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CASE STUDY I: Sperm
Allergy
My husband and I wanted to start a family right away so we tried getting pregnant one month after we married. We have now been married three years and we still don't have a child. My husband's sperm checks out fine. I've been to seven doctors and no one can seem to find anything wrong with me. I even underwent a laparoscopy and was told I look good inside and have no signs of endometriosis. My current doctor says he wants to do a test to see if I am allergic to my husband's sperm.
Doctors all say that getting pregnant is on my mind too much, that by thinking about it I'm making myself a nervous wreck and it's harder for me to conceive because I'm "obsessed”. About a year ago I miscarried during my first trimester and I haven't been able to get pregnant since. I'm twenty-eight and getting older all the time. Yes, I am worried. I keep hearing that everything is fine, but I still don't have a baby. Everyone says, "relax." Relax, relax—easy to say but not so easy to do. I need help.
—Shirley W.
A postcoital test is usually done as part of a normal infertility workup. A couple has sexual intercourse during the woman's ovulation and within hours thereafter, the woman visits the doctor so that he may analyze samples of her cervical mucus. Using a microscope, the physician will be able to determine whether or not the sperm are surviving in the mucus. If a high number of the sperm en route to the uterus have died in the mucus, the odds for conception are certainly decreased. The woman's mucus and her partner's sperm are in-compatible, and this may be an allergy case.
A woman's sperm allergy, as bizarre as it may seem, is a possible cause of infertility. Studies on the immune systems of women with infertility show that the women often have antibodies against her husbands’ sperm, called sperm-antibodies. This means that sperm allergy has been clearly associated with decreased egg fertilization, decreased success rates for in vitro fertilization (IVF).
Jane Liu felt it appropriate to combine acupuncture and Chinese herbal medicine to treat her infertility with sperm-antibodies: acupuncture to relax and reduce her stress; herbal treatment to normalize the immune system.
Shirley took the herbs in a powdered form. She came weekly for about eight weeks, receiving acupuncture treatment each time, and I adjusted her herbal prescription every two weeks. She soon felt much better and was now to sleep more deeply. After eight weeks, acupuncture was discontinued and Shirley proceeded with herbal therapy only. She returned for a follow-up visit every three weeks. Eight months after her initial visit, Shirley generally felt much more healthy and got pregnant. She did continue to receive the herbal supplement for 12 weeks and finally had a full-term pregnancy.
CASE STUDY II:
Endometriosis
I have been going to the doctor for two years to find out why I can't have a baby. I had one tubal pregnancy and three D & Cs (Dilatation & Curettage). The doctor did a laparoscopy and found adhesions between my uterus and tubes and a slight case of endometriosis. He said he didn't know if the endometriosis was causing my infertility and he didn't treat it for several months. When I still failed to conceive and felt pain during my period, he decided to put me on danazol. I want a child very badly and I would like to do everything before something terrible happens and I'm never able to have children.
—Janet C.
New studies show that ovulation often does not occur when endometriosis has attacked the ovary. This finding might explain why women with just a little bit of endometriosis have great difficulty becoming pregnant unless they are immediately treated. There is speculation that endometriosis might cause a filmy adhesion around the ovary that prevents the egg from escaping as it should during ovulation. A recent study has shown that women with endometriosis also produce high levels of prostaglandins, which could result in increased tubal and uterine cramping. The tube could squeeze out an egg before conception occurs.
The treatment for Janet consisted of herbal prescription and acupuncture combined with a prostaglandin-blocking drug—Danocrine (danazol)—which her ob/gyn prescribed to her for the case of endometriosis. Since Endometriosis carries with it the potential for serious problems, Jane Liu urge women to have it treated immediately.
Appropriate acupuncture points were selected, and the channels around the uterus, which were especially painful, were treated by using acupuncture needles in a pecking motion.
The purpose of herbal treatment is to increase circulation on the pelvis and regulate the immune system, thereby promoting drainage, discouraging adhesions, and facilitating removal of inflammatory substances. The herbs I chose for treatment act as hormonal precursors and balancers, and also improve liver function and digestion.
The result is usually symptom relief as a result of treating the underlying cause. Patients consistently report a marked decrease in dysmenorrhea, pain with intercourse, digestive symptoms, menorrhagia, and ovulation pain, along with an improvement in mental outlook and decrease of lassitude.
After three treatments the pain was markedly reduced. After three months of treatment, Janet was virtually pain free. Six months later, the medication was discontinued and Janet conceived. Ten months later, Janet got a baby boy.
CASE STUDY III: Over-production of Testosterone in Women
I'm not gorgeous but I'm not exactly ugly either. I've won three beauty contests. 1 entered them, though, because I wanted to prove to myself that the hair I have on my chin, belly, and breasts would not prevent me from succeeding in life. I went to a psychiatrist for over a year before I would let a boy touch me because I was so ashamed of my body hair. Now I'm twenty-four and married and have a wonderful husband, but we have had no luck conceiving. I remember that once a doctor told me that a lot of male hormone in my body made me hairy. I would like to reduce the male hormone level, which is connected to infertility.
-Martha
A woman who has hair on her chin and around her nipples, and pubic hair that grows in a triangular fashion, upward toward her navel, has the possibility of having Stein-Leventhal syndrome. This condition was pinpointed decades ago by two Chicago-based physicians who diagnosed women with excessive hair growth, irregular periods, and enlarged polycystic ovaries as sufferers of the disease. The doctors also analyzed hormones.
Every woman produces estrogen, progesterone, and testosterone, and if her ovaries enlarge, they will generate more of each hormone. Sometimes, when hormonal balance is off, a high amount of the male hormone, testosterone, is secreted. The increased male hormone can cause extra hairiness, which signals the syndrome.
A woman with Stein-Leventhal syndrome will also have irregular bleeding, and she might be overweight due to her increased hormonal production. Martha mentions that a doctor told her that she had too much male hormone, testosterone. If she also has an irregular menstrual pattern, she might have Stein-Leventhal syndrome, which might, indeed, be the cause of her infertility.
Today, doctors believe in treating the hormonal imbalance with medication, and surgery is only used in certain special cases. Physicians also avoid the use of steroids to decrease hair growth. Hair does not disappear with hormonal treatment. Early detection of the disease is important so that the situation can be corrected with medication.
Instead of medication or steroids, Martha was treated with herbal prescriptions. She initially found that the herbs she was given made her skin more smoothly , but her menstrual periods were still very irregular. With fine-tuning of her herbal therapy, after a period of about three months, there was a significant improvement in Martha’s condition. Six months later her skin was healthier than it had been for many years and she got pregnant.
Liu develops formulas of herbs fine-tuned for the individual. “It’s important not to use herbs like a cookbook, always prescribing the same herb for a given disease.” Liu uses a polypharmacy approach, combining various herbs, because, “combining appropriate herbs results in an enhanced effect.” She uses two of her own formulas, one for each phase of the cycle: between menses and ovulation (approximately day fourteen or later), and from ovulation to the beginning of menses.
CASE STUDY IV: Male
Infertility
My wife and I have been trying to start a family. We have had sex at different times of the day and night all throughout the month. We have been trying for the better part of the year and she has still not gotten pregnant. She thought she might need a D & C (Dilatation & Curettage), but I'm wondering if I'm not the one who should go to a doctor. So I had a sperm count and it was low. I realized that I am not able to get my wife pregnant.
-J.P.
Approximately 40 percent of all infertility problems are caused by the male. A man may have a low sperm count or his sperm may have poor motility (movement) or abnormal morphology (structure, shape). When a man and a woman are faced with the problem of infertility, it is very important that a man have a sperm count before his wife undergoes many painful, expensive tests. Quite often men have low counts due to malformations in the genitals, stress, excessive drinking or smoking, jogging in tight nylon shorts, or soaking in hot tubs, to name a few issues.
A man usually releases 3 to 5 cubic centimeters (cc) of semen with a pH ranging from 7.05 to 7.80. The normal sperm count is routinely greater than 40 million per cc. In the thirties, forties, and even in the fifties, it was assumed that 100 million sperm per cc was average. By 1974 a median sperm count had dropped to an average of 65 million. In a study of 150 students at Florida State University in 1975, the average sperm count was 60 million per cc with 23 percent of the men having fewer than 20 million. The 60 million figure is now considered the overall average and 20 million is thought to be the lowest amount possible for conception. This greatly reduced sperm count is attributed to modern-day stress, infections, environmental pollutants, and physical conditions such as varicocele, the bulging of the veins near the testicles, a condition that inhibits sperm motility.
My treatment recommendation for J. P. was a combination of acupuncture and herbal therapy. J. P. was treated initially twice weekly, and then weekly. After two months of acupuncture treatment he was sleeping much better, naturally benefiting his general energy level. He was still having some levels of anxiety but the intensity was markedly reduced.
Herbal prescription seemed to enhance his state of well-being as well. There are several classic formulas that would form the basis for a treatment of a condition such as this, and these can be adapted according to the specifics of the presenting signs and symptoms. Herbs were selected to increase his sperm count and sperm motility.
J.P. was encouraged to avoid excessive exercise, overeating, heavy drinking and smoking. He tried to keep himself fit, well-rested, and as stress-free as possible. After three months J. P. had received some significant benefit from the acupuncture and herbal treatment and his sperm count increased. One year later, he and his wife got a baby boy.
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