Infertility

General

Clinical Manifestations	The inability to conceive in women who have at least two years normal sexual life and whose partner has normal reproductive functioning. Habitual miscarriage May bear one child and fail to conceive after that Menstrual Phase: Endometrial lining is shed Menstrual bleeding Progesterone drops The Chong and Ren gradually empty Kidney Yin and Liver Blood are at their lowest levels Problems during menses are generally related to Qi and Blood flow Problems at the end of menstruation are usually related to Blood Deficiency Follicular Phase: New follicles containing eggs begin their growth The menstrual Blood flow is over FSH (follicle stimulating hormone) is released The ovarian follicles mature The dominant follicle releases its eggs on ovulation The regeneration of the endometrium takes place including tissue repair of the uterus and the development of estrogen and progesterone receptors Estrogen levels rise Proliferation of the endometrium ensues Cervical fluid is produced The Chong and Ren are filling with Yin and Blood Ovulatory Phase: Leuteinizing hormone is released Ovulation occurs Basal temperature increases during the second half of the cycle (switching from Yin dominance to Yang dominance) Luteal Phase: Egg fertilization occurs Egg implants in the endometrial lining Corpus luteum is formed Progesterone is secreted
Treatment Principle	Menstrual Phase: Clear Stagnation Move Qi and Blood Follicular Phase: Nourish Yin and Blood Clear Heat Nourish the Chong and Ren Nourish the Heart and Liver Ovulatory Phase: Strengthen Heart Qi and Blood Nourish Liver Blood Invigorate Qi and Blood Luteal Phase: Tonify Qi and yang Nourish Yin and Blood
Herb Formulas	Menstrual Phase: Tao Hong Si Wu Tang modified Follicular Phase: Gui Shao Di Huang Wan modified Ovulatory Phase: Fu Ren Bu Yin Pian Luteal Phase: Jia Wei Jian Gu Tang For abdominal pain and cramping: Shao Yao Gan Cao Tang For frigidity or lack of sexual desire due to Cold: Ba Wei Di Huang Wan Topical: Finely powder equal amounts of Rx. Polygalae Yuan Zhi, Rz. Zingiberis Gan Jiang. Fr. Cnidii She Chuang Zi and Fr. Evodiae Wu Zhu Yu. Wrap the mixture in fine silk and insert in the vagina. Cure should occur within two days. Patent Medicines: Nuan Gong Yun Zi Wan Wu Chi Pain Feng Wan
Points	Reduce LI-4, REN-14, SP-6, tonify GB-20, REN-3, REN-4, SJ-21, SJ-23, ST-30, KI-4, KI-6, LU-7, REN-3, SP-5, ST-30 For uterine displacement: Moxa SJ-4 (left side), REN-12 Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Tai Yang- Yang Ming - Shao Yin Heat

Clinical Manifestations	Dizziness Red, sore eyes Difficulty swallowing Nasal congestion and infection Thick, sticky nasal discharge and saliva Bitter taste in the mouth Dry mouth Focal distention in the chest and diaphragm Stifling sensation in the chest and diaphragm Manic behavior Carbuncles Heat rash Headache Acne Chills High fever Restlessness Urticaria Sore throat Swelling of the throat Coughing Reddish urine Dyspnea Vertigo Severe aversion to Cold Skin rashes Skin ruptures or ulcers Tense abdomen Shoulder stiffness Numb extremities Fatigue Constipation Dysuria with reddish urine Dark, rough urination Obesity Fullness of the abdomen Fullness of the epigastrium Heaviness in the head T: Red C: White or Yellow and greasy P: Flooding and rapid or Wiry and slippery or Floating, smooth and rapid or Floating, slippery, rapid and wiry or Floating, slippery, rapid and overflowing
Treatment Principle	Disperse Wind Release the Exterior Drain Heat Unblock the bowels
Herb Formulas	Fang Feng Tong Sheng Tang
Points

Lung And Kidney Qi Deficiency

Clinical Manifestations	Chronic cough with sparse sputum Sputum difficult to expectorate Shortness of breath Spontaneous perspiration Dry mouth and tongue Palpitations with a stifling sensation in chest Fatigue Irritability Thirst Dry throat Insomnia Listless speech T: Red and dry or Pink and dry C: Thin and dry P: Deficient and rapid or Irregular and slow or Thready and deficient or Consistently irregular
Treatment Principle	Augment Qi Clear Heat Stop Excess perspiration
Herb Formulas	Sheng Mai San
Points

Damp-Heat Injures The Spleen

Clinical Manifestations	Anorexia Abdominal distention and discomfort Suffocating sensation in the chest Epigastric mass Maybe abdominal pain on palpation Yang jaundice (sclera and skin are bright yellow) Dislike of oily foods Nausea Vomiting Lassitude Scanty, dark urine Maybe thirst or thirst with no desire to drink Diarrhea with foul smell or Constipation Fever Sweet sticky taste or bitter taste in mouth T: Pink C: Thick, yellow and greasy (maybe sticky) P: Soft and rapid
Treatment Principle	Clear Heat Benefit Dampness
Herb Formulas	Yin Chen Wu Ling San
Points	LI-11, REN-12, SP-9, ST-36, ST-44, UB-20 For Damp-Heat Diarrhea: LI-4, SP-9, ST-25, ST-36, ST-44, UB-25 For Damp-Heat Dysentery: LI-4, LI-11, SP-9, ST-25, ST-37, ST-44

Spleen Yang Deficiency

Clinical Manifestations	Sallow complexion Anorexia (maybe with vomiting) Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools or watery stools containing undigested food Shortness of breath Pain in the epigastrium with cold sensations (pain is relieved by warmth) Cold limbs Feeling chilled Mental fatigue Maybe scanty urine with edema Maybe clear, watery vaginal discharge T: Pale C: Thin and white P: Deep and weak
Treatment Principle	Warm the Center Dispel Cold.
Herb Formulas	Fu Zi Li Zhong Tang With constipation: Wen Pi Tang Chinese patent medicines: Fu Zi Li Zhong Wan
Points	Warm-needle UB-20, LIV-13, SP-3, SP-5, SP-6, ST-36, REN-12

Spleen Qi Deficiency

Clinical Manifestations	Early period Sallow complexion Fatigue Anorexia Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools Shortness of breath May be much Blood due to Spleen Not Governing Blood May be little Blood due to Spleen Qi Sinking The Blood is pale-red in color and watery An empty feeling in the lower abdomen T: Pale and flabby - may have teethmarks C: White P: Even, forceless and deficient
Treatment Principle	Tonify The Spleen Nourish Middle Jiao Qi
Herb Formulas	Gui Pi Tang Bu Zhong Yi Qi Tang Xiang Sha Liu Jun Zi Tang
Points	LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20

Spleen Not Governing Blood

Clinical Manifestations	Sallow or pale complexion Anorexia Four limbs feel tired and heavy Physical and mental exhaustion Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose or unformed stools Shortness of breath Dizziness Palpitations Sallow complexion Fatigue Anorexia Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools Shortness of breath T: Pale and flabby - may have teethmarks C: White P: Even, forceless and Deficiency
Treatment Principle	Benefit Qi Conserve Blood
Herb Formulas	Bu Zhong Yi Qi Tang modified Jiao Ai Tang
Points	REN-6, ST-36, SP-1, SP-8, UB-20, KI-3, LIV-3 DU-20, LI-11, REN-4, SP-1, SP-3, SP-4, SP-10, ST-36, UB-17, UB-20

Spleen And Stomach Deficiency Cold

Clinical Manifestations	Chronic, intermittent, dull abdominal pain which is better with warmth and pressure and ingesting warm fluids Waxy, pale or sallow lusterless complexion Anorexia (maybe with vomiting) Easily satiated Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools or watery stools containing undigested food Shortness of breath Pain in the epigastrium with cold sensations relieved by warmth Intolerance of Cold Cold limbs Feeling chilled Lethargy Fatigue Mental fatigue Depression Low spirits Maybe scanty urine with edema Maybe clear, watery vaginal discharge T: Pale maybe swollen C: White or Thin and white or White and greasy P: Deep, thready and forceless or Deep and weak or Thready and weak
Treatment Principle	Warm the Middle Jiao Strengthen the Spleen and Stomach
Herb Formulas	Fu Zi Li Zhong Tang Wu Zhu Yu Tang Xiao Jian Zhong Tang Chinese patent medicines: Li Zhong Wan With Kidney Yang Deficiency: Jin Kui Shen Qi Wan With Qi and Blood Deficiency: Shi Quan Da Bu Wan
Points	Moxa or moxa needle KI-3, LI-11, REN-4, REN-6, REN-7, REN-12, SP-4, SP-6, ST-25, ST-30, ST-36 With nausea: + PC-6 With severe pain or diarrhea : + strong moxa REN-8 Ear: Abdomen, Large Intestine, Small Intestine, Stomach,Spleen, Shenmen, Adrenal, Sympathetic

Spleen And Kidney Yang Deficiency

Clinical Manifestations	Continuous cramping pain in the abdomen Pain is not severe Pain is relieved by pressure Edema of the feet Urinary difficulty Slight edema (primarily of the lower limbs) Symptoms generally occur during pregnancy Pale face Fatigue Heaviness of head Lassitude Lower abdominal pain Dizziness Tinnitus Lumbago Edema Abdominal pain with edema during pregnancy due to Blood Deficiency and abnormal water circulation Oliguria	Palpitations Cold feet Extreme coldness of the hands and feet Vertigo Weakness and numbness of lower back and legs during pregnancy or postpartum Mal position of the fetus Dysmenorrhea Irregular menstruation Right upper quadrant pain Hepatomegaly Anemia Lack of energy Sore back Thirst with no desire to drink T: Pale or pink maybe petechiae on margin C: Thin or Greasy white P: Deep and weak or Soft, floating, small and slow or Wiry and small or Wiry and rough
Treatment Principle	Warm and Reinforce the Spleen and Kidneys
Herb Formulas	Dang Gui Shao Yao San Er Xian Tang  modified Wen Bao Yin Jia Jian Wen Bao Yin With a Cold Uterus: Jin Lian Zhong Zi Fang Zhong Si Wan With Dampness Accumulation: Kuan Dai Tang With with Blood Deficiency: Infertility #12
Points

Deficiency Cold Of The Stomach And Liver

Clinical Manifestations	Vomits clear fluid Body cold Diarrhea Complete exhaustion of Yang Vomiting immediately after eating Indeterminate gnawing hunger Acid regurgitation Belching May be epigastric pain Dry heaves or spitting of clear fluids with vertex headache Vomiting and diarrhea with cold hands and feet Restlessness Severe fidgeting Irritability So agitated, the patient wants to die Habitual headache Subcardiac distention A feeling of fullness and distention in the chest and diaphragm T: Pale C: White and slippery P: Weak or Slow and weak or Sinking or slow and thin or Slow and wiry
Treatment Principle	Warm Yang especially in the Liver and Stomach Descend turbidity
Herb Formulas	Wu Zhu Yu Tang
Points	Moxa REN-4, REN-6, REN-8, REN-9, REN-12, ST-25

Heart Fire Transferred To The Small Intestine

Clinical Manifestations	Burning, painful, concentrated, urgent and frequent urination A red complexion Mouth and tongue ulcers, particularly on the tip of the tongue Thirst with a desire for cold drinks A sensation of Heat in the chest Irritability Restlessness Agitation Anxiety Palpitations Insomnia Dream-disturbed sleep T: Red with a redder tip, may have ulcers on the tip C: Dry and yellow P: Rapid and big, especially in the distal position
Treatment Principle	Clear Heat from the Heart Promote urination
Herb Formulas	Dao Chi San modified With hematuria: Xiao Ji Yin Zi modified
Points	REN-3, ST-28, SP-6, SP-9, HT-8, PC-6, PC-8. KI-6, Yintang Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Liver Qi Stagnation

Clinical Manifestations	Infertility Inability to conceive for many years Decreased and dark-colored menses that contain clots or Scanty, pale-colored menses Irregular menstruation Breast and hypochondriac pain Abdominal pain with periods Maybe premenstrual breast distention Premenstrual breast tension Painful periods Irritability before periods Anxiety before periods Depression Abdominal distention Eructation Sighing Water retention Headache A history of cramping T: Normal color or slightly red on the sides; if Stagnation of Qi arises from Blood Deficiency, the sides might be Pale C: Normal P: Taut or Wiry; if Qi Stagnation arises from Blood Deficiency, it may be Choppy
Treatment Principle	Tonify the Blood Soothe the Liver   Unblock the Liver Move Qi Release Stagnation Regulate menstruation
Herb Formulas	Tiao Jing Zhong Yu Tang Kai Yu Zhong Yu Tang modified Infertility #3 Bai Ling Tiao Gan Tang   Chai Hu Shu Gan Tang modified Jia Wei Xiao Yao San Xiao Chai Hu Tang Xiao Yao San Infertility #21 De Sheng Tang Jia Wei Infertility #22 Infertility #23 Infertility #25 Shu Yu Tiao Jing Tang Infertility #27 Xiang Fu Wan Zhong Zi Fang Tiao Jing Yu Zi Fang With Blood Stagnation: Shao Fu Zhu Yu Tang  modified With severe Blood Deficiency: Hei Xiao Yao San For Liver Qi Stagnation Attacks the Stomach: Si Ni San With Stagnant Heat transforming into Deficiency Heat: Infertility #26 With Blood Stagnation, Yang Deficiency and low back and knee pain: Xiao Yu Li Qi Tang
Points	LIV-3, GB-34, SJ-6, REN-4, REN-6, KI-14, SP-4 on the right and PC-6 on the left LIV-3, SP-6, REN-6 REN-3, KI-14, KI-13, LIV-3, GB-34, SP-6 LIV-3, LIV-13, PC-6, REN-6, REN-17, SP-6 Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Liver Qi Stagnation Invades The Spleen

Clinical Manifestations	Abdominal distention and pain Gas Borborygmus Diarrhea Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Women: Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink C: White and greasy P: Slippery and wiry
Treatment Principle	Soothe the Liver Invigorate the Spleen
Herb Formulas	Dang Gui Shao Yao San
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37

Liver Qi Stagnation Invades The Stomach

Clinical Manifestations	Epigastric pain (worse when emotionally upset) Belching with acid regurgitation Nausea Vomiting Anorexia Epigastric distention Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink C: Thin and white P: Wiry
Treatment Principle	Soothe the Liver Harmonize the Stomach
Herb Formulas	Yue Ju Wan
Points	LIV-3, LIV-14, PC-6, REN-12

Liver Qi Stagnation Transforms Into Fire

Clinical Manifestations	Amenorrhea Scanty periods Irregular menstruation Infertility Thick hair Acne Distending pain in the chest, hypochondria or breasts Dry mouth with preference for drinking water Constipation T: Normal or Red edges C: Yellowish and thin P: Rapid and wiry
Treatment Principle	Sooth the Liver Relieve Stagnation Reduce Fire
Herb Formulas	Jia Wei Xiao Yao San Kai Yu Zhong Yu Tang
Points	IV-3, SP-6, REN-6 + Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Liver Qi And Blood Stagnation

Clinical Manifestations	Facial color dark and dull Emaciation Sides and ribs distended on both sides (maybe with sharp pain) Enlargement of the Liver and Spleen Suffocating sensation in chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Irregular menses Dysmenorrhea Infertility Breast distention and pain before and during menses T: Dark purple (maybe purple spots on edge of tongue) P: Wiry, choppy and slow
Treatment Principle	Invigorate Blood circulation Regulate Qi
Herb Formulas	Kai Yu Zhong Yu Tang Jia Jian Tao Hong Si Wu Tang modified Tiao Jing Zhong Zi Shen Xiao Fang With obstruction of the fallopian tubes: Infertility #29
Points	LIV-3, LIV-13, LIV-14, SP-6, UB-17

Liver Blood Stagnation With Blood Deficiency

Clinical Manifestations	Abdominal pain in women Dizziness Blurred vision Pale, lusterless complexion Pale nails Pale lips Generalized muscle tension Irregular menstruation with little flow Amenorrhea Periumbilical pain Lower abdominal pain Vertigo Tinnitus Blurred vision Insomnia Spotting of pale Blood Postpartum uterine bleeding Maybe five sole Heat Delayed menstruation Palpitations Dizziness Dry skin Maybe leukorrhea Maybe fever Firm, painful abdomen Sporadic fever and chills Dysmenorrhea Breast distention and pain before and during menses Menorrhagia Hard abdominal masses with recurrent pain Unstable fetus with bleeding Chills and fever T: Pale C: Normal P: Thready and wiry or Thready and choppy
Treatment Principle	Nourish the Blood Invigorate the Blood Dispel Stasis
Herb Formulas	Si Wu Tang Jian Wei
Points

Cold Stagnation In The Liver Channel

Clinical Manifestations	Pain, distention, fullness and cold sensation in lower abdomen Cold limbs Dislike of cold and preference for warmth Lower abdominal pain radiating to the testicles May be localized sensation of Cold Menstrual pain and hardness Hypochondriac pain Abdominal pain Mobile abdominal masses Flank pain Leukorrhea T: Pale C: White or White and greasy P: Deep and slow or Wiry and tight or Deep and wiry or Slow or Deep and Excess
Treatment Principle	Warm the Liver Dispel Cold.
Herb Formulas	Tian Tai Wu Yao San Nuan Gan Jian
Points	Moxa or moxa-needle REN-4. SP-6, LIV-1

Liver And Kidney Yin Deficiency With Qi Stagnation And Phlegm-Dampness

Clinical Manifestations	Facial complexion pale and sallow Both cheeks slightly red Dizziness Dry eyes Blurred vision Spots before the eyes Numbness of limbs Flaccid paralysis (Wei syndrome), weakness Tinnitus Deafness Forgetfulness Low back and knees sore and painful Throat dry and painful Five Sole Heat Low-grade fever Night sweats Irritability Insomnia Stools difficult to pass Constipation Men: Spermatorrhea Women: Irregular menses or Scanty menses or Amenorrhea Vaginal discharge Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Irregular menses Dysmenorrhea Breast distention and pain before and during menses Anorexia Edema Abdominal distention Chest and hypochondriac distention Nausea Vomiting Vertigo Thirst with no desire to drink Maybe no thirst Palpitations Shortness of breath T: Pink or Red C: None or Thin and white or Thick and slippery P: Thready and rapid or Wiry or Slippery, full and maybe wiry
Treatment Principle	Nourish and Reinforce the Liver and Kidneys
Herb Formulas	Tiao Jing Zhong Zi Tang
Points	KI-3, LIV-3, SP-6, UB-18, UB-23

Kidney Yang Deficiency

Clinical Manifestations	Long term infertility or infertility in an older woman Possibly a history of late menarche Delayed menstruation with decreased and pale menses or Infrequent menstruation Irregular periods Period either scanty or heavy Prolonged menstrual cycle Scanty, dark discharge at the end of menstruation Amenorrhea Loss of libido Aches and weakness in the waist and legs Back pain Cold limbs A dusky complexion Dull-pale complexion Increased clear urine	Loose stools Dizziness Fatigue Tinnitus Feeling cold Depression Cold limbs Frequent urination Long-drawn-out urination with a thin stream or dribbling Pain and coldness in loin and knees Severe lumbago Cold sensation in the lower abdomen T: Pale, swollen and wet C: White    P: Deep and weak or Thin and soft or Deep and thready or Deep, thready and forceless or Deep and slow
Treatment Principle	Tonify Kidney Yang Generate Blood Nourish the Chong and Ren channels Nourish the uterus
Herb Formulas	Ai Fu Nuan Gong Wan + Ju He Wan Yu Lin Zhu modified Ba Zhen Yi Mu Wan modified Ba Zhen Tang Jin Gui Shen Qi Wan You Gui Wan Hou Po Wen Zhong Tang Zan Yu Dan modified Zuo Gui Wan modified Wu Zi Yang Zong Wan Er Si Wu He Ji Yi Shen Yang Xue Tiao Chong Fang Infertility #2 Infertility #4 Infertility #5 Infertility #6 Infertility #7 Infertility #9 Infertility #10 Infertility #11 Wen Shen Wan Jia Jian Wen Shen Wan With Blood Stasis: Sheng Hua Tang Infertility #8 Use mid-cycle: Wen Shen Fang With Qi and Blood Deficiency: Yi Shen Nuan Gong Tang With Liver Blood Deficiency: Wen Gong Bu Xue Tang Chinese Patent Medicines: Tai Pan Tang Yi Pian Wu Zi Yan Zong Wan
Points	KID-13, KID-3, UB-23. UB-52, ST-28, LU-7 on the right and KID-6 on the left, moxa REN-4, REN-8, DU-4 Moxa needle DU-4, KID-3, REN-4, UB-23. Moxa DU-4, UB-23 DU-4, KID-3, REN-4, REN-6, UB-23 ST-25, ST-29, UB-23, moxa REN-3 DU-4, KID-3, KI-7, KID-13, UB-20, UB-23. Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Kidney Yang Deficiency With Liver Qi Stagnation

Clinical Manifestations	Premenstrual chest oppression Premenstrual vexation and agitation Premenstrual breast distention and pain Low back soreness and weakness during menstruation Pain in the legs and feet during menstruation Tinnitus during menstruation Post-menstrual scanty vaginal discharge Post-menstrual dry vagina Post-menstrual decline in sexual desire T: maybe dark C: White P; Deficient and wiry
Treatment Principle	Tonify Kidney Yang Regulate the Liver
Herb Formulas	Infertility #40
Points

Kidney Yang Deficiency With Blood Stagnation

Clinical Manifestations	Ovulation may be hindered Irregular menstruation Late, scanty menstruation Dark, dusky menstrual Blood Dysmenorrhea Urgent pain in the lower abdomen which worsens as the period draws near Dizziness Tinnitus Poor memory Weariness Lassitude Low back weakness and pain Diminished sexual desire Clear, long urination Excessive, abnormal vaginal discharge Maybe uterine myoma Maybe endometriosis Maybe fallopian tube blockage T: Pale or with ecchymotic spots, the sublingual veins may be distended C: White and moist P: Deep and thready or Wiry or Choppy
Treatment Principle	Tonify Kidney Yang Invigorate the Blood
Herb Formulas	Infertility #39 Infertility #42
Points

Kidney Yang Deficiency With Water Flooding

Clinical Manifestations	Edema of whole body particularly at and below the waist Pitting edema Low back pain, aching and heaviness Abdominal distention with full sensations Oliguria Cold limbs Face gray and congested or pale Feeling nervous and cold with mental weariness In severe cases: Ascites Edema of scrotum T: Pale and swollen C: Thin, white or Thick, white and sticky P: Deep and thready
Treatment Principle	Tonify Kidney Yang Warm the Kidneys Promote diuresis Generate Blood Nourish the Chong and Ren channels Nourish the uterus
Herb Formulas	Zhen Wu Tang Jia Wei Shen Qi Wan
Points	REN-6, REN-9, UB-20, UB-22, UB-23, UB-39, ST-28, ST-36, SP-6, SP-9, KI-7 Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Kidney Yang Deficiency: Kidney Qi Not Consolidated

Clinical Manifestations	Amenorrhea Scanty periods Irregular menstruation Infertility Thick hair Acne Distending pain in the chest, hypochondria or breasts Dry mouth with preference for drinking water Constipation T: Normal or Red edges C: Yellowish and thin P: Rapid and wiry
Treatment Principle	Sooth the Liver Relieve Stagnation Reduce Fire
Herb Formulas	Jia Wei Xiao Yao San Kai Yu Zhong Yu Tang Gui Fu Du Jin Zan Yu Dan
Points	IV-3, SP-6, REN-6 + Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Kidney Yang Deficiency With Waning Of Ming Men Fire

Clinical Manifestations	Impotence Infertility Listlessness Lack of Spirit Weakness and aching of the low back A pale, shiny complexion T: Pale C: White P: Deep and thready
Treatment Principle	Warm and tonify the Kidneys
Herb Formulas	Zan Yu Dan
Points

Kidney Yang Deficiency With Phlegm-Dampness

Clinical Manifestations	Patients are typically obese Chronic infertility or A history of miscarriage with two years or more since last conceiving Sallow, white facial complexion Dizziness The patients tend to be inactive and unmotivated Drowsiness A slimy mouth with excessive Phlegm Chest oppression Abdominal distention Pasty, excessive white vaginal discharge Late menstruation (may come only every 50 - 70 days) Scanty menstruation or Amenorrhea May be uterine myoma or Fallopian tube blockage May be anovulation T: Normal C: Slimy P: Slippery
Treatment Principle	Tonify the Kidneys Disperse Phlegm
Herb Formulas	Infertility #41
Points

Kidney Yin Deficiency

Clinical Manifestations	Long-term infertility Early menstruation Possibly a history of late menarche Irregular periods Infrequent menstruation Decreased menses with light colored Blood and no blood clots Period either scanty or heavy Prolonged menstrual cycle Amenorrhea Loss of libido Emaciation Dizziness Night sweating Blurred vision Palpitations Insomnia Tinnitus Hearing loss A weak lower body Five Sole Heat or Low-grade fever in the afternoon Back soreness Aches and weakness in the waist and legs Dry mouth Dry bowl movements Dry vagina Cold limbs A dusky complexion Dull-pale complexion T: Red C: Little or None P: Thready and rapid or Floating and Empty
Treatment Principle	Nourish the Kidney Yin Generate Blood Regulate the Chong and Ren channels Support the Liver Augment Jing
Herb Formulas	Yang Jing Zhong Yu Tang modified Yang Jing Zhong Yu Tang + Er Zhi Wan Infertility #1 Liu Wei Di Huang Wan  modified Zuo Gui Wan Zuo Gui Wan + Wu Zi Yan Zong Wan Yang Jing Zhong Yu Tang Jia Nu Zhen Zi Han Lian Cao Yu Yin Tang Jia Jian Ba Sheng Dan Infertility #14 Infertility #16 Wu Zi Tang With Heart Yin Deficiency: Tian Wang Bu Xin Dan With Liver Blood Deficiency and Blood Heat: Infertility #13 With Qi and Blood Stagnation: Shen Mi Zhong Zi Fang With Jing and Blood Deficiency: Ji Kun Da Zao Wan With Phlegm-Dampness and Qi Stagnation: Yu Qing Wan With Blood Heat and Qi Stagnation: Qing Gu Zi Shen Tang Jia Wei Liang Di Tang modified With Internal Heat: Qing Xue Yang Yin Tang With Liver Blood and Kidney Yang Deficiency: Infertility #15 With Irregular menstruation: Liu Wei Di Huang Wan  modified With emaciation and severe Blood Deficiency: Infertility #19
Points	REN-4, REN-7, KID-3, KID-13, SP-6, LU-7 on the right and KID-6 on the left, UB-52 UB-23, REN-4, SP-6, ST-36, KI-2, KID-13 If the tongue is not Red or only slightly Red and the pulse is very Fine: a small amount of moxa(as a warm needle) on KID-3 Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Kidney Yin Deficiency With Fire Flaring

Clinical Manifestations	Long term infertility Irregular periods Delayed cycle Mid cycle pain Vaginal discharge Adhesions Obesity Feeling of heaviness T: Fat C: Sticky P: Slippery
Treatment Principle	Resolve Dampness Remove obstructions from the Ren and Chong channels
Herb Formulas	Infertility #1
Points	REN-3, REN-9, Zigong, ST-28, SP-9, LU-7 on the right side of the body and KI-6 on the left side of the body, ST-30, KI-14, UB-32, (GB-41 on the right and SJ-5 on the left are used instead of LU-7 and KI-6 if there are symptoms of the Dai channel which include Damp Heat in the genital system, vaginal discharge, a feeling of heaviness of the abdomen, an abdominal pain that extends to the loins and a pulse that is Wiry on both Middle positions, GB-26, should be used in conjunction with SJ-5 and GB-41) UB-32 with electrical stimulation with negative pole and REN-4 In combination, is a modern treatment which is used specifically for obstruction of the fallopian tubes. For this treatment, the patient need to lie on her side. Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Kidney Yin And Yang Deficiency

Clinical Manifestations	Long-term infertility Early menstruation Irregular periods Decreased menses with light colored Blood and no blood clots Emaciation Dizziness Night sweating Blurred vision Palpitations Insomnia Tinnitus Hearing loss A weak lower body Five sole Heat or Low-grade fever in the afternoon Back soreness Dry mouth Dry bowl movements Increased clear urine Loose stools Feeling cold Depression Cold limbs Frequent urination Long-drawn-out urination with a thin stream or dribbling Fatigue Pain and coldness in loin and knees T: Red or Pale, swollen and wet C: Little or None or White    P: Thready and rapid or Floating and Empty or Deep and weak or Thin and soft or Deep and thready
Treatment Principle	Nourish the Kidney Yin and Yang Generate Blood Regulate the Chong and Ren channels Support the Liver Augment Jing Nourish the uterus
Herb Formulas	Su Ling Zhu He Che Da Zao Wan Shou Tai Wan With Fire Rising: Er Xian Tang For immunologic infertility: Gu Jin Jian With candidiasis: Er Xian Tang modified
Points	UB-23, REN-4, SP-6, ST-36, KI-2, KI-13 If the tongue is not Red or only slightly Red and the pulse is very Fine: a small amount of moxa (as a warm needle) on KI-3 Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Kidney Jing Insufficiency

Clinical Manifestations	Dizziness Tinnitus Low back and knees weak and aching Hair loss Graying or whitening of hair Weak sexual function Atrophy and weakness of feet with difficulty walking Poor memory Senility (premature or mature) Brittle bones Gradual deterioration of hearing In children: Retardation in mental and / or physical development Failure to thrive Late or incomplete closing of fontanel Poor bone development, brittle bones
Treatment Principle	Reinforce the Kidneys Benefit Jing
Herb Formulas	Bu Yin Tang
Points	DU-4, GB-39, KI-3, REN-4, ST-36, UB-11, UB-23

Jing And Blood Deficiency Due To Kidney, Heart And Spleen Deficiency

Clinical Manifestations	Fatigue Heavy and painful lower back Dream-disturbed sleep General weakness Lack of interest in food or drink Fever Night sweats Seminal emission Forgetfulness Toothache Dizziness Gum swelling General pitted edema which is worse in the lower body Vaginal discharge Discharge of rice-water like urination without dysuria Aversion to Cold Impotence Decreased libido Emaciation Loose teeth Signs of premature aging Abdominal Cold Easily frightened T: Pale or Pale and thick C: Smooth and white P: Moderate and weak or Deep and weak
Treatment Principle	Tonify the Spleen and Kidneys Nourish the Heart Enrich the Yin Nourish the Blood and Yang Augments Qi and Jing
Herb Formulas	Huan Shao Dan Infertility #17 With emaciation and Five Sole Heat: Infertility #18
Points

Qi And Blood Deficiency

Clinical Manifestations	Infertility Late and small period Lassitude Dizziness Blurred vision Palpitations Insomnia Anorexia Loose stools Weak limbs Abdominal distention Lumbar soreness Frequent, clear urine Clear, watery vaginal discharge T: Pale C: Thin and white P: Weak in the Qi position
Treatment Principle	Tonify Qi Nourish Blood
Herb Formulas	Gui Pi Tang Ba Zhen Tang Shi Quan Da Bu Wan Dang Gui Shao Yao San Infertility #24 Leading to Blood Stagnation: Ba Zhen Yi Mu Wan
Points	SP-6, REN-4, REN-6, ST-36, UB-17, UB-20, UB-23 Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Qi And Blood Deficiency With Cold In The Uterus

Clinical Manifestations	Infertility Thin and profuse leukorrhea Sallow complexion or Dark and gloomy complexion Pain of lower limbs Lassitude Lack of vitality Weakness Irregular circulation of channels Failure to conceive for a long time Intolerance of Cold Cold limbs Soreness of waist Pain in the lower back Long-term or heavy menstrual bleeding Painful menstruation which gets increasing worse Pelvic pain during intercourse Fullness and stuffiness in the hypochondriac region	Dizziness Tinnitus, Shortness of breath Difficult speech Delayed menstrual cycle Abdominal pain during menstruation Abdominal Cold pain which can be relieved by warmth Scanty menstruation Dark in color Blood masses or Amenorrhea Distending pain in the lower abdomen prior to or during menstruation which can be relieved by warmth T: Pale C: White or White and greasy fur P: Weak or Deep and tense pulse or Thready and weak or Deep and slow
Treatment Principle	Reinforce the Kidney and Liver Support Yang Eliminate Cold Warm the uterus to help conception Regulate menstruation Nourish the Blood Invigorate the Blood Relieve cramps associated with the menstrual cycle
Herb Formulas	Fu Ke Zhong Zi Wan
Points	Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Qi , Blood And Yang Deficiency

Clinical Manifestations	Fatigue Anorexia Dizziness Pale face Weak voice Reluctance to speak Sweating with little or no exertion Dizziness Palpitations Insomnia Dry skin Dry hair Poor memory Paleness Scanty periods Chills Cold limbs Inability to get warm Loose stools Profuse clear urine Spontaneous sweating Lassitude T: Pale C: White or Thin, white and dry P: Slow, deep and weak or Empty or Thready and rapid or Weak
Treatment Principle	Tonify Qi and Blood Strengthen the Spleen Tonify Yang
Herb Formulas	Ren Shen Dang Shao San
Points

Blood Stagnation

Clinical Manifestations	Infertility Irregular and painful periods or Delayed menstruation with decreased menses or Dysmenorrhea The menses may become dark purple in color and contain many clots May be abdominal pain with guarding Pain in the lower abdomen Pain that is fixed, stabbing and /or severe Pan is worse with pressure Dark complexion Fixed, palpable masses Bleeding with clots Purple lips Purple nails Dry skin Irritability Manic behavior Frequent abdominal pain Mental restlessness Blue, dark or purplish discoloration of skin in small or large areas Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Purple, possible purple or red spots Red purple if there is Heat Blue purple if there is Cold C: White P: Choppy or Wiry and choppy
Treatment Principle	Invigorate the Blood Promote Qi circulation Dispel Stasis Regulate menstruation Promote conception Pacify the Liver and the Chong channel Nourish the uterus
Herb Formulas	Xue Fu Zhu Yu Tang Shao Fu Zhu Yu Tang Shi Xiao San Gui Zhi Fu Ling Wan modified Zhe Chong Yin Infertility #28 Infertility #30 Zhong Yu Wan Tao He Cheng Qi Tang  modified With Cold: Shao Fu Zhu Yu Tang Wen Jing Tang Sheng Hua Tang Chinese Patent Medicine: Fu Ke Zhong Zi Wan To Jing Wan Bu Tiao Formula
Points	LIV-3, GB-34, UB-17, SP-10, SP-6, SP-4, PC-6, SJ-6, REN-6, REN-4, ST-29, KI-14, KI-6 on the right and LU-7 on the left REN-3, ST-29, SP-6, KI-13 SP-6, SP-10, ST-36, UB-17, UB-40 Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Blood Stagnation With Damp-Heat

Clinical Manifestations	Early menses Scant amount Purplish-red with clots Lower abdominal distention and pain, especially along the sides of the abdomen Dislike of pressure Stabbing pain in the lower abdomen Breast distention and pain Chest and flank distention and pain Abdominal pain which becomes worse as the period approaches Emaciation Chronic lumbar soreness Possible low-grade fever Possible abnormal vaginal discharge which is yellow and foul-smelling T: Red C: Thin and yellow P: Wiry and rapid
Treatment Principle	Clear Heat Eliminate Dampness Invigorate the Blood Dispel Stasis
Herb Formulas	Qing Re Xiao Yu Tang Tiao Gan Pi He Chuan Lian Zi San Jia Jian Bao Luo Huo Yu Tang Jia Jian Yin Qiao Hong Jiang Jie Du Tang  modified
Points

Blood Deficiency

Clinical Manifestations	Infertility Delayed cycle Scanty periods Pale Blood Maybe copious, watery menses Maybe amenorrhea Insidious pain after menstruation Tiredness Withered, sallow complexion Depression Dizziness Palpitations Breathlessness Pale complexion Blurred vision Insomnia Poor memory Dry skin Constipation A thin, weak body T: Pale and thin C: Little or Thin and white P: Choppy or Fine or Thin and soft
Treatment Principle	Nourish the Blood Nourish Jing Strengthen the Liver and the Kidneys
Herb Formulas	Gui Pi Tang Wen Shen Bu Xue Tang Si Wu Tang Dang Gui Bu Xue Tang Bai Zi Ren Wan Ren Shen Yang Rong Tang Yang Jing Zhong Yu Tang modified Infertility #20 Dang Gui Yang Xue Tang Jia Wei With Cold: Zhong Zi Wan With Yin Deficiency: Yu Yin Bu Xue Tang With Kidney Yang Deficiency: Yu Lin Zhu modified With a cold Uterus: Tiao Jing Zhong Zi Fang Chinese Patent Medicines: An Ho Tea Wu Qi Pai Feng Wan
Points	REN-4, ST-36, SP-6, KI-13, UB-20, UB-23, moxa UB 17, Zigong ST-36, REN-6, SP-6, SP-9, UB-20 REN-4, SP-6, SP-10, ST-36, UB-18, UB-20, Zigong

Blood Heat

Clinical Manifestations	Early periods (short cycle) up to twice a month Heavy flow Feeling hot during period Thirst Mental restlessness. T: Red C: Yellow P: Rapid and overflowing. Scanty menstrual volume, red purplish in color and mixed with clots. Distention and pain in the lower abdomen, especially along the sides, which refuses palpation. History of lumbar soreness Distension & pain of the chest and hypochondrium Tongue is red with a thin coating Pulse is wiry and rapid
Treatment Principle	Cool the Blood Regulate menstruation
Herb Formulas	Qing Jing Sanmodified Wen Qing Yin Chinese Patent Medicine: Huai Jiao Wan
Points	LI-11, SP-10, SP-6, KID-2, LIV 3, PC-3, UB-17, REN-4, LU-7 on the right and KI-6 on the left Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Stagnant Heat

Clinical Manifestations	Scanty menstruation The Blood is purplish red with clots Distention and pain in the lower abdomen Distention and pain in the flanks Refuses palpation Emaciation A long history of lower back pain Distention and pain of the hypochondrium T: Red C: Thin P: Wiry and rapid
Treatment Principle	Clear Heat Disperse Stasis
Herb Formulas	Qing Re Xiao Yu Tang
Points	GB-41, LIV-2, REN-3, SJ-6, SP-6, UB-32

Dampness In The Lower Jiao

Clinical Manifestations	Long term infertility Irregular periods Delayed cycle Mid cycle pain Vaginal discharge Adhesions Obesity Feeling of heaviness T: Fat C: Sticky P: Slippery
Treatment Principle	Resolve Dampness Remove obstructions from the Ren and Chong channels
Herb Formulas	Infertility #2 Wan Dai Tang Qi Gong Wan
Points	REN-3, REN-9, Zigong, ST-28, SP-9, LU-7 on the right side of the body and KI-6 on the left side of the body, ST-30, KI-14, UB-32, (GB-41 on the right and SJ-5 on the left are used instead of LU-7 and KI-6 if there are symptoms of the Dai channel which include Damp Heat in the genital system, vaginal discharge, a feeling of heaviness of the abdomen, an abdominal pain that extends to the loins and a pulse that is Wiry on both Middle positions, GB-26, should be used in conjunction with SJ-5 and GB-41) UB-32 with electrical stimulation with negative pole and REN-4 In combination, is a modern treatment which is used specifically for obstruction of the fallopian tubes. For this treatment, the patient need to lie on her side. Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Damp-Heat In The Lower Jiao

Clinical Manifestations	Infertility Failure to conceive after the last delivery Irregular periods Delayed periods Constant spotting White vaginal discharge Pains in the loins Abdominal pain which is worse with menstruation and fatigue Low-grade fever Premenstrual breast distention T: Red C: White and sticky or Yellow and sticky P: Wiry and rapid
Treatment Principle	Clear Heat Resolve Dampness
Herb Formulas	Jie Du Si Wu Tang Long Dan Xie Gan Tang
Points	Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Phlegm Stagnation

Clinical Manifestations	Blood mixed with sticky pale colored leukorrhea Generally overweight Cough with copious, dilute, white frothy or lumpy sputum Chest and epigastric congestion Palpitations Headache Pain and full feeling in chest Dyspnea - worse lying down Asthma Throat rattle Maybe anorexia Lassitude Nausea / vomiting Dizziness / vertigo Shortness of breath Wheezing Acute attack of panting with high pitched sound and rapid exhalation Facial edema Weak extremities T: Pale or Pink C: Thick, white and greasy or sticky P: Slippery or Soft or Slippery and wiry
Treatment Principle	Transform Phlegm Dry Dampness Promote blood circulation Regulate menstruation
Herb Formulas	Er Chen Tang Xiong Gui Er Chen Tang Xiang Sha Liu Jun Zi Tang
Points	Ear: Internal Reproductive, Endocrine, Subcortex, Liver, Spleen, Kidney, Pituitary Scalp: Human reproductive system (electro)

Phlegm And Blood Stagnation

Clinical Manifestations	Mild, persistent uterine bleeding of purple and black blood during pregnancy Abdominal pain that is worse with pressure Abdominal spasms and tension Immobile masses in the lower abdomen with pain and tenderness Amenorrhea with distention and pain Dysmenorrhea Headache Sinus congestion Constipation Excess weight in the pelvis Lower back ache Irregular menstruation Nervousness Fatigue Fetal instability Skin eruptions Scanty menstrual flow Scaly, dry skin Retention of lochia Headache Shoulder stiffness Vertigo Cold low body and feet Flushed face Protruding abdomen T: Dark purple or with echymoses or petechiae or pale with purplish spots C: White P: Choppy or Tense and deep and slow
Treatment Principle	Invigorate Blood Transform Blood Stasis Soften lumps Reduces fixed abdominal pain
Herb Formulas	Gui Zhi Fu Ling Wan
Points

Phlegm-Dampness In The Lower Jiao

Clinical Manifestations	Long term infertility A long history of Excess Phlegm Irregular periods Delayed menstrual cycle with sticky discharge or Amenorrhea Mid cycle pain Vaginal discharge Adhesions Obesity or overweight General feeling of heaviness Heaviness i the four limbs A pale complexion Puffiness Dizziness Lack of strength Possible swelling and edema of the lower limbs Chest tightness Palpitation A feeling of stuffiness in the chest Anorexia Nausea Copious viscid vaginal discharge T: Fat C: Sticky thick and white P: Slippery or Wiry and slippery or Slippery, soft and thready or Thready and retarded
Treatment Principle	Eliminate Dampness Eliminate Qi Stagnation Invigorate the Blood Dissipate Phlegm Remove obstructions from the Ren and Chong vessels Nourish the Chong meridian and reproductive organs Regulate menstruation
Herb Formulas	Qi Gong Wan  modified Cang Fu Dao Tan Tang Xiao Zhi Mo Dao Tan Tang Er Chen Tang  modified Bu Shen Hua Shi Tang Zao Shi Huo Tan Fang Bu Zhong Yi Qi Tang  modified Infertility #31 Infertility #32 Infertility #35 Infertility #36 Infertility #37 With Kidney Qi Deficiency: Infertility #33 With Blood Stagnation: Infertility #34 With a Cold Uterus: Infertility #38
Points	REN-3, REN-9, Zigong, ST-28, SP-9, LU-7 on the right side of the body and KI-6 on the left side of the body, ST-30, KI-14, UB-32, (GB-41 on the right and SJ-5 on the left are used instead of LU-7 and KI-6 if there are symptoms of the Dai channel which include Damp Heat in the genital system, vaginal discharge, a feeling of heaviness of the abdomen, an abdominal pain that extends to the loins and a pulse that is Wiry on both Middle positions, GB-26, should be used in conjunction with SJ-5 and GB-41) UB-32 with electrical stimulation with negative pole and REN-4 In combination, is a modern treatment which is used specifically for obstruction of the fallopian tubes. For this treatment, the patient need to lie on her side REN-3, ST-30, ST-40, SP-6, SP-9 KI-13, REN-3, REN-12, SP-6, ST-30, ST-40, UB-20 Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Cold In The Uterus

Etiology	This is a condition of Empty Cold in the Uterus from a Kidney Yang Deficiency; it is more common in young women or young girls.
Clinical Manifestations	Primary infertility Delayed cycle Prolonged discharge Scanty period Small clots Painful period Better with Heat Feeling colder during period Pale face Feeling Cold Cold lower abdominal pain Pain relieved by warmth Sore back T: Pale C: Thick and white or Thin and white P: Weak and tight or Deep and slow
Treatment Principle	Warm and tonify Kidney Yang Warm the Uterus Scatter Cold.
Herb Formulas	Ai Fu Nuan Gong Wan Ai Fu Nuan Gong Wan + Ju He Wan Wen Jing Tang With Blood Stasis: Sheng Hua Tang With Phlegm-Damp: Infertility #38
Points	Moxa REN-2, REN-4, DU-4, needle KI-7, UB-23, REN-7 DU-4, KI-3, REN-2, REN-4, REN-7, Zigong Ear Acupuncture: Kidney, Uterus, Ovary, Endocrine

Cold With Insufficiency Of The Chong And Ren Channels

Clinical Manifestations	Afternoon fever Five sole Heat Dry mouth Thirst Cold abdominal pain Infertility Dysmenorrhea Uterine bleeding Chronic pelvic inflammation Menopause Habitual miscarriage
Treatment Principle	Warms the menses Regulates menstruation Dispels Cold Warms the channels Nourishes the Blood Nourish the Chong and Ren channels
Herb Formulas	Wen Jing Tang
Points

Cold-Damp Accumulation In The Channels

Clinical Manifestations	Delayed menstruation or Prolonged menstruation Scant amount Dark, purple menstrual Blood with clots Cold pain in the lower abdomen. relieved by warmth A thin, white abnormal vaginal discharge T: Dull colored C: White P: Deep and slow
Treatment Principle	Warm the uterus Scatter Cold
Herb Formulas	Ai Fu Nuan Gong Wan Shao Fu Zhu Yu Tang  modified Wen Jing Tang Wen Jing San Han
Points

Cold And Blood Stagnation In The Channels

Clinical Manifestations	Abdominal pain with icy cold hands and feet Extremities are cyanotic and difficult to warm up P: Thready or Imperceptible
Treatment Principle	Warm the channels Disperse Cold Nourish the Blood Unblock the channels
Herb Formulas	Dang Gui Si Ni Tang
Points