中西醫整合療法治療多次試管嬰兒療程失敗之高齡不孕症婦女醫案報告

Integration of Traditional Chinese Medicine and Western Medicine in the Treatment of Infertility in Older Woman with Multiple Failed in Vitro Fertilization: A Case Report

試管嬰兒是人工生殖療程最主要的方式，但週期活產率隨著年齡上升而下降，43歲的週期活產率為4.6%。本病案為43歲女性，有子宮肌瘤、卵巢儲量不足、八次試管失敗、兩次流產，以中醫觀點來看則有風邪殘存、血熱體質，且因八次的IVF 療程加重了血熱體質。在第九次IVF療程採取中西醫整合療法，其治療方式基於中醫的腎主生殖、風為百病之長和五行的生剋理論，運用金水相生的觀念。治療的策略從外感殘存切入，在中醫調理期間同時進入IVF療程，而得以在第九次的療程成功受孕，故臨床上不孕症的治療可考慮從肺論治，雖然這是一個複雜而不易醫治的個案，但值得與中醫同道分析探討。

Assisted reproductive technology (ART) has been used in Taiwan to help women become pregnant. The main type of ART is in vitro fertilization (IVF). The report from Health Promotion Administration, Ministry of Health and Welfare illustrates the success rate of IVF declines with age, and the percentage of cycles resulting in live births among women aged 43 is 4.6%. Here we brief on the case of a 43-year-old women with uterine fibroma, lower ovarian reserve, two abortions, wind evil remnant and blood heat constitution. The blood heat constitution becomes severe due to the drug of IVF. In ninth IVF, patient adopted integration of traditional Chinese and Western medicine therapy. The theory of therapy is based on kidney governs reproduction, wind being the chief pathogen of all diseases, engendering and restraining among the five phases and metal and water engender each other. The starting point of therapy is wind evil. After 4 weeks of treatment, the patient had a successful IVF. According to this case, determining treatment from lung might be a viable and acceptable therapy for infertile older women.