E-ISSN:2456-3110

Case Report

Ksheena Shukra

Journal of Ayurveda and Integrated Medical Sciences

2022 Volume 7 Number 1 Jan-Feb
Publisherwww.maharshicharaka.in

Ayurvedic management of Ksheena Shukra - A Case Study

Sanjay Sabnis S.1*, Hiremath V.2
DOI:

1* Shrinidhi Sanjay Sabnis, Final Year Post Graduate Scholar, Dept of Samhita Siddhant, Ayurved Mahavidyalaya & Hospital, Hubli, Karnataka, India.

2 Vinaykumar Hiremath, Associate Professor, Dept of Samhita Siddhant, Ayurved Mahavidyalaya & Hospital, Hubli, Karnataka, India.

Low sperm count (oligospermia) and reduced motility of sperms (asthenospermia) is the main causes of male infertility and it can be correlated with Shukravaha Srotas Dushti and is a problem of global proportions. Worldwide infertility is affecting on an average 8-12% of couples. Acharya Sushrut has explained 10 types of Shukra Dushti which are incapable of producing a progeny. Shukravaha Srotas Dushti leads to Aharsha, Klaibya etc. there is no direct correlation of oligospermia but we can correlate it with Shukra Kshaya or Ksheena Shukra. A 38-year-old male who had been diagnosed as Oligoasthenospermia with low sperm count and non-motile spermatozoa with 10 years of married life and his wife with regular menstrual cycle, were treated successfully with Ayurvedic management. After Aamapachana, patient was administered with YapanaBasti along with Apatyakar Ghrita as Sneha for 30 days. There was marked improvement in the seminal parameters.

Keywords: Shukravaha Srotas Dushti, Ksheena Shukra, Male infertility, Yapana Basti, Apatyakar Ghrita

Corresponding Author How to Cite this Article To Browse
Shrinidhi Sanjay Sabnis, Final Year Post Graduate Scholar, Dept of Samhita Siddhant, Ayurved Mahavidyalaya & Hospital, Hubli, Karnataka, India.
Email: 		Shrinidhi Sanjay Sabnis, Vinaykumar Hiremath, Ayurvedic management of Ksheena Shukra - A Case Study. J Ayu Int Med Sci. 2022;7(1):406-410.
Available From
https://jaims.in/jaims/article/view/1649

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-01-26 2022-01-28 2022-02-04 2022-02-11 2022-02-18
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 18%

© 2022by Shrinidhi Sanjay Sabnis, Vinaykumar Hiremathand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

Journal of Ayurveda and Integrated Medical Sciences 2022;7(1)406
Sabnis S. et al: Ayurvedic management of Ksheena Shukra - A Case Study

Introduction

Oligospermia[1] means a condition of reduced number of sperm cell spermatozoa. Oligospermia, may also show significant abnormalities in sperm morphology and motility. According to WHO 2010 criteria sperm concentration <15 million spermatozoa per milliliter [2] is termed as oligospermia.

Except for some physical defects, low sperm count (Oligospermia) and poor sperm quality is responsible for male infertility in more than 90% of cases.[3]

Shukra is the terminal tissue element of the body which is considered as the sara of all other Dhatus. The specific function of Shukra is Garbhotpadan.[4] Healthy functioning of Shukravaha Strotas plays a vital role in maintaining the harmony and happiness in marital life.

According to Charakacharya “The man alone without offspring looks like a single tree having single branch, shade less, fruitless and with foul smell”.[5]

Karma of Shukra is Dhairya, Chyavana, Priti, Dehabala, Harsha and helps in production of progeny.[6] Charak Samhita as well as Sushrut Samhita explain about the Shukravaha Srotas & its Moolasthan.[7,8] Acharya Sushrut has proposed the following Shukradoshas - Vata, Pitta, Kapha, Shonit, Kunap, Granthi, Puti, Puya, Ksheena, Mutra, Purish, Retas.[9]

Case Study

Presenting Complains

A 38 year old male pt. driver by occupation visited OPD of HASS’s Ayurved Mahavidyalaya & Hospital in August 2021. He & his better half were trying for their second issue but unable to conceive despite unprotected coitus for more than a year. Past family clinical history was non-contributory.

Local Examination & History

Development of secondary sexual characters is normal. Pt. has never suffered from any chronic medical illness, Infections (mumps, orchitis, sexually transmitted infections) and genitourinary tract infections. There was no any history of delayed ejaculation, pre-mature ejaculation, and erectile dysfunction, surgical procedures involving the

inguinal and scrotal areas (vasectomy, orchiectomy and herniorrhaphy), exposure to heat or radiation.

The local examination did not show any anatomical abnormalities and there were no signs of inflammation, ulceration or rashes on scrotum, testes or penis.

Semen analysis conducted on 02/08/2021 indicated oligospermia (5 million/mi with 40% active motile). Through detailed history it was found that patient is a habitual tobacco chewer and consumes alcohol occasionally. He was often sleep deprived as he is a cab driver.

Investigations

Complete Blood Count

Hb - 15.9%

WBC - 8470 cells/ mm3

ESR - 10 mm/hour

Random Blood Sugar - 102mg/dl

Semen Analysis

Total Sperm Count - 05 million /ml

Motility - 40% active motile

Samprapti

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Materials and Methods

Pachana

For Amapachana and Koshtha Shodhana Haritakyadi Churna[10] 1tsp BD with hot water and jaggery was given for 5 days.

Abhyanga and Swedan

Sarvanga Abhyanga was done daily with Tila Taila and then Bashpa Sweda was given.


Journal of Ayurveda and Integrated Medical Sciences 2022;7(1)407
Sabnis S. et al: Ayurvedic management of Ksheena Shukra - A Case Study

Shodhana Chikitsa

Yapana Basti[11] was planned in Karma Basti schedule (30 days). In total 12 Yapana Basti and 18 Anuwasan Basti were administered. Sneh used in Yapana and Anuwasana Basti was Apatyakar Ghrita.[12]

Shaman Chikitsa

  1. Spermon 1BD
  2. Half tsp Shatawari + half tsp Ashwagandha Churna with milk
  3. Vanari Kalpa 2 tsp with milk BD

Pathya-Apathya

Patient was asked to stop the Ratraujagrana as well as tobacco chewing. Advised to have Shadrasatmak Aahar without prolonging the hunger.

Results

Before treatment, the Sperm count was 05 million/ml and after treatment, it increased to 30 million/ml and after 3 months of follow-up it doubled. Actively motile % increased from 40% to 60%.

Test Name Before Treatment [02/08/2021] After Treatment [28/09/2021] Follow Up after 3 months [04/01/2022]
Volume 01ml 01 ml 1.5 ml
fructose Positive Positive Positive
Color Greyish White Pale yellow Whitish
Reaction Alkaline Alkaline Alkaline
Viscosity Mucoid Viscous Viscous
Liquefication time < 30 minutes < 20 minutes < 30 minutes
Total Sperm Count 05 million / ml 30 million / ml 60 million/ ml
Actively motile 40% 50% 60%
Sluggishly motile 20% 10% 20%
Non motile 40% 40% 20%

Discussion

Generally, in Oligospermia the sperm count as well as its motility is found to be low. Treatment of Oligospermia should be aimed at increasing the sperm count as well as their motility. Shukradushti

is the causative factor for the infertility. Ksheenashukra is a type of Shukradushti which can be correlated to Oligoasthenospermia. The treatment of Ksheenashukra mainly aims at Shukrajanaka and Shukrapravartaka in-terms of increasing the sperm count and motility by using Vajeekarana Dravya.

Haritakyadi Churna has Haritaki, Amalaki, Haridra, Shunthi, Pipalli, Vacha, Vidanga and Saindhav. Mainly these drugs being Katu, Tikta Rasa Pradhan, Ushna Veerya help to correct the Agnidushti as well as do Vaata and Mala Anuloman.

Drugs used in Yapana Basti were Sahachar, Bala, Darbhamool, Sariva, Bruhati, Kantakari, Shatawari and Guduchi. Kalka of Madanphala, Yashtimadhu and Pippali was added to the Ksheerapaka of above drugs. Along with the Kalka, Madhu, Saindhav, Tila Taila and Apatyakar Ghrita were added as Prakshepa Dravya. Apatyakar Ghrita is prepared by Shatawari, Gokshur, Masha, Aatmagupta and Vidarikanda along with 8 times quantity of Godugdha. Sahachar, Bruhati and Kantakari have Katu, Tikta Rasas, Katu Vipaka and Ushna Veerya.

Thus, they help to regulate the vitiated Vata and correct its Prakrit Gati and Karma. Kantakari and Bruhati act on the actual Shukra Dhatu and help in its Sravana.[13]

Guduchi, Shatavari, Bala have Rasayan, Brumhan and Balya properties respectively as well as do Pitta Shamana.[14] Sariva having Madhur Rasa and Vipaka, Sheeta Veerya will pacify the Pitta and act on Shukra Dhatu.[15] Darbhamoola has regeneration property.

Bala Janana effect of Yapana Basti is observed if it is used for a long time, i.e., in Karma Basti schedule. Here it improves qualities of Dhatu upto the formation of Ojas by virtue of its Rasayana property and strengthens the body. Indriya Balam Param (increases strength of sensory and motor organs), Visham Avisham Bhavati Gatre (removes toxins from body parts), Medha Smriti Karam (promotes intellect and memory) and Jaravyadhi Prashamanam (allays aging). Rasayana conduce to the replenishment of Rasadi Dhatus. They contribute to the integrity of Saptadhatus and thus increase longevity.[16]

Apatyakar Ghrita contains all Vrushya and Shukral drugs. Goghrita and Godugdha both are Nityasevaniya Dravya and Shukravardhak.[17]


Journal of Ayurveda and Integrated Medical Sciences 2022;7(1)408
Sabnis S. et al: Ayurvedic management of Ksheena Shukra - A Case Study

After completion of 30 Basti, patient was given oral medication for 3 months. Tab. Spermon includes drugs like Shatawari, Ashwagandha, Aatmagupta, Musali, Talimkhana and Shilajatu which are all in the category of Vajikarana Dravya.  Shatawari and Ashwagandha Churna have Balya, Vrushya and Rasayan properties. Aatmagupta Beeja also promote the Vriddhi of Shukra due to its Vrushya and Sheeta Veerya.

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Conclusion

Ayurvedic medicine deals with infertility by Shodhana i.e., detoxification.


Journal of Ayurveda and Integrated Medical Sciences 2022;7(1)409
Sabnis S. et al: Ayurvedic management of Ksheena Shukra - A Case Study

It focuses on all aspects like Aahar, Vihara that play an important role in manifestation of any pathology. In the present case we applied Ayurvedic principles in treating Shukradushti. We found that after completion of the proper treatment based on Ayurvedic principles and changes in diet and daily regimen there was significant improvement in semen parameters such as sperm count and motility of sperms. Due to improved status of Dhatus and as well as the action of ingredients showed increased sexual desire, duration of coitus, getting an orgasm or sexual satisfaction along with increased sperm count and motility.

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