Diferencias inter e intra individuales Diferencias intra individuales ante el mismo estímulo

I treated one married couple in which the wife had irregular menstru-ation and the husband had a low sperm count as well as weak motili-ty. The female was 39 years old and the male was 42 years of age. The couple had two unsuccessful IVFs prior to treatment with acupuncture and Chinese medicinals. The first IVF produced 11 follicles, eight eggs, and four embryos, only one of which divided to eight cells. The patient became pregnant with this cycle. However, she miscarried early in the first trimester. In the second IVF, four eggs and only one embryo were produced. The patient did not become pregnant. In contrast, the third IVF, after utilizing acupuncture and Chinese medicinals, produced eight follicles and five high quality embryos. The treatments with Chinese medicine addressed both the husband and wife’s fertility issues and improved their chances in the use of IVF. Their third IVF was suc-cessful, and today they have a two year-old baby girl.

The female patient’s Chinese medical pattern discrimination was kidney and blood vacuity with qi stagnation and blood stasis. Her menstrual cycles were long and irregular, varying widely, though flowing an aver-age of 5-6 weeks apart. Therefore, the first step was to regulate the wife’s menstruation. To regulate her cycle, she was treated with Ding Jing Fang (Stabilize the Menses Formula) to quicken the blood and balance her hormones. This formula was modified with the addition of Dan Shen (Radix Salviae Miltiorrhizae) or, alternatively, Niu Xi (Radix Achyranthis Bidentatae) to quicken the blood. Several blood-supple-menting medicinals were also added. These included Gou Qi Zi (Fructus Lycii Chinensis), Huang Jing (Rhizoma Polygonati), and Ji Xue Teng (Radix Et Caulis Spatholobi). For qi depression, Xiang Fu (Rhizoma Cyperi Rotundi), Zhi Ke (Fructus Citri Aurantii), and/or Chen Pi (Pericarpium Citri Reticulatae) were used to course the liver and move the qi. Acupuncture points included Bai Hui (GV 20), Yin Tang (M-HN-3), Zu San Li (St 36), Tai Xi (Ki (M-HN-3), San Yin Jiao (Sp 6), He Gu (LI 4), and Zi Hu-Ban Men (Ki 13). This protocol regulated her menstrual cycles in three months and reduced her FSH level from four to two.

During the preparation for IVF, when the patient began the oral con-traceptive pills, she was started on Huo Jing Zhong Zi Fang (Quicken

the Essence & Plant the Seed Formula), i.e., Dang Gui (Radix Angelicae Sinensis), Chai Hu (Radix Bupleuri), Bai Shao (Radix Albus Paeoniae Lactiflorae), Bai Zhu (Rhizoma Atractylodis Macrocephalae), Fu Ling (Sclerotium Poriae Cocos), Gan Cao (Radix Glycyrrhizae Uralanesis), Zhi Ke (Fructus Citri Aurantii), and Dan Shen (Radix Salviae Miltiorrhize), with Gou Qi Zi (Fructus Lycii Chinensis) and Suan Zao Ren (Semen Zizyphi Spinosae) as modifiers to regulate her hormones. Once the hormone injections began (this client took Gonal-F and Repronex), Ding Jing Fang (Stabilize the Menses Formula) was prescribed in order to produce more follicles and increase her uterine lining. Sha Yuan Zi (Semen Astragali Complanati) and Huang Qi (Radix Astragali Membranacei) were added as modifi-cations. Huo Jing Zhong Zi Fang (Quicken the Essence & Plant the Seed Formula) was taken the night before as well as on the morning of the transfer, and once again Gou Qi Zi (Fructus Lycii Chinensis) was added to nourish the blood and Suan Zao Ren (Semen Zizyphi Spinosae) was added to quiet the spirit.

After transfer, Xiao Yao Fang (Rambling Formula) was prescribed to rectify the qi, nourish the blood, and relax the patient. Suan Zao Ren (Semen Zizyphi Spinosae) was added again along with Tu Si Zi (Semen Cuscutae Chinensis), Dang Shen (Radix Codonopsitis Pilosulae), Chen Pi (Pericarpium Citri Reticulatae), and Shan Zhu Yu (Fructus Corni Officinalis) to further supplement the qi and fill the essence.

Once pregnant, An Tai Fang (Safety Fetus Formula), i.e., Sang Ji Sheng (Ramulus Sangjisheng), Xu Duan (Radix Dipsaci Asteri), Tu Si Zi (Semen Cuscutae Chinensis), Gou Qi Zi (Fructus Lycii Chinensis), Shan Zhu Yu (Fructus Corni Officinalis), Dang Shen (Radix Codonopsitis Pilosulae), Bai Shao (Radix Albus Paeoniae Lactiflorae), and Bai Zhu (Rhizoma Atractylodis Macrocephalae), was prescribed, to which Huang Qi (Radix Astragali Membranacei) was added to fur-ther boost the qi. At this point, acupuncture points were limited to Bai Hui (GV 20), Yin Tang (M-HN-3), and Si Shen Cong (M-HN-1) in order to protect a possible pregnancy. At six weeks of pregnancy, the client experienced vaginal spotting. In order to prevent miscarriage, An Tai Fang was modified with the addition of Ai Ye (Folium Artemisiae Argyi) and E Jiao (Gelatinum Corii Asini) to nourish and stop bleeding.

The husband had been diagnosed with having a varicocele and had completed surgical treatment several years earlier. However, this sur-gery did not improve the husband’s condition. Laboratory analysis of the husband’s sperm reported a total count of 4.4 m/ml and motility at 47%. The second step, therefore, was to increase the husband’s sperm count and improve its quality. To increase sperm count and improve motility, Huo Jing Zhong Zi Fang (Quicken the Essence &

Plant the Seed Formula), i.e., Dang Gui (Radix Angelicae Sinensis), Chai Hu (Radix Bupleuri), Bai Shao (Radix Albus Paeoniae Lactiflorae), Bai Zhu (Rhizoma Atractylodis Macrocephalae), Fu Ling (Sclerotium Poriae Cocos), Gan Cao (Radix Glycyrrhizae Uralanesis), Zhi Ke (Fructus Citri Aurantii), and Dan Shen (Radix Salviae Miltiorrhize), was prescribed with the addition of Gui Zhi (Ramulus Cinnamomi Cassiae) to free the flow and increase the circulation in the channels. To supplement the kidneys, enrich yin, and foster the essence, thereby improving the volume and quality of sperm, Shan Zhu Yu (Fructus Corni Officinalis) and Shu Di Huang (cooked Radix Rehmanniae Glutinosae) were added. In order to specifically improve sperm motility, Huang Qi (Radix Astragali Membranacei) and Dang Shen (Radix Codonopsitis Pilosulae) were added to supplement the qi, while Ba Ji Tian (Radix Morindae Officinalis) and Rou Gui (Cortex Cinnamomi Cassiae) were added to warm yang. Strengthening the sperm and increasing the total count improved the opportunity for conception. A greater number of viable embryos were produced, which reduced the risk of miscarriage and facilitated a successful implanta-tion. The husband’s acupuncture prescription included Zu San Li (St 36), San Yin Jiao (Sp 6), Xue Hai (Sp 10), Tai Xi (Ki 3), Tai Chong (Liv 3), He Gu (LI 4), Qi Hai (CV 6), Bai Hui (GV 20), and ear points Kidney, Spleen, and Liver.