abstracted & translated by Honora Lee Wolfe, Lic. Ac., FNAAOM (USA)

Keywords: Chinese medicine, acupuncture, gynecology, infertility, anovulation, promoting ovulation

On page 257 of issue #6, 2004 of the Zhe Jiang Zhong Yi Za Zhi (Zhejiang Journal of Chinese Medicine), Zhang Hong et al. published an article titled, “Observations on Promoting Ovulation in 35 Cases with Supplementing the Qi Acupuncture Technique.” Because acupuncture for the treatment of infertility is currently so popular, a summary of this article is presented below.

Cohort description:

All 35 patients were 22-39 years of age and has been infertile for 1-8 years. All had been diagnosed with anovulatory infertility according to modern Western medicine as confirmed by ultrasound during days 12-17 of their cycles. All were shown to have follicles which developed but were not expressed. These patients either presented with primary or secondary amenorrhea for six months or more or had infrequent anovulatory cycles or anovulatory functional uterine bleeding. Heart, liver, and kidney function were all normal in all cases. Nineteen of these cases suffered from primary infertility, and 16 suffered from secondary infertility.

Treatment method:

On days 10-15, patients’ vaginal discharge was monitored for increase in vaginal secretions and follicular development was monitored with ultrasound. When the follicle had grown to 18mm in size, acupuncture treatment was commenced. After the patients emptied their bladder, Guan Yuan (CV 4), Zhong Ji (CV 3), and bilateral San Yin Jiao (Sp 6) and Shen Shu (Bl 23) were chosen as the main points. One and a half inch, 32 gauge needles were inserted into Guan Yuan and Zhong Ji. After obtaining the qi, twisting and turning supplementing hand technique was used. This hand technique was strong and resulted in the patient feeling a sagging, distended feeling in their lower abdomen radiating to their genitalia. These needles were retained for 20 minutes. After needling and obtaining the qi at Shen Shu, twisting and turning supplementing technique was applied, stimulating the needle for one minute before removing the needle. At San Yin Jiao, after obtaining the qi, twisting and turning supplementing technique was also used. However, these needles were also retained for 20 minutes.

In addition, other points were added based on pattern discrimination. If there was kidney essence debility and detriment with a dark, dusky facial complexion, low back and knee soreness and limpness or dizziness, tinnitus, and a fine, weak pulse, Yao Yang Guan (GV 3) and bilateral Tai Xi (Ki 3) were added. If there was liver qi depression and binding with emotional stress and agitation, tension, chest, rib-side, and breast distentionand pain, a red tongue with thin, yellow fur, and a bowstring pulse, bilateral Tai Chong (Liv 3) and Gan Shu (Bl 18) were added. If there was qi stagnation and blood stasis with emotional depression, slight lower abdominal distention, a purple tongue or possible static spots on the lingual edges, and a deep, choppy or rough or deep, bowstring pulse, Ge Shu (Bl 17) and bilateral Xue Hai (Sp 10) were added. If there was spleen vacuity with dampness and turbidity with obesity, lassitude of the spirit, lack of strength, a pale red tongue with teeth-marks on this edges, and fine, weak pulse, bilateral Feng Long (St 40) and Pi Shu (Bl 20) were added. These points were all stimulated with even supplementing-even draining hand technique, with needle retention for 20 minutes. This treatment was done two times per day, and three days equaled one course of treatment. Two hours after the first treatment on the third day, repeat ultrasound was done to determine if ovulation had occurred. If there was no evidence of ovulation, the acupuncture protocol was repeated a second time and ultrasound carried out one more time.

Study outcomes:

After four acupuncture sessions, ultrasound confirmed ovulation in 31 out of 35 patients for an effectiveness rate of 88.6%. Acupuncture was ineffective in four cases. There was not a single adverse reaction.

Discussion:

According to the Chinese authors of this study, ovulation occurs as a function of kidney yang’s stirring and the liver qi’s coursing and discharge. Guan Yuan and Zhong Ji are located on the lower abdomen in close proximity to the uterus. They pertain to the ren mai or conception vessel. Guan Yuan is an intersection point of the ren mai and foot three yin channels. Zhong Ji is an intersection point of the ren mai and the spleen channel. Both points have the effect of supplementing the kidney qi and warming the uterus. Shen Shu is the place where the kidney qi is transported and flows. San Yin Jiao is the intersection point of the three foot yin channels. Therefore, it is able to course and free the flow of the channel qi of the three channels of the spleen, liver, and kidneys. Hence the above points are able to supplement the kidneys, course the qi, fortify the spleen, move the qi, and quicken the blood. This then promotes the development of the ovum and its expulsion.

Copyright © Blue Poppy Press, 2004. All rights reserved.