Acupuncture for IVF and Assisted Reproduction

An integrated approach to treatment and management

1st Edition - September 18, 2014
Authors: Irina Szmelskyj, Lianne Aquilina
Editor: Alan Szmelskyj
Language: English
Hardback ISBN:
9 7 8 - 0 - 7 0 2 0 - 5 0 1 0 - 7
eBook ISBN:
9 7 8 - 0 - 7 0 2 0 - 6 1 1 8 - 9

The management of infertility using acupuncture is an expanding area of practice and one which is frequently rewarding for TCM acupuncture practitioners. Acupuncture for IVF and A… Read more

Acupuncture for IVF and Assisted Reproduction

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The management of infertility using acupuncture is an expanding area of practice and one which is frequently rewarding for TCM acupuncture practitioners.

Acupuncture for IVF and Assisted Reproduction has been specially prepared to meet the growing demand for information in this area and draws upon 20 years combined experience of the authors together with the latest evidence from both orthodox medicine and TCM.

Richly illustrated and clearly written throughout, the book takes the reader through the anatomy and physiology of reproductive medicine (from both an orthodox and TCM perspective) and explains the underlying basis of orthodox medical fertility tests and investigations. The volume then explores the pathology and aetiology of TCM syndromes and shows how common fertility-related conditions, such as endometriosis and male factor infertility, affect Assisted Reproductive Technology (ART) success rates. It explains in great detail how to take a reproductive medical history and successfully diagnose TCM syndromes. Acupuncture for IVF and Assisted Reproduction also provides guidelines on how to regulate the menstrual cycle in preparation for IVF treatment and shows how lifestyle can affect fertility and ART success rates.

Placing a strong emphasis on the practical aspects of patient care, Acupuncture for IVF and Assisted Reproduction contains an abundance of case history templates, algorithmic acupuncture treatment pathways and patient fact sheets and will be ideal for all acupuncture practitioners working in this field.

"A must have for the bookshelf of any acupuncturist who is ever called upon to treat fertility issues - if you have room for one book this surely must be it." Reviewed by The Acupuncture Fertility Centre March 2015

"Practitioners of all levels of experience and TCM students should find it compelling reading and an invaluable companion to their learning." Reviewed by Stephen Clarke, Journal of the Australian Traditional Medicine Society May 2015

"This book is extremely well re-searched and referenced." Reviewed by Danny Maxwell on behalf of Journal of Chinese Medicine, February 2015

1. Subfertility overview

Introduction / Definition of infertility disorder / Prevalence of infertility / Major causes of subfertility from an Orthodox Medical point of view / Contributory subfertility factors: the Orthodox medical perspective / Causes of subfertility from TCM point of view / Reproductive history and development from an Orthodox Medical perspective / Reproductive history and development from a TCM perspective

2. Anatomy and physiology of the reproductive system: pre-requirements for conception

Functional anatomy of the reproductive system from an Orthodox medical perspective / Sperm and egg production / Reproductive physiology from an Orthodox medical perspective / Reproductive physiology from a TCM perspective

3. The magic of conception

Sexual intercourse / Sperm transportation up the female reproductive tract / Pre-fertilization sperm changes / Egg maturation and ovulation / Egg fertilization / Transportation of embryo down the female reproductive tract / Comparison of natural fertilization (in vivo) with ART fertilization (in vitro) / Embryogenesis / Implantation: the first communication between the mother and her embryo / Conception from TCM point of view

4. Orthodox medical tests and investigations: optimising patient care

The initial consultation / Tests and investigations overview / Tests and investigations- female / Tests and investigations- male

5. Investigations from a TCM Perspective

Medical and fertility history taking / Clinical observations / TCM syndromes diagnosis in subfertile patients / Basal Body Temperature (BBT) charting as a diagnostic aid

6. The fundamentals of ART

Introduction / Types of ART treatment / Pharmacological drugs used in ART / Embryo grading / Advanced ART techniques / The role of acupuncture in ART / Future advances in ART: a potential role for acupuncture?

7. Pre-conception care in preparation for ART

Weight / Smoking / Alcohol / Caffeine / Recreational Drugs / Medication / Environmental and occupational factors / Nutrition and supplementation / Exercise and rest / Stress / Relationship and sexual issues

8. Identification and management of conditions detrimental to IVF outcome

Tubal pathology / Ovulatory disorders / PCOS / Thyroid disease / Endometriosis / Unexplained subfertility / Secondary subfertility / Male factor subfertility / Regulating the menstrual cycle with acupuncture / Treatment planning: setting realistic goals

9. Acupuncture during ART

Treatment during IVF / Adapting treatment principles to natural IVF / Adapting treatment principles to mild IVF / Adapting treatment principles to Frozen Embryo Transfer (FET) / Adapting treatment principles to ovulation induction / Adapting treatment principles to IUI / Adapting treatment principles to egg donor IVF / Adapting treatment principles to surrogacy and gestational carrier / Adapting treatment principles to ZIFT/GIFT / Adapting treatment principles to IVM

10. Clinical issues during ART

Poor follicular development / Immature or no eggs / Suboptimal endometrial lining / No sperm / Fertilization failure / Poor embryo growth or growth arrest / Difficult embryo transfer

11. ART complications

Ovarian Hyper Stimulation Syndrome (OHSS) / Multiple gestation

12. Managing the patient with a complex medical history

Repeated Implantation Failure (RIF) / Miscarriages and pregnancy loss / Reproductive immunology / Reproductive immunology from TCM point of view / Implications for acupuncturists: to refer or not to refer?

13. The therapeutic relationship in acupuncture practice

Mutuality / Trust / Care / Challenge and performance / Return to mutuality / Measuring the success of acupuncture treatment / The effect of subfertility on patients / Legal and ethical considerations

14. Aftercare

Negative outcome / Positive outcome: healthy transition from subfertility to pregnancy / Acupuncturist’s self-care: saying goodbye to patients

Appendices

1. Templates

2. Basal body temperature (BBT) chart template and instructions

3. Investigation reference ranges at a glance

4. Fertility factsheets

5. Commonly used medications in ART

6. Medications known to adversely affect fertility

Glossary of Orthodox Medical Terms

Glossary of Traditional Chinese Medicine (TCM) Terms

Irina Szmelskyj

Irina Szmelskyj is an acupuncturist with more than 10 years’ experience specializing in reproductive health care, including the health care needs of patients with infertility issues and the use of acupuncture in the clinical management of patients undergoing assisted reproductive treatments such as IVF. Irina’s method of managing subfertile patients is based on a thorough understanding of the value of combining the best of Traditional Chinese Medicine (TCM) and conventional medicine. Her approach emphasizes the clinical utility of integrating both classically based traditional acupuncture treatment techniques and concepts with the practical clinical application of contemporary evidence-based advances from the rapidly changing landscape of reproductive medicine research. Irina practises acupuncture at True Health Clinics in Godmanchester, Cambridgeshire, United Kingdom.

Affiliations and expertise

Lead Clinician, True Health Clinics and Founder of The Fertility Foundation, Godmanchester, Huntingdon; Lecturer and MSc Supervisor, Northern College of Acupuncture, York; Guest Lecturer, University of Lincoln, Lincoln, UK

Lianne Aquilina

Lianne Aquilina is a traditional Chinese medical acupuncturist. In 2005 the Faculty of Health, Life and Social Sciences of the University of Lincoln, awarded her the Dean's prize for Studies in Health. She is an experienced BSc (Hons) acupuncture clinical supervisor. Her role includes teaching third year acupuncture students the application of classical and traditional Chinese medicine principles along with the clinical utility of Chinese acupuncture. She is also a visiting guest lecturer to undergraduate students on the use of Chinese medicine and acupuncture treatment in the management of infertility and In Vitro Fertilization (IVF). She completed further training at the Guangdong Province Second Hospital of TCM in China. It was here where she observed an authentic combination of traditional Chinese and medical strategies in treatment and management of disease. Lianne's specializes in providing fertility acupuncture treatment, based on innovative applied classical Chinese philosophy and Traditional Chinese Medicine (TCM) concepts of reproductive health and fertility. Lianne practices acupuncture at Aquilia Fertility in Stamford, Lincolnshire, United Kingdom.