Abstract
Infertility is a condition that has been classified as a public health priority because of the effects that it is known to have on the psychological, social, physical, and economic aspects of peoples’ lives. An individual may be diagnosed with infertility if they have been unable to conceive after more than 12 months of regular unprotected intercourse. According to a report released in 2015, the World Health Organization (WHO) estimated at the time that between 60 to 80 million couples worldwide struggled with infertility. Another report released in 2020 found that approximately 37% of all cases of infertility are linked to a female-related cause alone. Complementary medicine is defined as any system of healthcare that is not fully integrated into the conventional medical system within a country. Homeopathy is a complementary medicine modality that is used as an alternative approach to the treatment of female infertility. There has been no study done to date to determine homeopathic practitioners’ approaches to the management of this condition.
The aim of this study was to determine homeopathic practitioners’ approaches to managing female infertility in South Africa by means of the Delphi technique.
The Delphi technique was used to establish expert consensus from South African homeopathic practitioners who are considered experts in treating female infertility. Twelve practitioners participated in this study, however only eleven completed all three rounds. A total of thirty-two recommendations achieved expert consensus for their usefulness in the management of female infertility. These recommendations were classified into the following categories: case management, homeopathic treatments, dietary recommendations, lifestyle adjustments, health supplements, and referrals.
All participants emphasised that a thorough history taking and scheduling regular follow-up consultations should be performed in cases of female infertility. Of the eleven participants, nine participants stated that repertorisation and treating layer by layer are useful approaches to adopt in case analysis. The use of nosodes, mother tinctures, gemmotherapy and organotherapy achieved consensus, with most participants agreeing on their usefulness. All the participants agreed that it may be beneficial if patients undergoing treatment for female infertility increase their intake of fruits and vegetables, eliminate or reduce processed foods, ensure adequate water intake, manage stress and get an adequate amount of sleep. Ten of the participants noted the usefulness of a high fibre diet and the elimination or reduction of sugar
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and refined carbohydrates, canola oil, caffeine, and cigarette smoking. Nine of the participants agreed on the benefit of the elimination or reduction of wheat, gluten, dairy, alcohol, and carbonated drinks as well as eating frequently throughout the day. Regarding health supplementation, the participants agreed on the importance of supplementation for adrenal support, and nine of the participants agreed on the use of magnesium and supplementation to support the liver. Most of the participants agreed on the usefulness of referring patients with female infertility to gynaecologists, endocrinologists, acupuncturists, reflexologists, psychologists and for ultrasound imaging.
The recommendations obtained from this study may be of use to homeopathic practitioners in the management of female infertility, but are not sufficient to be considered clinical practice guidelines. Further studies on these interventions may be useful to improve future patient care.