Case Study | Paige Waters

Case Study

Ambre – A 35 year old single female going through IVF for her first pregnancy. Possible PCOS – although not officially diagnosed (mentioned at an ultrasound by her fertility specialist), a history of period loss for 12 months at 25 years old. Intermittent OCP use from 16 years old until 30 years old. Otherwise regular cycles, feels like ovulates around day 20, but not confirmed.
No family history of fertility issues.
No other health complaints to report.
I saw her for the first time before her First IVF cycle. She was prescribed 150mg FSH, which was increased to 200mg after her first scan showed eggs weren’t developing as expected. This cycle resulted in the collection of 4 eggs, 4 fertilised, but just one was growing at day 3. Decided on a three day transfer which unfortunately resulted in a negative pregnancy test.
From a Chinese medicine perspective, Ambre was very cold. I had diagnosed her with Kidney Yang deficiency – this is when the body’s metabolic energy is slow. Her abdomen was cold to touch, her metabolism had slowed and weight was harder to lose. Women with this pattern tend to have poor egg quality and difficulty with implantation.
After the failed IVF cycle, we had a great opportunity to review dietary and lifestyle advice and make some changes. Ambre changed to a keto diet – high fat, was having more warming foods, was walking regularly and we started temperature tracking to monitor the effects of her treatments.
Her BBT chart showed low follicular temperatures, late ovulation, slow to rise temperatures after ovulation, low luteal phase temps and a short luteal phase.
After one month of acupuncture with her diet and lifestyle changes, her follicular and luteal phase temps were higher, she ovulated earlier, and luteal phase lengthened from 9 to 11 days.
I had referred her to another acupuncturist while I went on maternity leave and they continued treatments supporting her Kidney Yang deficiency.
Second IVF cycle – FSH was increased to 350mg, 19 eggs collected, but only one to transfer and one to freeze at day 5. Experienced OHSS. Both the fresh and frozen cycles resulted in negative pregnancy tests.
By this time, Ambre was wanting more answers and more ways to make a difference to her chances.
She had a hysteroscopy and endometrial scratch three weeks before the start of her third stimulated IVF cycle. She had a polyp removed. She lost 12kg with her keto diet, and the FSH was dropped down to 200mg. She also changed sperm donors.
I had returned from maternity leave just in time for her third stimulated cycle.
She was taking fish oils, NAC, activated B6 and 600mg ubiquinol daily.
Our treatments focused on warming Kidney Yang before the start of the stimulated cycle. I was using lots of moxa on her abdomen, as well as ginger and salt on her navel to really increase internal warmth and metabolism.
During the stimulated cycle, treatments focused on improving blood flow to the pelvis, ovaries and endometrial lining, increasing blood flow to improve medication delivery, warming the abdomen, increasing metabolic energy to support egg quality.
This cycle resulted in 10 eggs collected, 9 fertilised and three day 5 blastocysts. She had one grade AA transferred on her birthday which resulted in her beautiful little boy August born 19th July 2019.
Discussion: there were lots of factors in Ambre’s case that were changed throughout her three stimulate cycles – medication dosage changes, sperm donor changes, diet and lifestyle changes, supplements and treatments. I really do find that a holistic and integrative approach works best. The key features here for Ambre’s results…firstly getting the medication dosage right, second the high fat diet and a healthy weight range and of course the acupuncture support in improving blood flow, medication delivery and warmth.
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