Michelle’s Story: Premature Ovarian Aging and Busy Life
Michelle, 34 years old white female, was referred to my clinic by one of my patients. You could
see worry apparent in her eyes as she walked in. She told me she was a flight attendant and
hadn’t been able to settle down her life in the last ten years. However, she dreamed of having
three children.
After she and her husband decided to have a baby two years ago, she discovered that her AMH
was 0.16 and was diagnosed with Diminished Ovarian Reserve (DOR) .
Note:Anti-Mullerian Hormone (AMH) is released by antral follicles glanulosa cells in the ovaries
and can be used to evaluate the state of one’s ovarian reserve. AMH should progressively lower
from year to year and is expected to be extremely low around menopause. Considered low if it is
below 1.0 ng/ml, her AMH is considered in the bottom line .
When I first saw her, Michelle had failed six cycles of IUI with medication: three cycles used
clomid from 50 mg to 100 mg. but her antral follicles were still very low and would either grow
very slowly or stop growing at all. Her doctor used clomid in addition to Follistim in the other
three cycles. Each of her cycles produced one to two eggs but she never conceived.
She was not a candidate for IVF since she had very low ovarian reserve. But as in many other
cases, her doctor let her try one cycle of IVF to see what would happen but then warned that she
should try to get into a donor program if it was not successful. Michelle felt terribly sad and
feared that she would never have her own children.
Michelle didn’t have a family history of premature menopause. She didn’t understand how she
had come to this point. But her life provided some essential clues: Michelle was a flight
attendant for over ten years. Her irregular working schedule probably meant low quality and
quantity of sleep, which may have caused this accelerated aging.
Recent studies have shown that sleeping times can greatly affect cell activity. When sleep was
restricted to under six hours a night, researchers noted that genes either showed suppressed
activity or more activity than normal. These changes disturb body’s functions, including the
immune system.
For Michelle, her irregular sleep pattern affected her eggs quality and ovaries function. This
correlation between hardworking young women and premature aging problems is now
understandable: a lack of sleep can often result in an unhealthy body environment that strains
the body’s functions and accelerate the ovaries aging speed, causing such problems as
premature ovarian aging.
In Chinese medicine, less sleeping and stress–overusing one’s body– will result in a deficiency of
“yin.”. Everyone has had this experience: you develop cold sores or mouth ulcers after constantly
living under high stress and staying up late at night, especially when you’re around your 40s.
In Chinese medicine, night is “yin”; the lack of quality sleep will consume the yin cause“yin
deficiency.” Yin and yang must be balanced in order to keep the body healthy: yang will flare up
if the body is deficient in yin, but too much yang leads to a pathologic change called “heat.” An
ulcer is a result of yin deficiency with heat. “Heat” is characterized by the inability of the body to
discharge metabolites and other products of disease causing substances in our body, leading to
symptoms like ulcers or dehydration.
However, the symptoms of “heat” and yin deficiency may vary depending on the personal
weaknesses of the body. Michelle had hot flashes at night, disturbed sleeping, red dry tongue,
and less cervical mucus. This is unsurprising:“yin deficiency ”often happen to women in their 40s,
who often have hormone imbalance, stressed condition and weakened immune systems.
How might these issues be resolved using Chinese medicine? It could balance hormones and the
immune system according to several pharmacology studies. Michelle also was treated with
acupuncture, which helped alleviate stress and promote circulation.
Pregnancy would not be difficult with a balanced body. And, in Michelle’s case, it wasn’t. After
giving her herb and acupuncture treatments specific to her situation for four months, her AMH
increase to 0.39 and she had five antral follicles, and three mature eggs in the fifth cycle.
She became pregnant and carried a healthy baby girl to full term. “Without your help, I couldn’t
get pregnant,” she told me when she conceived for the first time. “I’ll come back for the second
one after my baby is born,”she promised.
Michelle got pregnant naturally again with Chinese medicine help while her AMH was 0.12 two
years later. The most exciting thing was that she had her third baby after she stopped breast
feeding!