Increase Endometrial Lining with Tradition Chinese Medicine and Acupuncture

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Case Report Open Access

MS Qing Zhang^1*

Acu-herbs Chinese Medicine Southampton, 170 Hill lane, Southampton SO15 5DB, UK.

*Corresponding author: MS Qing Zhang, Acu-herbs Chinese Medicine Southampton, 170 Hill lane, Southampton SO15 5DB, UK. Tel: 00447727123311;E-mail:

Received: June 14, 2019; Accepted: July 07, 2019; Published: July 16, 2019

Citation: Qing Zhang MS (2019) Increase Endometrial Lining with Tradition Chinese Medicine and Acupuncture. SOJ Gynecol Obstet Womens Health 5(1): 1-6. DOI: http://dx.doi.org/10.15226/2381-2915/5/1/00138

Case ReportTop

Thin endometrial lining is a difficult condition for IVF treatment. Thin endometrial lining can make it difficult for embryos to implant even when they are good quality embryos. Thin endometrial lining also can cause low pregnant rate and high miscarriage rate, which also cause miscarriages during earlier months of pregnancy. Many patients with this condition do not respond well to IVF drugs, even if Gynaecologists use different drugs and different protocols.

The reasons that cause thin endometrial lining are low estrogens (occurs in women in 40’s, when estrogens receptors in the endometrial have decreased, affecting endometrial lining increase), inadequate blood flow, fibroids of uterus; poor health of endometrial tissue (current miscarriages, the trauma of D&C or some surgeries), endometrial tuberculosis, affected by some drugs, long term use of birth control pills, gene disorder etc.,

TCM (traditional Chinese medicine) believes the reason causing thin endometrial lining are kidney deficiency (Kidney Qi, kidney Yin and kidney Jing), blood deficiency and blood stasis. TCM treatment principle is to totify Kidney Qi, kidney Yin and kidney Jing, nourish blood, and activate blood circulation and anti-blood stasis. The advantages of TCM treatment are working in a holistic way to improve balance of body Yin and Yang, balance body Qi and blood so as to improve body’s hormone level, improve ultras inner environments, endometrial receptivity and improve endometrial lining.

Case 1

Mrs S .H, 40 years old, suffered from premature ovarian failure. She started anticipation drugs injection Depo-Provera from 17 years old. She stopped these drugs when she was 29 years old. Her menstruation stopped since. She started to see gynaecologist when she was about 36 years old as she want to start her family. She was going to start IVF; she had still no period even with some different drugs. She was given different drugs, for months and months, she was even put on Viagra to see if that would work. But her endometrial lining was not thickening (below 5mm). Gynaecologist suggested that she should have acupuncture preparation for her IVF, and suggested that she come to my clinic

A. Patient symptoms: Dysmenorrhoea, Headaches before menstruation, PMS, cold extremities, abdominal fullness and pain, loose stool, sensitive to wheat and dairy products.

B. Differentiation of symptoms by TCM: Deficiency in both Kidney Yang and Spleen Qi, Qi stagnation and blood stasis.

C. Treatment principle: Strengthen Kidney Yang and Spleen Qi, Nourishing Qi, activate blood circulation and anti-blood stasis.

D. Herbal medicine: Jin Kui Shen Qi Pian, Shenling Baizhu Pian, Xiao Yao Pian, Tao Hong Si Wu Pian Xue Fu Zhui Yu Tang (Above herbs use concentrated Chinese herbal powders, two times daily)

E. Acupuncture points: San Yin Jiao, Tai Chong, He Gu, Zu San Li, Xue Hai, Pi Shu, Shen Shu, Da Chang Shu, Bai Hui. Moxibustion: Qi Hai, Tian Shu, Guan Yuan, Zhong Ji, Zi Gong.

Explanation and ResultTop

Mrs H suffers from Premature ovarian failure, thin endometrial lining. Her differentiation of symptoms by TCM is deficiency in both Liver and Kidney yin. The treatment from the conception of the organism as a whole, I gave her Liu Wei Di Haung Wan, Jia Wei Xiao Yao pain work on tonic her Liver and Kidney yin in general. Ba Zhen Tang and Ren Shen Yang Rong Wan nourishing and activating her blood circulation working her whole body and also her ultras and ovaries. I use acupuncture working on her ultras and ovaries area, stimulation her local meridians and channel to improve her ultras’ and ovaries’ blood circulation, repairing and healing her Endometrial. After six weeks acupuncture and Chinese herbs treatment, she felt more relaxed, her sleep is improved, her general energy is much better. Her IVF treatment started abroad. Her endometrial lining increased up to 6.5mm. She was transferred two embryos. She had a positive pregnancy test and had a scan when she was six and half weeks pregnant, her scan showed she was pregnant with twins. Then she started some bleeding. I prescribed some Chinese herbs prescription “An Tai Fang”. Ingredient: Sang Ji Sheng 10g, Xu Duan 10 g, Tu Si Zi 20 g, Dang Shen 15g, Bai Zhu 10 g, Sheng Ma 6 g, Niv Zhi Zi 10 g, Han Lian Cao 10 g and Zhi Gan Cao 6g. After two to three days she took the herbs, her bleeding stopped. She had a scan later. The scan showed that there was one heartbeat. She lost one baby, and another one survived. She entered labour when she was 40 weeks pregnant. She has a healthy, good looking baby boy. Her gynaecologist in UK was surprised and pleased when he knew her situation Figure-1.

Figure 1:

Case 2

Mrs., H.W 32 years old. She suffers from severe endometriosis for some years. She has severe dysmenorrhoea, her endometrial adhere her colon and her fallopian tubes. She had an operation to remove her left fallopian tube. She had failed two IVF, as her thin endometrial lining. Gynaecologist suggested that she should has some acupuncture to increase her endometrial lining and prepare her frozen embryo transfer next IVF.

A. Patient symptoms: Dysmenorrhoea, Headaches before menstruation, PMS, Cold extremities, abdominal fullness and pain, loose stool, sensitive to wheat and dairy products.

B. Differentiation of symptoms by TCM: Deficiency in both Kidney yang and Spleen Qi, Qi stagnation and blood stasis.

C. Treatment principle: Strengthen Kidney yang and Spleen Qi, Nourishing Qi, activate blood circulation and anti-blood stasis.

D. Herbal medicine: Jin Kui Shen Qi Pian; Shenling Baizhu Pian; Xiao Yao Pian; Tao Hong Si Wu Pian Xue Fu Zhui Yu Tang (Above herbs use concentrated Chinese herbal powders, two times daily. )

E. Acupuncture points: San Yin Jiao, Tai Chong, He Gu, Zu San Li, Xue Hai, Pi Shu, Shen Shu , Da Chang Shu , Bai Hui. Moxibustion, Qi Hai, Tian Shu, Guan Yuan, Zhong Ji, Zi Gong.

Explanation and ResultTop

Mrs H‘s main problems is endometriosis. This condition cause her poor endometrial receptivity’s and thin endometrial lining. She also suffers from bad IBS. I prescribed her Jin Kui Shen Qi Pian and Shen Ling Bai Zhu Pian working on her general Spleen Qi and her Kidney yang, improve her spleen and stomach function. Tao Hong Si Wu and Xue Fu Zhu Yu Tang nourishing blood circulation and anti- blood stasis on her ultras. I use acupuncture work on her whole body and her ultras, so as to improve her endometrial inner environments, improve her endometrial receptivity, and endometrial lining. I also suggested her massage and use Moxibustion on her abdomen and her legs acupuncture points every day. After two cycle menstruation acupuncture and Chinese herbs treatments, she started her IVF. Her ultrasounds scan showed her endometrial lining was about 8mm. She was transferred two frozen embryos, she had positive pregnancy test. She gave a labour of twins of healthy girls Figure-2.

Figure 2:

Case 3

Mrs S. is a 30 years old. She had two failed IVF. She had good quality embryos; the IVF did not work as her endometrial lining was thin.

A. Patient symptoms: She started her menstruation when she was 16 years old. Her period was irregular. She suffered from dysmenorrhoea. She is thin, weak, and easy to catch cold, poor appetite. She had abdomen fullness, loose stool and the symptoms worse before her period. PMS, Anxiety, Insomnia, Sensitive to wheat and dairy products.

B. Differentiation of symptoms by TCM: Kidney Qi and Yang deficiency; Spleen Qi and blood deficiency and blood stasis.

C. Treatment principle: Nourishing Kidney Yang and Kidney Qi, Tonic Spleen Qi; Nourishing blood; Activity blood circulation and Anti blood stasis.

D. Herbal medicine: Shen Ling Bai Zhu Pian, Jin Kui Shen Qi Pian. Ai Fu Nuan Gongi Wan, Tao Hong Si Wu Pian, Ren Shen Gui Pi Wan (Herbs use concentrated Chinese herbal powders, two times daily)

E. Acupuncture points: Zu San Li, San Yin Jiao, Yin Ling Quan, Tai Chong, He Gu, Xue Hai, Pi Shu, Shen Shu , Da Chang Shu, Bai Hui. Moxibustion: Qi Hai, Tian Shu, Guan Yuan, Zhong Ji, Zi Gong.

Explanation and ResultTop

Mrs. A has weak constitution, period start late, irregular period, small tongue, weak pause shows her Kidney Qi, kidney Yang both deficient, Spleen QI deficient. I prescript her Jin Kui Shen Qi Pian, Shenling Bai Zhu Pain, Aifunuangong Wan tonic her Kidney Qi and Yang, totify her Spleen Qi and warm her Ultras, I gave her acupuncture, working on her general and local points. I also suggested that she should massage and use Moxibustion working on her abdomen at home as well. After a few menstrual cycles of acupuncture and herbal treatment, she started her IVF. Her ultrasounds scan shows her endometrial lining is 6.5mm and still keeps this level. I started increased acupuncture stimulation with electrical acupuncture machine, cupping, Moxibustion. Her endometrial lining was increased about 8mm when she had her frozen embryo transfer. She had a positive pregnancy test. When she was six weeks pregnant, she started morning sickness. I gave her acupuncture points: Gong Sun, Nei Guan, Zu San Li, and some Chinese herbs Xiang Sha Liu Jun Pian. Her morning sickness was improved. She is pregnant 30weeks now. Everything is fine.

Table 1:

No	Names of patent herbal formulae	Ingredients of formulae in Chinese spelling names	Ingredients of formulae in Latin name	Dose (G)
1	Renshenguipi Pills	Renshen	Radix Ginseng	15
		Baizhu	Rhizoma Atractylodis Macrocephalae	12
		Huangqi	Radix Astragali	12
		Fushen	Poria	12
		yuanzhi	Radix Polygalae	9
		Suanzaoren	Semen Ziziphi Spinosae	12
		Longyanrou	Arillus Longan	9
		Danggui	Radix Angelicae Sinensis	9
		Dazao	Fructus Zizyphi Jujubae	9
		Zhigancao	Radix Glycyrrhizae	6
2	Xiaoyao Pills	Chaihu	Radix Bupleuri	9
		Dangui	Radix AngelicaeSinensis	9
		Baishao	Radix Paeoniae Alba	9
		Baizhu	Rhizoma Atractylodis Macrocephalae	9
		Fuling	Poria	9
		Bohe	HerbaMenthae	3
		Zhigancao	Radix Glycyrrhizae	6
3	Jinkuishenqi Pills	Shudihuang	Rehmannia Glutinosa Libosch	24
		Shanyao	Dioscorea OppositaThunb	12
		Shanzhuyu	Fructus Corni	12
		Mudanpi	Cortex Moutan	9
		Zexie	Rhizoma Alismatis	9
		Fuling	Poria	9
		Rougui	Cortex Cinnamomi	3
4	Jiaweixiaoyao Pills	Chaihu	Bupleurum Chinese DC	11
		Dangui	Radix AngelicaeSinensis	11
		Baishao	Paeonia Lactiflora Pall	11
		Baizhu	Rhizoma Atractylodis Macrocephalae	11
		Fuling	Poria	11
		Mudanpi	Cortex Moutan	9
		Zhizi	Gardenia Jasminoides Sllis	9
		Bohe	Herba Menthae	2
		Gancao	Glycyrrhizae Uralensis Fisch	9
5	Buzhongyiqi Pills	Huangqi	Radix Astragali	24
		Renshen	Radix Ginseng	12
		Baizhu	Altractylodes Macrocephala Koidz	12
		Danggui	Radix Angelicae Sinensis	12
		Shengma	Rhizoma Cimicifugae	6
		Chaihu	Bupleurum Chinese DC	9
		Chenpi	Pericarpium Citri Reticulatae	9
		Zhigancao	lycyrrhizae Uralensis Fisch	6
6	Shenlingbaizhupian	Renshen	Radix Ginseng	12
		Baizhu	Rhizoma Atractylodis Macrocephalae	12
		Fuling	Poria	12
		Zhigancao	Glycyrrhizae Uralensis Fisch	12
		Shanyao	Dioscorea OppositaThunb	12
		Baibiandou	Semen Dolichoris Lablab	9
		Yiyiren	Semen Coicis Lachryma-jobi	6
		Sharen	Fructus Amomi	6
		Jiegeng	Radix Platycodi Grandiflori	6
7	Liuweidi huang wan	Shudihuang	Rehmannia Glutinosa Libosch	24
		Shanyao	Dioscorea Opposita Thunb	12
		Shanzhuyu	Fructus Corni	12
		Mudanpi	Cortex Moutan	9
		Zexie	Rhizoma Alismatis	9
		Fuling	Poria	9
8	Taohongsiwutang	Chuanqiong	Radix Ligustici Chuanxiong	9
		Danggui	Radix Angelicae Sinensis	9
		Baishao	Paeonia Lactiflora Pall	9
		Shudihuang	Rehmannia Glutinosa Libosch	12
		Taoren	Semen Persica	9
		Honghua	Carthami Tinctorii	6
9	Bazhentang	Shudihuang	Rehmannia Glutinosa Libosch	18
		Danggui	Radix Angelicae Sinensis	15
		Baishao	Paeonia Lactiflora Pall	15
		Chuanqiong	Radix Ligustici Chuanxiong	9
		Renshen	Radix Ginseng	9
		Baizhu	Altractylodes Macrocephala Koidz	12
		Fuling	Poria	15
		Zhigancao	Glycyrrhizae Uralensis Fisch	6
10	Renshenyangyingtang	Baishao	Paeonia Lactiflora Pall	12
		Danggui	Radix Angelicae Sinensis	9
		Chenpi	Pericarpium Citri Reticulatae	9
		Huangqi	Radix Astragali	15
		Rougui	Cortex Cinnamomi	3
		Baizhu	Altractylodes Macrocephala Koidz	9
		Renshen	Radix Ginseng	12
		Zhigancao	Glycyrrhizae Uralensis Fisch	6
		Baizhu	Altractylodes Macrocephala Koidz	9
		Shudihuang	Rehmannia Glutinosa Libosch	12
		Wuweizi	Fructus Schisandrae	4
		Fuling	Poria	9
		Yuanzhi	Radix Polygalae	9
11	Aifunuangongwan	Xiangfu	Rhizoma Cyperi	12
		Aiye	Folium Aetemisar Argyi	6
		Danggui	Radix Angelicae Sinensis	12
		Huangqi	Radix Astragali	9
		Wuzhuyu	Fructus Evodiae Rutaecarpae	9
		Chuanqiong	Radix Ligustici Chuanxiong	9
		Baishao	Paeonia Lactiflora Pall	9
		Shudihuang	Rehmannia Glutinosa Libosch	9
		Rougui	Cortex Cinnamomi	3
		Xuduan	Radix Dipsaci Asperi	9
12	Xuefuzhuyutang	Taoren	Semen Persica	12
		Honghua	Carthami Tinctorii	9
		Danggui	Radix Angelicae Sinensis	9
		Chuanqiong	Radix Ligustici Chuanxiong	4.5
		Chishao	Radix Paeonia Rubrae	6
		Niuxi	Radix Achyranthis Bidentatae	9
		Chaihu	Radix Bupleuri	3
		Jiegeng	Radix Platycodi Grandiflori	4.5
		Zhike	Fructus Citri seu Ponciri	6
		shengdihuang	Ridix rehmanniae Glutinosae	9
		Gancao	Ridix rehmanniae Glutinosae	3

AnalysisTop

A. Infertility patients with a few IVF treatments are more likely to get stress and anxiety. Acupuncture treatment should release their stress and anxiety first, after their body relaxed; they would have better respond to treatments

B. Patients with thin endometrial lining have different root cause and some of them can be complicated .The treatment normally take time. Acupuncture and some Chinese herbs together would work better.

C. Most thin endometrial lining patients do not have good menstruation. Mostly they have light period, some patients suffer from amenorrhea. Treating this condition should work on regulate patient’s menstruation and improve blood flow. The endometrial lining would be improved when their menstruation improved.

D. Thin endometrial lining treatment can be complicated. Treating this condition should work with holistic way; see the conception of the organism as a whole. Treating a fundamental aspect of the problem, as well as those conditions. Acupuncture working for this condition needs to use general body points and also local points together.

E. Thin endometrial lining patients tend to have miscarriages easily during their pregnancy. We should treat them on time when they start to have some sign of miscarriage. We should give them acupuncture support during their pregnancy and prevent miscarriage. Prevention is better than cure.

ReferencesTop

Dan jiang. Protecting Embryo with Chinese Herbal medicine for treating Miscarriagees-4 Cases Study Enclosed. Perceptions Report med. 2018; 1(3): 1-6. doi: 10.31031/PRM.2018.01.000515
Michal Vilimovsky (EN). Thin endometrial lining: causes, symptoms,diagnosis and treatment.
Qing Zhang. Experience of Chinese Medicine and acupuncture Treatment during In-Vitro Fertilisation (IVF) ACTM. The Journal of Chinese Medicine and Acupuncture. ISSN 1745-684330. March 2017
Thin uterine lining - Causes and Treatments
Dan jiang. Infertility Caused by the Early Failure of Ovaries Has Cured By TCM with A Nature Pregnancy. Perceptions Report med. 2017;1(1): 1-2. doi: 10.31031/PRM.2017.01.000504
Liang Dong –Yun TCM treatment Strategy of Multifactor Difficult Infertility Journal OF CHINESE MEDICINE IN THE UK ISSN: 2049-4289 2019 Volume 8 Issue I

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