A previous doctor put her on progesterone which helped to lessen the PMS symptoms. The progesterone did not regulate her cycle. The addition of femara did not promote ovulation. Ovulation predictor kits showed no LH surge. At this point, Robin came to me.
Robin’s treatment plan focused on promoting ovulation, regulating her cycle, decreasing intense PMS symptoms and helping with sleep. With the first month of acupuncture and herbs, the period came on day 33 – a first reasonably timed period. The period was less heavy. Around ovulation fertile mucus appeared with no cramping.
The second cycle came on day 35, which was a pleasant surprise for Robin. Once again, she had cervical mucus during ovulation and less heavy bleeding during her period. Robin was experiencing intense mood swings during most of her cycle and it was not improving with treatment, I asked her to see an RE. During her examination, multiple large sized follicular cysts where found on both ovaries. FSH was normal, LH was almost undetectable while estrogen was sky high. Follicles were developing with each cycle and without the LH surge, ovulation could not occur. Follicles turned into cysts.
The hormonal imbalance from the cysts was causing her irritability and problems with ovulation. At the third month of treatment, Robin felt she needed a break from the acupuncture. She wanted to work with the RE to resolve the cysts.
I didn’t see Robin for 5 months. During the 5 months, the RE drained the cysts and prescribed Ovidrel as a trigger shot to prevent cyst formation. It had worked for 3 months, but the cysts had returned. Though her FSH was low, the doctor felt the high estrogen was suppressing it. AMH was low. She was diagnosed with premature ovarian failure.
During this time, Robin did research. She found 4 case studies about FSH secreting pituitary adenomas. When Robin approached her doctor about testing for the pituitary adenomas, the doctor felt it was very unlikely and to continue with the current treatment plan using Ovidrel.
When Robin returned for acupuncture, she was hopeful I could eliminate the cysts and the constant emotional rollercoaster ride. We continued treatment with focus on eliminating cysts and helping her feel like her old self. At the end of the first month, nothing had changed. A new cyst had formed and it was large. Robin’s estrogen levels were sky-high, again.
At this point, I had a feeling something diagnostically was missing. I usually get a good result treating cysts. Plus, components of Robin’s case did not make sense – if she was in premature ovarian failure, why was she producing cysts? Usually, follicles become unresponsive to FSH and thus the body releases more FSH to get the follicle to grow. Why was Robin’s ovaries responsive and grew several cysts with each cycle?
I decided to go back to the drawing board with her treatment plan and figure this out. After a massive amount of searching, I could not find one article on cysts formation related to ovarian failure. Something was amiss.
When Robin and I met at our next session, she mention about getting a scan to rule out a pituitary tumor. She felt frustrated since the doctor continued to dismiss any potential correlation with the cysts and a pituitary tumor. Robin discussed with me the 4 case studies related to FSH secreting pituitary adenomas she found on the internet. Between Robin’s unusual case of “POF” and the unresponsive nature of her cysts, I knew the pituitary tumor should be ruled out. Robin took this discussion to heart and I encouraged her to insist on MRI.
Three weeks later, the scan revealed a pituitary tumor. Post-surgery, the tumor was found to promote the release of FSH. Her tumor was causing the cysts. For Robin it was important to be heard and have a practitioner that showed interested in her case. She felt my feedback was essential – I thought her case was unique, something I had never seen before and not POF. Robin knew something was not right and with encouragement felt it was ok to demand testing.
After recovering from the surgery, Robin feels like her old self. Cycles are regular, mood swing gone, and she is ovulating with no cyst formation. After a couple of months of recovery Robin went to an RE who retested blood work and found AMH to be low. After two months of trying naturally, Robin conceived naturally.
I wanted to share this case with you because:
1. If there’s something in your health history that doesn’t make sense…follow your gut and figure it out. Your practitioner should be listening to you and care enough to figure out what’s going on. From experience, I felt something else was involved when Robin was not responding to treatment. I don’t believe acupuncture has to be the only treatment option. When your treatments are not being affective, examining your health from another angle is important. It’s my responsibility to assist you in understanding your choices. The end goal of the treatment process is addressing your concerns and helping you find a way to improve your health.
2. It’s so important for fertility clients to be heard and supported. Some decisions you make along the way are difficult and confusing. To have a practitioner that listens and assists you can completely change your experience. Your acupuncturists should be doing more than sticking needles into you.
3. I’m a strong believer taking the time outside the office to build treat plans and re-evaluate health concerns of clients not responding to treatment. In many ways, our medical system is failing to take the time and think client’s cases thoroughly.
4. You may not have a practitioner to help you, but don’t give up looking for answers. It’s ok to ask lots of questions and follow your intuition. When your gut tells you to keep searching…follow it. Find the practitioners who will listen and take the time to support you on your journey to having a baby.
5. Finally, AMH does not indicate if you can or cannot conceive. Don’t define your ovarian health by AMH levels. No one has studied AMH levels in women who conceive with no problems. Robin’s low AMH didn’t stop her from conceiving.
Ridgefield Acupuncture has been assisting women in conceiving the baby of their dreams. In my office, you are more than a set of ovaries and a uterus. You are a dynamic women with many facets which will play into your treatment program. Come and experience a different healing process.