Ayurvedic management of Infertility - A Case Report

Ashwini Appasaheb Bargi

doi:http://dx.doi.org/10.21760/jaims.8.5.45

Ayurvedic management of Infertility - A Case Report

Appasaheb Bargi A.^1*

DOI: http://dx.doi.org/10.21760/jaims.8.5.45

^1* Ashwini Appasaheb Bargi, Assistant Professor, Department of Kayachikitsa, SBG Ayurveda Medical College, Belagavi, Karnataka, India.

Infertility is defined as inability to conceive after 12 months of unprotected sexual intercourse. Infertility can be attributed primarily to male factors in 25%, female factors in 58%, and is unexplained in about 17% of couples.[1] It affects millions of people and has an impact on their families and communities. Estimates suggests that approximately one in every six people of reproductive age worldwide experience infertility in their lifetime.[2] Abnormalities in menstrual function constitute the most common cause of female infert.ility. Other disorders include ovulatory dysfunction, abnormalities of the uterus or outflow tract and psychological stress.[5] In this case study a female patient aged 29 years was unable to conceive since 2 years of marital relationship seeking for Ayurveda line of treatment. From detail history Agnimandya, Ama and stressful condition in work pattern were noticed. She was treated with classical Vamana followed by Shamana treatment. Agnidipana, Amapachana, Vamana, Matra Basti and oral medicines were started. Relaxation technique mediation was advised to the patient. After 2 months the urine pregnancy test was found to be positive and the same was confirmed by ultrasonography

Keywords: Infertility, Garbha Sambhava Samagri, Vamana, Matra Basti

Corresponding Author	How to Cite this Article	To Browse
Ashwini Appasaheb Bargi, Assistant Professor, Department of Kayachikitsa, SBG Ayurveda Medical College, Belagavi, Karnataka, India. Email:	Ashwini Appasaheb Bargi, Ayurvedic management of Infertility - A Case Report. J Ayu Int Med Sci. 2023;8(5):260-264. Available From https://jaims.in/jaims/article/view/2477

Introduction

Infertility is defined as inability to conceive after 12 months of unprotected sexual intercourse. Infertility is a serious health issue worldwide affecting approximately 8%-10% of couples worldwide. According to a report by WHO one in every four couples in developing countries is affected by infertility. In India the estimated prevalence of primary infertility among reproductive age group women is 11.8%. Primary infertility is a serious health issue which impacts on couples and society.^[6] Infertility in females is caused due to problems with the ovary, uterus, fallopian tube, endocrine glands- hormones, psycho-logical status.^[7] Infertility is classified as primary and secondary. Primary infertility is the condition, where the couple had never conceived.

According to Ayurveda important factors for conception are Ritu - fertile period for conception, Kshetra - healthy reproductive organs, Ambu - proper nutrition after conception, Beeja – healthy Sperm and ovum. Charaka Acharya has mentioned Soumanasya - peaceful psychological status in partners is one of the important factors for conception.^[8] The Apanavata regulates the reproductive functions, also has a major role.

In this case study Shodhana procedure was done – Vamana as Amahara and Kaphahara Chikitsa, Matra Basti was given to stabilize the Apana Vata (Vata Anulomana) followed by Shamana Chikitsa. Relaxation technique mediation was advised to the patient. The treatment was proved to be effective.

Case Report

A 29 years old married female patient, software engineer by occupation visited to the OPD with the complaints of inability to conceive 2 years of unprotected sexual life. The menstrual cycle was irregular and scanty bleeding 2-3 days per month.

Investigations were done previously; semen parameters of male were found to be within normal.

In female haemoglobin was 9 gms/dl, ultrasonography report showed polycystic appearance of right ovary and left ovarian simple cyst 1.8x1.1 cm.

The history suggests that patient was anxious to conceive and has psychological stress.

Past history: No H/o DM/HTN/Thyroid dysfunction or any other major medical and surgical history.

Family history

Mother - DM

Personal history

Diet - Mixed

Appetite - Reduced

Bladder - Normal frequency

Bowel - 1 time a day not clear

Sleep - Disturbed

Menstrual history

Age of menarche - 14 years

35 days cycle / 2-3 days scanty bleeding without foul smell and clots absent.

Obstetrical history - P0 L0 A0 D0

Contraceptive - Natural method

General examination

Built - Moderate

Nourishment - Moderate

Pulse - 78 bpm

BP - 110/70 mmHg

Temperature - 98.4°F

Respiratory rate - 18 cycles/min

Height - 152 cm

Weight - 48kg

BMI - 19.4

Tongue - coated

Pallor - present

Icterus / Cyanosis / Clubbing / Edema / Lymphadenopathy - Absent

Systemic examination

CVS - S1 S2 Normal

CNS - Conscious, well oriented

RS - Normal vesicular breathing no added sounds

P/A - Soft, no tenderness and organomegaly absent

Ashta Vidha Pareeksha

Nadi - 78/min

Mutra - 4-5 times a day

Mala - once a day not clear

Jihwa - Lipta

Shabda - Prakruta

Sparsha - Prakruta

Druk - Prakruta

Aakruti - Madhyama

Dashavida Pareeksha

Prakruti - Vata-Pitta

Vikruti - Kapha

Sara - Madhyama

Samhanana - Madhyama

Pramana - Madhyama

Satmya - Madhyama

Satva - Madhyama

Intervention

1. Dipana Pachana - Tab. Chitrakadi Vati - 1 tab B/F twice a day and Tab. Arogyavardhini Vati 1 tab thrice a day A/F for 3 days with warm water

2. Arohana Snehapana - Guggulutiktaka Ghrita

3. Vamana with Madanaphala Churna and Yastimadhu Phanta

4. Sahacharadi Taila Matra Basti 20ml night daily

5. Shamana Aushadhi

a. Sukumara Kashaya 15 ml BD A/F with warm water

b. Chandraprabha Vati - 2 tab BD A/F with warm water

c. Dhatri Loha 1 tab BD B/F with warm water

d. Rajani Yoga 1 tab BD B/F with warm water

e. Churna combination - Avippatikara Churna, Haritaki, Yastimadhu, Musta, Gokshura, Ashoka, Punarnava, Tamra Bhasma ½ tsf twice a day with warm water B/F

f. Castor oil 1 tsf with warm milk night

Lab investigations

Observation and Results

Date	Treatment	Medicine/procedure
26/8/2022	Agnidipana and Amapachana	Tab. Chitrakadi Vati 1 tab B/F twice a day and Tab. Arogyavardhini Vati 1 tab thrice a day A/F for 3 days with warm water.
29/8/2022	Snehapana	Guggulutiktaka Ghrita 30 ml- 1st day at 7: 15am 60 ml- 2nd day at 7:30 am 90 ml -3rd day at 7:20 am
1/9/2022	Vishrama Kala	Sarvanaga Abhyanga with Murchita Tila Taila followed by Bhashpa Sweda Kapha Utkleshakara Ahara - Curd rice, Jilebi, Lassi and Dahivada
2/9/2022	Vamana Karma	Madanaphala Churna 10 gms Pippali - 2gms Saindava Lavana - 2gms Yastimadhu - 4 gms Churna are mixed with Ushna Jala administered at 8:00 am Number of Vegas - 6 Vegas Pathya - Ganji, Kichadi, Rice dal, Ushna Jala Dhumapana with Haridradi Varti
3/9/2022 -7/9/2022	Samsarjana Karma
7/9/2022	Shamanoushadhi 1st visit	1. Tab. Arogyavardhini Vati 1 tab BD A/F with warm water
		2. Tab. Chandraprabha Vati 2 tab BD A/F with warm water
		3. Sukumara Kashaya 15 ml BD A/F with warm water
		4.Churna combination - Avippatikara Churna,Haritaki, Yastimadhu, Musta, Gokshura, Ashoka, Punarnava, Tamra Bhasma ½ tsf twice a day with warm water B/F
		5. Castor oil 1 tsf with warm milk night
22/9/2022	Shamanoushadhi 2nd visit	Above medications plus
		1. Dhatri Loha 1tab BD B/F with warm water
		2. Tab. Rajani Yoga 1 tab BD B/F with warm water
		3. Sahacharadi Taila Matra Basti 20ml night daily

After Shodhana - Vamana, Basti and Shamana treatment the patient got regular cycle and conceived on 2^nd cycle of Ayurvedic treatment.

Discussion

Vandhyatva or Infertility is the major leading problem which affects the mental and physical health of couples. The reports were analysed there were development of cysts in both the ovaries, the Chikitsa adopted was Rukshana and Kaphahara. Initially the Agni was corrected with Dipana Pachana drugs, Chitrakadi Vati acts ats at level of Koshta and Arogyavardhini Vati acts as Dipana Pachana and Medohara at the level of Dhatu. Snehapana was done by Guggulutiktaka Ghrita as it acts as Tridoshahara and also possess Lekhana property.

Shodhana procedure - Vamana was adopted as it removes the accumulated Doshas and clears Abhishyandi from Srotas and helped for proper absorption of medicines.

Sukumara Kashaya having properties like Dipana, Tridosha Shamana, Anulomana and indicated in Yoniroga and Udavarta helped in the above case. Tab. Chandraprabha Vati indicated in Kapha Medovikara acts as Agnidipana, Tridoshahra, possess Lekhana property helped in dissolving the cysts.

Dhatri Loha was advised as haemoglobin level of the patient was below normal. Tab. Rajani Yoga was advised as Haridra is the major ingredient and it acts as potent Raktashodhaka Dravya.

The drugs used in Churna combination possess Ruksha Guna, Tridoshahara, Vatanulomana, Agnidipana, Amapachana and Kapha Medohara properties.

Eranda Taila has properties of Ushna, Vata Anulomana helps in ovulation and acts as Avaranahara.

Sahacharadi Taila Matra Basti helps in regulating the Apana Vata Vikruti as Apana Vata Dushti is the major cause for Vyandhyatva. Acharya Charaka described Agroushada for Garbhadana as Soumanasya (peaceful mind). In present case couple was suffering with psychological stress due to continuous work using computers and sedentary lifestyle, hence relaxation techniques and meditation was advised.

Conclusion

Infertility affects both male and female partners especially physical, mental, emotional and social health of women. From the above case study Ayurvedic line of management for infertility was effective for successful conception. The overall treatment showed effect as Tridoshahara, normalizing the Apana Vata Dushti hence benefited the patient. The cause should be properly identified and treated to obtain results. Hence by adopting both Shodhana and Shamana treatment the present case was successfully managed.

Reference

1. Anthony S. Fauci, [et al.], Harrison’s Principles of Internal Madicine. 17th edition, Vol-2. New York: published by McGraw-Hill Education copyright- 2008, chapter 341, P-2330

2. https://www.who.int/news-room/fact-sheets/detail/ infertility

3. Maharshi Sushruta, Sushruta Samhita, Ayurveda Tatva Sandipika hindi commentry. Edited by Kaviraja Ambikadutta Shastri, Foreword by Dr. Pranajivana Manekchanda Mehta, published by Chowkambha Sanskrit Sansthan Varanasi Reprint edition -2009, Sharira sthana 2/35 P-19

4. Agnivesha, Charaka Samhita, with Ayurveda Dipika commentary of Chakrapanidatta, Edited by Vaidya Jadavaji Trikamji Acharya, Publishers Chaukhambha Orientalia Varanasi, Reprint Edition: 2015, Sharira sthana 3/3, P-308

5. Anthony S. Fauci, [et al.], Harrison’s Principles of Internal Madicine. 17th edition. Vol-2 New York: published by McGraw-Hill Education copyright- 2008, chapter 341, P-2331

6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6881900/

7. Anthony S. Fauci, [et al.], Harrison’s Principles of Internal Madicine. 17th edition. Vol-2 New York: published by McGraw-Hill Education copyright- 2008, chapter 341, P-2331

8. Agnivesha, Charaka Samhita, with Ayurveda Dipika commentary of Chakrapanidatta, Edited by Vaidya Jadavaji Trikamji Acharya, Publishers Chaukhambha Orientalia Varanasi, Reprint Edition: 2015, Sutra sthana 25/40, P-131

Manuscript Received	Review Round 1	Review Round 2	Review Round 3	Accepted
2023-03-21	2023-03-23	2023-03-30	2023-04-06	2023-04-13
Conflict of Interest	Funding	Ethical Approval	Plagiarism X-checker	Note
Nil	Nil	Yes	18%

Case Report

Infertility

Journal of Ayurveda and Integrated Medical Sciences

Ayurvedic management of Infertility - A Case Report

Appasaheb Bargi A.1*

Introduction

Case Report

Observation and Results

Discussion

Conclusion

Reference

Appasaheb Bargi A.^1*