The Effect of Chinese Herbal Medicine and Acupuncture on Female Infertility by Inducing Artificial Ovarian Cycle

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Julia Gordon
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1 The Effect f Chinese Herbal Medicine and Acupuncture n Female Infertility by Inducing Artificial Ovarian Cycle Dr Dan Jiang, MMedSci Visiting Prfessr f Beijing University f Chinese Medicine Supervisr f SSC fr medical students in the University f Sheffield Abstract: The disrders f reprductive and endcrinal systems are the cmmn causes f female infertility. The prblems can be either rganic r dysfunctinal. The authr analyses the aetilgy and pathgenesis f the illness, and the mechanisms f acupuncture and Chinese herbal medicine treatments. The article reprts predminantly f hw TCM therapies treat infertility by wrking n the menstrual and vary circle. Sme successful cases are included, f bth natural pregnancies supprted by TCM and pregnancies with IVF treatment and supprted by TCM. Disrders f the reprductive and endcrinal systems are cmmn causes f female infertility. These disrders can be either structural r dysfunctinal. In her practice ver the last decade, the authr helped mre and mre wmen with infertility cnceived their babies by using acupuncture and Chinese medicine t imprve their functinal disrders, r even cure their rganic diseases. I realized that it is a right treatment methd t use acupuncture and Chinese herbal medicine based n integrated theries frm traditinal Chinese medicine and mdern medicine fr treating female infertility caused by reprductive and endcrine disrders. 1. Backgrund understanding: A female starts a nrmal menstrual circle when her sexual harmny and reprductive functin have been matured arund twelve years ld. Under the effects f relevant hrmnes, such as Lutetrpic hrmne (LH), Fllicle-stimulating hrmne (FSH), gnadtrpic hrmne that are prduced by the pituitary and Hypthalamus, a fllicle develps mature and releases frm her vary every mnth, which mves t the uterus thrugh a fallpian tube. If it is fertilized with a vital sperm t make a fertilized egg and implant int the endmetrium f the uterus, a nrmal pregnancy will result. If it hasn t met a vital sperm, it will flw ut with sme pieces f endmetrial tissue as menstruatin. Fllwing the abve rutine, I classify the menstrual cycle int fur stages with different functins t be fcused n each week: In the first week: fllicle grwth; In the secnd week: fllicle is matured and detached frm the vary (vulatin); In the third week: prgesterne grwth; In the furth week: preparatin f menstruatin and menstruatin r prtectin f fetus. Therefre, I try t manage TCM treatments t fllw the abve rutine. In the West, there are increased incidences f infertility, which are caused by varius reprductive and endcrine disrders. The cmmn reasns include: Lng-term stress/depressin affecting the varian functin t cause varian mal-develpment, r early failure. Sme yung females suffer frm amenrrhea when they underg PHD study, r high degree curses, r after a severe accident. Excessive physical wrk r training during puberty causes mal-develpment in the varies r uterus resulting in menxenia, ften seen in sme athletes and dancers. Excessive use f the cntraceptive pill causes imbalance f Oestrgen & Prgesterne causing their varian activity decreased. Sme wmen in western cuntries take cntraceptive therapies fr ver 10 years. Marriage r pregnancy in later ages. Taking drugs, r excessive alchl intake. These reasns cause a disturbance f the menstrual/varian cycle and result in amenrrhea, dysmenrrhea, r menxenia, which are cmmn pathlgical causes f infertilities. Unexplained infertility accunts f nearly 50% f the ttal. The rutine treatment targets are t balance hrmnes, prmte vulatin, r strengthening f the rganic functins in a particular perid f the menstrual cycle. We need nt nly t re-regulate each rganic functin, but als t rebalance the whle system. 2. Methds f inducing artificial varian cycle by acupuncture & herbal medicines. 2.1 Fundamental thery f TCM: After in-depth reading f many academic literatures f varius schls f TCM frm traditinal classical bks and taking sme theries frm bimedical physilgy and pathlgy int accunt, I feel the imprtance f integrated theries frm bth TCM and western medicine t guide the treatment methds. I create TCM treatment principles accrding t the different stages f the menstrual cycle belw: (Sme different treatments will be selected fr the patients wh shw predminance n either the Kidney Yin r Yang Deficiencies.)

2 In the first week: strengthen kidney and spleen, which are pre-heaven and pst-heaven rgans t prmte fllicle grwth. TCM recgnizes that the kidney is an initial surce t prduce the riginal and reprductive Qi. The spleen is an imprtant rgan t cntinuusly supply Qi & bld. Therefre, treatment shuld be fcused n strengthening kidney and spleen in the first stage f the menstrual cycle. In the secnd week: nurish Yin and culture essence, mve stagnated Qi & bld stasis. Nurish kidney Yin t prduce essence fr strengthening maturing fllicles; mve stagnant bld t detach the matured egg frm the vary. In the third week: warm Yang and nurish Yin t prmte prgesterne grwth: If yu plan t strengthen Yang, yu must nurish Yin t treat Yang. This qutatin explains a treating experience, which is a key technique n kidney s tnificatin. It means yu shuld use herbs t nurish kidney Yin, befre warm kidney Yang, r use bth f abve herbs tgether. Strengthening Yang in the kidney meridian warms Qi & bld t remve their stagnatins in varies and uterus, which agitates prgesterne. In the furth week: Spread liver Qi and bld t regulate menstruatin; r strengthen spleen and kidney t prtect fetus when pregnant. a) When the wman is in the last week befre her menstruatin, she easily presents with liver Qi stagnatin leading t bld stasis, which can cause dysmenrrhea. Therefre, it is a necessary treating principle t mve stagnated Qi and stasis f bld t release dysmenrrhea. b) If fertilized, the wman becmes pregnant. Hwever, if she still pssesses a deficiency f Qi and bld, she culd easily present a miscarriage. Therefre, if a wman wh has a miscarriage histry, r has sme symptms and signs f Qi and Bld deficiency, cntinuing tnificatin in this stage t prevent miscarriage. 2.2 Fundamental thery and technique f Acupuncture: Acupuncture can be ften effective in treating infertility if applied crrectly, and it is mre acceptable by the British ppulatin. I always use acupuncture, ften cmbined with Chinese herbal medicine in treating female infertility. It has such effects: Stimulate and strengthen the self-regulating functins: Fr example, sme wmen present with unexplained infertility, which may be caused by taking cntraceptive pills fr a lng Treating principle Predminance in kidney yin def time. Due t excessive intake f artificial Oestrgen, the vitality f prgesterne in their bdy has been decreased, r the prprtin f these hrmnes is ut f balance. Therefre, they present with infertility, but n any structural abnrmality can be detected, s unexplained infertility is diagnsed. Acupuncture is gd at stimulating the self-regulating functin inside f the bdy t balance the hrmnal disrder Prmte vulatin: this has been prven by sme research Strengthen self-healing functin: Fr example, wmen with endmetrisis may have sme damages t their endmetrium f uterus frm excessive endmetrial tissues displacement. Endmetria becme unsmth, s it is hard fr the fertilized egg t implant. Acupuncture will strengthen the self-healing functin f endmetria t imprve the cnditin f the uterus. Acu pints: Main pints: Guanyuan (Ren3), Zhngji (Ren2), Guilai (St29), Shenqu (Ren8) Mxui Supprting pints: Baihui (Du20), Waiguan (Sj5), Zulinqi (Gb41), Zusanli (St 36), Zhahai (Ki6), Fuliu (Ki7), Taixi (Ki3), Taichng (Liv3), Sanyinjia (Sp6) These pints are selected accrding t the pattern/syndrme differentiatin. 2.3 Fundamental thery and prescriptin f herbal medicines: Chinese herbal medicine is used t supprt acupuncture. Integrating bth will make the treatment fulfill the purpse expected fr the individual patients. Many frms f Chinese herbal medicines can be selected: patent, cncentrated herbal pwder and natural dry herbs. The treating pwer increases fllwing the rder f the abve herbal frms. Hwever, the patent herbs are easy t take and cheaper, makes it mre suitable fr patients with mild r functinal disrders. Pwders and dry herbs are usually prescribed t individual cases and in crrespndence with different stages f the menstrual circle. In this way, herbal medicine can give better effects. Methd: Accrding t TCM syndrme differentiatin, herbs selected fr the different menstrual stages are shwn in the table. Predminance in kidney yang def Patent Pwder/dry Patent Pwder/dry herbs herbs The first Tnify f kidney and Guipi, Nuzhenzi, Bazhen, Xianma, week* spleen t prmte Zhibaidihuang Hanlianca, Wujibaifeng Yinyanghu, fllicles grwth Xuduan, Danggui, Xiangfu, Tusizi, The Nurish Yin essence, and Zhibaidihuang Danshen, Wujibaifeng Danggui, Xiangfu,

3 secnd week The Third Week The Frth Week mve bld stasis t supprt maturing egg and vulatin Warm Yang and nurish Yin t Prmte prgesterne s grwth Spread stagnated Qi and mve bld stasis t regulate menstruatin; r tnify kidney and spleen t prtect fetus, Tahngsiwu Bazhen, Jinkuishenqi Chaihushugan, Jiaweixiayan, Guipi Xiangfu, Taren, Hnghua, Shudihuang, Rucngrng, Tusizi, Heshuwu, Danshen, Xiangfu, Chisha, Zelan, ect., Bazhenyimu Nuangngyunz i, Buzhngyiqi Xiaya, Tngjing Taren, Hnghua, Baqitian, Tusizi, Danggui, Aiye, ect. Danggui, Xiangfu, Chuanxing, Zelan, ect.

4 * The first day f menstruatin is the start f the first week. 3. Case studies 3.1. Natural pregnancy supprted by acupuncture and herbal medicine Case 1: Unexplained infertility Ms C A, 27 years ld, wh is a physitherapist. N pregnancy fr five years after her marriage. Gynaeclgical cnsultant has dne all srts f the examinatins which are all negative. Therefre, unexplained infertility was diagnsed and she was referred t me fr TCM treatment. Present symptms: stress, restlessness, feeling weepy and nervus, wrse in the week prir t her perid, minr dysmenrrhea, and cnstipatin. Fllwing five mnths f regular menstrual cycle supprted by acupuncture and patent herbal medicine, she was naturally cnceived and delivered a healthy by in a full term. Case 2: Infertility caused by the early failure f varies Mrs. J W, 29 years ld, wh is a researcher in PHD degree, has irregular menstruatin fr all f her life. She has t take estrgen pills t give her regular perids. After her marriage, she wanted t becme pregnant, but she has nt had her perid fr mre than tw years after she stps her estrgen pill. Her estrgen level: < 50. S she was diagnsed as an early failure f varies. Present symptms: depressin, insmnia, nervus, restlessness As a medical researcher, she initially did nt have much cnfidence in TCM. After trying acupuncture weekly at first, then patent herbs being added fr three mnths, she fund that her estrgen level increased t 65. Therefre, she wanted t cntinue TCM treatment. I changed her treatment frm patent herbal frm t dry herbal prescriptin and cntinued her weekly acupuncture. Her estrgen level had increased t 165 after three mnths and she had her perid every ther mnth. Until being pregnant, she had been using TCM fr eleven mnths. She delivered a health baby by n term and gave eight mnths f breast-feeding. She started her regular perid, and then she had anther pregnancy the natural way 18 mnths after her first child. Case 3: Infertility caused by Plycystic Ovary: Ms H W, 32 years ld, wh is a medical researcher, had an irregular menstruatin fr five t six years. Amenrrhea ccurred smetimes, which always lasts 2 3 mnths. She was diagnsed with plycystic vary syndrme. She was given regular acupuncture and patent herbs until her perid became regular. Then she cnceived and delivered a health baby by. After tw years, she had anther pregnancy with similar TCM supprt. Case 4: Infertility caused by endmetrisis, with IVF failed. Mrs. C W, 29 years ld, wh is a clerk, suffered frm endmetrisis, which caused dysmenrrhea. After failing IVF twice, she was seeking the help frm TCM. Regular acupuncture and patent herbal medicines were given t help her cmpletely recver frm IVF and release her dysmenrrhea. Then she successfully cnceived and delivered a baby girl. Case 5: Habitual miscarriages caused by excessive prlactin. Mrs. C F, 35 years ld, wh is a secretary, has had three miscarriages during last three years. She had a high prlactin level. The gynaeclgical cnsultant believed that the excessive prlactin may be related t stress. She was nt fit t accept hrmnal treatment, s she was referred t try alternative and cmplementary treatment. Present symptms: During the first tw t three days after her last miscarriage, she felt stressed, depressed, weepy, had insmnia and abdminal pain. Anther ultrasund examinatin fund multiple cysts n bth f her varies, which were remved with a laparscpe. I used acupuncture and herbal medicine t help her

5 recver and supprt pregnancy. She has cnceived in a half year and cntinues t accept treatment fr fetal prtectin. She had a baby girl when she arrived full term. 2. TCM supprting IVF: Case 1: After three times f failed IVF, a successful pregnancy with triplets with supprt by TCM. Mrs. T F, 27 years ld, wh is a trainer, had had n result when she tried t becme pregnant fr mre than five years. She was diagnsed with a blckage n her left fallpian tube and cysts n her left vary. Her husband was fund having sme antibdies in his sperm, which cannt fertilize his wife s egg. A laparscpy has been dne t take the cysts away, but she was tld bth f her fallpian tubes being blcked,. The cuple bth received TCM treatments. The husband tk sme patent herbs fr imprving his sperm cnditin; the wife used regular acupuncture and cncentrated herbal pwders fr making a regular menstrual cycle. After tw years f treatment, she had her furth IVF with a successful multiple pregnancies and had a caesarean t have tw girls and ne by, all in healthy cnditins. Case 2: A wman wh is near menpause has been supprted by TCM t have a by thrugh IVF. Mrs. S M, 49 years ld, is a teacher. She was pregnant when she was 23 years ld, but had a miscarriage in 40 days. She had never been cnceived again since then. After she was 40 years ld, she started t wrry abut her reprductive functin and sught diagnsis and treatment. She had blckage n bth f her fallpian tubes and failed tw times with IVF. She visited me when she was 49 years ld after missing her menstruatin fr tw mnths. She als had exhaustin, ht flashes, depressin, tinnitus, insmnia, and ther symptms. After a half year f TCM treatment, with tnificatin f kidney and spleen t regulate her hrmnes, she restarted her perid and all the symptms disappeared. Then she had a healthy sn with a successful IVF. Cnclusin: Supprting the menstrual cycle and inducing varian cycle with regular acupuncture and herbal medicine is an effective therapy fr female infertility. Nt nly is it able t supprt females cnceiving, by imprving their reprductive functin; raising hrmnal levels and harmnizing the whle system; it als raises the success rate f IVF. By a way f analgy: acupuncture and herbal treatment functin like plughing which makes the seeds easier t implant. If a patient is in a gd general and lcal cnditin, she will als easily cnceive in a natural way, r with the help f IVF

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