265. Chinese Medicine In Fertility Disorders

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265. Chinese Medicine In Fertility Disorders

 

 

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Syllabus

1 Introduction ………………………………………………. 1

1 Fertility Treatment—Its Social and Cultural Context …………… 2
Reduced Fertility—Epidemiology—Causes . . 2
Reproduction and Sexuality ………… 4
In the West—Christianity, Enlightenment,
and the “Pill” ………………….. 4

In the East—Confucianism, Buddhism,
Daoism, and Modern China ………… 5
Integration: TCM ……………….. 6

2 Ethics ………………………………………………………. 8
Human Dignity ………………… 8
Circumstances of Conception—Criteria …. 8
Instrumentalization—Intervention in Fertility
Treatment ……………………. 10

Love, Sex, and Reproduction ……….. 11
Developments …………………. 12

3 Guanyin—Goddess of Fertility ………………………………… 13
Introduction …………………… 13
Starting a Family in China …………. 13
Legend—Who is Guanyin and Where Does
She Come From? ……………….. 13
Goddess of Compassion …………… 14
Guanyin—A Mother Goddess ………… 14

Song Zi Niang Niang—The Woman Who
Can Bestow Children …………….. 14
Times of Prayer ………………… 15
Willingness and Openness …………. 16
Transmitting Symbolism to the West ….. 16

4 The Wish for Sons—Woman and Family in Imperial China—Qiu Zi
(求子) ………………………………………………………. 18
The Status of Women ……………. 18
The Family ……………………. 18
Transition to Patriarchy …………… 19
Legitimization by the Philosophers …… 19
Rules for Women ……………….. 20
Physically Tied by Bound Feet ………. 20
The Life of a Girl ……………….. 21
Continuation of the Family in the Afterlife . 21

The Economic Aspect …………….. 22
Who Would Want Girls? ………….. 22
Men’s Special Privileges …………… 23
No Escape for the Woman …………. 23
Causes of Childlessness …………… 23
Conception and Sexuality ………….. 25
Couldn’t It Have Been Different? …….. 26
Contents

IX

5 Advice on Successful Sexual Intercourse from the
Medical Classics …………………………………………….. 28
How Often is the Man Allowed? Containing
the Damage in Spite of “Jing Loss” ……. 28
“The Soldier is not Ready for Action” ….. 31
When She Can’t Do
as She Wants ………………….. 33

The When and Where Must be Heeded as
Well ………………………… 33
No Offspring Even Though Everything Was
Done Correctly? ………………… 36
Pregnant at Last—Now How to Avoid
Mistakes? …………………….. 38

2 Fertility Treatment and Pregnancy—Reproductive Medicine
and TCM in Meaningful Cooperation ……………………….. 41

6 Fertility Treatment and Pregnancy—Reproductive Medicine
and TCM in Meaningful Cooperation …………………………. 42
Introduction …………………… 42
Requirements for a Successful Pregnancy . . 42
Causes of Subfertility and Infertility in
Women and Men ……………….. 45
The Four Phases of the Menstrual Cycle
from the Western and TCM Perspective … 45
Probabilities of Pregnancy …………. 45
Causes of Subfertility and Infertility in
Women and Men ……………….. 47
Diagnosis of Subfertility, Infertility, and
Sterility ……………………… 48
Symptothermal Method of Natural Family
Planning …………………….. 50
Biomedical Methods for the Treatment of
Infertility and Sterility ……………. 52
Hormone Therapy for Cycle Optimization . . 52
Intrauterine Insemination …………. 53
In Vitro Fertilization …………….. 53
Intracytoplasmatic Sperm Injection …… 54
Methods to Complement IVF and ICSI …. 55
Risks of Treatment with Reproductive
Medicine …………………….. 57
Risks to the Woman in the Stimulation
Phase ……………………….. 57
Risks to the Woman during Punction ….. 57

Risks to the Woman after the Embryo
Transfer ……………………… 57
Multiple Pregnancies …………….. 57
Risks to Children Born after Assisted
Reproduction ………………….. 58
Summary of the Risks ……………. 58
Options of TCM in the Treatment of
Infertility and Sterility ……………. 58
Special Characteristics of TCM Diagnosis
and Therapy …………………… 59
Diagnostic Procedures in TCM ………. 59
Therapeutic Options of TCM when Assisting
Reproductive Medicine …………… 63
Cooperation between TCM and Biomedicine 65
Case Histories …………………. 65
Case History 1: Female patient,
38 years (IUI) ………………….. 65
Case History 2: Female patient,
42 years (IUI) ………………….. 66
Case History 3: Female patient,
38 years (IUI) ………………….. 68
Case History 4: Female patient,
39 years (IVF) …………………. 68
Case History 5: Female patient,
38 years (ICSI) …………………. 70
Conclusion ……………………. 70

3 Fertility Treatment and Pregnancy—Foundations of TCM …….. 73

7 Physiology and Pathology of Fertility and Reproduction from
the TCM Perspective ………………………………………… 74
The Energies Jing, Qi, and Xue ………. 74
The Extraordinary Vessels …………. 79
The Energetic Interplay of the Extraordinary
Vessels ………………………. 80
The Viscera and Bowels …………… 81
Physiology and Pathology of the Kidney … 81
Physiology and Pathology of the Liver …. 83
Physiology and Pathology of the Spleen … 84
Physiology and Pathology of the Heart …. 85
Physiology and Pathology of the Lung …. 86

The Physiology of Menstruation from the
TCM Perspective ……………….. 86
Conception …………………… 87
Key Patterns of Female Infertility …….. 88
Pregnancy ……………………. 88
Causes for a Miscarriage …………… 88
The Pathology of Infertility from the TCM
Perspective …………………… 88
Summary of Infertility in Tables ……… 89

8 Worth a Thousand in Gold—The Quest for Perfect Children
in Early China ………………………………………………. 92
Introduction …………………… 92
Sun Simiao and the Bei Ji Qian Jin Yao Fang . 92
Fertility Treatments in the Qian Jin Fang … 94

Summary …………………….. 97
Pregnancy Treatments in the Qian Jin Fang . 98

4 Options and Methods in Fertility Treatment ………………… 101

9 Qi Gong …………………………………………………….. 102
Qi Gong and its Medical Applications ….. 102
Qi Gong for Fertility Treatment in China … 103
The Exercises ………………….. 103
Exercise and Therapy Plan …………. 104

Qi Gong as Treatment by the Practitioner . . 104
Qi Gong as Self-treatment ………….. 105

10 Tui Na Therapy …………………………………………….. 112
Effect and Application in Infertility ……. 112
Description of a Tui Na Technique and its
Effect ……………………….. 115

Self-massage in Infertility ………….. 117

11 Moxibustion ……………………………………………….. 119
General Effect …………………. 119
Forms of Moxibustion ……………. 119
Range of Applications for Moxibustion …. 121
Treatment Principles of Moxibustion ….. 121
The Use of Moxibustion in Fertility
Treatment ……………………. 121
Cold Stagnating in the Lower Abdomen
(“Cold Lower Abdomen”)
in Women ……………………. 123

Localization and Application ………… 123
The Most Important Points in the
Treatment of Infertility …………… 123
Problems in the Application of Moxa
Therapy ……………………… 124
Application in the Hospital or Clinic …… 124
Application at Home …………….. 124
Dangers ……………………… 124

12 Acupuncture ………………………………………………. 126
Points on the Pubic Line 5 Cun below
the Navel …………………….. 126
Points on the Line 4 Cun below the Navel . 129
Points on the Line 3 Cun below the Navel . 131

Points on the Line 2 Cun below the Navel . 132
Points on the Line 1 Cun below the Navel . 134
Important Points on the Liver Channel …. 135

13 Chinese Dietetics …………………………………………… 138
Food Culture and Dietetics …………. 138
To Preserve and Protect Jing ………… 139
Certified Organic Food and its Preparation . 141
Chinese Dietetics ……………….. 142
Thermal Nature ………………… 142
Yang, Warmth, and Food ………….. 142
Recommended Diet for Boosting Kidney Yin 144

Recommended Diet for Building Blood …. 145
Dampness, Phlegm, and Food ………. 146
Recommended Diet for Transforming
Dampness and Phlegm ……………. 147
Blood Stasis and Food ……………. 149
Recommended Diet for Blood Stasis …… 150

14 Chinese Medicinal Therapy in Threatened or Recurrent
Miscarriage and in Pregnancy ………………………………. 151
Miscarriage and Recurrent Pregnancy Loss
from the Perspective of Western Medicine . 151
Threatened Abortion …………….. 151
Missed Abortion ……………….. 151
Incomplete Abortion …………….. 151
Incipient Abortion ………………. 152
Septic Abortion ………………… 152
Habitual Abortion ………………. 152
Miscarriage and Recurrent Pregnancy Loss
from the TCM Perspective …………. 153
Threatened Abortion …………….. 153

Missed, Septic, or Incomplete Abortion … 157
Habitual Abortion ………………. 157
Concluding Remarks …………….. 159
Chinese Medicinal Therapy during
Pregnancy ……………………. 159
Contraindications for Chinese Medicinals . . 159
Concluding Remarks …………….. 160
Appendix …………………….. 160
To be Used with Caution During Pregnancy 160
Contraindicated during Pregnancy ……. 161

15 Formula Shao Fu Zhu Yu Tang—Decoction for Treating Infertility . 162
Introduction …………………… 162
The Traditional Formula Shao Fu Zhu Yu Tang 162
Formula Analysis ……………….. 164
Acrid and Hot Substances …………. 164
The Application of Shao Fu Zhu Yu Tang in
Modern Clinical Practice …………… 165
The Treatment of 41 Female Infertility
Patients ……………………… 166
The Treatment of Infertility Caused by
Blocked Fallopian Tubes …………… 166
The Treatment of 40 Female Infertility
Patients ……………………… 167

The Treatment of 12 Female Infertility
Patients ……………………… 168
The Treatment of Immune Infertility
Caused by Endometriosis ………….. 169
The Treatment of 20 Patients with Semen
Liquefaction Problems ……………. 170
Case Studies …………………… 171
Case Study 1: Infertility with Dysmenorrhea 171
Case Study 2: Infertility …………… 172
Case Study 3: Infertility …………… 172
Case Study 4: Male Infertility ……….. 173
Case Study 5: Infertility with Amenorrhea . 173
Conclusion ……………………. 175

5 Fertility Disorders and Treatment Concepts …………………. 177

16 Menstrual Disorders—Yue Jing Bing ………………………….. 178
Physiology of the Menstrual Cycle ……. 178
The Female Menstrual Cycle from the
Biomedical Perspective …………… 178
Female Physiology from the TCM Perspective 179
Distinctive Features in Diagnosis and
Treatment ……………………. 181
Distinctive Features in Diagnosis …….. 181
Distinctive Features in Therapy ……… 182
General Pathology ………………. 182
Excessive Bleeding ………………. 183
Abbreviated Cycle—Yue Jing Xian Qi ……………………. 183
Profuse Menstruation—Yue Jing Guo Duo ……………………. 189
Dysfunctional Bleeding ……………. 192
Acyclic Bleeding—Beng Lou ( Flooding and Spotting) ………………….. 192
Intermenstrual Bleeding—Jing Jian Qi Chu
Xue  ……………….. 195
Insufficient Bleeding ……………… 198

Delayed Menstruation—Yue Jing Hou Qi  ……………………. 198
Scant Menstruation—Yue Jing Guo Shao ……………………. 203
Amenorrhea—Bi Jing  ………… 206
Menstruation at Irregular Intervals ……. 210
Liver Qi Stagnation—Gan Qi Yu ……………………… 210
Dysmenorrhea …………………. 211
Menstrual Pain from Qi Stagnation—Qi Zhi ……………………….. 212
Blood Stasis—Xue Yu  ………… 213
Commonly Used Acupuncture Points and
their Combinations in Modern TCM …… 216
Case Studies …………………… 216
Case Study 1: Female Patient, Age 24
(Amenorrhea) …………………. 216
Case Study 2: Female Patient, Age 36
(Infertility with Dysmenorrhea and
Tendency to Miscarriage) ………….. 217

17 Early Menopause …………………………………………… 220
Introduction …………………… 220
Western Diagnosis ………………. 220

Symptoms ……………………. 220
Differentiation from the TCM Perspective . 220

Vacuity Patterns ………………… 221
Insufficiency of Kidney Yin …………. 222
Insufficiency of Kidney Yang ……….. 223
Insufficiency of Essence …………… 224
Repletion Patterns ………………. 225

Liver Qi Stagnation ………………. 225
Blood Stasis …………………… 226
Damp-heat in the Lower Burner ……… 228
Phlegm Accumulation ……………. 229
Conclusion ……………………. 230

18 Infertility and Sexual Disorders ……………………………… 232
The Three Dimensions of Sexuality ……. 232
Disorders of Male Fertility—Exhaustion of
Water (Kidney) and Wood (Liver) …….. 233
Disorders in the Sexuality of Men and
Women ……………………… 234
Always under Pressure—Liver Qi Congestion 234
Pondering and Reflection—Weakness of
Spleen Qi …………………….. 236
Missing Clarity—Dampness and Damp-heat 238

Additional Blockages: Heat and Dampness
in the Liver and Gallbladder ………… 238
The Source Dries Up—Kidney Vacuity ….. 241
Weakness of Kidney Yang with Cold and
Dampness ……………………. 243
A Limp Lumbus—Weakness of Kidney Qi . . 244
Strengthless—Weakness of Lung Qi …… 246
Chilled—Weakness of Heart Yang …….. 247
Differentiation between Patterns …….. 248

19 The Treatment of Male Infertility with TCM …………………. 251
Infertility—a Special Challenge ………. 251
Causes of Male Infertility ………….. 252
Diagnostics and Diagnoses of Male Infertility 253
Western Diagnostics and Diagnoses …… 253
TCM Diagnostics and its Most Relevant
Diagnoses ……………………. 254
Treatment of Male Infertility ……….. 254
Biomedical Therapies …………….. 254
TCM Therapies …………………. 254
Combined TCM Therapy in Accordance with
TCM Diagnoses ………………… 256

TCM Therapy in Accordance with a
Spermiogram ………………….. 257
Case Studies …………………… 258
Case Study 1 ………………….. 258
Case Study 2 ………………….. 258
Case Study 3 ………………….. 258
Case Study 4 ………………….. 259
Practical Experiences …………….. 259
Conclusion ……………………. 261

20 Endometriosis—Nei Ji ……………………………………….. 263
Causes and Pathogenesis from the
Biomedical Perspective ……………. 263
Endometriosis and Fertility ………… 264
Clinical Picture and Therapy from the TCM
Perspective …………………… 264
Treatment Prior to any Attempt to Become
Pregnant …………………….. 266
Treatment by Means of Medicinal Enemas . 267
Important Disease Patterns ………… 268
Liver Qi Congestion and Blood Stasis ….. 268

Stasis due to External Cold …………. 269
Insufficiency of Kidney Yang with Internal
Cold (Blood Stasis) ………………. 269
Damp-heat in the Lower Burner
(with Blood Stasis) ………………. 270
Damp-heat in the Lower Burner
(with Blood Heat) ………………. 270
Treatment during Menstruation ……… 272
Case Study ……………………. 272
Infertility due to Endometriosis ……… 272

21 PCO Syndrome and Fertility ………………………………… 274
How Does PCOS Arise? ……………. 274
Treatment with Biomedicine ……….. 274
Treatment with TCM …………….. 275
Differential Diagnosis …………….. 275

Kidney Vacuity …………………. 276
Phlegm-damp …………………. 276
Liver Fire …………………….. 277
Qi Stagnation with Blood Stasis ……… 278

22 Supplementary Chinese Medicinal Therapy in
IVF/ET Treatments ………………………………………….. 279
History of Fertility Treatment in TCM ….. 279
Preliminary Results ……………… 280
When and For Which Patients is IVF/ET or
ICSI/ET Treatment Appropriate? ……… 281
Complications in IVF/ET or ICSI/ET
Treatments ……………………. 281
Which Method for an Infertile Couple? … 281
Who is an Appropriate Candidate for IVF/ET
or ICSI/ET Treatments? ……………. 282
How Can We Support IVF/ET Treatment? . . 282
Case Studies …………………… 288
Case Study 1: Thin Endometrium …….. 288
Case Study 2: Thin Endometrium, PCOS,
OATS in the Partner ……………… 288
Case Study 3: Weak Ovarian Reaction …. 289
Case Study 4: Advanced Age and Infertility 291
Case Study 5: Endometriosis and
Adenomyomatosis ………………. 291

Case Study 6: Five Failed IVF/ET Treatments,
OHSS ……………………….. 292
Case Study 7: Six Unresolved, Failed
IVF/ET Treatments ………………. 294
Case Study 8: Pronounced Endometriosis . . 295
Why Can TCM Support In Vitro Fertilization? 296
The Gonads are Supported to Improve
the Number and Quality of Egg and Sperm
Cells ………………………… 296
The Receptiveness of the Endometrium
and the Embryo Implantation Rate are
Improved …………………….. 297
Embryonal Development is Promoted …. 298
Cooperation with Biomedicine Reduces
the Side-effects of IVF/ET Treatment ….. 298
Miscarriages are Avoided and Pregnancy
Rates Improved ………………… 298
Conclusion ……………………. 299

6 Patient Support …………………………………………… 301

23 Inviting the “Heavenly Spark”—Shen in the Support of Couples
in Fertility Treatment ………………………………………. 302
Shen as Consciousness and Mindfulness of
the Practitioner ………………… 302
Shen as Self-knowledge …………… 303
Shen as Clarity between Practitioner and
Patient ………………………. 303
Shen in the Treatment Situation ……… 304
Shen as Power of the Heart and Spiritual
Connection of the Couple ………….. 305
Shen as Expression of a Shared Will …… 305
The Shen Contact between the Partners
during Treatment ……………….. 306

Shen as Heavenly Spark during Conception 307
Correct Timing …………………. 307
Internal Self-cultivation …………… 308
Acceptance of Natural Cycles and Laws … 308
Erotic Passion …………………. 309
Shen and Jing ………………….. 310
Discussion ……………………. 310
Concluding Remarks ……………… 311

24 Stress and Infertility ……………………………………….. 313
What Causes Stress? …………….. 314
Authenticity—How do we Achieve it? ….. 314
Ideas, Concepts, Feelings—Where Do They
Come From? ………………….. 315
What is the Benchmark for our Actions
and the Pursuit of Happiness? ………. 315
The Motor—Ming Men ……………. 316
The End of Pushing ……………… 317

Losing and Gaining Identity ………… 318
Strategies for Harmonizing Self-awareness
and Partnership ………………… 319
The Wood Phase and the Liver ………. 319
The Fire Phase and the Heart ……….. 320
The Earth Phase and the Spleen ……… 320
The Metal Phase and the Lung ………. 321
The Water Phase and the Kidney …….. 321

25 Supporting the Couple in Successful and Failed Fertility
Treatment …………………………………………………. 322
Supporting Pregnancy ……………. 322
First and Second Month—The Wood Phase . 324
Third and Fourth Month—The Fire Phase . . 325
Fifth and Sixth Month—The Earth Phase . . 326
Seventh and Eighth Month—The Metal
Phase ……………………….. 327
Ninth and 10th Month—The Water Phase . 328

Support in Failed Fertility Treatment ….. 328
When Can the Woman Become Pregnant
Again? ………………………. 329
Fertility Treatment and Couple Dynamics . 329
Alternatives—Adoption and Accepted
Childlessness ………………….. 330

7 Appendix …………………………………………………. 331
List of Photos and Illustrations ………. 332
General Index ………………….. 333

Prescriptions Index ………………. 346

……………………………………………………………………………………………………………………………………………………………………………………………………………………

 

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