Ayurvedic management of Infertility - A Case Study

Jaya H. Malagoudar; R I. Jambagi

Ayurvedic management of Infertility - A Case Study

H. Malagoudar J.^1*, I. Jambagi R.²

DOI:

^1* Jaya H. Malagoudar, Professor, Dept. of Agadatantra, BVVS Ayurved Medical College and Hospital, Bagalkot, Karnataka, India.

² R I. Jambagi, Professor, Department of Rachana Shareera, BVVS Ayurved Medical College and Hospital, Bagalkot, Karnataka, India.

Infertility is the inability of a person, animal or plant to reproduce by natural means. Acharya have explained four important factors as Garbha Sambhava Samagri that is Rutu, Kshetra, Ambu and Beeja. These are important for conception. Infertility occurs if there is any abnormality in Garbha Sambhava Samagri. In this case study patient aged 23 years who was anxious to conceive since three years of regular and satisfactory marital relationship seeking Ayurved line of treatment. From detailed history involvement of vitiated Vata and Pitta, Agnimandhya and stressful mind was noticed. She was treated with classical Virechana followed by Shamana treatment and Satwavajaya Chikitsa. Classical Virechana procedure was followed then advised Shaman treatment to the patient. With above mentioned medications patient approached with history of secondary amenorrhea and when advised for Urine Pregnancy test and was found to be positive. Garbhasthapana medicines were administered to the patient and discharged.

Keywords: Infertility, Garbhasthapana, Virechana, Garbha Sambhava Samagri

Corresponding Author	How to Cite this Article	To Browse
Jaya H. Malagoudar, Professor, Dept. of Agadatantra, BVVS Ayurved Medical College and Hospital, Bagalkot, Karnataka, India. Email:	Jaya H. Malagoudar, R I. Jambagi, Ayurvedic management of Infertility - A Case Study. J Ayu Int Med Sci. 2022;7(1):353-358. Available From https://jaims.in/jaims/article/view/1694

Introduction

Infertility is the inability of a person, animal or plant to reproduce by natural means.^[1] There are two kinds of infertility - primary and secondary. Primary infertility means that the couple has never conceived. Secondary infertility means that the couple has experienced a pregnancy before and failed to conceive later.^[2]

Globally, most infertile couples suffer from primary infertility. It is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse (WHO-ICMART glossary).^[3] According to AIIMS, about 10-15 per cent of couples in India are said to have fertility issues. Infertility is a significant clinical problem today, affecting 8-12% of couples worldwide.^[4] A minimum of 80 million pairs suffer from involuntary infertility worldwide, secondary infertility (having had a previous pregnancy) rates were double the primary infertility rates, where primary infertility (no previous pregnancy) rate range from 3 to over 30%.^[5] The main disorders involved in infertility include pathologic spermiogram, ovulation problems / anovulation, tubal diseases, pelvic adhesion / endometriosis, cervical factors and idiopathic reason usually qualified as the so-called unexplained infertility.^[6] Beejam stands for healthy ovum and sperms.

Charakacharya said Apradustha Yoni, Garbhashaya and Garbhashaya Marga also as essential factors for conception, hence, it can be stated that healthy Shaareera of Stree possessing healthy Yoni, Garbhashaya and Garbhashaya Marga as Kshetra.^[7] Proper functioning of Vathaadi Dosha must be maintained for pregnancy and throughout the entire pregnancy period. Establishing the proper functioning of all these is the first step of infertility management in Ayurveda.

Case Study

A 23 year old married woman with her husband aged 33 year old man residing in Murnal Village, Bagalkot District, Karnataka, reported the Prasuti Tantra and Stree Roga outpatient department (OPD) with the complaint of not able to conceive even after trying for 3 years of unprotected married life. Consanguinity in marriage was present. From her treatment history, no obvious cause for infertility

was found in the couple. Oligospermia was found in semen analysis of the patient’s husband. The investigations like hematology, urology and biochemistry analysis were normal in the patient. Likewise, every report including TFTs and Prolactin level of the patient were normal. Patient not conceived after taking 4 to 5 months modern oral treatment for conception by the advice of modern gynecologist.

Lastly the gynecologist advised ART (Artificial Reproductive Technique) and the couple were not willing for that. They suggested ovulation induction, IVI fertility and IVF, but couple was refused and came to Ayurvedic line of treatment for conception.

From history it was known that she was suffering from chronic constipation and reduced appetite and psychological stress. She had no any previous medical or surgical illness. On general examination her all systemic examinations were normal. Her pulse and BP was found to be 70/min and 110/70 mmHg. No pallor or edema was found. She was overweight with BMI 27.05kg/m² (Weight-65kg and height-155cm).

Prakruti assessment revealed, she was having Kapha vatha prakruti and no any relevant findings on clinical examinations. LMP was found to be on 26.08.2021.

Menstrual history revealed normal cycles with the duration of 4-5 days and interval of 30-35 days cycle with scanty flow and pain abdomen during menses. No any abnormality was found in the coital history and had not taken any contraceptive measures after the marriage for family planning.

As per abdomen examination no any abnormalities were detected. Per speculum examination revealed healthy cervix without any abnormal discharge. As per vaginal examination revealed normal sized anteverted uterus with healthy fornix vagina. Cervical motion tenderness or cervical excitation sign was absent.

Treatment Given

Deepana with Chitrakadi Vati, Pachana with Ajamoda Churna, Snehapana with Mahakalyanaka Ghrita and for Virechana Trivrutta Avaleha had been given to the patient.

Shamana treatment given was - Pushpadhanva Rasa, Agnitundi Vati, Lodhrasavam, Dhatri Loha and Dashamoola Kashaya for two months.

Date	Medications	Dose	Anupanam	Time	Duration
19.07.2021	Pushpadhavna Rasa	1 BID	Water	Before Food	2 Months
19.07.2021	Agnitundi Vati	1TID	Water	Before Food	2 Months
19.07.2021	Lodhraasavam,	20 ml BID	Water	After food	2 Months
19.07.2021	Dhatri Loha	1 BID	Water	After food	2 Months
19.07.2021	Phala Ghritam	5ml BID	Warm Milk	After food	2 Months

He was treated with Tab Shilapravang special and Countplus granules for two months.

Date	Medications	Dose	Anupanam	Time	Duration
19.07.2021	Shilapravang special	1 BID	Water	Before Food	2 Months
19.07.2021	Countplus Granules	1TID	Warm Milk	Before Food	2 Months

With above mentioned medications patient approached with history of secondary amenorrhea and when advised for Urine Pregnancy test and was found to be positive with LMP on 30.08.2021 and EDD by dates on 02.06.2022. After that normal antenatal care, line of treatment in first trimester of pregnancy was given to the patient and advised bed rest, follow up after 15 days. On 13.10.2021 obstetric ultrasonography revealed single intrauterine gestation corresponding to a gestational age of 6 weeks 0 days, yolk sac seen, outline regular, embryo not visualized and EDD by scan was on 08/06/2022, recommended rescan at 12 to 13 weeks of pregnancy to assess NT. On 01/11/2021 OBG USG revealed single viable intrauterine pregnancy that corresponds to dates (8 weeks 5 days), CRL 22.3 mm and heart beat visualized. There was a healthy pregnancy. Yes, it’s beauty of Ayurvedic line of treatment.

Discussion

Infertility is a relatively common reproductive health concern which strikes deep into the psyche of couples experience it. Here in this case also they are suffering from psycho social problems due to infertility since three years. Moreover, no significant pathology was detected in both partners. It also worsened the psychological status of the couple. Thus, this case can be clearly considered as a case of unexplained infertility according to the contemporary science. In this case also, no obvious cause was detected and treatment was planned

according to above principle. Here in this case important consideration was given to Vataanulomana, because proper functioning of Vatadi Dosha’s necessary in every aspects of fertility (For proper functioning of Hypothalamic –pituitary –ovarian axis, ovulation, ascending of sperm through the female reproductive tract to reach the tube, fertilization, implantation etc.).

From the history of patient, it is evident that she is having Apanavata Dushti, as she is suffering from constipation. All disease occurs due to the imbalance in Agni (the digestive fire) and Agni is the single most important factor in buildup of Ama. More over patient was suffering from reduced appetite. Thus, the treatment was planned for ensuring Vataanulomana, Agnideepana, Satwavajaya Chikitsa and Swastya of Garbhasambhava Saamagri.

Conclusion

Infertility is becoming a burning issue since past decade and this is mainly due to the combination of environmental, social, psychological and nutritional factors. In contemporary medicine, treatment focusing on correcting dysfunction diagnosed with the several diagnostic tests. Moreover, the complications arising due to the infertility management including hormonal therapy, ovulation induction and invasive diagnostic techniques are huge. In cases of unexplained infertility, life style modifications and ART (Artificial reproductive techniques) are only treatment option available. But the success rates are less and highly expensive too. Ayurveda on the other hand, looks deeply into the individual constitution, and aims to enhance the functioning of body systems that participate in the process of fertilization in totally. From this case study itself it is clear that systematic approach with ayurvedic principles are effective in managing infertility as an effective, natural, safe and cost effective method. But this is mere a case report and further studies with proper research design is necessary for the scientific validation.

Reference

https://en.wikipedia.org/wiki/Infertility surfed on 07.01.2022 at 6:13PM
https://www.who.int/news-room/fact-sheets/detail/ infertility as surfed on 07.01.2022 at 6:17 PM.

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Brazdova, A., Senechal, H., Peltre, G., & Poncet, P. (2016). Immune Aspects of Female Infertility. International journal of fertility & sterility, 10(1),1-10.https://doi.org/10.22074 /ijfs.2016. 4762.
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Manuscript Received	Review Round 1	Review Round 2	Review Round 3	Accepted
2022-01-17	2022-01-19	2022-01-26	2022-02-02	2022-02-09
Conflict of Interest	Funding	Ethical Approval	Plagiarism X-checker	Note
Nil	Nil	Yes	19%

Case Report

Infertility

Journal of Ayurveda and Integrated Medical Sciences