18. Case of Secondary InfertilityPresenting Complaint: A 40-year-old woman presented with secondary infertility.
Menstrual History: Regular. No symptoms before or after. Dysmenorrhea. Chills and coldness all over the body during menses.
Investigations: USG 1st Feb 2023: Retroflexed adenomyotic, chocolate cyst of 3.2 cm. Endometriosis.
USG 13th march, 2024: Post LSCS. Mildly adenomyotic uterus. Endometrial hyperplasia.
Chocolate cyst right ovary. Luteal cyst right ovary. There is no e/o Deep infiltration.
No adhesions were noted between the pelvic organs and omentum, bowel or ureters.
Childhood: Lived in a joint family and she was quite comfortable with lot of people around.
Marital History: In the first year of marriage, she felt alone managing everything as her in-laws were ill. Also, there was a major lifestyle and food change. Sudden responsibilities caused stress, headaches, and exhaustion; needed husband’s support but struggled to express herself, and lost interest in physical intimacy.
Dreams:
Dreams of failure, loss, and missing out.
Nature: Organized, indecisive, creative; dislikes music now but liked listening to music earlier.
Past History: Known case of anemia since childhood.
AnalysisRx: Pituitary anterior 30C T. D. S. for 7 days followed by Natrum carb 30C, 200C, 1M and then Natrum carb LM2 O. D. for 15 days, Natrum carb LM3 O. D. for 15 days, Natrum carb LM4 O. D. for 15 days.
Follow up after 50 days: Had conceived the child.
Patient’s Note: I was shocked and pleasantly surprised to conceive, as I never believed it would be possible. I feel happy that I will have a child.
Reports: 22nd May 2024: HCG: 756.9; 24th May 2024: HCG: 1853.5
USG: 27th May 2024: 5 weeks 3 days pregnant
30th September 2024: Primary diagnosis: G2P1L1 with 21.4 weeks of gestation with DCDA twins with PROM (Premature preterm rupture of membranes) with GDM on diet and exercise for conservative management. Twin 1 Severe oligohydramnios to anhydramnios.
October 2024: Dichorionic diamniotic twin gestation. Leaking PV since 1 month. The study of fetal anatomy of twin 1 was restricted due to persistent fetal position and anhydramnios. Twin 2: normal amniotic fluids, normal development.
Postpartum anxiety, depression
History:
Depression and anxiety. Conceived twins after treatment for secondary infertility; one fetus died due to infection after meconium aspiration.
Present complaints: Confusion, severe anxiety, negative thoughts, frequent crying. Baby is in NICU. Feels helpless, guilty, and distressed due to separation from the child. Sleep is disturbed by constant worry and fear of something bad happening.
Mind State: Deeply torn and emotionally detached. Her thoughts are consumed by the baby she cannot hold, and she feels disconnected even from her elder child. She is unable to breastfeed due to reduced milk supply. Though usually cheerful, she is now irritable, withdrawn, and unable to tolerate interaction.
Fear: Concerned about her child’s health and worried when people ask about her own health. Fears that something bad may happen and feels she should have been more careful as a mother.
AnalysisRx:
Lac maternum 200C. After 10 days,
Folliculinum 200C B. D. for 2 days
Follow up: Anxiety has improved, grief has reduced, and mood is better. She feels more certain about the baby, is no longer weepy, and reports improvement in knee pain and weakness.
Rx:
Lac maternum 200C B. D. for 2 days
Follow up: Happy and cheerful. Energy levels are good now. Anxiety is completely gone.
Patient’s Note: Doctors were surprised, and she is very grateful for homeopathy. Anxiety and constant fear of losing her child are gone. She is more focused, and homeopathy helped her deliver her second child.