When I embarked on my career as a fertility specialist, I decided early on that I wanted to attain the highest level of specialist qualification possible in the area of Reproductive Endocrinology and Infertility, the CREI (Certification in Reproductive Endocrinology and Infertility).
Despite its importance, the relevance of choosing a CREI subspecialist to manage complex infertility is still poorly understood by both patients and by many GPs. It is often assumed that all gynaecologists working in the area of infertility and IVF are subspecialists when actually this is far from the case. “Do you hold the CREI and if not, what is your experience?” is a question that patients should be asking their fertility specialist.
Decoding letters after my doctor’s name – what do they mean?
All Australian gynaecologists hold a FRANZCOG (Fellowship of the Royal Australian and New Zealand College of Obstetrics and Gynaecology) or overseas equivalent. Many doctors working in the area of infertility also hold a Masters degree in reproductive medicine (MMed). You do not have to be a gynaecologist or actually even a doctor to hold this degree. It can be and is held by interested nurses, naturopaths, scientists and many others. Personally, I graduated from my Masters Degree in Reproductive Medicine and Human Genetics from the University of Sydney in 2008 when I was a first year O&G trainee. It was an excellent start to a much longer journey to become a qualified fertility subspecialist.
The only doctors who RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists) recognise as accredited to hold the title of Reproductive Endocrinologist and Infertility Subspecialists are those that hold both the FRANZCOG and the CREI. Unfortunately online, some doctors refer to themselves as “reproductive endocrinologists” who do not hold these qualifications, which some might consider a dishonest practice. It is important to ask.
So what is the CREI?
If a doctor has completed the CREI, this means that they are a qualified specialist gynaecologist, who has later formally sub-specialised and holds the RANZCOG advanced Certificate in Reproductive Endocrinology and Infertility (CREI). Acceptance to the CREI subspecialty training program is highly competitive.
Possession of the Certificate in Reproductive Endocrinology and Infertility (CREI) qualification demonstrates that your specialist is fully trained to provide the highest level of expertise to patients with reproductive endocrine and male as well as female infertility disorders, including management of the most complicated circumstances. It means they have completed an extensive logbook of IVF cycle management, menopause therapy, male and female microsurgical procedures and advanced laparoscopic surgery that has been formally assessed in a tertiary accredited training centre.
To obtain certification requires 3 years of advanced fellowship training. A doctor must have worked clinically in at least two IVF units and have published substantial research in an area that is highly relevant to fertility and reproductive endocrinology.
CREI is awarded after rigorous written and clinical subspecialist examinations have been passed. It is a hard journey, especially for women, but the reward at the end is that you come out a far better doctor, which translates to better patient outcomes.