Introduction
Sterility refers to inability to conceive three years after marriage with normal sexual life and without contraception, or inability to conceive for two years after giving birth to a baby or after abortion without contraception. It is usually caused by dysfunction of ovary secretion and ovum formation or deformity of genital organs. TCM believes that sterility is caused by kidney asthenia and dysfunction of the thoroughfare and conception vessels due to asthenia of kidney essence, liver depression and qi stagnation, blockage of the uterus by phlegm and dampness as well as blood stasis and cold coagulation.
Syndrome Differentiation
1. Kidney Asthenia Type
Sterility long after marriage, aching and weakness of loins and knees; the symptoms in delayed menstruation are scanty menorrhea with light color, even amenorrhea, profuse clear urine, loose stool, light-colored tongue with whitish color, thin and deep or slow pulse due to asthenia of kidney yang; the symptoms of early menstruation are scanty menorrhea with red color and without blood clot, emaciation, dizziness, palpitation, insomnia, dry mouth, fever, reddish tongue with scanty fur as well as thin and rapid pulse due to asthenia of kidney yin.
2. Liver Depression Type
The symptoms are sterility for years, irregular menstruation, abdominal pain during menstruation, unsmooth scanty menorrhea with blackish color and clot, distending pain in the breasts before menstruation, mental depression, dysphoria, susceptibility to anger, reddish tongue and taut pulse.
3. Phlegm-Dampness Type
The symptoms are sterility long after marriage, obesity, delayed menstruation, even amenorrhea, sticky leukorrhea, palpitation, dizziness, chest oppression, nausea, whitish greasy tongue coating and slippery pulse.
4. Blood Stasis Type
The symptoms are sterility long after marriage, delayed menstruation with scanty menorrhea, purplish menorrhea with clot, dysmenorrhea, unpressable abdominal pain during menstruation, blackish tongue with ecchymoses, taut and unsmooth pulse.
Treatment
1. Body Acupuncture
Prescription:
Zhongji (CV 3), Sanyinjiao (SP 6), Qixue (Ext.) and Zigong (EX-CA 1).
Modification:
For kidney asthenia, Shenshu (BL 23) and Rangu (KI 2) are added; for asthenia of kidney yang, Mingmen (GV 4) and Guanyuan (CV 4) are added; for asthenia of kidney yin, Taixi (KI 3) is added; for liver depression, Ganshu (BL 18), Taichong (LR 3) and Yanglingquan (GB 34) are added; for phlegm-dampness, Yinlingquan (SP 9), Fenglong (ST 40), Zusanli (ST 36) and Zhongwan (CV 12) are added; for blood stasis, Geshu (BL 17) and Xuehai (SP 10) are added.
Performance:
Needling is given from the 12th day of the menstrual cycle. For the treatment of kidney asthenia, reinforcing needling technique is used; Mingmen (GV 4) and Guanyuan (CV 4) are needled with warmed needles or applied with moxacone or moxaroll moxibustion. For the treatment of liver depression, mild reinforcing and reducing needling techniques are used; Ganshu (BL 18) is needled with reinforcing technique, Taichong (LR 3) and Yanglingquan (GB 34) are needled with reducing technique. For the treatment of phlegm-dampness syndrome, reducing needling technique is used; Zusanli (ST 36) is needled with reinforcing technique and the rest acupoints are needled with reducing techniques. For the treatment of blood stasis, reducing needling technique is used; Geshu (BL 17) and Xuehai (SP 10) are tapped with cutaneous needles and applied with cupping after needling.
2. Ear Acupuncture
Prescription:
Endocrine (CO18), Internal Genitalia (TF2), Kidney (CO10), Subcortical (AT4) and Apex of tragus (AT1, 2, 4i).
Performance:
Each time 2 - 3 acupoints are needled with moderate stimulation for 30 minutes. Or Wangbuliuxingzi (Semen Vaccariae) is used for ear acupressure. The two ears are pressed alternatively and the sealed seeds are changed once every 3 - 4 days. The patient is advised to press the acupoints 3 - 4 times a day.