Access the forefront of Gynecological medicine by acquiring the skills that will enable you to lead in a constantly evolving field” 

The nature of infertility and gynecologic pathologies requires highly specialized diagnosis, a personalized approach, and detailed management of each patient. The causes and treatments vary significantly from one case to another. At the same time, emotional aspects are fundamental in this process; patients face not only anxiety related to medical treatments, but also stress derived from social pressure and repeated failures.

In this regard, professionals must balance scientific innovations with respect for patients' rights while navigating complex regulatory frameworks that vary by region. All of this, coupled with the pressure to achieve successful outcomes and the psychological impact of treatments, makes the practice extremely demanding but also deeply meaningful. Assisted reproduction has become one of the fastest-growing medical specialties in recent decades, due to the increase in demand for treatments to overcome fertility problems. This academic opportunity focuses on key areas of gynecological care, with a special emphasis on three crucial aspects: the treatment of oncological problems, assisted reproduction, and minimally invasive surgery.

TECH offers a unique educational experience with a scientific, technical, and practical approach that provides all the knowledge necessary to be at the forefront of medicine in this field. With a 100% online approach and methodology, professionals are guaranteed to acquire the essential tools to excel in modern gynecologic surgery. In addition, graduates will have exclusive access to prestigious Masterclasses taught by renowned and internationally renowned directors.

This Advanced master’s degree provides you with the essential knowledge and tools through exclusive Masterclasses, preparing you to successfully face the most complex challenges in gynecological health”

This Advanced master’s degree in Gynecologic Pathology and Assisted Reproduction contains the most complete and up-to-date scientific program on the market. The most important features include:

• The development of practical case studies presented by experts in Gynecologic Pathology and Assisted Reproduction 
• The graphic, schematic, and practical contents with which they are created, provide scientific and practical information on the disciplines that are essential for professional practice 
• Practical exercises where the self-assessment process can be carried out to improve learning 
• Special emphasis on innovative methodologies in Gynecologic Pathology and Assisted Reproduction 
• Theoretical lessons, questions to the expert, debate forums on controversial topics, and individual reflection assignments 
• Content that is accessible from any fixed or portable device with an Internet connection 

Be part of the transformation of the medical sector by learning advanced techniques and innovative approaches at the world’s largest online university”

The teaching staff includes professionals from the field of Gynecologic Pathology and Assisted Reproduction, who bring their work experience to this program, as well as renowned specialists from leading societies and prestigious universities. 

The multimedia content, developed with the latest educational technology, will provide the professional with situated and contextual learning, i.e., a simulated environment that will provide an immersive learning experience designed to prepare for real-life situations. 

This program is designed around Problem-Based Learning, whereby the student must try to solve the different professional practice situations that arise throughout the program. For this purpose, the professional will be assisted by an innovative interactive video system created by renowned and experienced experts.

TECH offers you the opportunity to learn from experts, providing you with a competitive advantage in the job market”

Through a comprehensive, 100% online methodology, you will be up to date with the latest scientific advances”

This academic opportunity focuses on science, technique, and practice, covering everything from the fundamentals of gynecological care to specialized interventions. Special emphasis will be placed on three key areas: the treatment of gynecologic cancer, assisted reproduction techniques, and minimally invasive surgery. Throughout the course, students will develop skills in the latest advancements in diagnosis and treatment, including innovations such as egg cryopreservation, advanced in vitro fertilization techniques, and the management of conditions like endometriosis. In addition, the program integrates practical components and clinical experiences, allowing professionals to develop skills in direct patient care and offer innovative solutions to challenges in gynecology and reproduction. 

Be part of the transformation of the medical sector by learning advanced techniques and innovative approaches in assisted reproduction” 

Module 1. Female Surgical Anatomy 

1.1. Parametrial Surgical Anatomy
1.2. Musculo-Fascial Anatomy of the Female Pelvis
1.3. Pelvic Visceral System 

1.3.1. Uterus and Ovaries
1.3.2. Rectum and Sigmoid Colon
1.3.3. Bladder and Ureters

1.4. Abdomino-Pelvic Vascular System
1.5. Abdominal and Pelvic Nervous System
1.6. Dissection and Limits of Avascular Spaces
1.7. Vascular Abnormalities in the Pelvic Area 

1.7.1. Abnormalities in the Pelvic Area
1.7.2. Corona Mortis
1.7.3. Abdominal and Aortic Area Abnormalities
1.7.4. Use of Preoperative Imaging Techniques 

Module 2. Hysteroscopic Surgery

2.1. Introduction to Hysteroscopic Surgery
2.2. Organization of an Outpatient Hysteroscopy Consultation
2.3. Hysteroscopy Equipment and Instruments in Consultation

2.3.1. Peculiarities of the Hysteroscopy Tower
2.3.2. Types of Diagnostic Hysteroscopes
2.3.3. Types of Instruments

2.4. Hysteroscopy in Consultation

2.4.1. Indications for In-Consultation Hysteroscopy
2.4.2. In-Consultation Hysteroscopy Technique
2.4.3. How to Increase the Success Rate?

2.5. Surgical Hysteroscopy

2.5.1. Surgical Hysteroscopies Indications
2.5.2. Peculiarities of the Procedure in the Operating Room

2.6. Systematic Endometrial Exploration and Biopsy
2.7. Hysteroscopic Polypectomy
2.8. Foreign Body Removal (IUD, Essures)
2.9. Hysteroscopic Myomectomy

2.9.1. Limits to In-Consultation Interventions
2.9.2. Types of Hysteroscopic Morcellators
2.9.3. Suitable Techniques

2.10. Resection of Septum and Intracavitary Malformations
2.11. Intratubal Devices
2.12. Endometrial Ablation

2.12.1. Resectoscope Use
2.12.2. Novasure and Other Devices

2.13. Complications and Post-Procedural Management in Hysteroscopy

2.13.1. Uterine or Cervical Perforation
2.13.2. Infections
2.13.3. Vasovagal Syndrome
2.13.4. Bleeding
2.13.5. Postoperative Pain
2.13.6. Hyperosmolar Syndrome
2.13.7. Others

2.14. New Developments in Hysteroscopy

2.14.1. Use of Monopolar vs. Bipolar Energy 
2.14.2. Use of Laser in Hysteroscopy 
2.14.3. Other Developments

Module 3. Exploratory Laparoscopy and Benign Adnexal Pathology

3.1. General Considerations in the Operating Room
3.2. Use of Veress vs. Hasson Trocar
3.3. Placement of Accessory Trocars

3.3.1. Choosing the Right Trocar
3.3.2. How to Avoid Complications?
3.3.3. Use of Direct Vision Trocars

3.4. Performing the Pneumoperitoneum
3.5. Systematic Exploration of the Cavity: Biopsies and Cytology
3.6. Simple Adnexectomy and Salpingectomy
3.7. Ovarian Cystectomy of Simple Cysts
3.8. Management of Complex Non-Endometriotic Cysts

3.8.1. Ovarian Teratomas
3.8.2. Large Cysts
3.8.3. Adnexal Torsion
3.8.4. Ectopic Pregnancy
3.8.5. Pelvic Abscess and Inflammatory Disease

3.9. Remaining Ovary Syndrome

Module 4. Benign Uterine Pathology and Dysgenesis

4.1. Laparoscopic Myomectomy

4.1.1. Medical Treatment of Myomas
4.1.2. Surgical Treatment. Indications
4.1.3. Prevention of Bleeding

4.1.3.1. Injection of Vasoconstrictors
4.1.3.2. Temporary Clipping of Uterine Arteries

4.1.4. Basic Surgical Techniques

4.1.4.1. Choosing the Incision
4.1.4.2. Myomatous Dissection and Removal
4.1.4.3. Bed Suture
4.1.4.4. Morcellation of the Part

4.1.4.4.1. Risk of Uterine Sarcoma
4.1.4.4.2. Sealed Morcellation Systems

4.1.5. Fertility after Myomectomy

4.1.5.1. Obstetric Outcomes and Recommendations
4.1.5.2. Non-Stick Systems

4.2. Laparoscopic Hysterectomy

4.2.1. Use of Uterine Mobilizers

4.2.1.1. Types of Mobilizers
4.2.1.2. Fitting the Mobilizers
4.2.1.3. Advantages of Mobilizers
4.2.1.4. Automatic Uterine Mobilization Systems

4.2.2. Basic Simple Hysterectomy Technique
4.2.3. Technique in Complex Situations
4.2.4. Vaginal Vault Suture and Dehiscence

4.3. Genital Malformation Syndromes

4.3.1. Classification of Malformation Syndromes
4.3.2. Laparoscopic Resolution of Malformation Syndromes
4.3.3. Laparoscopic Neovagina

Module 5. Pelvic Floor Pathology and Transvaginal Mesh Use

5.1. Pathophysiology of Genital Prolapse
5.2. Etiopathogenesis of Chronic Pelvic Pain
5.3. Global Assessment of the Patient and Route of Approach 
5.4. Prosthetic Materials and Mesh Types

5.4.1. Types of Material
5.4.2. Meshes for Genital Prolapses
5.4.3. Urinary Incontinence Meshes

5.5. Laparoscopic Sacrocolpopexy

5.5.1. Choosing the Right Mesh
5.5.2. Surgical Technique

5.5.2.1. When to Preserve the Uterus?

5.5.3. Technique Complications
5.5.4. A Learning Curve

5.6. Treatment of Urinary Incontinence

5.6.1. Pre-Operative Study
5.6.2. Endoscopic Treatment of Incontinence
5.6.3. Vaginal Treatment of Incontinence
5.6.4. Placement of Mini-Slings
5.6.5. Placement of TVT - TOT
5.6.6. Other Procedures

5.7. Endoscopic Repair of Paravaginal Defects
5.8. Role of Cystoscopy in Gynecologic Surgery

Module 6. Laparoscopy in Endometriosis

6.1. Laparoscopy in the Treatment of Endometriosis
6.2. General Diagnosis of Endometriosis

6.2.1. Clinical Examination
6.2.2. Imaging Techniques
6.2.3. The Role of Tumor Markers

6.3. Endometriosis Classification

6.3.1. Classification Systems by Authors
6.3.2. Clinical Utility of Classifications 

6.4. Medical Treatment of Endometriosis

6.4.1. Non-Hormonal Treatment
6.4.2. Hormonal Treatment

6.4.2.1. Contraceptives
6.4.2.2. Progestogens
6.4.2.3. Danazol
6.4.2.4. Gestrinone
6.4.2.5. Others

6.5. Treatment of Ovarian and Peritoneal Endometriosis

6.5.1. Types of Peritoneal Disease
6.5.2. Adhesion Formation and Release
6.5.3. Ovarian Endometriosis

6.6. Management of Deep Endometriosis

6.6.1. General Concepts
6.6.2. Endometriosis Rectum Vaginal Septum
6.6.3. Lateral and Sciatic Compartment
6.6.4. Intestinal Endometriosis
6.6.5. Endometriosis in the Urinary Tract

6.7. Extrapelvic Endometriosis
6.8. Reproductive Effects of Laparoscopy and Endometriosis
6.9. New Developments in Endometriosis and Laparoscopy

Module 7. Minimally Invasive Surgery 

7.1. General Introduction 
7.2. History of Laparoscopy 
7.3. Introduction to Hysteroscopic Surgery 
7.4. Ergonomics in Laparoscopy 
7.5. Asepsis and Antisepsis 

7.5.1. Hand Washing 
7.5.2. Preparing Instrumentation. Sterilization
7.5.3. Preparing the Surgical Field 

7.5.3.1. Skin Cleansing 
7.5.3.2. Proper Cloth Placement 

7.6. Laparoscopic Operating Room 

7.6.1. Conventional Operating Rooms 
7.6.2. Integrated Operating Rooms 
7.6.3. Future Perspectives 

7.7. Preoperative Preparation for Laparoscopy 

7.7.1. Physical Preparation for Patients 
7.7.2. Preoperative Medication and Bowel Preparation 
7.7.3. Patient Position on the Operating Table 

7.8. Fast-Track/ ERAS Program
7.9. Anesthetic Considerations in Endoscopic Surgery 

7.9.1. General Overview 
7.9.2. Circulatory System Involvement 
7.9.3. Respiratory System Involvement 
7.9.4. Spinal Catheter Placement and Other Blockages
7.9.5. Postoperative Recovery 

Module 8. Instrumentation, Materials and Electrosurgery 

8.1. Laparoscopy Tower and General Supplies 
8.2. Specific Vision Systems

8.2.1. Full HD High Definition Systems 
8.2.2. 3D Vision Systems 
8.2.3. 4K Vision Systems 

8.3. Endoscopy 

8.3.1. Rigid Endoscopy 
8.3.2. Flexible and Angle Adjustable Endoscopes 
8.3.3. Small Bore Endoscopes

8.4. Insufflation Systems 

8.4.1. General Functioning 
8.4.2. Smoke Extraction Systems

8.5. Image Recording Modules
8.6. Access Instrumentation 

8.6.1. Veress Needle 
8.6.2. First Access Trocars 
8.6.3. Accessory Trocars 

8.7. Grasping Instruments

8.7.1. Types of Instruments 
8.7.2. Most Appropriate Uses for Each 

8.8. Cutting Instruments 
8.9. Electrosurgery 

8.9.1. Electrosurgery in Medicine 
8.9.2. Monopolar Energy 
8.9.3. Bipolar Energy 
8.9.4. Electrical Isolation of Instruments 
8.9.5. Precautions to Avoid Accidents 

8.10. Endoscopic Tissue Sealants 
8.11. Bags and Specimen Extraction 
8.12. Endodontics and Instrumentation for General Surgery 
8.13. Morcellators and Containment Systems 
8.14. Other Instruments: Aspiration, Suction, Retractors, Organ Suspension Systems, Port Closure Systems, Twist Drills, etc

Module 9. General Training in Minimally Invasive Surgery 

9.1. Introduction 
9.2. Training Programs. Learning Pyramid

9.2.1. Organ Bank and Artificial Phantoms 

9.3. Ergonomics in CL
9.4. Devices for CL Training Simulators

9.4.1. Justification 
9.4.2. Classification 
9.4.3. Requirements 

9.5. Live Experimental Models in Gynecologic Endoscopy

9.5.1. Animal Welfare 
9.5.2. Justification for Its Use 
9.5.3. Techniques Validated in Live Experimental Models 

Module 10. Laparoscopic Suturing Training

10.1. Introduction and Suture Use in Endoscopy 
10.2. Types of Needles 
10.3. Types of Sutures Used 

10.3.1. Conventional Sutures 
10.3.2. Vascular Suture 
10.3.3. Bearded Suture 
10.3.4. Automatic Suture Systems 

10.4. Specific Instruments 

10.4.1. Types of Needle Holders 
10.4.2. Low Knots 
10.4.3. LapraTy Applicator 
10.4.4. Others 

10.5. Technical Aspects 

10.5.1. Introducing the Needle into the Cavity 
10.5.2. Needle Placement in Holder 
10.5.3. Types of Sutures 
10.5.4. Intracorporeal Knotting 
10.5.5. Extracorporeal Knotting 
10.5.6. Single-Port Knotting 
10.5.7. Sutures and Special Types of Knots (Vascular, Intestinal) 
10.5.8. Suture Removal 

Module 11. Complications in Minimally Invasive Surgery

11.1. Access and Abdominal Wall Complications 

11.1.1. Arterial Wall Injury 
11.1.2. Vascular Lesions upon Entry 
11.1.3. Intestinal Lesions upon Entry 
11.1.4. Port-of-Entry Herniation 
11.1.5. Infections 
11.1.6. Others 

11.2. Intraoperative Vascular Complications 

11.2.1. Prevalence and Etiology 
11.2.2. Resolution 
11.2.3. Postoperative Aftercare 

11.3. Intraoperative Intestinal Complications 

11.3.1. Prevalence and Etiology 
11.3.2. Resolution 
11.3.3. Postoperative Aftercare 

11.4. Urologic Complications 

11.4.1. Prevalence and Etiology 
11.4.2. Resolution 
11.4.3. Postoperative Monitoring 

11.5. Nerve Complications
11.6. Inadvertent Complications 
11.7. Complications Specific to Radical Hysterectomy 
11.8. Complications Arising from the Meshes
11.9. Other Complications: Lymphoceles, Infections, PTE, etc

Module 12. Ultra-Minimally Invasive Surgery 

12.1. Introduction to Ultra-Minimally Invasive Surgery 
12.2. Single-Port Surgery 

12.2.1. Evidence in Gynecology for Its Use 
12.2.2. Specific Instruments 
12.2.3. Surgical Technique by Procedures 
12.2.4. Single-Glove 

12.3. Mini-Laparoscopic Surgery 

12.3.1. Evidence in Gynecology for Its Use 
12.3.2. Specific Instruments 
12.3.3. Surgical Technique by Procedures 

12.4. Surgery without Ports of Entry 

12.4.1. Evidence in Gynecology for Its Use 
12.4.2. Specific Instruments 
12.4.3. Surgical Technique by Procedures 

12.5. Other Ultra-Minimally Invasive Breakthroughs 
12.6. Comparison between the Different Techniques 

Module 13. Robotic Surgery in Gynecology 

13.1. Introduction and Advantages of Robotic Surgery
13.2. Different Types of Robotic Systems 

13.2.1. Da Vinci System 
13.2.2. Zeus System 
13.2.3. Amadeus-Titan System 
13.2.4. Others 

13.3. Instrumentation in Robotic Surgery
13.4. Docking and Setting Surgical Robots
13.5. Comparison between the Robotic Pathway and Other Pathways
13.6. Financial Factors and Robotic Efficiency
13.7. Complications in Robotic Surgery
13.8. Single-Port in Robotics
13.9. New Developments in Robotics 

Module 14. Biological Basis of Cancer

14.1. Cell Growth Regulation
14.2. Carcinogenesis and Carcinogens
14.3. Genetics of Cancer
14.4. Mechanisms of Apoptosis and Programmed Cell Death
14.5. Molecular Mechanisms of Cancer Production and Metastasis
14.6. Origin of Genetic Alterations
14.7. Epigenetic Changes and Oncogenes
14.8. Angiogenesis

Module 15. Principles of Chemotherapy Treatment, Adverse Effects, and New Therapies

15.1. Introduction
15.2. Justification for the Use of Chemotherapy
15.3. Development of Cancer and the Influence of Chemotherapy

15.3.1. Tumor Growth
15.3.2. Cellular Cycle
15.3.3. Specific Drugs for each of the Cellular Phases

15.4. Factors that Influence Treatment

15.4.1. Tumor Characteristics
15.4.2. Patient Tolerance
15.4.3. Treatment Objectives
15.4.4. Pharmacological Factors and Administration Routes

15.5. Principles of Resistance to Drugs
15.6. Combined Therapies
15.7. Treatment or Dosage Adjustments
15.8. Drug Toxicity
15.9. General Management of Secondary Effects and Complications of Chemotherapy
15.10. Antineoplastic Agents in Gynecology

15.10.1. Alkylating Agents
15.10.2. Antibiotics
15.10.3. Antimetabolites
15.10.4. Plant Alkaloids
15.10.5. Topoisomerase 1 Inhibitors
15.10.6. Anti-Angiogenic Drugs
15.10.7. PARP Inhibitors
15.10.8. Tyrosine Kinase Inhibitors
15.10.9. Other Drugs

15.11. Future Indications

Module 16. Endometrial Cancer I

16.1. Epidemiology and Etiopathogenesis
16.2. Precancerous Lesions
16.3. Hereditary Carcinoma
16.4. Pathological Anatomy and Different Types of Tumors
16.5. Diagnostic Process
16.6. Imaging Tests, Tumor Markers and Possible Screening
16.7. Molecular Diagnostic Tests
16.8. FIGO Classification and Others

Module 17. Endometrial Cancer II

17.1. Introduction
17.2. General Aspects of Surgical Treatment
17.3. Low Risk Tumors (Stage I, Grade 1)
17.4. High Risk Tumors (Grade 2-3, Serous or Clear Cells)
17.5. Laparotomy vs. Laparoscopy
17.6. Introduction of Robotic Surgery
17.7. Surgical Technique for High Risk Tumors
17.8. Adjuvant Treatment

17.8.1. Observation without Additional Treatment

17.8.1.1. Low Risk, Early Stage, Low Grade

17.8.2. Adjuvant Radiotherapy

17.8.2.1. Early Stage, Intermediate and High Risk
17.8.2.2. Advanced Stages

17.8.3. Adjuvant Chemotherapy
17.8.4. Peculiarities of Serous Tumors and Clear Cells

17.9. Hormonal Treatment
17.10. Recurrent Endometrial Cancer

17.10.1. Surgical Treatment
17.10.2. Radiotherapy
17.10.3. Chemotherapy

17.11. Follow-up Treatment of Endometrial Cancer
17.12. Prognosis

Module 18. Cervical Cancer I

18.1. Epidemiology and Etiopathogenesis of the Disease
18.2. Precancerous Lesions and the Evolutionary Process
18.3. Risk Factors for Contracting the Disease
18.4. Notions about Cervical Pathology and HPV
18.5. Normal Colposcopy and Vulvoscopy
18.6. Abnormal Colposcopy and Vulvoscopy
18.7. Cervical Cancer Screening
18.8. Hereditary Carcinoma
18.9. Forms of Presentation in Anatomic Pathology
18.10. Diagnostic Process: Imaging Tests and Tumor Markers
18.11. Role of New Technologies such as PET-CT
18.12. FIGO and TNM Classification in Cervical Carcinoma

Module 19. Cervical Cancer II

19.1. Treatment of Cervical Intraepithelial Neoplasia (CIN)

19.1.1. CIN Surgery
19.1.2. CIN Immunotherapy

19.2. Invasive Treatment of Cervical Cancer

19.2.1. Radical Hysterectomy with Nerve Preservation
19.2.2. Less Radical Hysterectomy
19.2.3. Radical Endoscopic Hysterectomy
19.2.4. Selective Sentinel Node Biopsy
19.2.5. Para-Aortic Advanced Stage Lymphadenectomy Staging

19.3. Radiotherapy and Chemotherapy

19.3.1. Concurrent Chemoradiotherapy
19.3.2. Enhanced Radiation Therapy Treatment Modalities
19.3.3. Chemotherapy Modalities in Concurrent Treatment
19.3.4. Preoperative Chemoradiotherapy
19.3.5. Adjuvant Therapy after a Radical Hysterectomy
19.3.6. Neoadjuvant Chemotherapy
19.3.7. Adjuvant Therapy after Neoadjuvant and Previous Surgery

19.4. Treatment of Metastasis, Recurrent or Persistent Disease

19.4.1. Surgical Treatment
19.4.2. Chemotherapy

19.5. Management of Cervical Adenocarcinoma

19.5.1. Adenocarcinoma In Situ (AIS)
19.5.2. Comparison Between Squamous Cell Carcinomas and Adenocarcinomas
19.5.3. Surgery vs. Radiotherapy in Invasive Adenocarcinoma
19.5.4. Chemotherapy

19.6. Monitoring

Module 20. Ovarian Cancer I

20.1. Epidemiology of Ovarian and Fallopian Tube Cancer
20.2. Etiopathogenesis and Tubal Origin, New Trends
20.3. Precancerous Lesions in the Fallopian Tubes
20.4. Ovarian Cancer Screening
20.5. Hereditary Carcinoma and How to Evaluate It
20.6. Histological Forms and Pathological Anatomy
20.7. Diagnostic Process

20.7.1. Clinical Features
20.7.2. Ultrasound
20.7.3. Computerized Tomography
20.7.4. Magnetic Resonance
20.7.5. Positron Emission Tomography

20.8. Serum Tumor Markers

20.8.1. CA125
20.8.2. HE4
20.8.3. CA 19-9 
20.8.4. CEA
20.8.5. Other Markers

20.9. FIGO Classification of the Disease

Module 21. Ovarian Cancer II

21.1. General Surgical Treatment
21.2. Complete Cytoreduction and Primary Debulking
21.3. Neoadjuvant Treatment and When to Choose It
21.4. Interval and Second Look Treatments
21.5. Adjuvant Therapy: Carboplatin-Taxol and Other Options
21.6. Radiotherapy: What Role Does it Play?
21.7. Hormonal Therapy Possibilities in Ovarian Cancer
21.8. Prognosis and Disease-Free Interval
21.9. Monitoring and Treatment of Relapses
21.10. Controversies in the Management of Ovarian Cancer
21.11. Peritoneal Carcinomas Hyperthermic Therapy
21.12. Intraperitoneal Chemotherapy, Indications and Results

Module 22. Vulvar Cancer I

22.1. Epidemiology and Relationship with HPV
22.2. Etiopathogenesis and Precancerous Lesions
22.3. VIN I, II, III VAIN and Other Lesions 22.4. Vulvar Cancer Screening
22.5. Hereditary Carcinoma
22.6. Pathological Anatomy, Histological Types
22.7. Imaging Tests and Extension Study
22.8. Tumor Markers: SCC

Module 23. Vulvar Cancer II

23.1. Introduction
23.2. Vulvar Paget’s Disease

23.2.1. General Overview
23.2.2. Paget’s Disease Type 1

23.2.2.1. Prevalence
23.2.2.2. Clinical Characteristics
23.2.2.3. Diagnosis
23.2.2.4. Treatment

23.2.3. Paget’s Disease Type 2 and 3

23.3. Invasive Paget’s Disease

23.3.1. General Overview
23.3.2. Prognosis

23.4. Invasive Vulva Carcinoma

23.4.1. Squamous Cell Carcinoma
23.4.2. Clinical Characteristics
23.4.3. Diagnosis
23.4.4. Dissemination Pathways
23.4.5. Staging
23.4.6. Treatment

23.4.6.1. Primary Lesion Management
23.4.6.2. Local Control after Primary Surgical Treatment
23.4.6.3. Management of Ganglionic Chains
23.4.6.4. Post-Operative Management

23.4.6.4.1. Early Postoperative Complications
23.4.6.4.2. Late Postoperative Complications

23.4.6.5. Use of Sentinel Lymph Node

23.4.6.5.1. Advanced Disease
23.4.6.5.2. General Overview
23.4.6.5.3. Management of Ganglionic Chains
23.4.6.5.4. Management of Primary Tumor

23.4.6.5.4.1. Surgery
23.4.6.5.4.2. Radiotherapy
23.4.6.5.4.3. Chemotherapy

23.4.6.6. Role of Radiotherapy in Vulvar Cancer

23.4.7. Recurrent Vulvar Cancer
23.4.8. Prognosis
23.4.9. Monitoring

23.5. Vulva Melanoma

23.5.1. Introduction
23.5.2. Clinical Characteristics
23.5.3. Pathology
23.5.4. Staging
23.5.5. Treatment

23.5.5.1. Primary Lesion Management
23.5.5.2. Management of Ganglionic Chains

23.5.6. Prognosis

23.6. Carcinoma of Bartholin’s Gland

23.6.1. General Overview
23.6.2. Treatment
23.6.3. Prognosis

23.7. Basal Cell Carcinoma
23.8. Verrucous Carcinoma
23.9. Vulva Sarcoma

23.9.1. Introduction
23.9.2. Leiomyosarcoma
23.9.3. Epithelioid Sarcoma
23.9.4. Rhabdomyosarcoma
23.9.5. Merkel Cells Carcinoma

Module 24. Uterine Sarcoma I

24.1. Introduction
24.2. Epidemiology

24.2.1. Incidence
24.2.2. Age
24.2.3. Histological Distribution
24.2.4. Racial Distribution

24.3. Risk Factors

24.3.1. Inheritance
24.3.2. Hormone Therapy
24.3.3. Radiation Exposure

24.4. Pathology

24.4.1. Leiomyosarcoma
24.4.2. STUMP
24.4.3. Benign Metastasizing Leiomyoma
24.4.4. Carcinosarcoma
24.4.5. Endometrial Stromal Neoplasms
24.4.6. Stromal Nodule
24.4.7. Endometrial Stromal Sarcoma
24.4.8. Mullerian Adenosarcoma

24.5. Clinical Manifestations
24.6. Imaging Tests

24.6.1. Magnetic Resonance 
24.6.2. Tumor Markers

24.7. FIGO Staging
24.8. Conclusions

Module 25. Uterine Sarcoma II

25.1. Introduction
25.2. Uterine Leiomyosarcoma

25.2.1. Early Stages

25.2.1.1. Surgery
25.2.1.2. Adjuvant Radiotherapy
25.2.1.3. Chemotherapy

25.2.2. Recurrent or Metastatic Disease

25.2.2.1. Surgery
25.2.2.2. Chemotherapy
25.2.2.3. Hormone Therapy

25.2.3. Prognostic Factors

25.3. Endometrial Stromal Sarcoma

25.3.1. Early Stages

25.3.1.1. Surgery
25.3.1.2. Pelvic Radiotherapy
25.3.1.3. Hormone Therapy

25.3.2. Recurrent or Metastatic Disease

25.3.2.1. Surgery
25.3.2.2. Chemotherapy or Radiotherapy

25.3.3. Prognostic Factors

25.4. Undifferentiated Endometrial Sarcoma

25.4.1. Early Stages

25.4.1.1. Surgery
25.4.1.2. Adjuvant Radiotherapy
25.4.1.3. Chemotherapy

25.4.2. Recurrent or Metastatic Disease

25.4.2.1. Surgery
25.4.2.2. Chemotherapy or Radiotherapy

25.4.3. Prognostic Factors

25.5. Conclusions

Module 26. Uncommon Gynecological Tumors

26.1. Vagina Cancer

26.1.1. Introduction
26.1.2. Clinical Manifestations
26.1.3. Diagnosis
26.1.4. Pathology

26.1.4.1. Squamous Carcinoma
26.1.4.2. Adenocarcinoma
26.1.4.3. Sarcoma
26.1.4.4. Melanoma

26.1.5. Tumor Staging
26.1.6. Treatment of Disease

26.1.6.1. Surgery
26.1.6.2. Radiotherapy
26.1.6.3. Treatment Complications

26.1.7. Monitoring
26.1.8. Prognosis

26.2. Gestational Trophoblastic Disease

26.2.1. Introduction and Epidemiology
26.2.2. Clinical Forms

26.2.2.1. Hydatidiform Mole

26.2.2.1.1. Complete Hydatidiform Mole
26.2.2.1.2. Partial Hydatidiform Mole

26.2.2.2. Gestational Trophoblastic Neoplasm

26.2.2.2.1. After Molar Pregnancy

26.2.2.2.1.1. Persistent Gestational Trophoblastic Neoplasm

26.2.2.2.2. After Non-Molar Pregnancy

26.2.2.2.2.1. Choriocarcinoma
26.2.2.2.2.2. Placental Site Trophoblastic Tumor

26.2.3. Diagnosis

26.2.3.1. Human Chorionic Gonadotropin
26.2.3.2. Ultrasound Study

26.2.3.2.1. Complete Mole
26.2.3.2.2. Partial Mole
26.2.3.2.3. Invasive Mole
26.2.3.2.4. Choriocarcinoma and Placental Site Tumor

26.2.3.3. Other Imaging Techniques

26.2.4. Pathology

26.2.4.1. Hydatidiform Mole

26.2.4.1.1. Complete Mole
26.2.4.1.2. Partial Mole

26.2.4.2. Invasive Mole
26.2.4.3. Choriocarcinoma
26.2.4.4. Placental Site Trophoblastic Tumor
26.2.4.5. Epithelioid Trophoblastic Tumor

26.2.5. Staging
26.2.6. Treatment

26.2.6.1. Chemotherapy

26.2.6.1.1. Low Risk Disease
26.2.6.1.2. High Risk Disease and Metastasis
26.2.6.1.3. Chemoresistant Disease

26.2.6.2. Surgery

26.2.6.2.1. Molar Evacuation
26.2.6.2.2. Hysterectomy
26.2.6.2.3. Myometrial Resection
26.2.6.2.4. Pulmonary Resection
26.2.6.2.5. Craniotomy
26.2.6.2.6. Other Surgical Procedures
26.2.6.2.7. Selective Arterial Embolization

26.2.7. Post-Treatment Monitoring

26.2.7.1. Monitoring after Molar Evacuation
26.2.7.2. Monitoring after Gestational Neoplasm Treatment

26.2.8. Prognosis

26.3. Metastatic Tumor in the Genital Tract

26.3.1. Introduction
26.3.2. Clinical Manifestations

26.3.2.1. Secondary Tumors in the Uterine Body or Cervix

26.3.2.1.1. From Genital or Pelvic Organs
26.3.2.1.2. From Extragenital or Pelvic Organs

26.3.2.2. Secondary Tumors in the Vagina
26.3.2.3. Secondary Tumors on the Vulva
26.3.2.4. Secondary Tumors in the Ovaries

26.3.3. Diagnosis
26.3.4. Pathology

26.3.4.1. Gastrointestinal Tumors

26.3.4.1.1. Metastasis of Intestinal Cancer
26.3.4.1.2. Krukenberg Tumor

26.3.4.2. Ovarian Lymphona

26.3.5. Treatment and Prognosis

26.4. Neuroendocrine Tumors

26.4.1. Introduction
26.4.2. Pathology

26.4.2.1. Well-Differentiated Tumors
26.4.2.2. Poorly-Differentiated Tumors

26.4.3. Clinical Manifestations and Diagnosis

26.4.3.1. Small Cell Tumor in the Vulva and Vagina
26.4.3.2. Small Cell Tumor in the Uterus
26.4.3.3. Neuroendocrine Tumors in the Cervix

26.4.3.3.1. Small Cell Neuroendocrine Carcinoma
26.4.3.3.2. Big Cell Neuroendocrine Carcinoma

26.4.3.4. Ovarian, Fallopian Tube and Wide Ligament Tumor

26.4.3.4.1. Ovarian Carcinoid

26.4.3.4.1.1. Insular Carcinoid
26.4.3.4.1.2. Trabecular Carcinoid
26.4.3.4.1.3. Mucinous Carcinoid
26.4.3.4.1.4. Strumal Carcinoid

26.4.3.4.2. Small Cell Lung Type
26.4.3.4.3. Undifferentiated Non-Small Cell Carcinoma

26.4.4. Treatment
26.4.5. Monitoring
26.4.6. Prognosis

26.5. Tumors of the Recto-Vaginal Septum

Module 27. Fertility Preservation

27.1. Indications of Fertility Preservation
27.2. Gametes Preservation
27.3. Role of Assisted Reproduction Techniques
27.4. Conservative Surgical Treatment
27.5. Oncological Prognosis after Fertility Conservation
27.6. Reproductive Results
27.7. Dealing with Pregnant Women with Gynecologic Cancer
27.8. New Research Paths and Literature Updates
27.9. Conservation of Ovarian Tissue
27.10. Uterine and Gonadal Tissue Transplantation

Module 28. Endoscopic Surgery in Gynecologic Oncology

28.1. Oncologic Laparoscopy

28.1.1. Effect of Pneumoperitoneum and Dissemination
28.1.2. Port-Site Metastasis
28.1.3. Uterine Manipulator and Dissemination

28.2. Tumor Dissemination Routes

28.2.1. Peritoneal Dissemination
28.2.2. Lymphatic Dissemination
28.2.3. Hematogenous Dissemination

28.3. Nodal Selective Study

28.3.1. Sentinel Lymph Node in Ovarian Cancer
28.3.2. Sentinel Lymph Node in Cervical Cancer
28.3.3. Sentinel Lymph Node in Endometrial Cancer
28.3.4. Types of Tracers
28.3.5. Sentinel Lymph Node Detection and Dissection Technique

28.4. Laparoscopy and Ovarian Cancer

28.4.1. Exploratory Laparoscopy in Ovarian Cancer

28.4.1.1. Suspicious Adnexal Masses
28.4.1.2. Advanced Ovarian Cancer. Laparoscopic Scores

28.4.2. Borderline Tumor Management

28.4.2.1. Laparoscopic Staging
28.4.2.2. Surgical Re-Staging

28.4.3. Staging Procedures

28.4.3.1. Abdominal Peritonectomy
28.4.3.2. Pelvic Lymphadenectomy
28.4.3.3. Para-Aortic Lymphadenectomy

28.4.3.3.1. Extraperitoneal
28.4.3.3.2. Transperitoneal

28.4.3.4. Laparoscopic Omentectomy
28.4.3.5. Other Procedures

28.4.4. Laparoscopy in Ovarian Cancer Recurrences
28.4.5. Laparoscopy in Interval Surgery

28.5. Laparoscopy in Cervical Cancer

28.5.1. Laparoscopy Indications
28.5.2. Laparoscopic Radical Hysterectomy

28.5.2.1. Radical Hysterectomy Classification
28.5.2.2. Nerve Preservation
28.5.2.3. Radicality Modulation
28.5.2.4. Detailed Surgical Technique

28.5.3. Special Characteristics of Radical Trachelectomy

28.5.3.1. Indications
28.5.3.2. Uterine Artery Preservation
28.5.3.3. Cervical Cerclage
28.5.3.4. Ovarian Oophoropexy

28.5.4. Laparoscopic Parametrectomy
28.5.5. Laparoscopic Treatment of Recurrences

28.5.5.1. Single Recurrences
28.5.5.2. Laparoscopic Exenteration

28.6. Laparoscopy in Endometrial Cancer

28.6.1. Laparoscopy and Staging in Endometrial Cancer
28.6.2. Laparoscopic Lymph Nodal Debulking
28.6.3. Other Particularities

Module 29. Laparoscopy and its Impact on Fertility

29.1. Utility of Laparoscopy in Reproduction
29.2. Restoration of Fertility

29.2.1. Essure Device Removal by Laparoscopy
29.2.2. Tubal Recanalization

29.3. Adhesive Syndrome and Laparoscopy
29.4. Chromopertubation Use
29.5. Laparoscopic Surgery and Pregnancy

Module 30. Introduction. Anatomy. Physiology. Cellular Cycle

30.1. Introduction to the Concepts of Assisted Reproduction. Epidemiology Reproductive Problems
30.2. Concepts of Reproductive Medicine
30.3. Epidemiology
30.4. Female Anatomy and Physiology
30.5. Ovogenesis
30.6. Ovarian Cycle Follicular Recruitment Waves
30.7. Male Anatomy and Physiology
30.8. Spermatogenesis
30.9. Gametogenesis. Meiotic Cycle
30.10. Ovogenesis. Ovogenesis-Foliculogenesis Relationship
30.11. Oocyte Quality Markers
30.12. Factors Affecting Oocyte Quality
30.13. Spermatogenesis and Sperm Production
30.14. Semen Quality Markers
30.15. Factors which Affect Seminal Quality

Module 31. Gamete Interaction. Fertilization. Embryonic Development

31.1. Interaction of Gametes in the Female Tract
31.2. Acrosomal Reaction and Hyperactivation
31.3. Sperm-Oocyte Interaction
31.4. Sperm-Oocyte Fusion. Oocyte Activation
31.5. Embryonic Development
31.6. Main Features in Pre-implantational Development
31.7. Implantation. Embryo-Endometrium Interaction
31.8. Pathology of Fertilization and Embryo Classification
31.9. Embryo Culturing. In Vitro Embryo Culture Systems. Culture Media, Environmental Conditions, and Supplements. One-Step and Sequential Cultures Renewal of Culture Media and Needs of the Embryo
31.10. In Vitro Embryonic Development Evaluation: Morphology and Morphokinetics Classical Embryonic Morphology. Time-Lapse Systems. Embryonic Morphokinetics. Embryonic Classification

Module 32. Study of the Female Factor. Role of Surgery in Reproduction

32.1. Ovarian Reserve Study
32.2. AMH (Anti-Müllerian Hormone)
32.3. RFA (Radiofrequency Ablation)
32.4. Tubal Permeability Assessment Techniques
32.5. Hysterosalpingography
32.6. Hysterosalpingosonography
32.7. Endometrial Assessment
32.8. The Role of Hysteroscopy
32.9.  Endometrial Scratching
32.10. Endometrial Culture. Microbiota
32.11. Window of Implantation Study
32.12. Immunological Factor Study
32.13. Polycystic Ovary Syndrome (PCOS). Ovarian Drilling
32.14. Endometriosis and Adenomyosis
32.15. Uterine Myomas and Fertility
32.16. Hydrosalpinx Tubal Surgery in Tubal Reconstruction Techniques and Fertility Restoration
32.17. Uterine Alterations. Metroplasties. Septoplasties
32.18. Uterine Transplant
32.19. Repeated Miscarriages. Implantation Failure

Module 33. Andrology Laboratory 

33.1. Basic Analysis of Semen. WHO 2010 Criteria
33.2. Sperm Mobility and Morphometry Analysis Using Automated Systems (CASA/CASMA)
33.3. Analysis of Sperm DNA: TUNEL, SCD, COMET, SCSA. Relationship with Fertility
33.4. Oxidative Damage Assessment. Determination of Antioxidants, Free Radicals and Evaluation of Lipid Peroxidation
33.5. Sperm Function by Molecular Markers: Apoptosis (AnnexinV, Caspases, Mb Permeability), Ubiquitination, Protein Phosphorylation
33.6. Epigenetic Alterations in Spermatozoa
33.7. Selection and Control of Semen Donors
33.8. Managing a Sperm Bank
33.9. Cleaning the Sperm in Patients with HIV or Hepatitis
33.10. Semen Preparation for Artificial Insemination

Module 34. Reproductive Treatments. Medication. Stimulation Protocols 

34.1. Evolution of Reproductive Treatments Throughout History
34.2. Drugs Involved in Ovarian Stimulation. Ovulation Induction
34.3. Artificial Insemination. Techniques. Results
34.4. Fertilization In Vitro. Ovarian Stimulation Protocols in High, Normal and Low Responders Luteal Phase Stimulation
34.5. Adjuvant Treatments Used in Low Ovarian Reserve
34.6. Fertilization In Vitro. Cycle Tracking. Ovarian Puncture. Embryo Transfer
34.7. Embryo Cryotransfer. Endometrial Preparation in Substituted Cycles
34.8. Egg Donation. Embryoreception Surrogacy
34.9. Complications in Assisted Reproduction Treatments
34.10. Multiple Pregnancy Reduction Policy

Module 35. Micromanipulation Techniques

35.1. IVF-ICSI
35.2. Use of Polarized Light Microscopy in Oocytes
35.3. Embryo Biopsy. Types of Biopsy. Corpuscule, Blastomere, Trophoectoderm
35.4. Collapse, Hatching, Fragment Aspiration
35.5. Improve the Embryo Quality. Transfer of Nucleus and Cytoplasm
35.6. Cloning in Mammals. Background. Basic Principles of Cloning Applications in Medicine
35.7. Problems with Cloning. Epigenesis Reprogramming 
35.8. Genetic Modification. CRISPR
35.9. Improve the Cytoplasmic Quality of the Oocyte
35.10. In Vitro Gamete Production

Module 36. Gamete and Embryo Cryopreservation

36.1. Cryobiology. Cryobiological Principles and Cryoprotective Agents. Cryopreservation Systems. Factors Affecting the Freezing Process Application of Cryobiology
36.2. The Sperm Cell Structure and Functionality. Physicochemical Processes that Induce Freezing in the Spermatozoon. Factors Determining Sperm Fertilization and Viability after Thawing
36.3. Cryopreservation of Semen. Features. 
36.4. The Oocyte Characteristics and Conditioning Factors in Cryopreservation Importance and Method of Selection. 
36.5. Cryopreservation in Human Embryos Importance and Method of Selection
36.6. Cryopreservation of Ovarian Tissue Laboratory Technique
36.7. Factors Affecting Performance in a Cryopreservation Program
36.8. How to Manage and Organize a Biobank and its Safety

Module 37. Fertility Preservation

37.1. Fertility Preservation. Cancer Epidemiology. Age and Reproduction
37.2. Fertility Preservation for Non-Medical Reasons
37.3. Fertility Preservation for Oncologic Reasons
37.4. Fertility Preservation for Non-Oncologic Medical Reasons
37.5. Oocyte Vitrification. Technique and Results
37.6. Ovarian Cortex Cryopreservation
37.7. Cryopreservation of Semen
37.8. Vitro Maturation of Oocytes
37.9. Other Methods of Fertility Preservation: Conservation Surgery in Gynecologic Cancer. Ovarian Transposition
37.10. Treatment with GnRH Analogues Prior to Gonadotoxic Treatments

Module 38. Genetics in Reproduction

38.1. Important Concepts in the Genetics of Reproduction
38.2. Epigenetics. Influence on Reproduction
38.3. Genetic Diagnostic Techniques
38.4. Genetic Anomalies Related to Male and Female Sterility
38.5. Indications for Genetic Studies in Assisted Reproduction
38.6. Screening for Recessive Diseases. Genetic Matching
38.7. Pre-implantational Genetic Diagnosis in Monogenic Diseases
38.8. Pre-implantational Genetic Screening in Assisted Reproduction Techniques
38.9. Mosaicisms
38.10. Genetic Counseling and Advice

Module 39. Quality. Research and Future Techniques

39.1. Importance of Traceability in the Laboratory. Electronic Traceability Systems
39.2. Research in Assisted Reproduction
39.3. Future of Reproduction. Automation
39.4. Non-Invasive Preimplantational Genetic Diagnosis
39.5. Artificial Intelligence
39.6. Ovarian Rejuvenation 

Develop your career in a highly sought-after specialty, opening new opportunities in both clinical practice and research”