Clinical Success Stories: Two Fertility Patients, Far End of Extremes in Severity of Problem & Duration of Treatment
Since I just had two fertility patients this week give birth to bouncing little perfectly healthy babies, I thought I’d share a write-up of what the treatment process looked like for them both.
Their cases were about as opposite as they come on the scale of both difficulty, as well as time to conceive & live birth. So I thought outlining the two cases would give people a perfect — and realistic — look at how natural fertility treatment with acupuncture goes.
Acupuncture for Natural Fertility Treatment vs. to Support IVF
Keep in mind that I only work with women who are trying to get pregnant naturally. The reasons why warrant another post. But what this means is that the job before us is to FIX the underlying problem that’s causing the infertility, rather than going around it, which is where IVF excels.
When women choose IVF and are just using acupuncture to support that modality, the results are often much faster, because each IVF cycle either works or it doesn’t, but it doesn’t depend on a woman taking the time (sometimes several cycles) to heal the underlying cause for needing to use IVF in the first place.
The two fertility acupuncture stories
(To maintain confidentiality, instead of using names I’m just using “Patient A” and “Patient B”)
Fertility Patient A:
Aged 34, she came to me having tried to get pregnant for about 1.5 years. Her cycles were irregular, varying between 23 and 40 days. She therefore never knew when to time intercourse because she never knew when she would be ovulating. After some research before coming to see me, she learned that having fertile/eggwhite mucous meant ovulation was close, so combining that with OPKs helped her learn when she was ovulating. However, after several months of still no pregnancy, that’s when she came to see me.
Her other symptoms were: mild anxiety, moderate to severe PMS, and migraines most typically in the week after her menstrual cycle. Her blood was light in flow, had some small dark clots, and she had moderate cramps starting a couple days before her period. Other than some mild dizziness when she got really stressed out, she was in good health. She had a thin, wiry body build and described herself as being a “stress-case”. To alleviate her stress she would do very vigorous exercise almost daily.
She had already started taking her basal body temperature (BBT) before coming to see me, and her charts showed that her temperatures in all phases of her cycle were not only all over the place, but also only showed a very slow increase in temperature at ovulation and then not staying up high like it should in the luteal phase. Her temperatures also didn’t drop down as they should on day one of bleeding, until about 6 days into her period.
She had a classic pulse and tongue picture for these symptoms:
- pulses: wiry and small across all points
- tongue: mildly purple and pale, with some slight red dots along the sides
This is a classic picture of a patient with the Chinese diagnoses of Liver Qi stagnation with Liver blood deficiency and blood stasis.
Whenever a patient presents this “textbook”, my job is easy. I have almost no doubts that acupuncture treatment will be successful, because the treatment goals are so blatantly clear:
Acupuncture & herbal treatment goals:
1) regulate her liver (the liver regulates the menstrual cycle, relates to stress and PMS, as well as to keeping everything open, flowing, and relaxed, as opposed to spasming like uterine cramps)
2) nourish her liver blood: when someone’s liver is stagnant and the blood is deficient, migraines and dizziness are common. The fact that her migraines would come after her period started (when she would lose blood), along with her light flow and pale tongue, all told me liver blood deficiency. If we don’t have enough blood, then our ovaries and endometrium aren’t getting good flow and nourishment.
3) Lastly, and this goes right along with the first two diagnoses, we need to “move” her blood. The dark clots and cramps indicated that her blood isn’t flowing well. When discussing fertility and blood flow, we’re mostly thinking of the microcirculation in the reproductive organs. And blood stasis often also comes along with inflammatory markers, which are also more and more commonly being seen as a contributing factor in fertility and miscarriage.
Acupuncture Treatment Process
I knew it was important for her to hold off on trying to conceive, because I was worried that with her blood stasis and deficiency, that her risk for miscarriage was increased. Blood stasis is one of the most common risks for early miscarriage. She reluctantly agreed. I also recommended that she try to decrease the intensity of her daily workouts, which was very scary for her since that’s what she felt kept her “sane”. I reassured her that the acupuncture should calm her stress enough that it would be OK, and suggested adding in more “yin” type activities like yin-yoga, relaxing walks, etc. I urged her to schedule in more time for relaxation so she could replenish her depleted body.
Month 1: The first month of treatment, her BBTs immediately normalized, and she had her first very clear and obvious shift between the follicular, ovulatory, and luteal phases. Cycle lasted 32 days. Her blood flow continued to be light, and bigger dark clots came out. She had almost no PMS or cramps, but she still got her typical migraine on day 3. Overall she reported being more relaxed since starting treatment. Her BBT however still did not show a good drop like it should when she started her period.
Month 2: This cycle was 27 days. Once again there was no PMS, but she did have much worse cramps and lots of dark, chunky, thick blood came out. She still got a migraine after her period came, but it was very mild and only required an OTC med. Her BBTs dropped sooner upon starting her cycle, but still not til day 4.
Month 3: This cycle was 29 days. No PMS, a little bit heavier flow and no clots or cramps at all. For the first time since she could remember, she didn’t get a migraine! Her BBT dropped down very well on day 2 of her bleeding. She also couldn’t remember the last time she’d had dizziness with stress.
Month 4: This cycle her BBT once again dropped on day 2 of her cycle — still not as ideal as dropping immediately once bleeding started. She had no PMS or cramps. Her BBTs looked quite ideal, and she went on to get pregnant that cycle, with a very good, healthy pregnancy without problems. She’s now a mommy!
Fertility Patient B:
She was 36. She was more plump in build, and had been through 3 failed IVF cycles. She’d been diagnosed with PCOS, and since the birth of her first child at age 28, her cycles were so irregular that she might only get 1 or 2 per year. Since she had no ultrasound showing the “string of pearls” on her ovaries, the diagnosis was mostly based on her body type, lack of cycles/ovulation, and very mild hirsutism. She did, however, have cysts on her ovaries that had come and gone her entire life.
She also had very bad allergies with constant sinus congestion causing frontal headaches. She had digestive problems which were mostly just extreme bloating, with a little bit of slower and hard/dry stools, both worse in times of stress or poor eating. She ran extremely hot and would often wake up drenched in sweat. Although sluggish in energy, once she laid down to sleep, she would often just lay awake for hours. She would also get migraines a couple times/month
She had also been doing her BBTs and we could see no “cycles” happening at all, including no clear evidence of ovulation. She had no fertile/eggwhite mucous. When she did have a period her bleeding was extremely heavy and musousy/stringy.
Like the first patient, she also confessed to being very stressed, but in her case she would turn to comfort foods in times of stress.
Pulse and tongue diagnosis:
- Pulse: many conflicting qualities, including wiry and full in some positions, almost imperceptible in others, and soggy and full in others. Over time this balanced out to being mostly small and soggy.
- Tongue: puffy and wet, with red dots on the sides and a thin yellow coat, getting thicker and greasy towards the back.
This patient had an extremely complex case, with many facets of imbalance. In a case this complex it’s too much to explain the diagnostics in an understandable way to laypeople, so I’ll just list out some of our treatment goals.
This is a classic case where first we have to solve one problem, then we can move onto the next. There were many, many problems that needed fixing and it wasn’t a surprise at all that her IVF cycles had failed.
Acupuncture & herbal treatment goals:
#1: Clear out “sludge” from the body. She had so much excess fluid accumulations and secretions, and until we cleared that out, we could’t move on to other steps. Examples: cysts, congestion, wet tongue, mucousy menstruation.
#2: Boost her body’s energy: We do this through benefiting the digestion, since it’s through the food we eat that we build more qi. That will help improve her bloating and stools, as well as increase her energy and decrease her heavy bleeding.
#3: Balance her liver to help the stress, regulate her cycles, improve sleep and help the night sweats.
#4: Once she started having menstrual cycles and ovulating, we would tweak the treatment process and herbs according to what was currently presenting itself.
The goal was that once her body started processing her fluids better, they would be able to perform their purposed functions of cooling her and creating good fertile mucous, instead of getting all mucked up as sinus congestion, cysts, and mucousy menstruation. These “sludgy” type constitutions likely have thick viscous fallopian tube secretions that might block the egg’s passage to the uterus. The slippery menstruation/endometrium also is likely impairing good implantation sites in the uterus, making it difficult for an egg to find a resting place.
But of course none of that matters if she’s not ovulating.
Acupuncture & herbal treatment process and progress:
I advised her to decrease her carbs as much as possible, and to do her best to get some form of movement in every day, even just a relaxing walk. I put her on an herbal formula that she would just take continuously until either 1) she had a period, or 2) she started getting fertile mucous. At that point her herbs would switch to different “formulas“.
Cycles 1-2 (approx 6 months): After 9 weeks of regular acupuncture treatments and continued use of herbs, she ovulated. Her BBTs continued to be all over the place and her temps didn’t stay up well after that ovulation. 10 days later she had a period. It was less sludgy but still as heavy. After another 11 weeks she ovulated again and this time her temps stayed higher and she got another period a perfect 14 days later. She had fertile mucous for the first time she could remember, in that second cycle.
Her energy really started improving about a month into treatment, which helped give her motivation for walking. She increased her walking more and had lost a little weight by month 2. Her sinus congestion disappeared after about week 5 of treatment, which meant her sinus headaches were gone. Her migraines also went completely away by week 7 of treatment. Her night sweats disappeared almost immediately, about two weeks into treatment, which helped her sleep, which helped her energy. Overall her quality of life had dramatically improved, although her cycles still needed a ton of work.
She reported feeling like a completely different person, in the best health of her life.
Cycles 3-5 (approx 5 months): Progress really picked up. She started having periods every 35-50 days, ovulating a perfect 14 days before each period would come. Her blood no longer had mucous in it and was less heavy. Her follicular phase BBT temps were still jumping all over the place, but less so than when we began.
She got pregnant. But lost it at week 6 just before her appointment to check for a heartbeat. . :-(
Cycles 6-8: We both expected her to not get another period for a few months after this pregnancy, but to our surprise, 6 weeks after her miscarriage she had a very clear ovulation with great fertile mucous. Her period came at the correct time and was normal flow. She had one more period that came 32 days later, and in the next cycle she got pregnant again.
Her hcg started dropping at week 5 and they were worried about another miscarriage. They also detected a subchorionic hematoma and the patient had light spotting but no cramps. I continued her treatment on herbs and acupuncture, seeing her often during this time. At her next OB appointment at week 6, her hematoma had decreased in size and her spotting had decreased. After some scary fits and starts, including the fetus being small for its age, everything suddenly normalized around week 13.
This was a much tougher case, but after about 14 months of regular treatment, she went on to have a healthy pregnancy and just gave birth to a lovely baby girl. She consented for me to share her story anonymously so that it might encourage/motivate other women in similar situations.
Fertility Treatment Summary:
You can see from these two examples, that the journey of natural fertility is different for every woman. Our age, overall health, menstrual history, and just overall constitutional strength has so much impact on the treatment duration, prognosis, and outcome.
I hope this very long post is helpful in illustrating how different the journeys can be, and how quick, or slow, the process can be.