Case Study: Chinese Medicine for Infertility
Over the last 20 years, Chinese Medicine has been widely implemented in the West for the treatment of infertility in women. Some acupuncture clinics specialize in women’s fertility, working alongside their Gynecologist and IVF/IUI treatment providers.
It is no surprise that when working with women on fertility, seeing them get pregnant and deliver a healthy baby is an immense pleasure as a practitioner.
Although there are many women in the Bay Area, especially those who are in their 30s or 40s, who want to get pregnant and are willing to do anything for that outcome, I only started seeing infertility patients last year. Prior to that, I was providing care only to pregnant and post-partum women. Perhaps my curiosity, which grew through the experiences of patients and friends experiencing difficulty conceiving, attracted more patients to my clinic about fertility.
I wanted to share a case study from my clinic about how Chinese Medicine can be used for infertility. I have also listed some of the research about the success rate of using acupuncture during IVF treatment and also of acupuncture having a positive outcome on the mental health of women who are going through IVF treatments.
As in Western Medicine, there can be many causes of female infertility, and similarly, we see many different diagnoses for the cause of infertility in Chinese Medicine as well. Based on these diagnoses, we have different treatment strategies that include different acupuncture points, Chinese Herbal Formulas in addition to lifestyle and dietary recommendations.
Case Study from my clinic:
The Patient (30-year-old female) came to my clinic in October 2020 with a primary complaint of severe neck and shoulder pain due to a pinched nerve that was radiating to the left hand. Her second complaint was infertility as she had been trying to conceive for over a year. She had a 4-year-old child but also had six miscarriages.
During the first four treatments, we focused on musculoskeletal issues by using acupuncture, cupping, and gua sha therapy. After 4 acupuncture treatments, she no longer had numbness in the left hand and the severe neck and shoulder pain was reduced from 10/10 to 3/10, so she wanted to work with me on her infertility.
After doing a thorough intake, my Jing Fang (Classical Chinese Herbalism) diagnosis was 3 yin with blood deficiency and blood stasis. Here is my thought process that lead me to the diagnosis and treatment:
The Patient had a very strong musculature body type and exercised almost every day, including running and cross fit. She was in school and had a job as well as taking care of her child and pets.
In appearance, she looked very strong but in contrast to that her pulses were deep, she had weak chi positions, she was wiry and thin on the left guan and her tongue was pale with very interesting purple spots on the front. diagnosis: possibly shao yin, and jueyin with blood deficiency and stasis
Her body temperature and extremities were cold and she was easily fatigued even though she did not appear to be. diagnosis: possibly shaoyin
She had dry eyes and blurry vision. diagnosis: body fluids and blood deficiency
She had some bloating and abdominal pain, and her bowels movement varied from being loose to sticky, incomplete, and forceless. diagnosis: taiyin deficiency
She had chronic upper body tightness and sometimes pain. diagnosis: possibly half and half disharmony, due yin in this case
She had irregular menses and her flow was scant for only a day or two. She had some pelvic pain before the menses. diagnosis: blood deficiency and stasis
Her sleep was superficial and poor and she did not feel refreshed when she woke up. diagnosis: blood deficiency
Her abdomen, especially the lower abdomen, was cold to touch diagnosis: shaoyin
I prescribed her Chai Hu Gui Zhi Gan Jiang Tang with Dang Gui Shao Yao San and Ge Gen minus Ze Xie for 3 weeks. I used Mr Tung infertility points Fu Ke, and spleen and pericardium points for her blood and jueyin. I used rice grain moxa on her lower abdomen and did some local points and gua sha for upper body tension.
After the 3 weeks, the Patient reported having more energy and better digestion with less bloating and former stools, but she was still cold and her pulses were still deep and weak.
I changed the formula to modified Wen Jing Tang with Fuling and Chang Zhu and Fu Zi. I gradually increased the dosage of Fu Zi each week. By the third week, she started to feel warmer and her pulses also started to become less deep.
She was on modified Wen Jing Tang formula for over 3 months. During that time her sleep and energy improved, her pelvic pain was reduced, and she had more regular menses. She decided to try IUI as well as acupuncture and herbal treatment. Both her gynecologist and I recommended she reduce her intense exercise regimen, doing fewer cardio workouts especially before and after the IUI treatment. After the IUI treatment, I stopped adding Fu Zi to her formula.
2 weeks after the IUI treatment, she reported not feeling as tired and cold anymore (she did change to having a lighter exercise routine). The following week, she reported being pregnant and we no longer needed to use Wen Jing Tang.
Patient continued to receiving almost weekly acupuncture treatment and herbal treatments to both prevent miscarriages and also for other issues related to pregnancy such as pelvic pain, fatigue, and constipation. She has been doing very well so far and expects to deliver the baby in November.
Related research:
Objective: After giving informed consent, 160 patients who were undergoing assisted reproduction therapy (ART) and who had good quality embryos were divided into the following two groups through random selection: embryo transfer with acupuncture (n = 80) and embryo transfer without acupuncture (n = 80).
Intervention(s): Acupuncture was performed in 80 patients 25 minutes before and after embryo transfer. In the control group, embryos were transferred without any supportive therapy.
Result(s): Clinical pregnancies were documented in 34 of 80 patients (42.5%) in the acupuncture group, whereas the pregnancy rate was only 26.3% (21 out of 80 patients) in the control group.
Semi-structured interviews were conducted with a sample of 50 women drawn from the cohort who had consented to take part in the randomized controlled trial (RCT). In the RCT, women aged 18–42 years having a fresh IVF or intracytoplasmic sperm injection cycle and not using acupuncture were recruited and randomized to a control sham acupuncture or treatment group.
Result(s): Many women believed that their well-being was enhanced by having acupuncture during treatment, describing this as reduction of stress typically characterized as relaxation.
This study asked whether providing a multiphasic fertility acupuncture protocol to women with sub/infertility would increase their awareness of fertility and achieve normalization of their menstrual cycle compared with a lifestyle control.
In a pragmatic randomized controlled trial sub/infertile women were offered an intervention of acupuncture and lifestyle modification or lifestyle modification only. There was a statistically significant increase in fertility awareness in the acupuncture group (86.4%, 19) compared to 40% (n = 8) of the lifestyle-only participants.
Result(s): Those receiving the acupuncture conceived within an average of 5.5 weeks compared to 10.67 weeks for the lifestyle-only group (p = 0.422).