Case Study: Fertility Challenged Couple
Steve,* 45 and Bethany,* 40 a couple from Berkeley, California came to Tao to Wellness in the hopes of getting pregnant.
Steve is a professor at UC Berkeley, he works all day and teaches sometimes late into the evenings. For the most part, his health is solid, his energy is consistent, he sleeps soundly and his digestion is normal. He is athletic; early morning boot camp three times a week and mountain biking in Marin on the weekends with his friends. He is also working on his first novel. He doesn’t smoke, has one coffee a day in the morning, drinks 2 glasses of red wine nightly and eats a Paleo diet. Lastly, Steve has never gotten anyone pregnant.
Bethany is a banker in the Financial District of San Francisco, she has a high stress job, she works late and sometimes even on weekends, but she is making a concerted effort to pull back on her hours. She also does boot camp with Steve early in the mornings and goes running on the weekends. Bethany is tired most of the time, but the fatigue really hits her around 3pm. She drinks coffee in the morning and also around in the late afternoon to help her through the crash. She usually ends up drinking 3-4 cups of coffee per day. Her sleep is interrupted, she can fall asleep easily, but usually wakes up between 2-3am, it can take her up to an hour to fall back asleep. Her digestion is fine, no issues and is consistent daily. She was pregnant once and had an abortion when she was 23 years old.
Steve and Bethany have been trying to get pregnant for almost 17 months. Initially they tried to conceive naturally for one year with no luck and then went to see their OBGYN. After sending Bethany to the lab and Steve for a semen analysis, their doctor decided to try Clomid with timed intercourse for 3 cycles, they did and although Bethany responded well, unfortunately there was no pregnancy. When Steve and Bethany came to us, they were just about to take the next step and do an IUI with Follicle stimulating injectables.
Bethany’s Lab Values
FSH: 4.6
LH: 2.0
Estradiol: 23
Progesterone: 8 (7 days post ovulation)
AMH: 1.9
Steve’s Lab Values
Steve’s semen analysis was all in the normal range, but his sperm count was overall low normal.
Assessment
Steve and Bethany are in a very common place as are most of our patients at Tao to Wellness.
Steve is in pretty good health, his sperm analysis was in normal range, but his count was on the low end of normal. His doctor didn’t see any issue, but since we look at the whole body, we thought there was definite room for improvement.
As far as Bethany, she was in need of a lot more re-balancing. Her signs and symptoms pointed to a potential Liver and Kidney imbalance and this was definitely affecting her fertility health.
Concerning her labs; keep in mind, all labs use different reference ranges and depending on the doctor, these labs could be coined ‘normal’. However, through our lens, Estradiol is too low at 23. Fertility centers like Pacific Fertility Center in San Francisco recommend an Estradiol of 50 or higher and from a Chinese medicine point of view, to little Estradiol/Estrogen can mean to little Yin in the body. Also, Bethany’s Progesterone value at 8 is on the low side as well. A lab value of 10 or above says that the last ovulation was ‘good’ so this is too low. From a Chinese medicine perspective, something is happening in the luteal phase also and her body doesn’t have enough heat or Yang to produce a good Progesterone value.
Treatment Plan
We first recommended that Steve discontinue his mountain biking, there is too much research that shows biking of any kind can increase the temperature of the testicles, thereby creating death and destruction of sperm. This could indeed point to why his count is on the low end. We also recommended he decrease his wine intake to one glass, three times a week. We saw Steve once a month for acupuncture, gave him an herbal medicine prescription to help increase his sperm count and some antioxidant supplements. He came every month and was diligent with his herbs and supplements, although he was slightly resistant around discontinuing mountain biking, he did it anyway. He was willing to do anything to help solve their fertility issues.
Unfortunately, female factor usually needs far more attention then male factor. In this particular case, if we take a quick look at Bethany’s overall health, her body certainly needs more balancing with her list of symptoms and lab values. The other advantage is as we are working on increasing Bethany’s fertility health, all of these symptoms will be relieved as well, thereby balancing the liver and kidney while creating more fertile harmony.
For most of our female patients, we recommend acupuncture at Tao to Wellness at least once a week. This is because we want to impact each different phase of the cycle, menstruation, follicular, ovulatory and luteal. In addition, almost all of our female fertility patients receive herbal medicine as well.
Bethany was no different and had acupuncture once a week and took her herbs daily. Her formulas consisted of a separate follicular and luteal formula and no herbs at all during her menstruation. She was also recommended to look into meditation; the high stress of her job was not helping her body ‘nest’, it was doing the exact opposite and robbing energy and decreasing the blood flow of the uterine artery into the uterus. We also recommended that she look into yoga instead of boot camp. And lastly she was to decrease her running on the weekends as well. From a nutritional standpoint, we recommended a high protein diet, with little or no gluten and no alcohol at all after ovulation until her period started or if she found out she was pregnant.
As a couple, they decided not to move forward into assisted reproductive technology right away to give us some time to work together to re-balance their bodies so they could increase their chances when they were ready. They were still trying naturally.
Outcome
Just as they were about to prepare for the injectables, they got pregnant!
We supported Bethany with weekly acupuncture treatments throughout her first trimester to week 13, since this is the most fragile time of the pregnancy. She took most of the 2nd trimester off from acupuncture and then resumed again towards the end of the 3rd trimester to help prepare her body for labor and delivery. Bethany carried to full term and had an easy pregnancy. On January 5th, 2018, Bethany and Steve welcomed Elijah Daniel to the world!
We are so honored to be a part of their journey, once we get Bethany re-balanced and strong, they want to try for baby #2!
If some or all of this story sounds like you, we’d love to support you with our work, feel free to reach out to book a complimentary consultation or an appointment.
* All names have been changed to protect patient confidentiality
