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Case #4:  Endometriosis and Infertility without IVF

38 year old female   Office visit date:  April 1995
Tried for pregnancy 10 years, 0 pregnancies
10 year history of endometriosis and severe cramping
Western Diagnosis: Endometriosis and primary infertility

The patient had surgery ten years before to remove right ovary completely due to damage from endometriosis.  After surgery, the patient received a normal course of “hormonal artificial menopause treatment.”

After the first surgery and a course of treatment, the patient started to try to get pregnant.  She received three cycles of clomiphen citrate and another four cycles of IUI with ovulation stimulation medicine over the first five years, but pregnancy didn’t occur.  Five years after the first surgery, severe cramping resumed and increased.  The patient underwent laparoscopic surgery and follow-up hormonal therapy with Danazol for six months. After this, the couple was told that they needed to go for IVF, otherwise the pregnancy would be very difficult to achieve. They both felt financially and mentally unready for IVF, so they decided to try naturally for another two to three years.  After that time, they felt tired and decided to give up trying for pregnancy.

Four years after the laparoscopy, the patient came to my office because the menstrual cramping returned.   The patient feared that another surgery and course of drugs would be the Western medical approach to her case.  Since she was still young, her period was regular.  They had never tried TCM before, so I suggested they try conceiving naturally using Chinese medicine and acupuncture.  I also suggested treatment for her husband since he worked very hard, felt tired all the time, and intercourse was possible only one time per cycle.

At the time of treatment the patient’s symptoms were:

Cramping, vaginal dryness and pain with intercourseA regular cycle of 28 days with spotting 3-4 days before and after mensesDark red blood with small clotsFatigue, anxiety, insomnia, stress, frequent urinationLow sex drivePale, yellow and dark complexionTongue: Pale and a little dark (purplish), cracks, little tongue coatPulse: Thin, choppyTCM Diagnosis: Kidney Essence and Liver Blood deficiency, Chong/Ren stasis with Blood accumulationTreatment principle: Remove Blood stasis, harmonize the Qi and Blood to stop pain; Tonify Kidney Essence to inhance infertility.

First cycle of treatment
: Acupuncture 1 time per week for one month, herbal medicine daily.  Due to the long history of endometriosis, focus primarily on moving to clear Blood stasis, with Kidney and Liver tonification secondary. 

After the first cycle treatment, the patient’s menstrual cramping decreased a little, intercourse pain decreased.  No increase in cervical mucus. No change in spotting and vaginal dryness. Next Page>



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