Journal of Ayurveda and Integrated Medical Sciences

Recurrent pregnancy Loss is defined as the sequence of 2 or more spontaneous abortions as documented by either sonography or on histopathology before 20 weeks.^[1] It may be primary or secondary (having previous viable birth). Spontaneous pregnancy loss is a surprisingly common occurrence, whereas approximately 15% of all clinically recognized pregnancies pregnancies result in spontaneous loss, there are many more pregnancies that fail prior to being clinically recognized.^[2] More than one factor may operate in a RPL case and after a complete evaluation, the causes of RPL can be determined in two-thirds of cases. The most common factors are Genetic, Anatomic, Endocrine, Infections, Autoimmune and non APS thrombophilias. Identification and treatment of problems significantly increases the successful outcome in most cases. Male factors also play an important role in healthy pregnancy. Advanced paternal age, many environmental factors, such as cigarette smoking, obesity, exogenous heat, and exposure to toxins, have been associated with increased risks for pregnancy losses. In conventional system of medicine it is advised that the treatment should be directed towards any treatable cause, and may incorporate in vitro fertilization along with preimplantation genetic diagnosis, use of donor gametes, and surgical correction of anatomic abnormalities, correction of endocrine disorders, and anticoagulation or folic acid supplementation. Antenatal counselling and psychological support should be recommended to all the couples with RPL, as this helps to improve the pregnancy success rates. Prognosis will depend on the underlying cause for pregnancy loss and the number of prior losses.

Recurrent pregnancy loss can be correlated with Puthraghni Yonivyapath and Garbhasravivandhya Vandhya explained in Ayurvedic classics. Puthraghni is a Yoniroga characterised by repeated pregnancy losses due to the excessive use of Rooksha Ahara and Vihara which leads to Vata Prakopa further causing Shonita Dusti and Artava Dusti which inturn results in repeated loss of pregnancy. Acarya Caraka classified this under Vatika Yonivyapath whereas Acarya Susruta considered it as Paithika Yonivyapath. Acarya Susruta explained that in this condition, the foetuses are repeatedly destroyed

Recurrent pregnancy Loss is defined as the sequence of 2 or more

spontaneous abortions as documented by either sonography or on histopathology before 20 weeks. It affects approximately 1% to 2% of women. The causes of recurrent abortion are complex & obscure. More than one factor may operate in a case. At present there exist a small number of accepted etiologies for RPL. They are genetic factors, anatomic factors, autoimmune factors, Infections, endocrine factors and unexplained factors.^[1] After a complete evaluation, the cause(s) of RPL can be determined in two-thirds of cases. The two main concerns of couples with recurrent pregnancy loss who seek treatment are to explain them the reason for their pregnancy losses and to establish the chance for a successful live born child. The number of prior pregnancy losses also influences the forecast for future success; the chance of recurrence increases as the number increases, in a couple with unexplained RPL.

In Ayurveda Recurrent Pregnancy Loss can be correlated with Garbhasravi Vandhya explained in Haritha Samhitha and Puthraghni Yonivyapath explained in Brhathtrayees. In Vandhyatva Chikitsa the treatment should be aimed at rectifying the cause and a single line of management cannot be applied. In Garbhasravi Vandhya Sodhana Chikitsa followed by Samana Chikitsa according to the Doshas involved, should be followed. Acarya Caraka mentioned that only in a Sudha (healthy) Yoni which is achieved after Sodhana Chikitsa, conception will occur by the union of healthy gametes along with the descent of Jiva.^[5] Therefore Sodhana Chikitsa is mandatory before Samana Chikitsa to purify the body. For the management of RPL especially in unexplained losses, Ayurveda advises to do Shodhana Karma or purificatory therapies ending with Uttara Vasthi. In majority of RPL cases the cause is unknown. Healthy Ovum in female and healthy sperm in males completely depends on healthy metabolic processes in the body. Dhathwagni plays a pivotal role in the transformation of Rasa Dhatu to Shukra Dhathu, if any derangement in the Dhatvagni will results in the formation of improper or unhealthy Sukra and Artava (ovum) causing infertility or pregnancy losses.

The Ayurveda treatment protocol for recurrent pregnancy loss was found to be effective. About 42.3% had live births and 1 more patient will deliver within 2 weeks making a success rate of 46.15%. There will be chances of more patients getting pregnant in coming months as well. Ayurveda bestows a healthy and cost-effective method of treatment which not only helps to procure a healthy progeny but also enhance the physical and mental health of the couple.