liliana trovalusci & pietro russo - sipnei the fertility journey human reproduction keynote...

PNEIFERT: AN INNOVATIVE CLINICAL MODEL FOR A PERSONALIZED AND PARTICIPATORY CARE IN

REPRODUCTIVE MEDICINE

Liliana Trovalusci & Pietro Russo

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CNS ANS

immune system

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endocrine system

stress THE PNEI NETWORK

geneticsepigenetics

REPRODUCTION

chances of conceivement

diseases risk factors

geneticsepigenetics

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MULTIFACTORIAL CONDITION

INFERTILITY

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PSYCHOSOCIAL BURDEN

AFFECTED BY STRESS

CAN BE PREVENTED(risk factors)

HOW DO WE PLAY THIS GAME...

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ART(ASSISTED REPRODUCTIVE TECHNOLOGY)

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IVF

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ART:IT DOES SOLVE

PROBLEMS,BUT ALSO CREATES

FALSE EXPECTATIONS

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BIOMECHANICS IS NOT THE ONE AND ONLY ANSWER

ABOUT BODY AND SOUL(or the body of soul...)

PSYCHE CULTURE

WHERE OUR CULTURAL IMAGERY COMES FROM

DIVINE ACTION

DIVINE MEDIATION

COMMUNITY MEMBERSHIP

HUMANIZATION PROCESS THROUGH RELATIONSHIP

THE ADVENT OF THE BODY

BODY PARTIALISATION

SOCIO-ECONOMIC CAUSES

FAMILY GHOSTS AND TRANSGENERATIONAL

MANDATES

SOCIAL CONTROL

SEXUAL DEPOLARIZATION

LATE ADOLESCENCES

DIFFERENT FAMILY STRUCTURES

NARCISSISM AND ONNIPOTENCE FANTASIES

EPIGENETIC RECURRENCES

MORE INVISIBLESDREAMS AND TRANSPERSONAL

UNCONSCIOUS IMPLICIT TRASCENDENT ELEMENTS

SUFFERING

SENSE OF INADEQUACY TOWARDS PROCREATION

REQUIREMENTS

VISIBLE

SCIENCE AND TECHNOLOGY

LIMITS AWARENESS 

HOW DO WE PLAY THIS GAME...

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WE NEED A PATIENT-CENTRED TEAM TO MANAGE A FERTILITY CLINIC

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focus onREPRODUCTION

// MAY 2015� Look ahead to Lisbon � ESHRE news� Best of ESHRE & ASRM 2015

� Developments in infertility counselling� The case for patient centred treatment

On the fertility journey

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Human Reproduction keynote lecture

“Preconception stress increases the risk of infertility:results from a couple-based prospective cohort study,the LIFE study”, the article of Dr Courtney D. Lynchfrom Ohio State University, has been chosen as thisyear’s Human Reproduction Keynote lecture.Dr Lynch’s presentation will take place on 15 June2015 from 8.30 to 9.00 and will be the opening lectureof ESHRE’s 31st Annual Meeting.

Her paper can be read in Human Reproduction

ESHRE 2015 http://www.eshre2015.eu/

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ESHRE!Psychology!and!Counselling!Guideline!Development!Group!

March!2015!

Routine!psychosocial!care!in!infertility!and!medically!assisted!reproduction!–!A!guide!for!fertility!staff!

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๏ INTEGRATION OF COMPETENCES๏ INTERVISION๏ EFFECTIVE COMMUNICATION๏ FREQUENT STAFF MEETINGS FOR SHARING AND

INTEGRATING OF DATA AND FOR PLANNING OF DIAGNOSTIC AND THERAPEUTIC STRATEGIES

๏ TIMELINES KEEPING๏ SOP - QC

TEAM WORKING

endocrinologistgynecologyst

THE FERTILITY CLINIC TEAMAS TODAY

urologist

biologist(clinical embryologist)

psychologist

geneticianmidwife

endocrinologistgynecologyst

urologist

biologist(clinical embryologist)

psychologist(better with etnopsychological

compentences)

genetician

nutritionist(not just loosing weight...)

midwife

acupuncturist qi-gong, tuina, yoga...

THE FERTILITY CLINIC PNEI TEAMAS TOMORROW

phytotherapy osteopathy

IS THIS ENOUGH?

WE NEED AN EDUCATIONAL PROCESS TO BUILD A PATIENT-CENTRED TEAM TO

MANAGE A FERTILITY CLINIC

PNEIFERT: AN INNOVATIVE CLINICAL MODEL FOR A PERSONALIZED AND PARTICIPATORY CARE IN

REPRODUCTIVE MEDICINE

BASICS

ACTIVATING THE ENERGETIC FIELDBUILDING-UP THE THERAPEUTIC ALLIANCE

THERAPEUTIC RELATIONSHIP

KEEPING THE BALANCE, AVOIDING TO YELD TO PATIENT’S COMPLEXUALITY IN A NEVROTIC COMPULSORY URGE TO

REALIZE THE IMPOSSIBLE

WELCOMINGto make people feel they are entering in their own healing place

EMPATHIC LISTENINGto the stories, the body language, the invisibles, beyond filling out of an anamnesis form

ANALYSING THE QUESTIONwhat lies beyond the search of conceivement

CLINICAL EVALUATIONinfertility conditions and risk factors

DIAGNOSIS AND REPRODUCTIVE PROGNOSISanswer the Questions: can I conceive? Why cannot I conceive?

PNEIFERT - working steps #1

COMMUNICATION AND CURE

Guides and aims

๏ balancing posture๏ personal empowerment๏ restoration of decisional power๏ respect of autonomy๏ information and technical consulting๏ facilitatory role๏ personalization of cures๏ support throughout the process

PNEIFERT - working steps #2

PNEIFERT - working steps #3THERAPEUTIC STRATEGIES

๏ before IVF (all we can do to avoid IVF)๏ reducing and eliminating risk factors๏ curing infertility conditions๏ IVF (when needed)

๏ beyond IVF (all we can do to effectively support patient’s health as a whole)

๏ psychological route๏ integrated medicine (TCM, phytotherapy, osteopathy...)๏ timelines keeping๏ best cost/benefit ratio

NEW AND SYNCRETIC LANGUAGE๏ acquired and shared by the team๏ accessible to patients๏ not childish๏ technically correct๏ minding of body and soul

PNEIFERT - tools

A PNEI LANGUAGE: AN AWARE LANGUAGE AIMING THE DEEP

COMPREHENSION AND EVOKING NEW THOUGHTS CAPABLE TO MODIFY BOTH MIND AND BODY

Dammi l’acquadammi la manodammi la tua parolache siamo,nello stesso mondo.(Chandra Livia Candiani)

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a process to effectively support patient’s health as a whole, beyond results, as an

evolutionary opportunity even to transform parentshood desire into wide creative

potentialities

WHO DOES PLAY THIS?

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THE WHOLE TEAMunder the psychologist’s supervision

WHAT’S GOING ON...

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PILOT EDUCATIONAL PROGRAM IN A FERTILITY CLINIC (CENTRO CHEMIS, NAPLES)

BUILDING A CONSULTANT NETWORK OF FERTILITY SPECIALISTS (SR BIOS, CATANIA)

SMILES AT WORKBYE, FOR NOW...