Treating Premature Ovarian Failure with Acupuncture and Chinese Herbs

Abbreviations

IVF: In Vitro Fertilization; POF: Premature Ovarian Failure; TCM: Traditional Chinese Medicine; ITP: Idiopathic Thrombocytopenic Purpura.

Condition Analysis

The primary issue the patient faces is infertility caused by premature ovarian failure. Although the fourth IVF attempt resulted in a successful pregnancy, subsequent treatments have shown poor egg quality and quantity, further decreasing the likelihood of natural conception. Considering the patient’s medical and surgical history, the doctor recommends using donor eggs for the next IVF attempt to increase the success rate.

Acupuncture points

• Xinshu, Feishu, Ganshu, Pishu, Shenshu, Ciliao. Neiguan, Gongsun, Zusanli, Sanyinjiao, Qihai, Xuehai, Taichong, Shenmen, Guanyuan, Zhongji, Zigong, Guilai, Baihui.
• Gongsun, Neiguan (regulating Chong and Ren).
• Shenshu, Ganshu, Taixi, Sanyinjiao, Taichong (nourishing liver and kidney, replenishing the foundation of congenital essence to improve egg quality, providing material support).
• Feishu, Pishu, Neiguan, Zusanli, Sanyinjiao, Qihai, Guanyuan (regulating spleen and stomach, replenishing the foundation of acquired essence, source of Qi and blood for metabolism).
• Baihui, Xinshu, Shenmen (regulating spirit, calming and soothing the mind).
• Zhongji, Guanyuan, Zigong, Guilai, Xuehai (improving ovarian function, enhancing endometrial receptivity, regulating Chong and Ren, preparing for embryo implantation).

Diet and Lifestyle Recommendations

• Dietary Adjustment: Consume foods rich in protein, vitamins, and minerals, such as lean meat, fish, eggs, soy products, vegetables, and fruits. • Avoid Cold Foods: Prefer warm foods and avoid cold or raw foods to prevent damage to the spleen and stomach yang energy. • Emotional Regulation: Maintain a cheerful mood, avoid excessive anxiety and tension, and consider activities like yoga, tai chi, and walking to help regulate emotions. • Regular Routine: Maintain a regular routine, avoid staying up late, and ensure adequate sleep to facilitate the body’s self-repair. • Quit Smoking: Stop smoking to improve overall health. • Limit Alcohol Consumption: Consume alcohol in moderation or not at all. • Avoid Caffeine: Eliminate or reduce the intake of caffeinated beverages. • Maintain a Healthy Weight: Avoid being overweight through balanced diet and regular exercise.

On her third visit, on November 2, 2015, the patient told me she felt her energy was a hundred times better. Her sleep improved, her mental stress and anxiety reduced significantly, her mood noticeably improved, she became happier and more relaxed. After one menstrual cycle of treatment, her menstrual cycle shortened from 40 days to 31 days, with reduced menstrual flow that was brighter red and less dark, fewer blood clots, and less menstrual pain. Her hot flashes and night sweats disappeared. On her fifth visit.

November 24, 2015, her period lasted 5 days without blood clots or menstrual pain. On her seventh visit.

December 22, 2015, the 11th day of her menstrual cycle, she began to have vaginal discharge. I used acupuncture points such as Kidney Yu, Ba Liao, Guan Yuan, and uterine acupuncture to promote ovulation. She later told me that the second day after treatment, she ovulated, with noticeable vaginal discharge, and her basal body temperature showed a biphasic pattern, indicating ovulation—0.4 degrees higher in the luteal phase than in the follicular phase.

On January 19, 2016, she was 5 weeks pregnant and very happy. (Treatment lasted about 3 months.) I continued to provide acupuncture treatment, calming her mind and supporting pregnancy once a week for the first 12 weeks, and every two weeks thereafter until delivery. She gave birth to a beautiful and healthy baby girl. She later told me that her daughter is calm and happy, in contrast to her son who is hyperactive and impatient. She attributes this to the acupuncture treatment during pregnancy. With acupuncture’s help, she remained relaxed and in good spirits throughout her pregnancy. She continues to come to me regularly for body maintenance. She has referred her husband, father, relatives, friends, and colleagues to my clinic.

A few days ago, she came to get medicine for her father, bringing her daughter, who is very beautiful. She said to her daughter, “Without Qing’s help, and without your arrival.” Her daughter asked in confusion, “Why?” She said to me, “She’s too young to understand.”

Analysis

The patient’s infertility, her kidney deficiency, and deficiency of Qi and blood are the main pathological mechanisms. She suffers from a hereditary blood system disorder. With low platelets and congenital kidney Qi deficiency, as well as Qi and blood deficiency, these primary mechanisms lead to secondary issues. Liver blood deficiency causes stagnation in the slow-flowing stream, leading to liver Qi deficiency and subsequent liver Qi stagnation over time. This stagnation can progress to blood stasis due to liver blood deficiency, causing insufficient heart blood and resulting in a deficiency of nourishment for the heart spirit, leading to insomnia and anxiety.

Due to kidney Qi deficiency and Qi and blood deficiency, various bodily systems’ functions are insufficient, causing endocrine disorders and resulting in a series of issues such as ovarian cysts, uterine fibroids, and infertility.

She has low platelets and poor coagulation mechanisms, resulting in heavy menstrual bleeding, creating a vicious cycle leading to damage to the Chong and Ren channels. This damage, combined with endocrine disorders, ovarian cysts, uterine fibroids, and infertility, has led to unsuccessful attempts at IVF several times.

In treatment, I emphasize nourishing the liver and kidneys, nourishing blood and essence, supplementing Qi and nourishing blood, and supporting liver Qi circulation while promoting blood circulation and removing blood stasis.

• Baihui (Hundred Meetings Point), DuMai (Govern Spirit Point): Baihui is where hundreds of vessels converge, a crucial point for governing the spirit. The Governing Vessel is a sea of yang channels that governs the entire body’s yang meridians, regulating the flow of qi and blood. Baihui, located at the top of the head, is also the area where the central nervous system circulates. Stimulating this point effectively regulates brain function and the central nervous system, thereby adjusting the endocrine and urinary reproductive systems, making it an effective point for regulating spirit. • Fengchi (Wind Pool Point): Located in the muscles under the occiput, this neck point relieves tension and anxiety, which can otherwise restrict blood supply to the brain. Thirty percent of the brain’s blood supply comes from the vertebral arteries. Relaxing the muscles in the neck can improve cerebral blood circulation and enhance brain function. • GanShu, (Liver Shu Point), PiShu (Spleen Shu Point), ShenShu (Kidney Shu Point): These points nourish the liver, spleen, and kidneys. They are also points on the bladder meridian where sympathetic nerves enter and exit. They connect with the sympathetic nervous system, and needling these points can effectively regulate the autonomic nervous system, endocrine system, and urinary reproductive systems. This regulation improves hormone secretion and balance, thereby enhancing reproductive system function effectively.

Integration of Jing (Essence), Qi (Energy), and Shen (Spirit) is the highest realm of traditional Chinese medicine treatment: This is the essence of TCM treatment. Achieving harmony among Jing, Qi, and Shen allows patients to relax fully and achieve organic balance and coordination among various body systems. This can stimulate the body’s potential for self-healing to achieve optimal therapeutic benefits. Our treatment aims to stimulate the patient’s internal factors through external stimuli, inducing and activating the body’s self-healing potential to cure diseases. • For POF4 [4] patients, our TCM treatment principle: TCM treatment focuses on nourishing the kidneys, replenishing blood, and regulating the Chong and Ren meridians, effectively improving egg quality (while the quantity of eggs is innate and unchangeable, we can improve egg quality). In our practice, many women over 40 have successfully become pregnant with only 2-3 eggs retrieved under IVF ovulation induction medications, which demonstrates significant improvement, the patients who come to us for treatment typically have issues such as years of infertility, multiple failed IVF attempts, and difficulty getting pregnant.