At the end of June 2010, a 39-year-old gynecologist came to my clinic seeking acupuncture treatment following her fertility doctor’s advice to improve her chances of successful IVF.
In the past twelve years she had nine IVF’s and two successful pregnancies, but unfortunately she had miscarried each at about 10 weeks. The reason for her infertility and miscarriages was determined to be from an autoimmune condition that caused the pregnancies to be rejected. She desperately wanted to get pregnant and have her own biological child. On her first visit, she brought magazines containing articles that revealed acupuncture was used to assist IVF, and she hoped to use the methods recommended by the articles to assist her IVF. After reading the articles, I explained that the process of Traditional Chinese Medicine and acupuncture depended on the patient’s specific circumstances to design the protocols for each individual. I said that I would design a protocol for acupuncture combined with Chinese herbal formulas to treat her unique conditions, which could be helpful for her IVF, as determined by examination of her tongue and pulse accompanied with her symptoms. After this explanation, she accepted the idea of customized and individual treatment.
She complained: stress, anxiety, over-thinking, too much worry, difficulty calming down and always hyperactive. She slept poorly, waking up three or four times a night with difficulty falling asleep again, even to the point of occasionally needing medication to sleep. Her sleep generally totaled about five hours a night. She was always very busy with her family and office, and usually went to bed around 12:00am, and got up by 6:00am, arriving at the office to start work at about 7:30am. She often worked through lunch. She had lassitude, fatigue and weakness of body; she also had poor appetite, no acid reflux, and two or three bowel movements a day without diarrhea. She didn’t have headaches, back pain or leg pain, any coldness or hot sensation in her body. She first menstruated at eleven years old, and her menses came regularly, with pink blood and tiny clots, with five days of bleeding per each twenty-six day cycle. She had menstrual cramps four days before her menstruation with abdominal discomfort and bloating, and obvious anxiety. Her libido and urination were normal.
She walked very fast, expressed tension on her face with a moderately slim body and dark circles under her lower eyelids. Examination showed that her tongue body was medium size with little teeth marks on the edge of her tongue, and pale red tongue body color with a thin, white, moist tongue coating. Her pulse was thin wiry. She didn’t feel pain from slight touch to the neck, back and legs. Ear exam revealed significant painful sensation from slight touch on the corresponding parts of the brain, neck, endocrine, chest, back, leg and shenmen, and other points – she described the severity as 7-8/10. She had a test that revealed her uterine blood circulation was below normal.
Based on Traditional Chinese Medicine, her condition was Spleen and Kidney deficiency, disorders of Qi and Blood, and shen disorders. The treatment was to tonify the Spleen and Kidney, invigorate the Blood and regulate the Qi, and calm the shen to help her stress and anxiety. The acupuncture included electric acupuncture points of DU20, Yintang, RN12 and 14; the manual acupuncture points included ST36, 27 and 25, SP6, RN10 and 6, Zigongxue, LI4, KI3, LV3 and UB57. Acupuncture treatment, including electric acupuncture, was administered fifteen minutes twice a week. The ear points included brain, endocrine, waist, stomach and Shenmen. The Chinese herbal formula included Huang Qi, Dang Shen, Bai Zhu, Dang Gui, Bai Shao Yao, Chuan Xiong, Xian Mao, Xian Ling Pi, Tu Si Zi, Gou Qi Zi, Xiang Fu, Zhi Shi, Pu Huang, and Gan Cao. The formula was 50g of an herbal powder prescribed for one week, to be taken orally three times a day, 2g per dose, mixed with about 2-3 oz. warm water.
Treatments for follow up visits modified some points for acupuncture protocol and the herbal formula according to the progression of the patient.
During the second visit, after one session of acupuncture treatment, she said she felt significant improvement of stress, anxiety and tension, but the improvement did not last until the second visit. She also said her fertility doctor agreed with her taking Chinese herbs. After five treatments, she felt significant improvement of sleep, tension and anxiety, and found it easier to quiet her mind and activity. A test revealed that her uterine blood circulation improved significantly, to almost normal. By the nineteenth treatment she was able to sleep six to seven hours a night without waking up.
On the twenty-second treatment, she complained of being very frustrated. Her fertility doctor had decided to start IVF, place her embryo into the uterus next week, but only one embryo qualified. She placed three qualified embryos in IVF nine times before, but failed seven times – she believed that this history meant that with only one qualified embryo, there would be no possibility of a successful pregnancy. However, I explained to her that there was a possibility of successful pregnancy, because there were many research reports in China of acupuncture and Chinese herbal formulas increasing fertility. Because her physical condition had improved significantly, and especially because her intrauterine blood circulation (per test) had improved substantially, I explained that overall her condition was very good.
Two weeks later, she called to report that she was indeed pregnant, but that she was very nervous and anxious due to fear from her history of miscarriages. She asked how I could help. I suggested that she come back for acupuncture treatments with Chinese herbal formulas to prevent miscarriage, which were commonly and effectively used to prevent miscarriages in China.
After two days she came back to my clinic. She complained of high nervousness and anxiety, her face looked stiff with tension, gritted teeth, trembling hands and body. She felt tired and always wanted to sleep. She also felt slight abdominal fullness, slight nausea and occasional vomiting, with loss of appetite. Her bowel movements were once or twice a day with slight constipation. Her tongue was pale red with a thin, white coating. Her pulse was smooth and rolling. The acupuncture points included ST36, RN12, DU20, Yintang, and PC6. Acupuncture was administered once a week. The Chinese herbal formula included Dang Shen, Huang Qi, Bai Zhu, Fu Ling, Sheng Jiang, Sha Ren, Bai Dou Kou, Zi Su Ye, Shan Yao and Gu Ya. This formula was to tonify Spleen and harmonize the Stomach to stop nausea and increase her appetite. She felt better after two weeks of treatment, with most symptoms improved. The acupuncture treatment was the same as before, the Chinese herbal formula changed to Shou Tai Wan, adding Huang Qi, Dang Shen, Bai Zhu, Chen Pi and Shan Yao. This special treatment was to prevent miscarriage until the tenth week, the time of her previous miscarriages.
Since she usually walked fast with agility, I asked her to walk more slowly, and with small steps. I also suggested that she nap for five to ten minutes at lunchtime to help her relax. If possible, she needed to reduce her workload to ensure prevention of miscarriage. She wanted to comply, but it was very difficult because she had too many patients waiting for her help. She continued acupuncture treatment with Chinese herbal formulas until the tenth week of pregnancy, which passed the time of her two previous miscarriages.
In August 2011, she came to my clinic to express her deep gratitude with a card two months after delivery. She wrote: “You made me realize the dream as a mother.”