Clinical Cases

Primary Infertility in a Woman of 29

Written by Vitan Gosain

Dr. Vitan Gosain presents a case of primary infertility in a woman of 29. His analysis of the patient’s personality leads to the simillimum.

This is a case of primary infertility in a female of 29 years. The patient had been an old case of polycystic ovarian disease and used to suffer from irregular menstrual cycles the last two years. She had amenorrhea since 2 months but her urine pregnancy test was negative.

In her last menstrual period, which was three months before she came to visit my clinic, she just had spotting for two days. I happened to see this case in December 2020. The patient had got all the tests done which were advised by her gynaecologist.

Parameters altered in reports

  • Raised prolactin – causes amenorrhoea and infertility – anti oestrogen
  • Reduced LH – causes decreased ovulation
  • Reduced AMH (measures ovarian reserve /egg reserve)

PHYSICAL GENERALS
Thermal – Chilly
Thirst- thirsty
Desires – sweets, sour
Sweat – face, palms, feet
Stool – constipation since childhood

PAST HISTORY

  • Polycystic ovarian disease
  • Recurrent attacks of tonsilitis which occur even till date
  • Sore throat as soon as she speaks for long

HOMOEOPATHIC APPROACH IN CASES OF INFERTILITY
Patients come to us and say that they desperately want a child and are trying to conceive but without success. However, we must enquire as to why she may not want a baby and what is stopping her from conceiving. These conflicts are extracted from the subtle realms of the subconscious, and it requires an extra effort on the part of the physician to ascertain the psychological factor predisposing the to infertility.

The statements of the patient cannot be totally relied upon as that is nothing but a mere projection of how they want to appear in front of the physician and their family (sycosis). Infertility is a syphilitic process and we need more than a projection in such cases.

  • Why does the girl not want to conceive?
  • Why is she afraid of adulthood?
  • Why does the girl not want to have a child with this man?
  • Why does she feel that it is not good to be born as a girl?
  • Does she have any kind of aversion to the opposite sex?
  • Does she feel that the act of coitus is dirty/ sinful/ demeaning?
  • Is she afraid to lose her freedom and become confined?

The conflict became apparent when this patient discussed her life history and all the traumas she had suffered since her childhood. To have a chronic syphilitic pathology the patient must first manifest psoric and sycotic defense responses. No man or woman can escape psora as everything alive has sensitivity and irritability which represent psora. After the initial physiological responses fail to cope with the conflicts and circumstances, the body resorts to structural changes (in this case seen as PCOS).

INTERPRETATION OF PATHOLOGY

  • Infertility – does not want to bear a child – (against nature – Syphilis).—endocrines—syphilis
  • Polycystic ovarian disease – a protection to the ovary in the form of numerous cysts to defend against any fear of loss (Ovary – loss, conflict) – Sycosis (fortify to safeguard against insecurity). —mesoderm —sycosis
  • Recurrent Tonsillitis – an inflammatory response (physiological / psora) at the level of endoderm pertaining to recurrent conflicts (not able to swallow something). The inability to speak in sore throats arises when the person has not been able to speak up for himself or herself. —endoderm —psorosycosis

CONFLICT

  • The patient said that after marriage her husband initially did not favour having a child as he felt that they were not financially secure. However, the patient said that she wanted to have a child as it was expected of them to have a family. Since the last year her husband had become willing to try for a child and they started attempting for conception but were failing repeatedly.

The patient said she wanted a child but only when her husband is willing and there was never any kind of hurry in her mind about having a child.  After inquiring about her relationship with her husband, her in laws and the home atmosphere nothing was found in her circumstances and thought process which could lead to a pathology of primary infertility in this patient.

She also developed polycystic ovarian disease just after marriage as her menstrual cycles started getting delayed by a month every time.  Prior to her marriage her menstrual cycles had been more regular than now, and it was only after the marriage that the changes in the menstrual cycles became evident and she went to the gynaecologist for a check-up.

So, the conflict must have happened sometime around her marriage which led to polycystic ovarian disease (symbolic of insecurity at the level of ovaries and increase in the mass of the ovaries with formation of multiple cysts which is symbolic of an added protection for the organ).

When, this did not suffice the body went into primary infertility as a defense mechanism (which is symbolic of not wanting to have a child at the subconscious level even though the patients often express their willingness to have a child in front of the physician)

I decided to inquire about the period just before her marriage and sometime after it as well. The patient had been in a relationship with another man for four years prior to her marriage. Two months after she had a breakup with him, she agreed to marry another man on the insistence of her parents. The break-up happened after long period of discords.

The patient said that it was a very serious relationship, and she was very devoted to him, but her partner was very aggressive and used to impose a lot of restrictions on her regarding the clothes that she would wear and the people she would meet. The patient said that things became toxic when he used to secretly spy on her and check her chats on WhatsApp.

The patient exclaimed that she had made future plans with him and had even planned her future according to the wishes of that man and his family. She said that it pinched her whenever she remembered her past relationship and she felt that she should have retaliated long back and did not deserve to suffer the misery of that relationship.

Despite all her efforts to sustain that relationship the man never made any efforts from his end and never understood her. She said that she should not have suffered so much in that relationship and should have walked out of it long before.

When I asked her why she did not quit the relationship earlier she said that she had become habituated to that relationship and that had become a major part of her life and daily routine. She said that even on the day when she separated from him, she took her cousin along with her to act as her spokesperson and tell him about all the misery and toxicity that she had to face in that relationship.

When I asked her about the impact of that relationship on her, she said that she never felt free to do anything as long as that relationship lasted. She could not go anywhere if she wanted, could not meet anyone whom she wanted to meet, could not wear anything as per her choice and could not interact with males in her office.

She became distant to everything around her, and it seemed that she lost the touch with her surroundings on account of the restrictions imposed on her by the ex-boyfriend. She said she had always been a rank holder throughout her school and college and her professional life also became miserable because of that relationship as she had to take leaves and at times on the insistence of the man.

She even failed in a test in her office as she was not able to prepare for it because she was forced to go on a trip with him and his friends. She blamed that man for her downfall and that was the first time she felt that she must walk out of that relationship.

It was her cousin who talked to the boy regarding the breakup. She had told her cousin that she will not speak, and he will have to speak for her and tell the man that they must part ways. She wanted someone else to talk instead of her as she could not express her disgust openly and would have been dominated or influenced by the man again.

CASE ANALYSIS
Listening to the patient’s narration of her life history it became evident that this girl had always worked as per the discretion of others. She could not walk out of the toxic relationship as she never held a position where she could command the relationship.

She was dominated by her partner and her role in the relationship was only to obey to his commands and live as per his discretions. When the girl’s parents wanted her to get married, she simply agreed without paying any heed to the previous traumatic relationship or even introspecting whether she wants to marry or not.

It was done just because the parents asked her to do so. After the previous relationship the girl had become so much habituated to being at the receiving end of any relationship. The impact of the domination in her past life was so profound that the girl started accepting commands in every relationship.

Even after her marriage, she was not insistent on having a child and was alright with the fact that she did not have a baby, till the time her husband did not wish to have a child. It was only after her husband agreed to have a child, that they started trying for conception.

Throughout the case history one major point of highlight was that this patient never acted according to her wishes (as if she had no wish of her own ) and blindly kept accepting and obeying whatever came her way. All her decisions were as per the commands of others, and she never had any discretion of her own.

The rubric that I selected were:

1. Delusion, legs, cut off, legs are
Delusion legs cut off is taken as a metaphorical delusion symbolic of her powerlessness and her resignation.

2. Indiscretion
Indiscretion as she had no choice of her own and kept acting as per the wishes of ex bf, husband and family members
Baryta carb and Stramonium covered both the rubrics.

PRESCRIPTION
As the patient was chilly, thirsty and had a strong history of tonsillitis I prescribed BARYTA CARB 50M, UNIT DOSE.

There was an important point of observation in this case that confirmed my prescription. The patient’s hands were very small like that of a child.

FOLLOW UP
The woman conceived within a month.

About the author

Vitan Gosain

Vitan Gosain received his BHMS one year ago from Nehru Homoeopathic Medical College (Delhi University). Now there are two homeopaths in his family, as his father Dr. Bimal Gosain is also a homoeopathic physician, practicing for the last 30 years. Vitan has been sitting in on cases with his father regularly for the last five years. He also learned from Dr. L.M. Khan of Calcutta.

Leave a Comment