Fertility Impacted by Certain Types of Fibroids

great post Ray !

I know Bob Flaws would say that we can't use any western disease as a "pattern" in TCM diagnosis, although .... because they are finding that different fibroids are having different impacts on fertility maybe as the diagnosis gets more specific we could begin to make the cross over and say This type of fibroid relates to Blood Stasis, This type of Fibroid related to Phlegm Stagnation, This type of Fibroid is more commonly due to Qi stagnation, ...

Any thoughts?

I think that Bob (and other TCM practitioners) are correct, that we must treat the pattern/differential diagnosis in order to be successful with myomas/fibroids, or any other disease or condition. We must use the diagnostic tools and treatment modalities available to us in TCM to have an effect.

However - I posted this research because I feel that when we are working with patients trying to conceive, we must always bear in mind the whole picture. This is an area where a good basic knowledge of western reproductive medicine can inform our treatment plan. For example, let's say that you have a 40 year-old female who presents to your office with a diagnosis of Primary Infertility and she tells you that her OB has informed her that she has 2 intramural myomas. Depending upon their size and location in the Uterus - and given the patient's age, it might be more prudent for the TCM practitioner to refer this patient to an REI for a myomectomy so that she can proceed immediately with IVF - assisted by Acupuncture support during the IVF cycle. Because we are aware of research like this, and because we know that embyonic chromosomal non-dysjunction and aneuploidy increase markedly with age, and we know that treating Myomas with chinese herbs and acupuncture can take many months - we would actually be doing this particular patient a potential disservice by trying treat her fibroids to improve her fertility.

Whether it's the patient above - or the female infertility patient who casually mentions in the intake that she had a bout of chlamydial PID in college, but has not had an HSG and the TCM practitioner refers her to an REI where it's discovered that she has bilateral tubal occlusion - in both situations the TCM practitioner has greatly improved these patients' chances of conception by referring - not treating.

Ray.

In one of Bob Flaws' gynecology distance learning classes, he actually recommends that fibroids over a certain size be removed surgically, that it would take too long with TCM. In a woman over 40, this would be especially true.