Ms Dan Jiang Acu-Herb Consultant

Case Studies Blog

ART Case 6: 2 pregnancies after IVF of donor eggs after TCM promotion and miscarriage prevention


2 times of successful pregnancies produced by IVF with donor eggs following TCM promotion and miscarriage prevention:


Ms. C is a 41 years old university lecturer with PhD degree. Due to continuous and busy study and work, Ms. C attempted pregnancy for 7 years without a positive result. She gradually started to have irregular menstrual circles for over a year and amenorrhea for two months and a small fibroid (1x1cm) is found in her uterus. She was refused by the infertility clinic for ART due to her amenorrhea, so she visited me for help.


Clinical figures:


Amenorrhea for two months, stress, nervousness, abdominal discomfort, poor sleep, hot flashes, aching in general. Light red tongue with less white coating, wiry pulse


Diagnosis of Conventional western medicine:


1 Infertility,

2 The early failure of ovaries

3 Fibroid


Differentiation of TCM:

Liver Qi stagnation with blood stasis and Liver and Kidney yin deficiency


Acupuncture:

Ren8 sheque: Moxibustion

Ren3 zhongji, Ren6 qihai, St29 guilai,

Sp9 yinlingquan, Sp6 sanyinjiao; Ki10 Rangu, Ki6 zhaohai, Ki3 taixi

Du20 baihui, Sj5 waiguan, Gb41 zulinqi


Herbal medicine prescription:

Xiangfu (Rhizoma Cyperi Rotundi) 10,

Shudihuang (Radix Rhemanniae Glutinosae Praeparata) 15,

Dangguiwei (Radix Angelicae Sinensis (extr¨|mit¨| inf¨|rieure)) 10,

Yimucao (Herba Leonuri Heterophylli) 10,

Chishao (Radix Paeoniae Rubrae) 10,

Honghua (Flos Carthami Tinctorii) 10,

Chuanxiong (Radix Ligustici Wallichii) 10

Taoren (Semen Pruni Persicae) 10,

Huangbai (Cortex Phellodendri) 10,

Zhimu (Radix Anemarrhenae Asphodeloidis) 10,

Nvzhenzi (Fructus Ligustri Lucidi) 10,

Shanzhuyu (Fructus Corni Officinalis) 10,

Hanliancao (Herba Ecliptae Prostratae) 10,

Zishiying (Fluoritum) 10


Above herbs are decocted for drinking twice daily as one dose of herbs, 6 packets per week.


Explanation:

The main points of acupuncture should be Ren3 zhongji, and Ren 6qihai which stimulate the original Qi and Kidney Qi, also near uterus; St 29 Guilai which strengthens spleen and releases excessive dampness, also near both ovaries; Du20 baihui, Sj5 waiguan and Gb41 push stagnated liver and general qi through; Sp9 yinlingquan and Sp6 sanyinjiao promote spleen Qi; Ki10 rangu, Ki6zhaohai and Ki3 taixi reinforce kidney Qi and Yin for nourishing and double feeding the weaker ovaries.


Xiangfu (Rhizoma Cyperi Rotundi) pushes stagnated Liver Qi, Shudihuang (Radix Rhemanniae Glutinosae Praeparata), Danggui (Radix Angelicae Sinensis), Chishao (Radix Paeoniae Rubrae

) and Chuanxiong (Radix Ligustici Wallichii) nourish Yin and blood; Yimucao (Herba Leonuri Heterophylli) and Dangguiwei (Danggui tail) (Radix Angelicae Sinensis (extr¨|mit¨| inf¨|rieure))


release the blood stasis; Nvzhenzi (Fructus Ligustri Lucidi) and Hanliancao (Herba Ecliptae Prostratae) nourish Kidney yin; Huangbai (Cortex Phellodendri)and Zhimu (Radix Anemarrhenae Asphodeloidis) nourish kidney- according to laboratory research, their effect is similar to Estrogen; Zishiying (Fluoritum) promotes ovulation and Shanzhuyu (Fructus Corni Officinalis) increases this function too.


Outcome:

Her menstruation arrived the next month. Since then, she has been receiving regular TCM treatments and has got regular period. When she visited infertility consultant, she was suggested to have an IVF with donor egg. Due to the fear that her menopause may come early if otherwise, she and her husband agreed to accept IVF, with the donor egg from another healthy lady, in Barcelona infertility clinic in Spain.


In the next month, two high quality fertilized embryos got transferred into her uterus. After coming back to UK, she kept accepting regular acupuncture with me. At the 8th weeks of her pregnancy, she felt bad nausea, and minor symptoms from over reaction to pregnancy, and some vaginal bleeding. I advised her that should take some herbal medicine to prevent miscarriage. However, she hesitated and did not take any herbs during pregnancy, and as a result, she lost one baby. Then, she started taking herbal decoction and maintained acupuncture until the 12th weeks of her pregnancy. She had a healthy baby boy in the full term.


The herbal prescription for preventing her miscarriage is:


Sangjisheng (Ramulus Loranthi) 15,

Baidoukou (Fructus Amomi Cardamomi) 10,

Xiangfu (Rhizoma Cyperi Rotundi) 10,

Duzhong (Cortex Eucommiae Ulmoidis) 10,

Gouqizi (Fructus Lycii) 10,

Huangqi (Radix Astragali Membranacei) 15

Tusizi (Semen Cuscutae Chinensis) 10,

Chenpi (Pericarpium Citri Reticulatae ) 10,

Shanyao (Radix Dioscoreae Oppositae) 10,

Fuling (Sclerotium Poriae Cocos) 10,

Ejiao (Gelatinum Corii Asini) 10,

Shenqu (Massa Medica Fermentata) 10,

Zhigancao (Radix Glycyrrhizae Uralensis) 5


After above herbs are taken for one week, she stopped vaginal bleeding, and the symptoms from over reaction to pregnancy also got improved. From the 8th to the 10th week of pregnancy, she took 4 weeks of herbs until she entered a normal procedure of pregnancy.


2 years later, she got transferred another fertilized embryo again, with acupuncture preparation and miscarriage prevention; this time she displayed no miscarriage signs and labored a healthy baby girl again in the fully term.


Analysis:


IVF with donor egg is suitable for ladies who possess unsatisfactory ovary state, so she may not be able to produce good quality eggs. Hence, a younger lady donated her eggs to Ms. C, to be fertilized with her husband’s sperm. The fertilized embryos were then transferred into Ms. C, who then needed to go through the whole procedure of pregnancy. She still needed to have a healthy ovary function to respond to the conception.


Due to too much pressure from study and work at the university, she displayed some signs that are caused by weak ovary. Doctors in charge of IVF can’t accept any ladies without regular menstrual circles. Although with TCM she regained regular menstrual circles, the doctor may still believe that her ovary is not optimal for a normal IVF. She and her husband hence had to agree on doing an IVF with donor eggs.


During pregnancy, because of her weak ovary, she manifested signs of potential miscarriage —vaginal bleeding and low back pain; she managed to keep one baby after starting to take decocted herb, but by that time she has already lost one baby.


From this case, it can be seen that it is quite necessary to support pregnancy when the lady has weak ovaries. TCM plays a complementary role in giving the lady a better state for accepting IVF with donor eggs and prevents miscarriage.



Reference:

Dan Jiang, Tianjun Wang, Chapter 8: TCM’s promotion to Assisted Reproductive Technology (ART), Understanding, Managing and Treating Female Infertility with Traditional Chinese Medicine, Edited by Peilin Sun, Weixiang Wang, Shulan Tang, Dec 2018, Publisher: Singing Dragon.

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