Homoeopathic Approach to Infertility- Holistic Care Approach[1]
Anand R Kapse MD (Hom), MBA (Education Management)1*
Janhavi A Kapse, BHMS2
Kavita R Jadhav, MD (Hom)3
______________________________________________________________________
1Professor and Head, Dept of Organon of Medicine, Dr M. L. Dhawale Memorial Homoeopathic Institute; Consultant, Infertility OPD and Director, Rural Homoeopathic Hospital, Palghar
2Consulting Homoeopathic Physician, Kalyan, Maharashtra
3Sr. Research Fellow, Infertility OPD, Rural Homoeopathic Hospital, Palghar
*Corresponding author: Dr Anand Kapse
Email: arkapse@gmail.com
How to cite this article:
Kapse AR, Kapse JA, Jadhav KR. Homoeopathic approach to infertility- a holistic care. Journal of Integrated Standardized Homoeopathy (JISH) 2019; 02(01)
Received on: March 10, 2019
Accepted for Publication: March 29, 2019
Abstract:
Infertility has been recognized as a public health issue worldwide by the World Health Organization (WHO).One in every four couples in developing countries is affected by infertility. This article includes five caselets of couples with infertility; all the cases focus on different clinical conditions and aspects of the condition as well as how the Homoeopathic approach helps in dealing with all these issues. Homoeopathy is a big relief as it avoids painful procedures, reduces the financial burden, provides natural conception, removes the emotional blocks regarding sex, helps in improving the relationship of the couple. Hence, it is a holistic treatment! It treats not only infertility but also its psychological effects. It is therefore a complete mode of treatment compared to modern medicine strategies.
Key Words- Infertility, Homoeopathic Approach, Holistic care
Introduction:
Infertility is defined as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse” (1). Primary infertility denotes patients who have never conceived. Secondary infertility indicates previous pregnancy but failure to conceive subsequently. Approximately 85% couples achieve conception, if they so desire, within one year of having regular intercourse with adequate frequency (4-5 times a week). Another 10% will achieve this objective by the end of the second year. Therefore, up to 10% will remain infertile by the end of the second year. Conception depends on the fertility potential of both partners. The male partner is directly responsible in 30-40% cases, the female partner in 40-55%, and both are responsible in about 10% cases. The remaining 10% is unexplained despite thorough investigations (2). Infertility has been recognized as a public health issue worldwide by the World Health Organization (WHO). One in every four couples in developing countries had been found to be affected by infertility (3). This denotes a vast population dealing with this complex issue.
Holistic Approach to Infertility: Basic assumptions and roles
Infertility is an emotional roller coaster. If one wants a baby more than anything, the physical, emotional, and financial costs are formidable. The treating team approached the couples in the study based on some assumptions about marriage that were based on previous clinical experiences.
- Marriage has the potential of providing happiness through love and companionship.
- Rearing a child helps the parents mature as individuals and completes the couple as a unit.
- An infertile couple tends to develop dysfunctional patterns due to attempts by the husband and wife to adapt to the vacuum.
- Infertility is known to cause psychological effects. Partners may become more anxious to conceive, increasing sexual dysfunction. Women trying to conceive often have depression rates similar to those in women who have heart disease or cancer (3).
- Marital discord often develops, especially when the couple is under pressure to make medical decisions.
Infertility causes immense emotional pain, which can be avoided through treatment that enables natural or artificial conception, or through adoption. Nobody should have to live with the pain of childlessness. The problem has a solution. A child, whether biological or adopted, gives us the same happiness and pain.
In our institute, we treat infertile couples preferably with a team of a male and female physician; in essence, a therapist couple who provide a therapeutic environment and eases the process. Homoeopathy promotes natural processes for conception as against the artificial methods used by modern medicine. Struggling with infertility is like dealing with the five stages of grief every month- you Deny, Bargain, Get Angry, Cry, and Accept- then you pick yourself up and do it all over again (4). This repeated experience is traumatic for a couple. Couples often need considerable encouragement from the treating physician to maintain their motivation. Dealing with the specific difficulties of the couple becomes of prime importance. Counselling also plays a major role. The cure is therefore a collective effort of the therapist couple, who play the roles of an educator, guide, motivator and advisor, and counsellor who regularly discuss specific issues with a couple and try to determine the possible outcome.
CASELET 1- COUPLE WITH OLIGOZOOSPERMIA AND PCOD
This couple was referred by a gynaecologist surgeon. The husband was a 29-year-old assistant mechanical engineer working in MIDC. The wife was a 25-year-old housewife. They had been married for 3 years. The husband’s sperm count was 2000 – 1 million/mL with sluggish motility, suggesting oligo-astheno-zoospermia. The husband had an ambivalent relation with his father as he felt that the father had given undue importance to his sister (the patient’s paternal aunt). He would stop talking and cut off relationships even after minor quarrels with friends. After marriage, he was angry at his in-laws for perceived disrespectful behaviour. He was irritable+3, intolerant to contradiction+3, egoistic+2, reserved+2, and harboured feelings of hatred+3. However, he was also sentimental+3; during the interview, he suddenly burst into tears. On 19/9/90, the patient was initially administered Silicea 30C in multiple doses with Tub Bov 1M. This did not help him. The physicals had misled the physician. On 30/10/90, semen analysis showed motility 5-10%, total count 1.4 million. The case was reviewed on 31/10/90. After understanding the sentimentality, irritability, and intolerance of contradiction, he was put on Natrum Mur 30C multiple doses. On 13/12/90, his semen analysis showed motility 10-15% and total count 2.5 million.
The wife was simultaneously defined for polycystic ovarian disorder (PCOD). She belonged to an orthodox religious and affectionate joint family, was fearful since childhood, especially of ghosts, and used to feel that somebody was coming to take her away. She would scream during sleep. She was anxious to conceive3, had temper tantrums where she refused to speak or eat. She had religious dreams, dreams of snakes, water, children, and her sisters. Her physical characteristics included sun<, bus<, menses staining brown, backache during menses, weakness during menses, and no desire to walk. In this patient, irritability with long lasting anger, Sentimentality, H/O psychological disturbances, and<sun pointed to Natrum Mur. Staining menses and several dreams brought in Magnesium, but the forenoon aggravation of typhoid in the past tilted the balance. Therefore, Natrum Mur 200C was started on 19/09/90, daily doses. The potency was raised to 1M on 31/10. LMP-30/11. She had slight spotting one day on 26/12, c/o nausea and vomiting with a positive pregnancy test.
Learning:
This case focused on many aspects of infertility such as psychological stresses in an infertile couple. The physician experienced the anxiety of a man who comes to know that the fault lies with him. We learnt the importance of past history in Materia Medica differentiation, where the Similimum can produce results in a most rapid, gentle, and cost-effective way. In a case where allopathic Rx had not produced results after 2 years, conception occurred within 2 menstrual cycles after both partners received the right constitutional medicines! This was a big achievement for us, because this was our first case of infertility. We witnessed that Homoeopathic treatment produces results not only through increasing the number of sperms, but also through improving their quality and functionality. Here, conception occurred with a sperm count of only 2.5 million.
CASELET 2- COUPLE WITH UNCONSUMMATED MARRIAGE
The wife was a 38-year-old woman working as a postal assistant in Bombay Foreign mails, while the husband was a 39-year-oldpersonal assistant to an executive. Inauspicious horoscopes had led to a late marriage, 3years prior.
The female physician treating the wife reported: ‘she was a very plain-looking, thin lady with thick spectacles and absolutely no charm. Her face was very dull, passive, and expressionless. She was quite slow in all actions, including entering the OPD and answering questions; she often spoke inaudibly. I had to make her repeat her answer 3-4 times before I could understand. I felt that she needed to come out of her shell. In the subsequent follow-ups, I tried to make her talk. Information about her premarital life, marital life was enquired repeatedly. Slowly, she started responding to my queries. I was more anxious for her to have a child than she herself appeared to be. After almost six months of treatment, she confessed that the husband’s sexual problem was not yet completely solved! I wondered how a couple could remain so inactive with so little time on their hands! Inability to conceive is one thing and lack of attempts to sort out the problem is another. I asked her to bring the husband to the clinic for treatment.’
She was depressed, sulky, irritable, and would get exhausted easily. She had irritable bowel syndrome (IBS), where diarrhoea was initiated by consumingmilk+3, nuts+3, potatoes+, and spicy/rich food+; she was better on empty stomach. She had sun headaches+3, motion sickness+3, Av – sour+3. Her headache was< by sun+3, headbath+3, oiling+3, and in winter+. Her backache was <by exertion and >by lying on the back.
Husband had sexual debility; weak or incomplete erections. The problem commenced on the wedding day itself. He ejaculated twice in a span of two hours even while embracing. Then, he never really tried for sex during the first year, only slept next to the wife, and was satisfied with foreplay. He could not do anything more. He made many attempts, but with constant fear anticipating another disastrous result. He never fully regained confidence. The problem was only compounded by weak erections, lack of orgasm, and if at all some erection took place, lack of ejaculation. He was unable to penetrate. Stimulation from the wife never really created an avowed interest for sex. He consulted a doctor who did not see any visible fault and prescribed some vitamin tablets, which did not work. In the second year, he could penetrate a little bit but not to the satisfaction of both. They never reached climax. Their performance was relatively better in cool atmosphere, especially in the early morning hours. His repeated attempts resulted in failure and then he resigned to the fact that with advancing age of both, little could be done to retrieve the situation. Since the last four months or so, he was living in constant depression, foreseeing a gloomy picture with no further happiness in life and with no prospects of a child to have some grip in life.
While working in Saudi Arabia, he started masturbating on a regular basis after being advised by his physician, which generated tremendous guilt+3. He got a wife who was unattractive, was averse to sex, and never stimulated him or invited affection. Husband who was by disposition a shy+3, reserved+3 person due to impotency started communicating less, feeling depressed, nervous, and hopeless about having a child. He had multiple characteristic dreams+3 of dead persons, death, diseases, animals, murder, fire, boss, money, child, and of being oppressed. He was chilly, with a lean constitution, headache <from sun <from anger, <tobacco, perspiration staining yellow.
This person tended to suppress anger, first at the dominating father during childhood and in adult life to a dominating boss at work. From a submissive mother, he had developed insecurities with low self-esteem and fears since childhood, which were repressed and presented through multiple dreams. The frigid, disinterested wife became an additional factor to his disposition to increase his anxieties for performing at work and in the sexual aspect. The guilt of masturbation in the past with lack of stimulation and aversion to sex from wife made him impotent.
To resolve the conflict of this couple, we confronted the lady to break her shell, suggested to her to be more responsive and warmer. We advised the couple to go on short trips on weekends. They were advised to start yoga to calm their minds. The husband was counselled to learn to assert rather than escaping from the boss so that his work tensions will be reduced. We guided them about trying different positions, foreplays, and afterplay while having intercourse to find pleasure in this act.
The wife received Sepia 200 1P weekly while the husband received Mag carb 200 1P weekly to start with. Subsequently, we increased the repetitions to daily; we later stepped up the potency to 1M. After administering 1M, the lady conceived. It was a twin pregnancy to start with, but eventually only one foetus developed fully. The couple was blessed with a daughter.
Learning
Managing infertility in a couple who were already 38-39years old created pressure on the physician. Getting the wife to open up was another difficult task! The wife had other physical complaints that needed treating, such as IBS and recurrent headaches. A Homoeopath requires patience, faith, and case taking skills such as questioning, confronting, and exploring. They also need comprehensive knowledge of sexual dysfunctions, psychodynamic correlations, and psychological studies available to understand a person from the evolutionary aspect. They must develop skills to form rapport with the couple as patients are mostly not comfortable sharing sexual history.
CASELET 3 – HEN-PECKED HUSBAND AND TEMPESTUOUS WIFE
A 27-year-old housewife, short and well dressed, consulted for primary infertility with a 37-year-old husband, the owner of a flower shop. They were Maratha and married for 5years. The husband’s semen analysis was normal, while the wife was diagnosed with PCOD. She had received allopathic treatment for 2 years including drilling of ovaries. Wife was irritable+3, quarrelsome+3 obstinate+3, used to stop talking after quarrels. She could not tolerate contradiction+3. She was very reserved person+3 and had aversion to company+3. She was suspicious+2 about husband having an affair. She was chilly (C3H2) with soles always covered. She had aversion to coition+2. She had a histrionic personality with tension headaches.
The husband was very worried about the patient’s nature; she did not maintain good relations with anybody, so he was anxious about who will take care of her after delivery. Once, the patient quarrelled with her husband and she did not prepare food for 2 days. She did not allow him to eat outside nor did she eat herself. If he wants to meet his sisters, they must come to his shop. He seemed to be in a helpless state with respect to her behaviour. He was not enjoying his life; he is a social person who would like to mingle with people and live in a joint family, but she hated all these things. Considering this, she was prescribed Nat Mur 200C 1P weekly with Sepia as her closest differential remedy. With one dose of constitutional Rx, her headaches subsided. After increasing the repetition to daily, the patient conceived and stopped reporting as she felt that now she must report to the referring gynaecologist for ANC check-ups.
During the 3rd month of pregnancy, the wife attempted to burn herself by pouring kerosene (this appeared to be a hysterical attempt). The husband had to call his brothers for help. The matter worsened and a police complaint was lodged. Reason for suicide attempt was that patient had a suspicion that her husband was having an affair and the other thing was that patient did not like her husband talking with her sisters and sisters-in-law. During pregnancy, the patient reported with warts (verruca vulgaris) on the chin and dorsum of hand. Her sleep and appetite were disturbed, with nausea+ and hair fall+. She showed no weight gain during pregnancy, remaining constant at 50 kg. Patient had continued to report to the referring gynaecologist. She was advised to take regular Homoeopathic Rx till delivery. She was given Nat Mur 200 daily to QDS, after which all her warts disappeared and her weight increased. She delivered a healthy daughter.
Learning
Managing PCOD after failure of surgical intervention and allopathic treatment was the chief learning. The challenge was to manage a personality disorder along with infertility. As the husband was cooperative, we could help this couple in a better way. We must appreciate the action of constitutional medicine in treating the psyche and soma of the patient. The constitutional remedy also resolved her ANC complaints. This shows that Homoeopathic treatment would be beneficial till delivery.
CASELET 4- A CASE OF in-vitro fertility (IVF) WITH DECREASED ENDOMETRIAL THICKNESS
This was a case of a software engineer, who was already under treatment for renal calculi and then came for infertility due to oligozoospermia. Many prescriptions had failed, including Lycopodium 30 to 1M, Magnesium Mur 200 to 1M, Silica200, Magnesium Carb 30, Thuja mother tincture, and Nat Phos200. Finally, we stopped treatment for him. His wife was 29 years old, a tourism officer with PCOD and varicose veins. The couple decided to undergo IVF procedure. During IVF, the ovum pick up was successful, but embryo transfer was not possible due to decreased endometrial thickness (6mm). The couple was a firm believer in Homoeopathy. So, we defined the wife’s case for decreased endometrial thickness. She was a practical, irritable+2 and anxious+2 lady with no attachments. She was irritable during menses. She had craving for warm food+2 and spicy+2, with cracked heels and an obese build. She would become angry on repetitive questions or instructions. She used to weep if reproached. She was afraid of snakes and deep water. Her anxiety led to diarrhoea.
Based on the totality, she was prescribed Sepia 200C 1P weekly and then 3P weekly. After 3P, her varicose veins were better+3, along with improvement in endometrial thickness up to 10-12 mm within 2 months. Embryo transfer was then successful. The conception was uneventful, as was the twin pregnancy, which also had a normal anomaly scan. Finally, the patient delivered twin boys.
Learning
A different horizon for Homoeopathy was seen through case 4. We could see that a Homoeopath can co-operate with an allopath in getting the desired results. The physician had failed many times in getting at the similimum for the husband, but the patient had greater faith in Homoeopathy. This gave him a second chance and he made full use of it. A properly selected similimum can alter the disharmony in every aspect.
CASELET 5- RIGHT TUBAL BLOCK WITH BICORNUATE UTERUS
A 26-year-old married woman was referred by a gynaecologist for primary infertility with irregular menses. Hysterosalpingography showed bicornuate uterus with right tube block. The patient could not afford further investigations due to extreme poverty. Whether to accept such a case was a big question. We knew that tubal block is an irreversible pathology and bicornuate uterus is a congenital condition with increased risk of miscarriage/precipitate labour. However, we thought we could at least regularize the menses. Patient still had one tube patent and could technically conceive. Therefore, we decided to treat!
The patient was shy+3, timid+3, obstinate+2, slow, sluggish+2 neat and clean+2 and chilly+3 with profuse perspiration, motion sickness, hunger<+2, delayed wound healing, delayed suppuration+2, menses staining fast+2. She had dreams of dead bodies+2 and snakes+. She was fearful with specific fear of dark and night+2. We administered Silica 200C (3p) weekly considering moderate sensitivity and susceptibility at mind and body level. She improved her menses within 3 weeks and leucorrhoea (not disclosed during the original case taking) within 2-3 weeks. Abdominal pain subsided within 2 weeks.
At the same time, the husband’s case was defined. He was a 10th failed hand pump worker belonging to a poor, illiterate family. He had male pattern baldness, thermally chilly, with a history of bronchial asthma during winter. He was an anxious+2 person; used to have sleeplessness before exams or results. He was hard working+2, sympathetic+2, punctual+2, calm, and sincere+2. He too received Silica 200C (IP) weekly. After 2 weeks, patient said that his tension had decreased and now he was feeling better. Silica 200 was continued in weekly doses till the wife conceived, which was within 2 ½ months of treatment.
Learning
In this case, the patient conceived despite having congenital bicornuate uterus and irreversible tubal block. Here, we could help the conception occur through regaining her ovulatory cycles with only one patent fallopian tube. We also witnessed how Homoeopathy could be of immense help to poor patients. The total treatment cost was less than Rs. 1000, where modern medicine would advise this couple to opt for IVF or surrogacy, which would cost up to Rs. 2 lakhs. The physicians had hope in Homoeopathy, which ultimately paved the way to success.
Numerous such experiences from private practice helped in conceptualizing and starting the Homoeopathic Infertility OPD at the Rural Homoeopathic Hospital, Palghar. This OPD has functioned at the Rural Homoeopathic Hospital for the past 3 years, 57 couples registered. Among these, 22 fell pregnant, of which 2 aborted and 20 delivered successfully. A detailed study of this experience is in process.
Conclusions:
Through Homoeopathic case taking, we encourage our patients to communicate and voice out their innermost wishes, desires, thoughts and feelings which help them to release their innermost knots which comprise their deepest blocks. That acts like a mirror to them and self-analysis or self-realization works wonders for their total make over. The sharing helps couples come closer by finding areas of common interest. Hence, we say- good case taking is half the job done!
A Homoeopath dealing with infertility requires faith in self and Homoeopathy, patience, knowledge of sexual dysfunction, its causes, consequences, psychodynamic understanding of a disease, different issues bothering a couple, and ways to deal with them.
Homoeopathy offers cost-effective treatment offering natural conception at an affordable price. Modern medicine treatments can cost lakhs, Homoeopathic treatment costs only in thousands (Rs. 2500/6 months Rx and Rs. 5000/1 years’ Rx at our hospital). Homoeopathy thus surpasses the barrier of finances and can benefit all classes of society.
After seeing the above variety of cases, we could say that Homoeopathic medicine will be able to regularise menses, ovulation, improve quality of sperms, and help in some congenital conditions. It can be associated with modern medicine treatments in cases where IVF is a last resort.
Homoeopathy is a big relief for the couple suffering from Infertility! It avoids painful procedures, reduces the financial burden, provides natural conception, removes the emotional blocks regarding coition, also helps in improving the relationship of the couple. Hence, it is a holistic treatment.
References:
- World Health Organization- Human Reproduction Programme HRP. Infertility definitions and terminology. [Online] Accessed on 11 March 2019 http://www.who.int/reproductivehealth/topics/infertility/definitions/en/
- Dutta D C. Dc Dutta’s Textbook Of Gynecology Enlarged & Revised Reprint of Sixth Edition. New Delhi : Jaypee Brothers Medical Publishers (P) LTD, November 2013, p. 227.
- World Health Organization- Human Reproduction Programme HRP. Global prevalence of infertility, infecundity and childlessness. [Online] Accessed on 11 March 2019. http://www.who.int/reproductivehealth/topics/infertility/burden/en/.
- Grief.com Because Love Never Dies. [Online] Accessed on 24 March 2019. http://grief.com/the-five-stages-of-grief/.
Reference Readings:
These are some of the books on sexual medicine and human psychology that can be used as reading references while dealing with cases of sexual complaints:
- Benjamin James Sadock, Virginia Alcott Sadock, Kaplan & Sadock’s Synopsis of Psychiatry Behavioral Sciences/Clinical Psychiatry, Chapter 21- Normal Sexuality, Abnormal Sexuality & Sexual Dysfunctions, Tenth Edition, Philadelphia, USA, Lippincott Williams & Wilkins, 2011
- Thorwald Dethlefsen & Rudiger Dahlke, The Healing Power of Illness, Shaftesbury, Dorset Publishers: Element Books Ltd.,1990
- Cameron N and Rychlak, Personality Development and Psychopathology, A Dynamic Approach, 2nd edition; Boston, J. Publishers: Houghton Mifflin Co., 1985.
- William Masters and Virginia E Johnson, Human Sexual Response, illustrated, reprint edition, Ishi Press International, 2010
- William Masters and Virginia E Johnson, Human Sexual Inadequacy, illustrated, reprint edition, Ishi Press, 2010
- William Masters and Virginia E Johnson, Masters and Johnson on Sex and Human Loving, 2nd edition, USA, Publisher: Hachette Book Group (30 April 1988)
- Dr Phiroze Dastur, Sex Power, Reprint edition, Originally published: 1983, Mumbai, Popular Prakashan, 2009
- Vatsayana, The Kama Sutra of Vatsyayana Translated From The Sanscrit In Seven Parts With Preface, Introduction and Concluding Remarks, Kama Shastra Society of London and Benares, January 18, 2009
1Based on a paper presented at the HOMAI National Conference, 2018 at Patna, India
