11.Case of Infertility and PCODPresenting Complaint: A 32-year-old female patient with PCOD presented with primary infertility in January 2021. Gynecologist suggested IVF treatment.
Characteristics: Long-standing painful acne, predominantly white, itchy eruptions along the jawline, aggravated before menses. Right-sided abdominal pain before ovulation, radiating upward and downward, aggravated by eating.
Other Complaints: Abdominal bloating with bitter and sour eructations and offensive flatulence, relieved after passing gas. Sneezing episodes in the morning.
Physical Generals: Desire for rice and spicy food, aversion to nuts; thirstless; offensive perspiration on underarms; thermally chilly.
Ailments From: Frequent conflicts with in-laws causing significant stress. She often cried and felt overwhelmed managing everything alone with difficulty adjusting to and accepting the change from her parental home to her in-laws’ home.
Nature: Marked mood swings, easily affected by minor issues; clings to her husband, desires consolation, and becomes angry when offended. Trembling of hands; feels compelled to share her feelings immediately. Fastidious.
Fears: Claustrophobic; fear of something happening to parents; anxiety when she sees someone fighting, anxiety begins with palpitation.
On Observation: Emaciated in spite of good appetite; greasy skin.
Investigations: USG report: left ovarian cyst, left ovary volume 5.7 x 5.2 x 4.6 cms. MRI: Multiple follicles seen on both ovaries. Thin smooth wall and septation in right ovary.
MRI reports:
Portrait of disease
Infertility with ovarian involvement
Oily skin with offensive perspiration
Strong attachment to family
Intolerance to change
Easily affected by trifles
Anxiety with fears of suffocation and death, accompanied by palpitations
Thermally chilly
Childlike traits
Rx:
Graphites LM1 O. D. for 7 days.
Folliculinum 30C B. D. for 2 days (First - 2 days of menses
13th, 14th & 15th day of ovulation)
Follow up in Feb 2021: Acne unchanged without worsening. She is feeling much better overall. Anxiety has significantly reduced, abdominal pain was well managed this time, and her anger, fears, and stress have subsided.
Rx:
Graphites LM1
Follow up in April 2021: Initially,
Graphites was very effective and almost completely cleared the acne, but following stressful sonography reports and anxiety around menses, the acne recurred. The acne is now itchy with yellowish pustular discharge. No menses this month.
Mentally, anxiety with sudden breathlessness, anger with palpitations, and frequent weeping. Continues to adjust with family situations.
Rx:
Graphites LM2 O. D. Alternate every 1 month
Follow up in May 2021: UPT positive; happy and cheerful mind state. Abdominal bloating and right sided pain. Painful acne.
Rx:
Graphites LM2
Case Review: The patient, under treatment for PCOD and primary infertility, conceived within four months. She continued regular consultations throughout pregnancy and delivered a healthy child by normal vaginal delivery.