E-ISSN:2456-3110

Case Report

Unexplained Female Infertility

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 3 March
Publisherwww.maharshicharaka.in

Management of Unexplained Female Infertility through Ayurvedic treatment - A Case Study

Deepika Bhat P.1*, Mamatha K.2
DOI: http://dx.doi.org/10.21760/jaims.8.3.31

1* P. Deepika Bhat, First Year Post Graduate Scholar, Department of Prasoothi tantra and Streeroga, Sri Dharmasthala Manjunatheshwar College of Ayurveda, Udupi, Karnataka, India.

2 K.V. Mamatha, Professor and Principal, Sri Dharmasthala Manjunatheshwar College of Ayurveda, Udupi, Karnataka, India.

Infertility is an emerging health issue in present scenario. The term ‘Unexplained infertility’ may be applied to a couple who has failed to establish pregnancy despite an evaluation uncovering no obvious reason for Infertility or correction of the factors identified as probably responsible for infertility. It is commonly accepted that approximately 15% of couples will be determined to have unexplained infertility. Ayurveda explains female infertility as Vandhyatwa and Primary factors associated with Vandhyatwa are abnormalities in Garbha Sambhava Samagri. In this case study patient aged 29 years who was anxious to conceive since 10 years of married life seeking Ayurvedic treatment in SDM College of Ayurveda, Udupi was taken. Routine investigations of partners showed Normal Study. The line of treatment followed in this case was Vatanulomana, Shodhana, Rasayana, Vrishya, Garbhasthapana with psychological assurance which is most important for conception and the patient conceived.

Keywords: Unexplained infertility, Vandhyatwa, Ayurveda, Vatanulomana, Shodhana, Rasayana, Vrishya, Garbhasthapana

Corresponding Author How to Cite this Article To Browse
P. Deepika Bhat, First Year Post Graduate Scholar, Department of Prasoothi tantra and Streeroga, Sri Dharmasthala Manjunatheshwar College of Ayurveda, Udupi, Karnataka, India.
Email: 		P. Deepika Bhat, K.V. Mamatha, Management of Unexplained Female Infertility through Ayurvedic treatment - A Case Study. J Ayu Int Med Sci. 2023;8(3):165-168.
Available From
https://jaims.in/jaims/article/view/2354

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-01-28 2023-01-31 2023-02-07 2023-02-14 2023-02-21
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 17%

© 2023by P. Deepika Bhat, K.V. Mamathaand 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 2023;8(3)165
Bhat P et al: Unexplained Female Infertility through Ayurvedic treatment

Introduction

Reproduction is a biological process which plants and animals are capable of. Whereas human beings, being in a superior position among all living beings elevate it from a mere biological cum physiological process giving it a spiritual and psychic dimension. If this is not achieved it affects the mental and physical health of the couple and disturbs their family and social life. Infertility is the Inability to conceive within one or more years of regular unprotected coitus.[1] Infertility is a prevalent problem affecting about 10-12% of the couples worldwide. Infertility cases are rising due to stress, obesity, lack of exercise and environmental pollution. Unexplained infertility is earmarked to those couple who have undergone complete basic infertility work up and in whom there is no abnormality.

The disease entity Vandhyatwa is the closest approximation to unexplained infertility in the Ayurvedic Classification of diseases. Vandhyatwa is mentioned one among the Vataja Nanatmaja Vikaras.[2] Ayurveda has the best solutions for infertility, through Purificatory procedures and optimizing the functions of ‘reproductive tissues’ (Artava and Shukra Dhatu) in both Male and female.

Case Report

A 29 years old married, nulliparous woman and her 36 years old husband presented with the complaints of inability to conceive presented to the OPD of Shri Dharmasthala Manjunatheshwara Hospital, Udupi. In 10 years of married life, irrespective of unprotected sexual life, she has not conceived. On interaction with the couple, it was found that there were no contributing reasons for not having conception. Her IUI attempts failed 6 times and IVF failed thrice. The lady’s Menstrual cycles were regular and the bleeding period was for 4 days with dysmenorrhea on first 2 days. In the coital history no abnormalities were detected. No Contraceptive measure was adopted.

Examination
Dashavidha Pariksha

  • Prakrithi - Vatapitta
  • Vikriti - Vata
  • Sara - Madhyama
  • Samhanana - Madhyama
  • Satva - Avara
  • Satmya - Madhyama
  • Aharashakti - Madhyama
  • Vyayamashakti - Madhyama
  • Vaya - Madhyama
  • Pramana - Madhyama

On General examination

  • Built - Moderate
  • Pallor / Icterus / Cyanosis / Clubbing / Edema / Lymphedenopathy - Absent
  • Pt constantly worries about the conception and was anxious and stressful.
  • BP - 120/80 mm hg
  • Pulse - 74 bpm
  • Weight - 58 kg
  • Height - 152 cm.

Systemic Examination

CVS - S1 and S2 heard

CNS - Well oriented, conscious

RS - Normal Brochovesicular Sounds heard

P/A - Tenderness - Absent

No Organomegaly

Per Speculum and Per vaginal examinations were normal

Investigations: The semen analysis of her husband performed prior to IUI’s yielded normal results. All the Routine investigations including haematological, biochemical reports were normal.

Intervention: Following intervention was carried out and the patient. She was counselled and was advised to take Laghu, Ushna Ahara and to avoid Diwaswapna.

Date Treatment Given Shamanoushadhi
14/7/21 Abhyanga with Dhanwantara Taila followed by Bashpa Sweda Snehapana with Phalaghrita Virechana - 14 Vegas Gandharvahastadi Kashaya 3Tsp Tid
Shatapushpa Churna - 12 g OD  
17/8/21 Mustadi Yapana Basti Uttarabasti with Phalghrita (The couple was advised to try for conception for the next 3 months) Shatapushpa Churna 12g OD
Gandharvahastadi Kashaya 3 Tsp Tid
Kalyanaka Guda - 5g BD
7/12/21     Anuvasana Basti with 30ml Phala Ghrita+ 30 ml Kalyanaka Ghrita Vatankura Nasya for 5 days Abhyanga with Ksheerabala Taila Shashtikashali Pinda Sweda Phala Ghrita Pichu BVC with gold 1-0-1
Sukumara Ghrita 2 Tsp Bd
Garbhapala Rasa 1 Bd
Dadimadi Ghrita 2 Tsp Bd
T. Leptaden 2 Bd
Suvarna Bhasma 1 OD

Journal of Ayurveda and Integrated Medical Sciences 2023;8(3)166
Bhat P et al: Unexplained Female Infertility through Ayurvedic treatment

Result

The follow up consultation on 20/2/22 showed that patient was pregnant. Her LMP was on 13/1/22.UPT was positive on 20/2/22. She reported feeling great. She underwent FTND in the 36th week of her pregnancy without any complications and gave birth to healthy baby boy of body weight 2.86 kg on October 2022.

Discussion

The treatment principle adopted here was Vatanulomana, Shodhana, Rasayana, Balya, Vrishya, Garbhasthapana with psychological assurance. The main treatment course included Shodhana i.e., Virechana, Sthanika Chikitsa like Uttarabasti and Pichu along with Shamanoushadhis.

Virechana finds its application in Vandhyatwa, as it does Dhatuvishuddhi and increases the potency of seed(ovum).[3]

Virechana not only expels morbidity but roots out ailments, restores normal strength and complexion, brings about longevity.[4]

Vatanulomana was adopted to subside symptoms like dysmenorrhea. As Vata is mainly involved in Vandhyatwa and Basti is Paramoushadha for all Vata disorders.[5] Hence, Basti was given. Mustadi Yapana Basti was given because it has properties like Vrishya, Rasayana, Sadhyobalajanana and Dhatupushtikara[5], Drugs which are used in this basti like Bala are mentioned in Prajathapana properties. It also contains Ksheera which is Amritopama[6] Kalyanaka Ghrita is Balya, Mangalya and is Sheshta for Pumsavana.[7] Hence was used for Anuvasana Basti. It helped to treat her anxiety too. Phala Ghrita is Prajaavardhana.[8] It Primarily targets adaptogenic, rejuvenative, aphrodisiac and general strengthening of the reproductive tissues, anxiolytic and Antidepressant properties. It is beneficial for the health of Yoni. Hence, Uttara Basti with Phala Ghrita was given. Vatankura Nasya was given as it does Garbhasthapana. Kalyanaka Guda does Vandhyaamaya Nashana in Stree.[9] Shatapushpa is the best drug for Vandhya[10] as it is Artavajanaka.

The combined effect of all these treatments proved to be effective.


Conclusion

Infertility is becoming a burning issue since past decade which strikes deep into the psyche of couple. In contemporary medicine, treatment focuses on correcting the dysfunctions which are diagnosed based on diagnostic tests. Also, there are various complications due to the treatments like hormonal therapy, ovulation induction and some of the diagnostic tests. In Ayurveda, for any case, correct diagnosis based on Roga and Rogi Pariksha and timely management with properly advised lifestyle and diet always yields good results. The present study concludes that the holistic approach of Ayurvedic system of medicines gives miraculous effects even in the cases of Unexplained infertility.

Reference

1. Dutta DC. Textbook of Gynaecology, 8th edition, page no 188.

2. Sharma H.P., Commentary of Vidyotini Hindi on Kashyapa Samhita, Sutrasthana, Rogadhyaya, Chapter 27, verse 29, Varnasi: Chaukambha Sanskrit series,2009;146.

3. Sharma H.P., Commentary of Vidyotini Hindi on Kashyapa Samhita, Siddhisthana, Trilakshanasiddhiadhyaya, Chapter 2, Varanasi: Chaukambha Sanskrit series,2022;225.

4. Acharya YT, editor, Commentary of Chakrapani on Charaka Samhita, Sutrasthana; Upakalpaneeya Adhyaya, Chapter 15, Verse 22. Varanasi: Chaukambha Sanskrit Sansthan, 2015;96

5. Acharya YT, editor, Commentary of Chakrapani on Charaka Samhita, Siddhisthana; Kalpanasiddhi Adhyaya, Chapter 1, Verse 29. Varanasi: Chaukambha Sanskrit Sansthan, 2015; 682.

6. Acharya YT, (1st Ed), Sushruta Samhita of Sushruta, Sutrasthana: Annapanavidhi Adhyaya; Chapter 46, verse 428, Varanasi: Chaukambha Orientalia, 2017; 244.

7. Shastri Paradakara Hari Sadashiva, editor, Commentaries of Arunadatta ‘Sarvangasundara’ and ‘Ayurveda Rasayana’ of Hemadri on Astanga Hridaya of Vagbhata, Uttaratantra: Garbhavakrantishaareera Adhyaya, Chapter 6, Verse 26 ½ -31. Varanasi: Chaukambha Sanskrit Sansthan, 2018;364.



Journal of Ayurveda and Integrated Medical Sciences 2023;8(3)167
Bhat P et al: Unexplained Female Infertility through Ayurvedic treatment

8. Shastri Paradakara Hari Sadashiva, editor, Commentaries of Arunadatta ‘Sarvangasundara’ and ‘Ayurveda Rasayana’ of Hemadri on Astanga Hridaya of Vagbhata, Uttaratantra: Garbhavakrantishaareera Adhyaya, Chapter 34, Verse 63-67. Varanasi: Chaukambha Sanskrit Sansthan,2018;901.

9. Shastri Paradakara Hari Sadashiva, editor, Commentaries of Arunadatta ‘Sarvangasundara’ and ‘Ayurveda Rasayana’ of Hemadri on Astanga Hridaya of Vagbhata, Kalpasthana: Virechanakalpa Adhyaya, Chapter 2, Verse 17-20. Varanasi: Chaukambha Sanskrit Sansthan, 2018;364.

10. Sharma H.P., Commentary of Vidyotini Hindi on Kashyapa Samhita, Kalpasthana, Shatapushpaashatavareekalpa Adhyaya, Chapter 8, verse 17, Varnasi: Chaukambha Sanskrit series, 2022;281.


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