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Acupuncture for IVF and assisted reproduction. An integrated approach to treatment and management
  1. David Frederick Mayor
  1. Correspondence to David Frederick Mayor, 86 Handside Lane, Welwyn Garden City, Herts AL8 6SJ, UK; davidmayor{at}

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Irina Szmelskyj and Lianne Aquilina. Published by Churchill Livingstone (Elsevier), Edinburgh, 2015. 429+xviii pp. £44.99 (hardback). ISBN: 9780702050107.

Embedded ImageThis is an immensely ambitious and impressive book, packed with essential information for all those who see patients with subfertility issues. Assisted reproductive technology (ART)—and in vitro fertilisation (IVF) in particular—are rapidly developing fields, and acupuncture has gained a deserved reputation of being a useful adjunctive therapy for those using these methods. Indeed, many acupuncturists now specialise in this area, both outside and within the NHS. This book will provide a resource both for them and for other professionals who want to find out what acupuncturists do and how they do it.

Other books on the topic, directed more specifically at those who use a traditional Chinese medicine (TCM) approach (including herbs) in their practice are Lifang Liang's Acupuncture and IVF (Blue Poppy Press, 2003) and another Elsevier blockbuster, Jane Lyttleton's Treatment of Infertility with Chinese Medicine (2004; 2nd edition 2013). A less technical approach, more for the neonate professional or the non-academically inclined reader interested in the subject, is Nick Dalton-Brewer's Increasing IVF Success with Acupuncture: An Integrated Approach (Singing Dragon, 2014). Only Irina Szmelskyj and Lianne Aquilina, however, really do justice to the complexities involved in integrating acupuncture with IVF and ART.

For this reason, their book is not for the casual reader. Encyclopaedic in scope, and with hundreds of references provided, it is heavy going to read from cover to cover, but will be an important asset when treating patients who have to deal with the challenges of subfertility (whether physiological, intellectual, emotional or even spiritual). After a somewhat dry historical Foreword by TCM doyen Giovanni Maciocia, the authors provide chapters integrating Western medical (WM) and TCM overviews of subfertility, reproductive anatomy and physiology, and the magic of conception, followed by separate coverage of WM and TCM investigations that may be encountered. ART and preconception care in preparation for ART come next, followed by chapters on identifying and treating conditions detrimental to IVF, acupuncture during ART, clinical issues and complications that arise during ART, managing the patient with a complex medical history, and finally the ‘softer’ (and more thoughtful) stuff—the therapeutic relationship and aftercare. Six hefty appendices (record templates, basal body temperature data, investigation reference ranges, patient factsheets, medications used in ART and those that may adversely affect fertility) and two glossaries (WM and TCM) precede the final index.

One particular problem I had (particularly as an older reader with ever-shortening retention time) is the plethora of technical terms, acronyms and abbreviations used on every page (sometimes ahead of their definitions). For me, the glossaries are quite inadequate in this respect, and although some of the abbreviations are included in the index, a separate list of them would have been appreciated. Less irritating, although surprising, is that the only mention of electroacupuncture in the index is in connection with polycystic ovary syndrome—although it does appear in several other contexts in the book as well (as used in the ovarian stimulation phase, for improving utero-ovarian blood flow, before/during egg retrieval and in modulating immune function). I also wonder at the classification of canola oil as ‘mineral’ in origin.

Such quibbles apart, I think this is an important book—a milestone in the integration of acupuncture and WM approaches to subfertility. It demonstrates the seriousness of those from a TCM background, as well as the need for those who venture into this field to fully acquaint themselves with the technicalities involved. It is not enough to look up a few old studies on Medline and think that this provides sufficient evidence for adequate practice. Real life is much more subtle and involved than that, and undertaking specialist training in acupuncture for IVF and ART is advisable. However, even without it, the results of using acupuncture in this population can sometimes be very satisfying. You do not have to be a TCM expert to read this book or to get out of it what you need. In addition to in-depth background information, clear treatment protocols are provided for most eventualities. For these alone, this is a worthwhile purchase for the medical acupuncturist.

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  • Provenance and peer review Not commissioned; internally peer reviewed.

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