Recurrent Miscarriage d/t Chromosomal Translocation
Patient is a 33-year-old female complaining recurrent miscarriage x 3, all occurring before the 6th week of pregnancy due to translocated chromosomes. She characterizes her menses as painful, clotty, accompanied by PMS and dark brown discharge.
Other complaints include chronic lumbosacral pain, constipation, heartburn, migraines and insomnia. One month before commencing acupuncture treatment, the patient also had a cancelled IVF cycle due to poor ovarian response in which only 4 follicles were retrieved. PGD (preimplantation genetic diagnosis) was recommended by the patient’s reproductive endocrinologist due to findings of chromosomal abnormalities.
1st treatment: 12/18/04 P: weak, thready T: fissured, deep cracks in midline, pale dusky color.
TCM diagnosis: Chronic kidney deficiency with blood stasis and liver qi stagnation. Started oral contraception for 2nd IVF cycle.
2/18/05: IVF chemical pregnancy resulted in 4th miscarriage. Procedure resulted in the retrieval of 8 follicles, only 2 of which matured. No PGD was attempted due to poor response to meds. Pt. will try to conceive naturally.
5/19/05: Menses arrived, clots, cramps and brown slimy discharge. Recommended Mind Body Fertility Handbook by Niravi Payne to cope with miscarriages, along with osteopathic manipulations for alleviation of chronic lumbosacral pain.
6/10/05: Patient saw osteopath for manipulation; said sacrum was tilted and anteriorly rotated. Also did exercises in fertility book recommended and stated her anxiety was improved.
6/17/05: Positive beta HCG: 350 first reading! 5 weeks pregnant with slippery pulse on right. Patient also taking progesterone suppositories since ovulation as recommended by her R.E.
6/24/05: HCG 1700, heartbeat detected on US.
02/06: Patient delivered healthy baby girl.
Conclusion: This case demonstrates the need to address mind and body through different modalities to achieve positive results. Although fertility drugs can be most helpful in many circumstances, this was not the case for this patient. Interestingly, the month that she addressed her feelings about the 4 miscarriages she experienced, along with addressing the position of her sacrum a healthy pregnancy was achieved. No herbs were used in the month preceding the pregnancy and acupuncture was utilized weekly since December of 2004, focusing on opening the Ren and Chong through the extraordinary vessels. The patient was seen throughout her pregnancy in which treatment was aimed at alleviation of heartburn, nausea and lumbosacral pain.
Content provided by Chinese Medicine Tools, http://www.chinesemedicinetools.com
When To Consider Chinese Medicine in the Treatment of Infertility
(Appearing in Fall 2004 South Florida RESOLVE newsletter)
By Farrar V. Celada, D.O.M, A.P., Licensed Acupuncture Physician
As media coverage of acupuncture’s role in the treatment of infertility increases, certain questions repeatedly arise from prospective patients. As an acupuncturist specializing in infertility, I will attempt to clarify as much as possible the benefits and drawbacks to beginning a course of acupuncture and Chinese herbal medicinal treatment.
Q: What is Oriental Medicine and how does it help with infertility?
A: Oriental Medicine has developed over thousands of years to include acupuncture, Chinese herbal medicine, tui-na (soft tissue mobilization), and qigong (meditative breathing and movement). The most popular branch of Oriental Medicine in the West, however, is acupuncture. Acupuncture has been proven to increase success rates of IVF by nearly twenty percent when administered in a German study in 2002.
Of course, Chinese doctors have known of the benefits of Oriental Medicine in the treatment of infertility long before it was ever studied in the West, with the first known publications on infertility appearing several hundred years ago. Due to recent studies, we now know that acupuncture affects the pituitary gland and acts on the sympathetic nervous system to reduce stress and regulate hormones. In the treatment of infertility, it has also been shown to increase blood flow to the uterus.
Herbal medicine has been rigorously studied in China and some herbs have been shown to increase sperm motility in men and balance estrogen and progesterone in women.
Q: Both of my fallopian tubes are blocked, can acupuncture help?
A: In this case, ART (assisted reproduction technology), rather than acupuncture, would be recommended. Unfortunately, some patients in this situation pursue “natural” therapies too long when their main or only choice of success is IVF.
Q: What types of infertility respond best to Oriental Medicine?
A: Relatively minor complications such as slightly low sperm counts, irregular ovulation, mild endometriosis, and vague hormonal imbalances tend to respond best. Acupuncture and Chinese herbal medicine often can correct such imbalances successfully in most women. Those with infertility due to PCOS also fit into this category.
Q: My doctor doesn’t want me to take herbs during my IVF cycle, will the acupuncture alone be effective?
A: While no treatment is 100% guaranteed, acupuncture without Chinese herbs can still be quite effective. At Florida Complete Wellness, we often will combine herbal medicine with acupuncture if we can see the patient prior to the start of ovarian stimulation. After that point, the herbs can be discontinued and only acupunture will be used. Many IVF clinics ask their patients to avoid herbs during a stimulated cycle, which is good advice considering the strong medications that are circulating in the patient’s body. However, in a case where a woman is over the age of 40 and has undergone several unsuccessful IVF and ART attempts already, Chinese medicine might be recommended along with acupuncture (with the agreement of the patient’s doctor) to increase her chances of pregnancy.
Q: Should my partner be undergoing acupuncture and herbal treatment as well?
A: In Oriental medicine theory, both partners should address their health in order to achieve the best outcome. As it takes about 80-90 days for sperm to mature, men are usually asked to begin treatment as early as possible in the case of mildly low sperm count. Additionally, nutritional recommendations are made to maximize treatment benefits. Acupuncture can also assist both partners by decreasing stress and promoting relaxation during IVF treatment.
Q: How long does acupuncture treatment last?
A: A typical acupuncture visit will last anywhere from 30 to 45 minutes depending on complexity, with the initial visit lasting as long as 1 1/2 hours (including examination and treatment). If the patient is considering IVF, acupuncture treatments will usually occur 1-2 times per week, with more frequent visits the week of retrieval and implantation. If trying to conceive naturally, an acupuncture course is usually once per week for at least 3 to 6 months (or, if pregnancy is achieved, until end of first trimester). The patient will be re-evaluated periodically and will be encouraged to chart basal body temperature, cervical fluid, etc. to track changes.
Q: I don’t like needles. Is acupuncture painful?
A: This is an important question concerning those undergoing IVF, as the fear of needles will sooner or later have to be addressed. Many patients find acupuncture a good way to relieve their “needle-phobia” in preparation for their injections at the end of their IVF cycle. Acupuncture needles are the width of a human hair, and most patients will feel a sensation similar to a mosquito bite near the point site. Other areas, such as the feet and hands, are more sensitive but rarely bothersome. The effects of acupuncture usually result in relaxation or even a short nap during treatment.
Q: My doctor diagnosed me with “unexplained infertility.” Can acupuncture help?
A: Although no detectable abnormality is apparent, Chinese medicine often can detect a possible cause. By taking into account an array of symptoms presented from an Oriental medicine perspective, the correct acupuncture and Chinese medicinal protocol can be prescribed. In cases where the patient is motivated, the results are often good.
Q: How do I know if my acupuncture physician (A.P.) is qualified?
A: In order to practice acupuncture in the state of Florida, an A.P. Must be licensed by the Florida Department of Health and board certified by the NCCAOM (National Certification Commission of Acupuncture and Oriental Medicine). Formal training at an accredited acupuncture school is completed in 3 1/2 to 4 years, in addition to at least 60 credit hours of undergraduate school beforehand. After graduation or during the last year of acupuncture training, the student can complete their training at affiliate hospitals in China.
When choosing an A.P., you may first want to inquire as to their specialty before embarking on your acupuncture journey. Generally, an A.P. specializing in infertility is to be sought out, and many websites are devoted now to listing qualified practitioners by region.
In my experience, I have found that both Western and Chinese medicine have strong, effective solutions to infertility and both systems of medicine have much to offer one another. As information grows about the benefits of Oriental medicine, it is important that patients develop a “team” of knowledgeable practitioners that understands the strengths and weaknesses of both systems and can help them along the highly anticipated road to fertility.
Farrar V. Celada is a licensed acupuncture physician and member of Resolve,
with a private practice in Hollywood, FL.
She may be reached at
954-241-0271 for further questions pertaining to this article or by email at fc@floridaholistichealth.com.
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