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Hello,
I am a physician that practices acupuncture treatment
with patients with musculoskeletal injuries and with palliative
care patients.
I have a patient/friend who is suffering from unexplained
secondary infertility. They have tried various forms of
assisted reproductive therapies all the way to intracytoplasmic
sperm insemination.
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They are at wits end and asked if there is any efficacy in female
reproductive hormone stimulation using acupuncture.
My question is, is there? What would we be thinking, Liver/Spleen?
What points/protocol would you recommend in a healthy 36 year
old female for infertility therapy.
Thank you,
Dr. TS
Dr. S,
Good question. It's been my experience that sometimes these difficult-to-diagnose
(with western medicine) problems can be successfully treated by
Chinese medicine (CM). And the German study does demonstrate efficacy.
I appreciate that you use acupuncture as part of your practice-
I think it's great when we can blur the lines a bit between medicines,
and not stay behind the walls of our own fortresses.
I'd like to help answer your questions, but need some more info
from you first.
Can you clarify for me the western diagnosis, or if there isn't
one, what pathomechanisms might be involved, and which have been
eliminated? Sounds like - since you're not looking in that direction
- the man's reproductive function is ok. Is the intracytoplasmic
sperm insemination putting the sperm into the egg? Is it that
her eggs are not functioning correctly? Or it's not implanting
into the uterus?
I'm not sure how much training you have in CM; to answer your
question about Liver/Spleen would require more information- also,
I'm not sure if you meant the Liver and Spleen channels or organ-systems?
Pattern Diagnosis is Essential
Of course, the Chinese medicine perspective is not only the channel
system but also the system of pattern diagnosis. We must do a
differential diagnosis on the infertility. Which symptom pattern
is present? If you haven't been trained in this system, I can
help you differentiate it, but I'll need a complete list of all
her symptoms in all bodily systems. I can email you an intake
form if necessary.
With the pattern diagnosis, we can choose the appropriate acupuncture
and herbal strategies. Also, we can add some single herbs (whose
pharmacologic action we know) to a pattern-based formula, if we
know the western pathomechanism. For example, there are herbs
that stimulate the gonads (male and female), herbs that stimulate
spermatogenesis, herbs that stimulate or inhibit galactogenesis,
and herbs that inhibit uterine contractions.
Acupuncture Assisted In-Vitro Fertilization
Another option, though it may not fit their scenario, is acupuncture-assisted
IVF. A German study (n=160) showed a 42.5% success rate with acu
vs. 26.3% in the control group. Of note is the fact that the acu
procedure was performed in the hospital, before and after. As
an MD, you're more likely to have hospital privileges than most
of us non-MD acupuncturists. I can get the acupuncture protocol
for you if they want to go that route.
Brian Carter, MSci, LAc
www.PulseMed.org
Editor's Note: On re-reading this correspondence, a couple
of things occurred to me: First, the doc asked for a protocol-
MD's who practice acupuncture (medical acupuncturists) tend to
think in terms of points combinations for specific western diseases
(which do exist, but are rather basic and general), rather than
the theory behind the point functions, why those points were chosen,
and how to construct their own protocols. Of course, some medical
acupuncturists are very good, and learn at least as much as the
average non-physician acupuncturist.
But it's quite possible Dr. S may have no interest in diagnosing
his patient in terms of pattern differentiation. For some reason,
MD's tend to poo-poo it. I'm not sure why- patterns are basically
syndromes, groups of symptoms. There are many western diseases
that are really just syndromes… they have no idea what causes
the condition, only a list of symptoms. Why they wouldn't want
our set of syndromes, which come with effective treatments attached,
I cannot fathom.
The second thought was, that an MD may not be able to allow an
acupuncturist to help him diagnose in any way- and I don't mean
legally- I'm talking about the MD ego. Not all docs have it, but
it's still quite common… In some hospitals, for example,
acupuncturists are the lowest on the totem pole, regardless of
their level of training, knowledge, or effectiveness at healing
patients.
In short, Dr. S may not have gotten the answer he liked.
B
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