Herbs and IVF

December 31, 2003

Hi All,

I have a patient, 53 years old and post-menopausal who will be undergoing IVF in

January. With the support of hormone injections, she plans to sustain a

pregnancy and bear her second child. She became pregnant with her first child

in the same manner, and gave birth two years ago. After birth, she developed

severe menopausal symptoms she had never had before, even though her menses

stopped in 1998. Her symptoms include hot flashes 4-5 times daily and night

sweats which wake her up drenched in sweat, 3 times nightly and prevent her from

having restful sleep.

I have seen her for one month using acupuncture only, and have seen change in

her night sweats; now she wakes up only once nightly, and the sweating (both day

and night) is only slightly less intense. I have recommended the following herb

formulas for her, both by Health Concerns: Coptis Purge Fire (Long Dan Xie Gan

Tang Modification) to clear heat, and Nine Flavor Tea (Liu Wei Di Huang Wan

Modification) to nourish yin. The ingredients are listed below, and these are

my questions:

Is there any reason Nine Flavor Tea should interfere with the pregnancy and the

health of the baby? Does anyone see any reason it should be contraindicated?

Her Yin deficiency is severe and under any other circumstances, I would expect

to use a Yin-nourishing formula Yin for a long time.

I expect to use Coptis Purge Fire for only a short time to clear heat but not

endanger her Spleen and fluids (and the fetus). How long before the embryo

implantation should she discontinue using this formula? How long does it stay

in the system?

Is it typical for the hormone injections to impact the menopausal symptoms? If

so, what should I expect to see? What would be typical?

In terms of pharmaceuticals, this patient takes pre-natal vitamins, and

wellbutrin for depression. I wish this patient had come to see me with more

lead time before her scheduled IVF, but this is our working reality. Are there

any other contraindications I should be aware of? I have not worked with IVF or

pregnant patients before, and want to be even more cautious than usual.

Also, Health Concerns' formula guide says that Er Xian Tang (their Three

Immortals formula) is better suited to pre-menopausal women than post-menopausal

women. I haven't researched this yet, but am wondering why this should be so.

Any ideas?

If anyone knows of an acupuncturist-herbalist who specializes in IVF

pregnancies, I could use a good resource.

Thank you for your help! May you and yours have a wonderful new year!

Coptis Purge Fire

Huang Lian

Dan Zhu Ye

Chai Hu

Sheng Di Huang

Dang Gui

Bai Shao

Mu Tong

Zhi Mu

Huang Bai

Long Dan Cao

Ze Xie

Che Qian Zi

Huang Qin

Ku Shen

Lian Qiao

Zhi Zi

Gan Cao

Nine Flavor Tea

Shu Di Huang

Sheng Di Huang

Shan Yao

Fu Ling

Shan Zhu Yu

Mu Dan Pi

Ze Xie

Xuan Shen

Sha Shen

Mai Men Dong

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December 31, 2003

I see women for acupuncture infertility treatments who are referred from

Emory University's IVF program. Prior to referring pts they did

interview me and we had an extensive discussion about herb use. For them

herbs during these procedures are a problem, as they are activley

controlling the womens hormonal profile during the course of the tx. Due

the adaptogenic properties of some herbs, just presents an unknown

variable for them. At Emory they are very supportive of herbal use post

IVF w/ women who are not successful, as a means to nourish and

rebalance the system possible for a second attempt.

My understanding and use of Long dan xie gan tang is for excess

conditions and i would be surprised if your pt was excess. I would more

expect to see yin def w/ night sweats more on the order of steaming bone

disorder due to the IVF hormonal tx /chidlbirth on a post menopausal

woman. If that is the case probably would use some combination w/ zhi mu

and huang bai.

Warren Cargal

January 1, 2004

Cases such as this raise an ethical dilemma that has not been

adequately addressed in the medical community, to my knowledge, as

yet. Just because we can do something, and a patient desires it,

does it mean we should comply? Having seen numerous children born to

older parents, mostly with the aid of combinations of IVF and

constitutional therapy, my feeling is that the declining wellspring

of jing that is contributing to the infertility is unfortunately

passed to the child. These children, in my experience, seem to

suffer disproportionately from alleries, atopy, learning

difficulties, behavioural problems and weak immunity. In addition,

older parents with less reserve of energy themselves are less likely

to be able to cope with, and give an ill or difficult child the

requisite care they need. The potential health status and future

prospects of the child should be considered in equal proportion to

the desire of the parents for offspring.

As TCM practitioners we can definitely improve the live birth

outcome of IVF procedures for older parents, and in many cases

improve the overall health of the mother and father. But jing cannot

be replenished, and the ramifications of this for the children

concerned are now becoming clearer.

Will Maclean

January 1, 2004

RE - " These children, in my experience, seem to

suffer disproportionately from alleries, atopy, learning

difficulties, behavioural problems and weak immunity. "

Will, your point of view troubles me. Are there any studies to back up what

you're saying about the deficiencies passed to children of older parents and

their subsequent difficlties in life? If there are, I haven't seen them (the

studies, that is). Perhaps you only see the children who are in need of help,

and you don't see all the children who are thriving. For every anecdote in

line with what you're saying are the countering stories like mine - my parents

had three children in their 20's and one child in their 40's. The youngest

child by far had the better parenting, and seems to be doing fine, the mother

now

of 2 children, a vice-president of a bank, and going to law school at night.

Yes, we need to consider how we use the medicine; but for all of us this

means also examining how we might use CM to bolster our own unexamined

prejudices.

Perhaps an abundance of or relative lack of jing doesn't have the same

meaning for survival now as it did 2,000+ years ago.

Anytime I hear someone question a woman's or a couple's right to try

extraordinary measures in order to conceive a child 'for the sake of the child'

I

wonder: would it be better if the child had no chance at life? Me, I'd rather

be

alive with allergies than to not be alive at all. One need not be a perfect

specimen to enjoy life and to contribute greatly to others and to society.

RoseAnne Spradlin

January 2, 2004

, ra6151@a... wrote:

> Anytime I hear someone question a woman's or a couple's right to try

> extraordinary measures in order to conceive a child 'for the sake of the

child' I

> wonder: would it be better if the child had no chance at life? Me, I'd

rather be

> alive with allergies than to not be alive at all. One need not be a perfect

> specimen to enjoy life and to contribute greatly to others and to society.

It is relevant whether CM theory is right about this matter. so setting aside

the ethics

of IVF inthe first place as no amount of debate will ever change anyone's mind

on this

subject, my question is the same as the senders. We know its much harder to

conceive after age 35, with a very low rate of success in infertile women even

using

IVF. As Flaws will tell you, CM does no better, just less invasive. But the

critical

question is still whether conception at this age results in more defects or

worse

health for the offspring. does anyone know? But the ethic of whether to

conceive at

this age when the consequence is something like allergies rather than spina

bifida

may be more akin to whether a poor person should conceive. Life may not be

optimum, but it still maybe rewarding for all. Great love or great achievement

does

not require great health. However , without withholding the RIGHT to conceive,

one

should be fully informed about what TCM says. Unlike your story, my 40 year old

cousin will be spending the rest of her life taking care of a child who will

never

develop the ability to eat, speak or walk on her own. Anecdotes are no way to

settle

this matter, but if traditional chinese thought on this matter is valid, we

should heed

them at least a bit. Everythign is open to challenge, but the challenges must

be

based on logic and research, not emotions or bias.

January 2, 2004

, ra6151@a... wrote:

Me, I'd rather be

> alive with allergies than to not be alive at all. One need not be a perfect

> specimen to enjoy life and to contribute greatly to others and to society.

I don't practice peds or OB, but I do see a lot of women who had children in

their late

thirties who developed chronic health prolems soon afterwards. So I would also

be

curious if women expereince greater debility before or after pregnancy. I know

certain diseases have a lower incidence post-pregnancy such as endometriosis,

but I

do not think this has been balanced against the possible detriment of

middle-aged

pregnancy. I figure the child is usually fine as the body will sacrifice itself

for the

offspring. However, in the interest of full information, another concern of the

conceiving mom should be whether her own health will be permanently

compromised. I think this issue is rarely addressed by anyone. The question is

whether is it factually correct, anyway. Of course, once alive, we all would

rather live,

but we wouldn't even know any of this if we had never been conceived. that's

really a

moot point to me (and I doubt I would have survived the wilds myself). It

really is

about what in the best interests of all. Optimum health is not the only reason

to live,

but if we mustr share information about how to avoid poor health so one may

decide

to sacrifice health for something else (like various pleasures or indulgences

that come

to mind). We cannot just interject our own biases into this matter, whatever

they may

be (though I will admit I personally agree with Will in this matter)

January 2, 2004

> I don't practice peds or OB, but I do see a lot of women who had children in

their late

> thirties who developed chronic health prolems soon afterwards. So I would

also be

> curious if women expereince greater debility before or after pregnancy.

For sure it is my experience that the older the woman and the longer she

breastfeeds, the harder it is for her to recuperate after giving

birth and the more likely it is that she will develop some significant health

problems postpartum.

Doesn't mean that she shouldn't conceive, but there is a definite benefit/risk

ratio that should be taken into account. Then it's the

couple's choice. The more serious the potential risk, such as accelerated MS,

the more serious is the choice. Have seen a patient

really go downhill physically and mentally/emotionally with MS after giving

birth to her second child. I think she had the baby to " save "

her marriage, but ended up wrecking it.

BTW, I may have missed a post which already mentioned this, but BPP recently

published a book on CM and IVF written by Lifang

Liang. She says acupuncture and Chinese herbal medicine can increase IVF rates

up to 60%. She has a whole step-by-step protocol.

She specialized in this in the PRC and has continued on this path since coming

to the U.S. She has a clinic in S.F. Seems like a

very nice woman. Her CM is on the " modern " end of the spectrum, meaning

influenced by WM.

Bob

January 2, 2004

Hi all -

I haven't chimed in in a long time because I have been overwhelmingly

busy but this one really got me. (It got me into a long discussion about

Buddhism, Daoism and Confucian moral thought as well) so I thought I should

comment.

First of all re Lifang Liang's book. It is excellent and I highly

recommend it to anyone treating patients using IVF (and I see a lot - about

50% of my current practice) Back to clinical thoughts later. First, to the

moral/ethical issues.

Here we have a post-menopausal woman of 53 who, under normal circumstances

would not be able to conceive. It is quite apparent that her first

pregnancy affected her health quite dramatically. What was the cause of

her beginning to experience more menopausal symptoms. There were

many. First of all, the drugs. They basically switch off a woman's normal

hormonal system and take over chemically. Many women who do the IVF or IUI

w/ clomid route experience many " menopausal signs " like night sweats, poor

sleep etc. Then, we have the fact that a women who was post-menopausal was

suddenly asking her body to nourish a fetus with blood that she could ill

afford. The result, nine months later, a basically health baby (as far as

we know at this point) and a mother whose health (essence, blood, yin) has

been damaged. Now she wishes to go through the process again. What is our

role? By helping her to conceive are we " aiding and abetting " harm to the

patient because we suspect that it will cause greater damage to her

constitution or are we in fact reducing that damage which she is determined

to inflict by treating her and ideally minimizing the impact that carrying

the baby has on her physical state.

The Confucian moralist might say that this woman should not be attempting

to conceive this child and should be content with her life - and by the way

why didn't she have children at an appropriate age?

The Daoist might say: it is not worth damaging your own essence to bring

another life into this world. Spend your energy on improving your own

physical condition.

The Buddhist might say that bringing this child into the world is an

extremely generous act on the part of the woman and she should be aided in

her goal.

What do we say? Well, I help a lot of women, old, young and in the middle

to get pregnant. As a mother I know that bearing children is an

incredible experience and that any " selfish " aspect of why we bear children

is quickly subsumed by the amount of effort that goes in to raising a

child. But, I also always talk to my patients about their plans should

they not be able to conceive. Would they consider adopting? In the case

of this woman, adoption could be a wonderful thing rather than putting her

body through this again. But, if she is determined to do it, then I would

tend to go with the idea that by treating her I will be preventing a

certain amount of the damage that her body might otherwise undergo.

So, how would I treat her: Well, first of all what is the pattern?

Andrea Beth tells us the following :

After birth, she developed severe menopausal symptoms she had

never had before, even though her menses stopped in 1998. Her symptoms

include hot flashes 4- 5 times daily and night sweats which wake her up

drenched in sweat, 3 times nightly and prevent her from having restful sleep.

I have seen her for one month using acupuncture only, and have

seen change in her night sweats; now she wakes up only once nightly, and

the sweating (both day and night) is only slightly less intense. I have

recommended the following herb formulas for her, both by Health Concerns:

Coptis Purge Fire (Long Dan Xie Gan Tang Modification) to clear

heat, and Nine Flavor Tea (Liu Wei Di Huang Wan Modification) to nourish yin.

But: what are the pulse and tongue? what about her appetite, bowels, urine

etc. More info would be helpful. Assuming that the diagnosis is as Andrea

Beth implies a kidny yin vacuity with effulgent fire then the Liu Wei Di

Huang Wan Jia Jian should be somewhat helpful although I am not sure that

the pill form of the formula will be strong enough - if possible I would

try to get her on powders. The question is is her stomach qi sufficiently

strong to handle the sticky nature of the Di Huang? As far as the Coptis

Purge Fire, I'm not sure I would use it. The amount of draining in that

formula combined with the draining herbs in the other formula may increase

urination to such an extent that the yin will be further damaged. Also,

how is her Qi? This is why I ask about appetite & bowels. Is it only the

yin aspect that was affected by the pregnancy/birth? I doubt it. It seems

to me that in addition for nourishing yin and clearing heat you may also

need to boost the spleen qi so that she can hold the fetus in and produce

sufficient post-natal qi to nourish herself and the baby. Perhaps

something like a Dang Gui Bu Xue Tang. Also, once she has conceived you

will probably need to help her hold the fetus with a formula like Shou Tai

Wan.

Just a few preliminary thoughts.

Marnae

The ingredients are listed below, and these are my questions:

Is there any reason Nine Flavor Tea should interfere with the pregnancy and

the health of the baby? Does anyone see any reason it should be

contraindicated? Her Yin deficiency is severe and under any other

circumstances, I would expect to use a Yin-nourishing formula Yin for a

long time.

I expect to use Coptis Purge Fire for only a short time to clear heat but

not endanger her Spleen and fluids (and the fetus). How long before the

embryo implantation should she discontinue using this formula? How long

does it stay in the system?

Is it typical for the hormone injections to impact the menopausal

symptoms? If so, what should I expect to see? What would be typical?

In terms of pharmaceuticals, this patient takes pre-natal vitamins, and

wellbutrin for depression. I wish this patient had come to see me with

more lead time before her scheduled IVF, but this is our working

reality. Are there any other contraindications I should be aware of? I

have not worked with IVF or pregnant patients before, and want to be even

more cautious than usual.

Also, Health Concerns' formula guide says that Er Xian Tang (their Three

Immortals formula) is better suited to pre-menopausal women than

post-menopausal women. I haven't researched this yet, but am wondering why

this should be so. Any ideas?

If anyone knows of an acupuncturist-herbalist who specializes in IVF

pregnancies, I could use a good resource.

Thank you for your help! May you and yours have a wonderful new year!

Coptis Purge Fire

Huang Lian

Dan Zhu Ye

Chai Hu

Sheng Di Huang

Dang Gui

Bai Shao

Mu Tong

Zhi Mu

Huang Bai

Long Dan Cao

Ze Xie

Che Qian Zi

Huang Qin

Ku Shen

Lian Qiao

Zhi Zi

Gan Cao

Nine Flavor Tea

Shu Di Huang

Sheng Di Huang

Shan Yao

Fu Ling

Shan Zhu Yu

Mu Dan Pi

Ze Xie

Xuan Shen

Sha Shen

Mai Men Dong

At 05:04 PM 1/2/2004 +0000, you wrote:

> > I don't practice peds or OB, but I do see a lot of women who had

> children in their late

> > thirties who developed chronic health prolems soon afterwards. So I

> would also be

> > curious if women expereince greater debility before or after pregnancy.

>

>For sure it is my experience that the older the woman and the longer she

>breastfeeds, the harder it is for her to recuperate after giving

>birth and the more likely it is that she will develop some significant

>health problems postpartum.

>

>Doesn't mean that she shouldn't conceive, but there is a definite

>benefit/risk ratio that should be taken into account. Then it's the

>couple's choice. The more serious the potential risk, such as accelerated

>MS, the more serious is the choice. Have seen a patient

>really go downhill physically and mentally/emotionally with MS after

>giving birth to her second child. I think she had the baby to " save "

>her marriage, but ended up wrecking it.

>

>BTW, I may have missed a post which already mentioned this, but BPP

>recently published a book on CM and IVF written by Lifang

>Liang. She says acupuncture and Chinese herbal medicine can increase IVF

>rates up to 60%. She has a whole step-by-step protocol.

>She specialized in this in the PRC and has continued on this path since

>coming to the U.S. She has a clinic in S.F. Seems like a

>very nice woman. Her CM is on the " modern " end of the spectrum, meaning

>influenced by WM.

>

>Bob

>

>Chinese Herbal Medicine offers various professional services, including

>board approved continuing education classes, an annual conference and a

>free discussion forum in Chinese Herbal Medicine.

>

January 2, 2004

, Marnae Ergil <marnae@p...> wrote:

>

> The Confucian moralist might say that this woman should not be attempting

> to conceive this child and should be content with her life - and by the way

> why didn't she have children at an appropriate age?

>

> The Daoist might say: it is not worth damaging your own essence to bring

> another life into this world. Spend your energy on improving your own

> physical condition.

>

> The Buddhist might say that bringing this child into the world is an

> extremely generous act on the part of the woman and she should be aided in

> her goal.

>

Marnae

I appreciate your pragmatic and thoughtful response to this issue. If the

patient will

do IVF or seek out another CAM px anyway, why not do harm reduction. I hadn't

thought of that. and we all missed your absence. :-)

January 2, 2004

, Marnae Ergil <marnae@p...> wrote:

>

> First of all re Lifang Liang's book. It is excellent and I highly

> recommend it to anyone treating patients using IVF (and I see a lot - about

> 50% of my current practice) Back to clinical thoughts later. First, to the

> moral/ethical issues.

>

if I may, what is your success rate? and what are your pt. demographics?

January 3, 2004

Todd - success varies. Depends, as we can all imagine upon the age of the

patient. In general, if at all possible, I try to get the patient to give

me three months of treatment drug free (I can usually get about one

month). My experience has been that most women who are using all of the

IVF drugs to get pregnant are very wary of using herbs at the same time so,

although I encourage it, I often use acupuncture alone. I see about 20

private patients/week in a 3 day work week. Of that about 1/2 are seeing me

for fertility issues, some doing IVF, some doing IUI, some trying the

old-fashioned way. This has definitely increased in the last 6 months. So

far my success rate is about 75%. For many of these women, it really is

just a matter of moving the liver qi. I had one patient who had done IUI 5

times (with donor sperm - not her husbands) and failed each time. On the

6th round she cam to see me for 3 weeks before insemination. She got

pregnant on that one. Would she have gotten pregnant anyway? Maybe, but

she was so uptight about it all that I do think we made a

difference. Anyway, the number are not large enough yet to really say that

I know that it helps - and it is all merely anecdotal and not controlled,

but...

Marnae

At 08:39 PM 1/2/2004 +0000, you wrote:

> , Marnae Ergil <marnae@p...> wrote:

>

> >

> > First of all re Lifang Liang's book. It is excellent and I highly

> > recommend it to anyone treating patients using IVF (and I see a lot -

> about

> > 50% of my current practice) Back to clinical thoughts later. First, to

> the

> > moral/ethical issues.

> >

>

>if I may, what is your success rate? and what are your pt. demographics?

>

>Todd

>

>Chinese Herbal Medicine offers various professional services, including

>board approved continuing education classes, an annual conference and a

>free discussion forum in Chinese Herbal Medicine.

>

January 3, 2004

does anyone know?

>>>Besides the regular risks of preg in aged women, there is not difference in

IVF kids

Alon

January 3, 2004

I know

certain diseases have a lower incidence post-pregnancy such as endometriosis,

but I

do not think this has been balanced against the possible detriment of

middle-aged

pregnancy.

>>The biggest benefit is lower risk of breast cancer

Alon

January 3, 2004

She specialized in this in the PRC

>>>How much IVF is done in china?

Alon

January 4, 2004

I dont think much IVF is done in China - as I recall Lifang specialized in

OB GYN in China and then spent a few years in Texas with a research doc who

was working with IVF before moving to SF and beginning to teach at

ACTCM. She has been there since about 1990.

Marnae

At 01:50 AM 1/4/2004 -0600, you wrote:

>She specialized in this in the PRC

> >>>How much IVF is done in china?

>Alon

>

January 8, 2004

I see them all the time, too. I call them " hollow " kids. 6'4 " , 265 pounds,

lethargic, allergic people. However, I am an incubator baby myself, 1 month

premature, and am happy to be here with my spondylo, allergies, and other

similar goodies.

I do think there might be some sort of educational thing done to let folks

know that they are doing this to their future children, and let them make the

choice.

DAve

In a message dated 1/1/04 11:40:31 PM, wbm40 writes:

> Cases such as this raise an ethical dilemma that has not been

> adequately addressed in the medical community, to my knowledge, as

> yet. Just because we can do something, and a patient desires it,

> does it mean we should comply? Having seen numerous children born to

> older parents, mostly with the aid of combinations of IVF and

> constitutional therapy, my feeling is that the declining wellspring

> of jing that is contributing to the infertility is unfortunately

> passed to the child. These children, in my experience, seem to

> suffer disproportionately from alleries, atopy, learning

> difficulties, behavioural problems and weak immunity. In addition,

> older parents with less reserve of energy themselves are less likely

> to be able to cope with, and give an ill or difficult child the

> requisite care they need. The potential health status and future

> prospects of the child should be considered in equal proportion to

> the desire of the parents for offspring.

>

> As TCM practitioners we can definitely improve the live birth

> outcome of IVF procedures for older parents, and in many cases

> improve the overall health of the mother and father. But jing cannot

> be replenished, and the ramifications of this for the children

> concerned are now becoming clearer.

>

> Will Maclean

>

January 9, 2004

Hi All,

I was ill most of this last week, so am responding to the " ethics and morality "

issue regarding IVF a bit late, but I want to express my viewpoint. As far as

I'm concerned, it is not my job to decide what is or is not moral where my

patients' choices are concerned; it is my job to educate about all possible

outcomes of all treatments, and then to let go of the choices my patients make.

I imagine they struggle enough with their own belief systems, consciousnesses,

and experiences and have the right to choose as they wish. My concern is that

their choices are as informed as possible. This is often personally difficult

and painful for me, but it is not an issue about IVF alone. I have diabetic

patients who choose to eat cookies and cake, asthmatics who choose to smoke,

athletes who will not rest to let their injuries heal, and many other examples

of people who make choices that worsen the very conditions they are seeking to

remedy in their treatment with me. I have taken the

position that people who seek my help want to get well, and how motivated they

are is the real issue in their success. It is sad but true that most people are

not all that motivated to change " comfortable " habits which may actually be

leading to their downfall. I can be a role model, I can educate, I can speak

truth to power, but I cannot change someone's decision and actions for them.

This has to come from them. Sometimes, over time, what I am saying and the work

I am doing seeps in and the person " suddenly " has a " spontaneous " realization

that they need to change. That's when the real fun begins.

I acknowledge that the concern about future life is real and valid. The health

of IVF children is important to weigh in the decision-making. However, I also

want to acknowledge that our medicine teaches that the quality of the essence we

pass on to our children is impacted by our everyday experience, the quality of

the food we, in addition to our biological age at the time of conception, or in

this case, implantation. There are very few people I know of who safeguard

their jing so that what they pass on to future generation is of the highest

quality. Maybe in other cultures, but not here. We live in a jing-wasting

culture. We take it for granted, squander it, and damage it. So then, is this

really so different from passing on " old " jing in a post-menopausal pregnancy?

My concern is more for the future health of the mother, than for the child.

< wrote:

, ra6151@a... wrote:

> Anytime I hear someone question a woman's or a couple's right to try

> extraordinary measures in order to conceive a child 'for the sake of the

child' I

> wonder: would it be better if the child had no chance at life? Me, I'd

rather be

> alive with allergies than to not be alive at all. One need not be a perfect

> specimen to enjoy life and to contribute greatly to others and to society.

It is relevant whether CM theory is right about this matter. so setting aside

the ethics

of IVF inthe first place as no amount of debate will ever change anyone's mind

on this

subject, my question is the same as the senders. We know its much harder to

conceive after age 35, with a very low rate of success in infertile women even

using

IVF. As Flaws will tell you, CM does no better, just less invasive. But the

critical

question is still whether conception at this age results in more defects or

worse

health for the offspring. does anyone know? But the ethic of whether to

conceive at

this age when the consequence is something like allergies rather than spina

bifida

may be more akin to whether a poor person should conceive. Life may not be

optimum, but it still maybe rewarding for all. Great love or great achievement

does

not require great health. However , without withholding the RIGHT to conceive,

one

should be fully informed about what TCM says. Unlike your story, my 40 year old

cousin will be spending the rest of her life taking care of a child who will

never

develop the ability to eat, speak or walk on her own. Anecdotes are no way to

settle

this matter, but if traditional chinese thought on this matter is valid, we

should heed

them at least a bit. Everythign is open to challenge, but the challenges must

be

based on logic and research, not emotions or bias.

Chinese Herbal Medicine offers various professional services, including board

approved continuing education classes, an annual conference and a free

discussion forum in Chinese Herbal Medicine.

January 9, 2004

Hi Marnae and all,

My comments are in italics below.

Marnae Ergil <marnae wrote:

What was the cause of

her beginning to experience more menopausal symptoms. There were

many. First of all, the drugs. They basically switch off a woman's normal

hormonal system and take over chemically. Many women who do the IVF or IUI

w/ clomid route experience many " menopausal signs " like night sweats, poor

sleep etc.

This woman did not use clomid. The eggs came from another woman, who did use

clomid.

Then, we have the fact that a women who was post-menopausal was

suddenly asking her body to nourish a fetus with blood that she could ill

afford. The result, nine months later, a basically health baby (as far as

we know at this point) and a mother whose health (essence, blood, yin) has

been damaged.

Yes, as far as we know, but toddler is healthy, and the mother is paying a high

price.

Now she wishes to go through the process again. What is our

role? By helping her to conceive are we " aiding and abetting " harm to the

patient because we suspect that it will cause greater damage to her

constitution or are we in fact reducing that damage which she is determined

to inflict by treating her and ideally minimizing the impact that carrying

the baby has on her physical state.

This patient came to me for symptomatic relief, not for pregnancy support, and

this is my job as I see it. This does mean, as I understand it, helping to

mitigate the harmful effects of the past pregnancy as well as the one she is now

planning.

The Confucian moralist might say that this woman should not be attempting

to conceive this child and should be content with her life - and by the way

why didn't she have children at an appropriate age?

I don't think it is my place to ask why someone did not have children at a

younger age, nor to tell them they should be content with their lot.

The Daoist might say: it is not worth damaging your own essence to bring

another life into this world. Spend your energy on improving your own

physical condition.

What if she is not a Daoist, and does not subsribe to this way of thinking? She

might think it is a very worthwhile endeavor.