Paul Magarelli

Goals and Outlines

Objectives

• Update your understanding of key aspects of western reproductive medicine for the CAM practitioner
• Review and understand current controversies and challenges of our newer understanding and evolving technologies
• Review our now “mature” data on TCM interactions with IVF protocols and care as well as create awareness of new challenges for the CAM community for further integration
• Develop a how to guide for presenting Chinese & naturopathic medicines impact on infertility care treatments for the Western Mind
• To be used as an ABORM exam prep course

Outline
 

• Biology of Reproduction
• Infertility 101
  • Male Factor
  • Female Factor
  • Couple Factor
• • Ask First, then Treat – benefits of testing and its pitfalls o Sperm Testing
  • Egg testing
  • Uterus testing
  • Fallopian Tube Testing
  • Testing for PCOS
  • Testing for Recurrent Pregnancy Loss
• • Dis-Eases
  • Endometriosis
  • PCOS
  • Fibroids
  • Recurrent Pregnancy Loss
  • Advanced Maternal Age
  • Advanced Paternal Age
  • Cancer
  • Amenorrhea
  • Thyroid Dysfunction
  • Human Sexuality
  • Transgender (not disease)
• • TCM and Western Medicine – Facts and Future
  • Raw data to Meta Data
  • Future Shock
• • Nutrition, Fertility and Human Reproductive Function
• • ART is it art or ART?
  • Embryoscope
  • Immunotherapy
  • Freeze All
  • Mitochondrial therapy
  • Three parent gametes
  • SART/CDC – reality or fiction
  • End of “mom and Pop” IVF centers what does that mean to access
  • High Quality Affordable Fertility Care… what it is and why ABORM should support it (self-serving… maybe) or the “right way to go” the Amazon model of care.

- Evolution of Insulin Resistance (IR): an integrated medical model to manage Insulin Dysregulation

Evolution of Insulin Resistance: What counts is Context not Calories

Why we spell Diet…DIE with a T!

Teens and Insulin Resistance

Lipids and You: The “DYS” in Insulin Dysregulation is Dyslipidemias!

Herbs, PCOS, & Obesity

- Creating a Modular IR program within your acupuncture practice

Food & Cooking for Insulin Resistance

Managing Skin and Hair for Insulin Resistant Patients

Cost of Obesity

Libido and IR: Health = Happy, Hungry, Horny!

Nutraceutical: Role, Function, and Optimization

Integration of a Sustained Health™ program in your clinical practice

This module is designed to give the participants the tools necessary to differentiate normal and abnormal sexual development.

1.       Normal Sexual Differentiation
2.       Abnormal Sexual Differentiation
3.       Masculinized Females

• Incompletely Masculinized Males
• Abnormal Androgen Synthesis
• Disorders of Gonadal Development
• True Hermaphroditism
• Gonadal Dysgenesis
• Noonan Syndrome
• Diagnosis of Ambiguous Genitalia
• Describe the hormonal changes relative to the reproductive cycle
• Define the concepts of gonadostat, adrenarche, premature adrenarche, premature thelarche
• Describe the normal sequence of age of onset of female pubertal milestones
• Detail the differential diagnosis and workup and treatment of disorders producing precocious puberty
• Detail the Differential Diagnosis of delayed puberty

Module 2 - Western Reproductive Endocrinology - Amenorrhea and Anovulation and PCOS (Unedited version)

To acquire knowledge pertaining to the concepts related to differential diagnosis of amenorrhea of all types utilizing procedures available to all clinicians. This module will also include the problems of galactorrhea and pituitary adenomas, exercise and amenorrhea.

To acquire knowledge pertaining to the concepts related to how loss of ovulation can occur and the clinical expressions of anovulation.  This module will also include the polycystic ovary and hyperinsulinemia.

Module 2 Outline:

• Definition of Amenorrhea 
• Basic Principles in Menstrual Function 
• Evaluation of Amenorrhea 
• High Gonadotropins 
• Low Gonadotropins 
• Hypogonadotropic Hypogonadism 
• Specific Disorders within Compartments 
• ->Compartment I: Disorders of the Outflow Tract or Uterus
• ->Compartment II: Disorders of the Ovary
• ->Compartment III: Disorders of the Anterior Pituitary
• Pathogenesis of Anovulation 
• The Polycystic Ovary 
• Insulin Resistance, Hyperinsulinemia, and Hyperandrogenism 
• The Clinical Consequences of Persistent Anovulation 

Module 3 - Western Reproductive Endocrinology - Female and Male Infertility‏

To acquire knowledge pertaining to the concepts related to an approach to the problem of infertility in females and males

Module 3 Outline:

• The Epidemiology of Infertility in the U.S. 
• Aging and Female Fertility 
• Guiding Principles in the Evaluation of Infertility 
• The Female Infertility Evaluation 
• Male Factor: Abnormalities of Semen Quality 
• Ovarian Factors: Ovulatory Dysfunction 
• Cervical Factor: Abnormalities of Sperm-Mucus Interaction 
• Uterine Factor: Anatomic and Functional Abnormalities
• Tubal Factors: Tubal Occlusion and Adnexal Adhesions
• Unexplained Infertility 
• Adoption 
•  Explain the basic anatomy and physiology of the male reproductive system 
• Describe the components of a semen analysis and the possible reason each parameter is abnormal 
• Detail the methods and principles of the sperm penetration assay (SPA) and the immunobead assay 
• Discuss the arguments in favor and against varicocele repair 
• Understand the possible benefits and side effects associated with gonadotropin superovulation and IUI 

Module 4 - Western Reproductive Endocrinology - Recurrent Early Pregnancy Loss and Endometriosis‏

To acquire knowledge pertaining to the concepts related to the evaluation and management of recurring spontaneous losses in early pregnancy. To acquire knowledge pertaining to the concepts related to diagnosis and suitable treatment for the individual patient.

Module 4 Outline:

• The Epidemiology of Pregnancy Loss 
• Genetic Factors 
• Anatomic factors 
• Immunologic Factors 
• Inherited Thrombophilia's 
• Endocrine Factors 
• Infectious Causes 
• Environmental Factors 
• Unexplained Recurrent Pregnancy Loss 
• Summary of Evaluation and Treatment for Recurrent
• Pregnancy Loss 
• The Pathogenesis of Endometriosis 
• Epidemiology of Endometriosis 
• Diagnosis of Endometriosis 
• Medical Treatment 
• Surgical Treatment 
• Prevention of Infertility