After treating infertility cases for twenty-one years I've arrived at some conclusions which I'd like to share.
2. Endometriosis can still contribute to infertility even after laparoscopy. Why? Because it may not be possible to eradicate all endometriosis due to several reasons.
a. Some endometriotic tissue looks exactly like normal tissue and therefore, the surgeon will not be able to observe this tissue as diseased tissue.
b. Some endometriotic tissue may be on structures which are difficult or dangerous to reach and the surgeon will opt not to try and excise this tissue.
Endometriosis does more than cause tubal pathology; it changes the uterine environment by causing an inflammatory state in the uterus. This is not amenable to facilitating an ongoing implantation. This is why acupuncture and herbal medicine should be included in the reproductive medicine protocol of those trying-to-conceive who have been diagnosed with endometriosis as acupuncture and herbal medicine can reduce inflammation and make the uterus more hospitable to an implanting embryo.
3. PCOS We all think of PCOS as a metabolic-endocrinological disorder whose main deterrent to conception is lack of ovulation. All of this is correct but myopic. Clomid or gonadotropins can cause one to develop mature eggs and other meds are used to actually facilitate ovulation - but that's not enough. Why do many PCOS patients not conceive after several IUI's or even IVF's? Because women with PCOS have excess androgen within the follicular fluid. Androgen is an anti-estrogen and as such causes or can contribute to poor egg quality. This is why PCOS patients have a difficult time conceiving or frequently miscarry. In fact, those with PCOS are twice as likely to miscarry as those in the non-pcos population. Acupuncture and herbal medicine should be included in your reproductive medicine protocol is you have PCOS since we know that these Chinese medicine protocols help clear the ovary and its contents of 'debris' and other pathological substances, i.e. androgen excess.
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