Efecto inhibitorio

A 37 year-old woman came in for treatment with the Western medical diagnosis of infertility. She and her husband had been trying to con-ceive for four years prior to coming to my clinic. She had two failed IVF attempts and three failed intrauterine inseminations (IUIs) before treatment with acupuncture and Chinese medicinals. In her previous IVF cycles, only 2-7 follicles were produced. This demonstrated poor ovarian function. Her husband’s sperm was reported to be of poor quality, with a motility of 14% (normal is >50%) and a total count of 0.6 m/ml (normal is >25 m/ml). Therefore, I treated both the husband and the wife with acupuncture and herbs.

The third IVF, which took place two months into receiving acupunc-ture and herbs in my clinic, also produced only three follicles. Because of this, the third attempt at IVF was abandoned. Instead, the patient used IUI. While she did not become pregnant in the procedure, the patient did conceive one month later on a natural cycle without the use of IVF or IUI. The hormones used in IVF linger for over a month and continue to influence a woman’s ovarian function. I would encourage women to keep this in mind and to not give up after the disappoint-ment of a failed IVF. This case was an example of how important it is to continue trying to get pregnant in the months after an IVF cycle.

Treatment was focused on the patient’s Chinese medical pattern dis-crimination of kidney vacuity with qi stagnation and blood stasis. This woman’s presenting signs and symptoms were fatigue, tinnitus, poor sleep, vaginal dryness, and low sex drive for several years. She was emotionally depressed. She also experienced discomfort in her lower abdomen and very bad cramps at the beginning of her menstrual cycle.

Her tongue was slightly dusky with white fur and a red tip, while her pulse was weak in both cubit positions and slippery overall.

In preparation for IVF, the patient was placed on Xiao Yao Fang (Rambling Formula), i.e., Chai Hu (Radix Bupleuri), Dang Gui (Radix Angelicae Sinensis), Bai Shao (Radix Albus Paeoniae Lactiflorae), Bai Zhu (Rhizoma Atractylodis Macrocephalae), Fu Ling (Sclerotium Poriae Cocos), and Gan Cao (Radix Glycyrrhizae Uralanesis), before

and during her menstruation to course the liver and rectify the qi as well as nourish the blood. This was modified with Dang Shen (Radix Codonopsitis Pilosulae) to fortify the spleen and supplement the qi and Zhi Ke (Fructus Citri Aurantii) to further regulate and rectify the qi.

After her menstruation, she was placed on Ding Jing Fang (Stabilize the Menses Formula), i.e., Dang Gui (Radix Angelicae Sinensis), Bai Shao (Radix Albus Paeoniae Lactiflorae), Chai Hu (Radix Bupleuri), Fu Ling (Sclerotium Poriae Cocos), Shan Yao (Radix Dioscoreae Oppositae), Dang Shen (Radix Codonopsitis Pilosulae), Ba Ji Tian (Radix Morindae Officinalis), and mix-fried Gan Cao (Radix Glycyrrhizae Uralanesis), to supplement the qi and nourish the blood. Tu Si Zi (Semen Cuscutae Chinensis) was removed from the base formula and Sha Yuan Zi (Semen Astragali Complanati) was added instead to supplement the kidneys and both nourish yin and invigorate yang. Suan Zao Ren (Semen Zizyphi Spinosae) was added to nourish the blood and quiet her spirit.

Long Yan Rou (Arillis Euphoriae Longanae) was chosen as a modifica-tion to fortify the spleen and boost the qi, supplement the heart and nourish the blood. Chen Pi (Pericarpium Citri Reticulatae) was added to aid digestion. At ovulation, to warm and invigorate yang, even more Ba Ji Tian (Radix Morindae Officinalis) and Zhi Ke (Fructus Citri Aurantii) were added to relax the cervix, thereby facilitating the sperm’s entrance into the uterus. Acupuncture before and during her menses consisted of Zu San Li (St 36), San Yin Jiao (Sp 6), Tai Xi (Ki 3), Tai Chong (Liv 3), He Gu (LI 4), Bai Hui (GV 20), and Yin Tang (M-HN-3). Xue Hai (SP 10), Zhong Ji (CV 3), Qi Hai (CV 6) and ear points Kidney, Spleen, and Shen Men were also used. Infrared heat was used on her lower abdomen in all treatments. After menstruation, Xue Hai, Zhong Ji, and Qi Hai were removed from the above prescription, and Zi Gong Xue (M-CA-18) was added. Heat was again applied with the infrared lamp.

After two months of treatment, the patient’s menstruation was less painful with fewer cramps and less clotting. Emotionally, she felt hap-pier and her energy was very much improved. The husband’s semen also improved over the course of his treatment. His pulses were small and weak bilaterally in the cubit positions. His tongue was pale with white fur. I categorized his pattern as liver blood and kidney vacuity with some liver depression qi stagnation. Therefore, his herbal pre-scription was a modified Xiao Yao Fang (Rambling Formula).

Modifications included added Zhi Ke (Fructus Citri Aurantii) and Dan Shen (Radix Salviae Miltiorrhizae) to regulate and rectify the qi and blood, Dang Shen (Radix Codonopsitis Pilosulae) to fortify the spleen, supplement the qi, and generate fluids, and Suan Zao Ren (Semen Zizyphi Spinosae) to nourish the liver and quiet the spirit. The patient was also treated with acupuncture points Zu San Li (St 36), Tai Chong (Liv 3), San Yin Jiao (Sp 6), He Gu (LI 4), Qi Hai (CV 6), and Yin Tang (M-HN-3) along with infrared heat treatments on his lower abdomen.

While the third IVF attempt was not successful, once the patient’s nat-ural cycle returned the following month, she did conceive and carried the baby full term. Once pregnant, her treatment focused on maintain-ing a healthy pregnancy. Therefore, she was placed on 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). This was modified with E Jiao (Gelatinum Corii Asini) to nourish the blood and prevent bleeding.

Shan Yao (Radix Dioscoreae Opppositae) was also added to supple-ment the spleen and kidney qi and yin, and Gan Cao (Radix Glycyrrhizae Uralanesis) was added to harmonize all the other medic-inals in the prescription. No acupuncture was used once this patient became pregnant, although moxibustion was applied to Bai Hui (GV 20) and Zu San Li (St 36) as a preventative against miscarriage. The patient now has a healthy three year-old daughter!