Clinical Cases

Paving the Way for Pregnancy Making Tubes Patent with Homeopathy – A Case Report

Dr. Kanika Sabharwal cures a woman of 31 from secondary infertility (bilateral cornual block) with the simillimum.

Abstract:

Mrs. T.S, 31/F consulted us for Secondary Infertility. She has a 3 year old daughter from her first marriage but is unable to conceive since her current marriage of 2 years. HSG (Hysterosalpingography) showed non-visualisation of both fallopian tubes and no spillage of dye, suggesting bilateral cornual block. Subsequently a recanalization was done after which adhesions were freed but still no spillage of dye was seen. On starting the homeopathic simillimum, within 3 months she conceived and was monitored for her ANC (ante-natal care) with Homeopathy.

Keywords: Infertility; Tubal block; Homeopathy; Aurum metallicum

INTRODUCTION:

Tubal block accounts for 20% of cases of female infertility. It comes under the ICD 10 classification N97.1. Distal tubal occlusion (affecting the end towards the ovary) is typically associated with hydrosalpinx formation and often caused by Chlamydia trachomatis. Pelvic adhesions may be associated with such an infection. In less severe forms, the fimbriae may be agglutinated and damaged, but some patency may still be preserved. Mid-segment tubal obstruction can be due to tubal ligation procedures as that part of the tube is a common target of sterilization interventions. Proximal tubal occlusion can occur after infection such as a septic abortion.

Common causes leading to a tubal block are as follows:

·         Endometriosis·         Pelvic Inflammatory Disease (PID)
·         Ectopic pregnancyTubal Ligation Removal
·         Genital Tuberculosis (still common in developing countries, especially India)·         Complications from lower abdominal surgery such as Cesarean section.


CASE HISTORY:

Preliminary Data:

Name – Mrs. TRS

Address- Chandivali, Andheri (E)

Age- 31 years

Gender- F                                Marital status: Married since 2 years

Occupation- Homemaker                  Date of consultation- 02/03/2016

Chief complaint:

Patient is unable to conceive.

Married since 2 years, no H/O (history of) contraception used

ODP- Unable to conceive despite regular, unprotected coitionà consulted her Gynaecologist and was investigated for the sameà HSG showed non-visualisation of both fallopian tubes & no spillage of dye- suggesting bilateral cornual block. Subsequently a recanalization was done after which adhesions were freed but still no spillage of dye was seen and she was then referred for Homeopathy.

Coital History: 3-4/week; no H/O contraception used and no H/O dyspareunia or post-coital bleeding

Associated complaint:

Headache since 4-5 years. Headache is accompanied by giddiness & blackout. Husband confirms that there are episodes of blackout & such episodes occur 1-2/ month. She had taken treatment for the same without much relief.

F/H: Father- Died due to CA of Tonsils

P/H: Appendicitis, 10-11 years back

Patient as a person (Physical Characteristics):

Appetite: Diminished due to medication    (for headache)                         Non-Veg

Likes: spicy food 2+

Thirst: cold water, 2-3lit/day

Stool: NC (but occasional itching around anus)

Urine: NC

Perspiration: Profuse on scalp, patient says it has increased after first delivery, earlier it was scanty.

Sleep: Decreased during night but feels sleepy during day time.

Dreams:

  • Of people fighting, death of family members.
  • Sometimes dreams of baby and dreams of menstruation. ( especially before menses)

M/H:

F.M.P (first menstrual period): 10 years

L.M.P (last menstrual period): 26/02/2016

–        Colour: Dark red with clots

–        Duration: 5days

–        Cycle: regular, 25-30 days

–        Odour: offensive

–        Quantity: profuse

Complaints: before- pain in legs and abdomen

During -pain in abdomen and lumbar region

Leucorrhoea: Moderate; thin watery, causes itching in parts and weakness

Obstetric History:

G1 P1 A0 L1– female child-3.5years; FTLSCS due to Breech presentation.

  • H/O- PPH (20 days after LSCS )

General Reactions (Including Thermal Modality):

HOT patient

Height: causes giddiness                                       light: irritation in eyes

Bus riding: vomiting

Mental Characteristics:

Patient lives with her husband and daughter; (this is her second marriage)

In 1st marriage, in-laws were expecting more financial income and her husband was accusing her of having an extra-marital affair with a work colleague (current husband) and other accusations which she could not tolerate so she left him after 3 months.

Her present husband supported her through that phase and said- “Your marriage ended because of me so I will marry you and look after your daughter too.”

She always feels guilty that her husband has sacrificed a lot for her, and that’s why to make all things proper, she now wants a baby. Her in-laws tell her husband that because she already has a daughter she doesn’t want a child with you and this upsets her a lot. She says this marriage is very understanding. In family quarrels, she never answers back.  She says “childhood was not childhood” since at a very early age she started working and became independent, and now if at home she feels like a “typical housewife” which she doesn’t like (she has recently quit work for her infertility treatment & headache)

She likes to work, says “job was a stress reliever from family clashes”; she is still ambitious, wants to start her own firm and get back to work. Due to her complaint (secondary infertility) she feels very angry and irritated, wants to have a baby desperately.

Her husband says she is very focused on her work and is ambitious. She is always very serious, not much into going out and recreation.

General examination:

Pulse:  68 /min.              BP:  112/70   mm of Hg         R.R.:  16 /min                    Temp:  afebrile

PALLOR++

Systemic examination:

C.V.S: S1S2 heard

R.S.: AEBE clear

G.I.T.:  PA soft

Investigations:

03/02/16- Serum creatinine:1.20                 HIV:    -ve            Hep. B :  -ve

16/12/15- Beta HCG- below 1.2                           LH-0.513                       FSH- 3.675

21/12/15 Hysterosalpingography-

Both fallopian tubes are not visualized and no spill is seen s/o cornual block

Diagnosis: Secondary Infertility (tubal factors)

Totality:

Guilty about not conceiving (R- Reproaching herself)

Strong sense of responsibility at an early age (R- Taking responsibility too seriously)

Serious disposition

Ambitious (R- Ambition increased)

Better when occupied (R- occupation amel)

Dreams of fights

Desires- spicy food

Motion sickness (R- Nausea after riding a carriage)

Perspiration on scalp

Hot patient

Infertility (R- Sterility)

Prescription:

AURUM MET 200 (3P)

SL 30 TDS X 15DAYS

Follow up:

DateFollow upTreatment
19/03/16– Headache > 50%

– New complaint: lower back pain since 4-5 days

– Feels she will get her menses with heavy sensation

< Exertion > rest

– B/L leg pain since 4-5 days

– Generals- Normal                    O/E- pallor+

– Adv- iron supplements

AURUM MET 200 (3P)

SL 30 TDS X 30 DAYS

 

04/05/16-Headache — > —-

-Vertigo —-> —–

-Fainting attacks—- > —

-Backache —>—

-Generals- Normal

-Got menses on 2nd May, bleeding heavy with clots, no complaints before, during, after

AURUM MET 200 (1P)

SL 30 TDS X 15 DAYS

 

06/06/16– Headache—0—no episode

-Vertigo—->—-

-Fainting episode—O—-

-Backache—->—–

– LMP-02/05/16      Did UPT- weakly +ve

-Adv: Beta HCG

S. Progesterone

S/B- Dr. Uday Rane-

Adv: T. Folfil    &    T. Susten 200 bd( vaginal)

AURUM MET 200 (1P)

SL 30 TDS X 15DAYS

 

20/06/16Reports noted-

– Beta HCG-260.10 (06/06/16)

-Early Intrauterine Gestational sac of 5 weeks. (11/06/16)

-Beta HCG- 20654.33(17/06/16)

C/O-

-Vomiting more < after eating and drinking.

-Vertigo< in morning

-Sleep disturbed (due to anxiety)

FERRUM MET 30 BD * 15 DAYS

 

 

Adv- USG obstetrics after 05/07/16

   
07/07/16– Nausea constant++

-Vomiting with burning in stomach & throat

-Water brash

O/E:

-No oedema feet         -BP: 110/70mmhg     -Pallor +

USG done on 06/07/16-

A single viable intrauterine fetus of 8-9 weeks gestation.

EDD by USG-11/02/16

SYMPHORICARPUS 200 TDS* 15 DAYS
Patient is following up and is doing well


DISCUSSION:

In cases of tubal block, the following is the protocol followed in modern

medicine:

  • If the block is at the terminal (fimbrial) end of the fallopian tube it often forms a hydrosalpinx. Earlier, tubal surgery was performed to open this kind of blocked tubes. However, the results were very poor. The tube would usually close down again, or would never function properly, because its inner lining was damaged – damage which cannot be repaired by surgery. Some of these patients would then go on to have tubal (ectopic) pregnancies.
  • If the tube is blocked at the cornual end, it’s sometimes possible to repair these tubes. Sometimes the block is not a real block, but just an apparent block because of tubal spasm. Sometimes the block is because of a mucus plug or debris, and this can sometimes be cleared with the help of FTR (fluoroscopic tubal recanalization).

As regards our case, it was possible that the block was due to a previous LSCS or an apparent block due to spasm/debris/mucus plug. However, despite recanalization there was no release of the block which is an indicator that it was the homeopathic medicine that opened the block. While assessing the efficacy of the therapy, it is also to be noted that the associated complaint was also cured.

While taking on such cases, the scope of treatment must be explained to the patient clearly- we had given a time frame of 5 months to Mrs. TRS.

Aphorism 3 lays emphasis on knowledge of medicines- Aurum metallicum was prescribed for her basic core of ambitiousness, strong sense of responsibility, serious disposition and feeling of guilt towards the husband with self-reproaching; keeping in mind it is a great remedy for infertility.

About the author

Kanika Sabharwal

Kanika Sabharwal

Dr. Kanika Sabharwal, Assistant Professor, Department of Obstetrics & Gynaecology at CMP Homeopathic Medical College has done her MD in Paediatrics and is currently practicing at Opera House, Sion & Mumbadevi Homeopathic Hospital in Mumbai. She has had articles published in the esteemed Homeopathic Heritage & National Journal of Homeopathy.

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4 Comments

  • Excellent approach. I also experienced about Aurum Met. in curing infertility case. I want to take MD in Homoeopathic. Let me guide from where and how can I get this degree. I am DHMS and practicing since 20 years.

  • The case is really educative. The style the author applied at the time of case taking deserves attention to all homeopaths. It is a classical case recorder. Everyone who are beginners to the dais of homeopathy will get the exact knowledge from the case history, rubrics, repertorization and followups. At last the author presents the discussion. All are peerless. She gives more importance to the mind symptoms. In fact, the mind symptoms are indeed the key to the whole case record. In the case of tubal block a homeopath is always careful, because if the block is total and congenital then it goes to the domain of surgery. Anti-sycotic medicines have the power to dissolve some extra-growth inside the fallopian tube, or elsewhere. Sometimes, combined medical therapy produces good result.
    I thank the author for her scientific case presentation.