Recurrent Miscarriages (RM) & Implantation Failure (IF) have remained an enigma to clinicians and researchers. Even after ruling out all possible causative factors, 50-60% cases still remain “Unexplained’. A majority of these so called “Unexplained” cases are now found to have immunological basis.This book is going into the Immunological aspects of these clinical dilemmas, demystifying the role of Immunology and Immunotherapy in RM and IF. The authors have been working in the field of Reproductive Immunology and Immunotherapy for the last 25 years and they have come out with this book combining the international studies with their own experience. The purpose of writing this book is to provide a comprehensive treatise about Immunotherapy, so that it can become an acceptable modality of treatment in cases where it is needed and is effective.The book discusses the basics in Reproductive Immunology. The immunological changes occurring during pregnancy, the role of Cell mediated Immunity (T cells), Humoral Immunity including cytokines is explained. The normal immunological mechanisms protecting the embryo are highlighted and how these mechanisms are disturbed leading to RM and IF, is also explained.The first and the most discussed method of Immunotherapy is Lymphocyte Immunization Therapy (LIT). The book has given a complete overview of LIT, describing how it created euphoria when it was first introduced, how it gradually went into disrepute and how it is now making a comeback. As the authors have personal experience of LIT, the book gives a detailed and complete information about this active form of immunotherapy.The book has a special section on case studies where the authors have given some clinical case reports (including some of their own), who were treated for immunological factor in RM/IF and were treated with Immunotherapy. These cases can be a useful guide to the readers.The book will be useful not only for undergraduate and postgraduate students but also for clinicians in their practice and for researchers for review of developments in the field.

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 Simplifies complex information into easily accessible and understandable material Explains reproductive anatomy and physiology from the perspectives of both orthodox medicine and TCM Explains the underlying basis of orthodox medical fertility tests and investigations Explores the pathology and aetiology of TCM syndromes Provides detailed information on how to take a fertility medical history and how to diagnose TCM syndromes Presents the evidence for the influence of various lifestyle factors on fertility and ART success rates Provides guidelines on how to regulate the menstrual cycle in preparation for IVF treatment Explains how common fertility-related conditions such as endometriosis, Polycystic Ovary Syndrome, thyroid disease, and male factor infertility affect ART success rates Explains how to adapt acupuncture treatment to different ART protocols Provides case history templates, algorithmic acupuncture treatment pathways and patient fact sheets Explains how to manage patients with complex medical histories Looks at Repeated Implantation Failure, reproductive immunology dysfunction, and recurrent miscarriages Explains how to support patients if their IVF is unsuccessful and how to treat patients during early pregnancy Examines ethical considerations relevant to fertility acupuncture practice

Since a September, 1992, Nature article which read: “Can there be life without LIF?”, researchers now realize that the maternal immune system is both a foe (it can reject the conception) and a friend (immune cells and molecules are also necessary for successful pregnancy). Leukemia Inhibitory Factor (LIF) when absent, prevents embryo implantation in rodents. From fecundation to parturition, immunity acts as a Janus, required but potentially dangerous. However, the complexity and the diversity of immunity in pregnancy deters many from entering the field. This book will try to give a complete overview of immunity from gametes till parturition, in brief, but with complete chapters and subsections, each written by specialists in the field. The importance of the topic relies not only on “the riddle of the fetal allograft”, which is per se fascinating, but on its consequences, linked to the development of IVF and in general, Assisted Reproductive Technologies (ART) / Medicine. Since the discovery that there would not be (mammalian) life without LIF, it has become clear that Immune Molecules, and in general, transient post mating inflammatory reactions are required for successful implantation. Disruptions of this process can lead to implantation failure / sterility. In later stages of pregnancy immunological cells, mostly of the innate immune system, control formation of local spiral arteries. Finally, a state of tolerance establishes itself, whose “break’ leads to immune abortion and the vascular bed is further transformed and enlarged, till delivery, and here again “immunological cytokines” do play a major role and can eventually cause immune mediated abortion. Failure of, not just, the cytokine and cell recognition mediated dialogue, but also the pre and peri-implantation “preparation of the uterus”, as stated, leads to sterility, early pregnancy loss and recurrent abortions. There is also an increasingly stronger argument to implicate immunology in pre-eclampsia. Further still, immunology is also implicated in the control of local infection, mother to child transmission of pathogens (notably, but not limited to, HIV). Finally, pregnancy is the only known physiological phenomenon where the once named “suppressor T cells,” re-emerge as “regulatory T cells”, and play a cardinal role. This E-book provides a complete compendium of gynecological immunology, spanning from fecundation to delivery. Topics also include the role of various cell types (such as T regs ad NK cells) in implantation and uterine changes as well as the genetic regulation of immunological processes. As such it will be of interest not only to fundamental and reproductive immunologists, but more importantly, clinicians in obstetrics and gynecology.

High Risk Pregnancy examines the full range of challenges in general obstetrics, medical complications of pregnancy, prenatal diagnosis, fetal disease, and management of labor and delivery. Drs. David James, Philip J. Steer, Carl P. Weiner, Bernard Gonik, Caroline Crowther, and Stephen Robson present an evidence-based approach to the available management options, equipping you with the most appropriate strategy for each patient. This comprehensive reference features the fully searchable text online at www.expertconsult.com, as well as more than 100 videos of imaging and monitoring. giving you easy access to the resources you need to manage high risk pregnancies. Prepare for clinical challenges and save time in addressing them thanks to expert advice on treatment options from international contributors. Find and apply the information you need quickly and easily through a consistent organization and at-a-glance summary boxes that discuss evidence-based management options. Access the fully searchable text online at www.expertconsult.com, along with links to Medline. View over 140 videos of detailed fetal imaging and monitoring that aid in diagnoses. Tap into recent developments in treatment and management in four new chapters—Global Maternal & Perinatal Health Issues; Recurrent Pregnancy Loss; Surveillance of the Fetus and its Indications; and Training for Obstetric Emergencies. Apply new evidence-based management options to treat genetic and constitutional factors leading to a high-risk pregnancy (such as diabetes, obesity, hypertension, and cardiac disease) through new and expanded coverage of these increasingly common presentations. Reference pregnancy-relevant laboratory values with an updated and comprehensive appendix on "Normal Values in Pregnancy." Effectively manage patients newly diagnosed with hematologic and immunologic malignancies, and explore the available drug options. Confirm your diagnoses with greater confidence thanks to full-color images throughout the text.

This book offers a highly informative guide to treating unexplained infertility and recurrent miscarriage (RM). In particular, it provides detailed treatment strategies for infertility or RM derived from uterine circumstance such as chronic endometritis and perturbation of endometrial decidualization, as well as maternal immunological rejection of an embryo as semi-allograft. Unexplained infertility refers to those types that cannot be detected by the general screening test. The causes are sometimes detected in the course of treatment with assisted reproductive technology including IVF. However, some unexplained infertility is intractable even after intracytoplasmic sperm injection or repeated implantation of morphologically suitable embryos. Patients with unexplained RM also have a high likelihood of undetectable risk factors of miscarriage. As a result, gynecologists often repeatedly provide these couples with general treatments for infertility and miscarriage or even discontinue treatment because they cannot detect the reason, which places serious financial, physical and mental burdens on the couples affected. This book offers gynecologists essential insights into the pathological condition of unexplained infertility and RM, equipping them to identify it, explain it to patients, and consider further examinations and more aggressive fertility treatments.

Sixteen British specialists pool their extensive knowledge of spontaneous abortion in one source. Their discussion is directly applicable to clinical situations and helps identify areas of debate and alternative methods.