The sunrise in the east affirms the balance and harmony within the universe. As the golden glow of the western sky sets, it shimmers with the promise of hope for tomorrow. The endless facets of nature complement one another; light and dark, cold and warmth, life and death. Having a baby is no different; the integration of mind and body, male and female, must work together to achieve the balance needed. For many couples facing infertility, maintaining this equilibrium seems elusive and out of reach.

In the Southwest, the symmetry of East and West are working in concert to bring options and hope to couples experiencing infertility. In March of 2004, Reproductive Medicine & Fertility Center (RMFC) joined with the University of New Mexico, Department of Obstetrics & Gynecology to form RMFC@UNM™, whose private practice specialization is in vitro fertilization (IVF) treatments. Medical director Paul Magarelli, M.D., Ph.D., a board certified reproductive endocrinologist and infertility specialist, says RMFC@UNM™ seeks to provide New Mexico’s infertile couples with compassionate, exceptional, ad-vanced IVF services.

Nationwide, the Centers for Disease Control and Prevention reports 99,629 procedures were performed in 2000 by in vitro fertilization (IVF) — fertility treatments in which the egg and sperm are handled in the laboratory — resulting in 25,228 live births and 35,025 infants. In New Mexico limited access to fertility specialists has resulted in declining IVF procedures. With the opening of RMFC@UNM™, Magarelli estimates that within two years, 150 to 200 procedures will be performed annually in Albuquerque.

In 2002, in an effort to enhance reproductive services in New Mexico, Magarelli conducted a seminar in Santa Fe. Three people attended. At a subsequent seminar, a few months later, the room was filled. “We have the capability and people want this information. New Mexico as a whole is interested in integrative care.”

RMFC@UNM™ is an outgrowth of Dr. Magarelli’s fertility practice in Colorado Springs and a response to genuine desire for expanded services in New Mexico. Working with local professionals in Albuquerque and Colorado Springs, Magarelli offers comprehensive services to his patients at both centers. He hopes the new center in Albuquerque and his affiliation with the University of New Mexico will enhance the one other program operating in New Mexico.

The Problem
When couples face infertility, they want answers. A desire to understand exactly why they cannot get pregnant is of the utmost importance. Dr. Magarelli has created a simple chart outlining four critical questions all patients should ask their doctors. The answers will determine the appropriate treatment for each couple.

Ask your doctor to check the following: Are there sperm? A semen analysis at an Andrology Lab; Are there eggs? Day 2, 3, or 4 after your menstrual cycle starts have your doctor check your blood for Estradiol, FSH, and LH hormones; Can the sperm and egg meet? Have your MD order an HSG or X-ray dye test on Day 10 of your cycle — this will tell him if your fallopian tubes are open or not; Does the baby have a safe place to grow? The same HSG above will also tell your MD that you can safely carry a child.

A Partnership
For a specific and challenging segment of Magarelli’s practice, “high tech” Western medicine seemed to provide few answers. He looked to a respected colleague and an ancient medical tradition for alternatives.

Diane Cridennda is a doctor of oriental medicine (D.O.M.) practicing in Colorado Springs. Magarelli began referring some of his more challenging patients, those with a limited chance of getting pregnant, to Cridennda for acupuncture treatments.

Two articles have appeared in the scientific literature that thrust acupuncture into the spotlight as a viable complementary modality for the treatment of infertility. The protocols outlined in the articles are widely accepted and used successfully in conjunction with IVF to treat infertility.

Cridennda has been following the protocol for 10 years. “Participating in the acupuncture treatment gives women a sense of control; it’s empowering to be able to contribute and actively participate in their care,” she says. Cridennda adds, “The rewards are heartwarming.”

The protocol includes:

• EIGHT TREATMENTS BEFORE EGG RETRIEVAL, TWO TIMES PER WEEK FOR FOUR WEEKS
• ONE TREATMENT THE DAY BEFORE OR MORNING OF EGG RETRIEVAL
• ONE TREATMENT AFTER THE EGG TRANSFER.

The acupuncture treatments before and after egg transfer are to bolster the heart energy and connect the heart with the head. The other treatments promote increased blood flow to the uterine arteries, preparing to accept the embryo. The final treatment facilitates closure and enables the woman to hold the embryo and bring the baby to term.

Dr. Cridennda treats prospective fathers as well as mothers. The process for men is a little different. It takes three months of treatments to affect the sperm. The treatments consist of vitamins, antioxidants, and specific herbs.

Because of their collaboration, Doctors Magarelli and Cridennda have given birth to a three-year retrospective study, assessing the efficacy of combining IVF and acupuncture to treat infertility. Their results have not been duplicated.

The Bottom Line
Not only are 16 percent more women getting pregnant, but also more women are having babies. “It’s so neat,” Magarelli beams, “to tie together two areas that are really helping women.” The soon-to-be published study is the first to examine birth rates. “We’ve changed the focus to the baby, not just getting pregnant. We want babies, not just pregnancies.”

Despite the focus on babies, cost is an enormous factor. In the past, IVF treatments were “up front, pay as you go” procedures. In New Mexico and Colorado, things have changed, thanks to an innovative funding program called Shared Risk, implemented by Dr. Magarelli.

Using in vitro, it takes approximately 2.2 attempts to get pregnant. Multiple attempts are costly and may not result in pregnancy. Through the Shared Risk program, patients receive four complete cycles of in vitro for the price of one. By making a deposit and affordable monthly payments, patients and doctors share the financial and fertility risk. This lowers the cost to families, increases the chances for pregnancy, and broadens access to these specialized services. Magarelli maintains, “We want to provide New Mexico women with options.”

For couples facing infertility, having a baby can be an arduous journey. The time and energy spent identifying resources and agonizing over how to pay for it all, coupled with the spiritual and emotional toll, can be daunting. Through it all, couples wrap themselves in hope and persevere.

East and West have converged in the high desert plains of the Southwest with a message of hope, anchored in traditional Chinese medicine and the promise of innovation that characterizes Western medicine. This balanced approach emanates from the very core of human existence and will move into the future helping couples, one baby at a time.Jahaan Martin is a freelance writer living in Albuquerque.