疏肝補腎法治療高齡不孕病例報告二則

Infertility in Women of Advanced Age Treated with Soothing Liver and Tonifying Kidney Methods: Two Case Reports

李維哲(Wei-Che Lee) ； 張馨予(Hsin-Yu Chang) ； 謝瓊慧(Chiung-Hui Hsieh)

《中醫藥研究論叢》 25卷1期 (2022/03) Pp. 113-126

https://doi.org/10.6516/TJTCM.202203_25(1).0009

摘要

根據國際婦產科聯盟（International Federation of Gynecology and Obstetrics, FIGO）的定義，初產婦的年齡若超過35歲，即屬高齡產婦，社會的繁榮進步帶動高學歷人才的需求，遞延初入職場的時間，導致晚婚，其結果是生育的年齡不斷延後，但年紀卻與懷孕機率成反比關係，因而高齡不孕求診的患者屢見不鮮。本文報告兩個病例為43與42歲女性，分別有經痛史與卵巢儲量不足問題，並經歷流產或人工受孕失敗因而前來中醫門診。透過中醫診斷及辨證，屬於肝鬱腎虛之證，採疏肝補腎法治則，並搭配月經週期療法，依基礎體溫不同時期調整用藥，兩例皆於半年內順利自然懷孕。高齡不孕常面臨複雜又不易醫治的挑戰，故撰文對此二成功受孕案例予以探討。

關鍵字

高齡不孕 ； 經痛 ； 卵巢儲量不足 ； 疏肝補腎法 ； 月經週期療法

並列摘要

According to the definition of the International Federation of Obstetrics and Gynecology (FIGO), maternal age of 35 or greater at the time of childbirth is considered to be 'advanced maternal age (AMA)'. There is a decrease in fertility with advancing age, and infertility becomes more pronounced over age 35. However, late marriage and busy life make the age of childbearing delayed in our modern society. So, infertility at an advanced age is becoming a more and more important issue. In this report, we present two cases of 43 and 42-year-old women with dysmenorrhea or a history of failed artificial fertilization respectively, who searched for Traditional Chinese Medicine (TCM) treatment in our department. In the view point of TCM, the symptom is due to liver-stagnation and kidney-deficiency. After the treatment of soothing liver and tonifying kidney, combined with menstrual cycle therapy, both of them became pregnant naturally within half a year. It is often complicated and difficult to deal with the problem of age-related infertility. Here we provide these two successful experiences to suggest that soothing liver and tonifying kidney therapy may be effective and applicable for infertility in women of advanced reproductive age.

並列關鍵字

Infertility in women of advanced reproductive age ； Dysmenorrhea ； Insufficient ovarian reserve ； Soothing liver and tonifying kidney methods ； Menstrual cycle therapy

參考文獻

內政部。中華民國內政部統計年報（1951至2019年）。2020。

Wan GH, Chung FF. Working conditions associated with ovarian cycle in a medical center nurses: A Taiwan study. Japan Journal of Nursing Science. 2012; 9: 112-8.

World Health Organization (WHO). International Classification of Diseases, 11th Revision (ICD-11) Geneva: WHO 2018.

Practice Committee of American Society for Reproductive Medicine: Definitions of infertility and recurrent pregnancy loss. 2020; 113: 533-5.

Silber SJ, Kato K, Aoyama N, Yabuuchi A, Skaletsky H, Fan Y, Shinohara K, Yatabe N, Kobayashi T. Intrinsic fertility of human oocytes. Fertil Steril. 2017 May; 107(5): 1232-1237.