrastructure relevant to the specialty: (as per norms)
OT : As Annexure - V
ICU : As Annexure - VIII
NICU : As Annexure - VII
Laboratory : As Annexure - IV
Instruments / Equipments relevant as per norms : As Annexure IX
Support Services / Equipment Available : As Annexure XII
Accreditations / Certifications by other bodies such as
 ISO : NO
 Profession Bodies : IMA
 Indian : ISAR, TAPISAR
 International : ESHRE, ASRM
 Academic Facilities : NIL
 Library : YES
*Books : As Annexure - X
*Journals
*Internet Connectivity : YES
Final Recommendation : SATISFACTORY
Remarks if any:

3
Attach Annexure:-
 Instruments (As Annexure - IX)
 Equipments (As Annexure - IV, V, VII, and VIII.)
 Library Books ( As Annexure - X)
 Journals ( As Annexure - X)
 Any other (Dr’s C.V.) - Dr’s Certificates enclosed ( As Annexure I)

Specialty specific requirement for Reproductive Medicine – Assisted


Reproductive Technology Center (IVF Unit)
Clinician(S) : Dr.S.Dhanabagyam., MD (OG)., ART
Dr.S.Pradeepa., M.B.B.S., DGO., DNB (OG)., ART
Reproductive Endocrinologist: Dr.Krishna Seshadri., M.D ( Internal Medicine)
Andrologist : Dr.Rupin Shah., M.Ch (Urology)
Endoscopic Surgeon : Dr.Madhankumar M.V., M.S (General Surg)
General Surgeon : Dr.Gopinath.M., M.Ch (Urology)., DNB (Gen Surg)
Embryologist Qualification : Miss.S.Rajarajeswari.,Msc.(Bio Tech)
Mr.S.Kamalakannan., M.Sc (Bio Tech)

Name Qualification Years of Full Part time number Remarks


Experience Time of hours / week
List As Annexure
Enclosed - I
IVF Facility : YES
Certification ISAR/ISO/Other: NO
Existing teaching programs if any: CMEs, Workshops regularly conducted

4
Clinical Area :
 Out Patient Area : 1385 sq ft
 Consultation Area : 238 sq ft – 2Nos
 Examination Rooms : 154 sq ft – 2Nos

 Imaging Facility : Ultra Sonography: 3D & 4D Scan


a. Follicular Studies : YES
b. Doppler : YES
c. Sono Hysterogram studies : YES

 Laboratory Facilities – In House : YES 24X7


a. Routine Hematology : YES 24X7
b. Hormone Assay : YES 24X7
c. Counseling room with computer facilities: YES 24X7
d. Record Keeping : YES 24X7
Therapeutic Procedures – Assisted Reproductive Technology
 IUI : DONE
 IVF : DONE
 ICSI : DONE
 TESA - ICSI : DONE
 Blastocyst Culture : DONE
 Assisted Hatching : DONE
 PGD : NO

Cryo Procedures
 Semen Freezing : DONE
 Testicular Tissue Freezing : DONE
 Cleavage Stage Embryo Freezing : DONE
 Blastocyst Freezing : DONE

Number of Cycles per Year


 IVF : 126
 ICSI : 284
 IVF + ICSI : 15

5
 Frozen Embryo Transfer : 240

Indications
 Female : YES
 Tubal : YES
 Endometriosis : YES
 PCO : YES
 Unexplained : YES
 Male : YES
 Previous failed IVF : YES
 POF : YES
IVF Center Lab Facilities
 Embryo Culture Lab Facilities : AVAILABLE
 Sperm Preparation Room : AVAILABLE
 Cryo – Lab for gamete/embryo freezing : AVAILABLE
 Supplies Storage Area : AVAILABLE
 Dedicated Uninterrupted power supply : AVAILABLE
 Water Supply- ( R.O) : AVAILABLE
 Dedicated Sterlization facility : AVAILABLE
 Hormones Assay facility : AVAILABLE

Procedure Area
 Sperm Collection Area : AVAILABLE
 Sperm Processing Area : AVAILABLE
 IUI Procedure Rooms : AVAILABLE
 Dedicated IVF Theater : AVAILABLE
 IVF LAB : AVAILABLE

Equipment
IVF Lab (As Annexure - III)
 Laminar Airflow Cabinet : AVAILABLE
 Two Station : NIL
 Single Station : AVAILABLE
 Co2 Incubators : AVAILABLE (3 NOS)
 Microscopes : AVAILABLE ( 2+1=3)
 Inverted : AVAILABLE
 Phase Contrast : AVAILABLE (1)
 Micromanipulator : AVAILABLE (1)
6
 Cryo system : YES ( 7)

IVF Theatre (As Annexure - VI)


 Anesthetic Machine : AVAILABLE
 Multi parameter monitor and defibrillator : AVAILABLE
 Pulse Oxymeter : AVAILABLE
 Ultrasound Machine Dedicated : AVAILABLE
 Oocyte aspiration pump : AVAILABLE
 Test tube warmer : AVAILABLE
 Centrifuge : AVAILABLE
 Hormone assay equipment : AVAILABLE
Others:
 Fresh air system with HEPA filters : AVAILABLE
 Room Clean Air System : AVAILABLE

CONCLUSIVE OPINION

OG SPECIALIST PATHOLOGIST

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