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The Homoeopathic Similimum in Infertility of Unexplained Cause in Females

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The Homoeopathic Similimum in Infertility of Unexplained Cause in Females The Homoeopathic Similimum in Infertility of Unexplained Cause in Females A research dissertation presented to the Faculty of Health Sciences, University of Johannesburg in partial fulfillment of the Masters degree in Technology: Homoeopathy By Bianca De Canha (Student Number: 820407128) Supervisor: ___________________________ __________________ Dr K. Peck Date B.A., M.C.H. Co-Supervisor: ________________________ __________________ Dr Z. Bengis Date M. Tech (Hom) (Cum Laude) Johannesburg, 2009 DECLARATION I, Bianca De Canha, declare that this dissertation is my own, unaided work. It is being submitted for the Degree of Master of Technology at the University of Johannesburg. It has not been submitted before for any degree or examination in any other Technikon or University. ___________________ Signature of Candidate ________ day of _______________________ ii ABSTRACT Infertility is defined as the inability to conceive after a minimum of one year of regular intercourse without contraception (Carlson et al, 2002). This may occur as primary infertility, where individuals have never had a biological child, or secondary infertility where individuals have had at least one previous documented conception (Greer et al, 2003). Infertility, in the African setting, is seen as a violation of the social norm. It contributes to psychological distress and marital instability as well as the loss of social security, social status and gender identity. Parenthood is considered culturally mandatory making childlessness unacceptable. Not only does Africa have the highest fertility rates in the world, Africa also has the highest number of infertility cases globally (Dyer et al, 2005; Ragone & Twine, 2000). Unexplained infertility is diagnosed when the routine investigation of semen analysis, tubal patency and assessment of ovulation show no abnormality and the couple have engaged in regular sexual intercourse. Unexplained infertility is thus a diagnosis of exclusion. When a previously identified cause of infertility is corrected, yet infertility persists a diagnosis of unexplained infertility is also given (Behrman et al, 1988). Before a diagnosis of unexplained infertility can be made four aspects are generally assessed. Each aspect encompasses a different aspect of the reproductive process: the number and quality of sperm, maturation and release of the ova, barriers to fertilization and barriers to implantation and maintenance of pregnancy (Cooper-Hilbert, 1999). The aim of this research was to evaluate the efficacy of homoeopathic similimum treatment in females pre-diagnosed with unexplained infertility using case studies. Cases were evaluated using fertility and parameters related to fertility which include basal body temperatures and midcycle cervical mucous changes. In addition, general parameters such as general well-being, premenstrual symptoms, dysmenorrhoea and sexual function were also evaluated. Concomitant symptoms were included in the analysis of each participant’s holistic case. The male partner was also required to be free of any structural and functional pathology. This research was accepted by the Higher Degrees Committee and Ethics Committee of the University of Johannesburg on the 22nd of February 2008, ethical clearance number 04/08. The research study was advertised in pharmacies, local newsletters and newspapers in order to recruit volunteers for the study. All volunteers were required to complete a Participant Selection Questionnaire which ultimately resulted in the recruitment of eleven participants. The eleven iii participants recruited matched the inclusion criteria and had undergone relevant investigations regarding their infertility. After the selection process had been completed, the first consultation was conducted where an informed consent form was completed. Pre-consultation counselling regarding the optimum circumstances for conception was completed. Thereafter a full case history was taken and a physical examination performed. Each participant’s unique physical, mental and emotional symptoms were holistically used by the researcher to determine the similimum remedy for each participant’s case. Each participant attended seven consultations over a period of six months. At each consultation the participants were required to complete general well-being questionnaires which were collected and compared at the end of the trial. Participants were also required to record basal body temperatures and midcycle mucous changes on a daily basis. Treatment focused on the constitutional and emotional aspects of the individual. The physical manifestations of each participant were also considered. This complies with the principles of classical homoeopathy which states that the individual is a holistic entity and should be treated as such. The study was predicted to provide an alternative and safe form of treatment to individuals pre-diagnosed with unexplained infertility. The average age of the group of participants was 35.7 years of age. Five of the eleven participants had previously undergone artificial insemination. None of the artificial insemination attempts made by this group had been successful. Five of the eleven participants had undergone in vitro fertilisation therapy. Of this group a total of eight attempts had been made, with only two of the attempts producing a live birth. A minimum of two years before the trial, six of the participants had used Clomid® for purposes of assisted conception. This highlights the complexity of each case and ultimately, the research trial. The results of the study showed that treatment with the homoeopathic similimum over six months was not effective in the treatment of unexplained infertility. However, improvement was noted regarding related fertility parameters, general parameters, related function in premenstrual symptoms, dysmenorrhoea and concomitant symptoms. A longer term study would be justified based on these results. iv DEDICATION This study is dedicated to the memory of Maria Dolores De Gouveia, my grandmother - whose work of art was her children, in the hope that more women may be given the opportunity to be the kind of mother she was. v ACKNOWLEDGEMENTS The researcher would like to thank the following individuals for their contribution in the realisation of this dissertation and dream: To my parents, Tiago and Anabela De Canha, for their love and encouragement. Thank you for giving me the opportunity to study homoeopathy and for helping me to succeed. To Dr Kathryn Peck for her homoeopathic input and for the opportunity to learn through your experiences and gain from your knowledge. To Dr Zoë Bengis for her support and for giving of her time and assistance beyond the role of a co-supervisor. To the eleven participants who participated in this study. Thank you for the heartache, hope and tears you placed in my care. Without you, this study would not have been possible. To Dr Neil Gower for his valuable knowledge and insight as well as for all the time you put into my research in Dr Kathryn Peck’s absence. Your patience and unlimited support are greatly appreciated. To Dr Jaci Schultz for proof reading this dissertation and for her appreciated support and encouragement throughout the duration of the study as well as for her valued friendship. Dr Danny Pillay for proof reading this dissertation and for his willingness to provide assistance in the formation of this dissertation. Dr Leanne Scott, Dr Ameesha Manga, Dr Graeme Yutar and Dr Mareze Cape for their interest and assistance in this research project. Your reassurance and guidance will always be treasured and remembered. To Dr Radmilla Razlog for her advice, guidance and never ending support. To Jaclyn Smith and the Statkon team for assisting with their statistical expertise. To Adam Sayers for his encouragement, for his patience and mostly for his limitless love. Thank you for being there to celebrate the highs and to reassure me during the lows. To my friends Bernadete Grota, Kelly Joffe, Leanne Gouveia, Nicolette De Freitas, Reshma Patel and Sandra Pita who never held back their love and support. To my brother, Damian De Canha, my family and to my godchildren, Brigid Da Silva, Claudia Da Silva and Steven De Canha who were always so proud of me. vi TABLE OF CONTENTS DECLARATION……………………………………………………………………………..........ii ABSTRACT……………………………………………………………………………………….iii DEDICATION………………………………………………………………………………..........v ACKNOWLEDGEMENTS………………………………………………………………………vi TABLE OF CONTENTS………………………………………………………………………...vii LIST OF FIGURES…………………………………………………………………………........xv LIST OF TABLES……………………………………………………………………………….xvi ABBREVIATIONS……………………………………………………………………………...xvii CHAPTER ONE INTRODUCTION………………………………………………………………………………...1 1.1 PROBLEM STATEMENT…………………………………………………………..……1 1.2 IMPORTANCE OF THE PROBLEM……………………………………………….........2 1.3 HYPOTHESIS……………………………………………………………………….........3 1.4 PURPOSE OF THE STUDY……………………………………………………………...3 1.5 DELIMITATIONS………………………………………………………………...…........4 1.6 ASSUMPTIONS………………………………………………………………...…….…..4 1.7 DATA VALIDITY…………………………………………………………………..........5 CHAPTER TWO REVIEW OF RELATED LITERATURE……………………………………………………....6 2.1 INTRODUCTION TO INFERTILITY……………………………………………………6 2.2 INCIDENCE AND EPIDEMIOLOGY……………………………………………………6 2.3 THE FEMALE REPRODUCTIVE SYSTEM……………………………………...…….8 2.3.1 Functional and Structural Anatomy of the Female Reproductive System……...…....8 2.3.2 The Ovarian Cycle…………………………….…………………………………….10 2.3.3 The Menstrual Cycle………………………………………………………………...11 2.3.4 Changes
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