OVARIAN OPTIMISM AND CLINICAL BRUTALITY

Gynaecological acu-moxa therapy (Wellcome library)

Like most acupuncture clinics these days, at the London Acupuncture Clinic we see many women experiencing difficulty getting pregnant. Although these women present with various pathologies – endometriosis, polycystic ovaries and fibroids, for example – perhaps the most common presentation is of women in their late thirties and early forties who have received a ‘diagnosis’ of dwindling ovarian reserves during attempts to have IVF treatment. Such a diagnosis is based on blood tests of follicle-stimulating hormone (FSH) and anti-Mullerian hormone (AMH) levels, antral follicle count, and possibly the woman’s previous response to IVF stimulation drugs. Sometimes the patient is even unable to start their IVF treatment because based on these results their ovaries would be unlikely to respond to the stimulation drugs. These patients invariably receive the cold, clinical – and at times frankly brutal – pronouncement on their fertility from the mouths of fertility consultants who seem unaware of the potentially devastating results of their communication on the woman’s well-being.

I have written about traditional Chinese and modern biomedical perspectives on ‘egg reserves’ in an article published in The Journal of Chinese Medicine in 1998. Today’s prevailing medical perspective asserts that women are born with all the eggs they will ever have, and which once used up are gone forever. In fact, I once had a good old humdinger of an argument with an acupuncture colleague, who argued (against my evidence-informed opinion) that such dogma is rubbish and merely constitutes a materialistic trap that will limit the possibilities of those who believe in it. However, the work of Jonathan Tilly and his colleagues may mean that those of us espousing the current biomedical party-line may need to reconsider their views. This is because Tilly et al have all but disproved the theory, widely held since the 1950s, that mammalian females are unable to produce any further eggs after they are born. Those who want a ‘lite’ digest of Tilly’s research should read this excellent précis published in The Independent, whilst those with who want a more academic approach can read a summary by Tilly et al here.

Where do these findings leave those of us who are open to thinking beyond reductive materialistic dogma, but who do not wish to be naïve and subject to fuzzy thinking (both for our own sake and the sake of our patients)? In my JCM article I pointed out the potential conceptual overlap between stem cells – the wild-card/joker in the pack of human cells that Tilly’s work has shown have the potential to become viable eggs – and the Chinese medicine concept of jing (essence, frequently defined in as being a type of raw physiological potential). Consideration of this question is important for practitioners of Chinese medicine engaged in the treatment of fertility, as throughout the last two millennia various Chinese herbal medicines and acupuncture points/protocols have been described as being able to strengthen/augment/replenish/enrich jing-essence. Given the possible correspondence between jing-essence and stem cells (as well as eggs/sperm), does this mean that such Chinese medicine interventions to  ‘tonify Kidney-essence’ might be able to facilitate the recruitment of these ovarian stem cells and assist their development into eggs? Those of us using acupuncture and Chinese herbal medicine in the field of infertility frequently see significant changes in women who have accessed our services for help with ‘low egg reserve’ and/or ‘poor egg/embryo quality’, although few of us would suggest that Chinese medicine treatment will reliably increase the numbers of eggs available during a subsequent IVF cycle. Given such research findings, however, who knows what might be possible?

Post Navigation