Introduction

Male infertility is defined by the World Health Organization (WHO) as the inability of a male to make a fertile female pregnant for a minimum of at least 1 year of regular unprotected intercourse. The male is solely responsible for about 20% of cases and is a contributing factor in another 30% to 40% of all infertility cases.^[1]

Infertility is two types Primary infertility denotes those patients who have never conceived. Secondary infertility indicates previous pregnancy but failure to conceive subsequently.^[2]

This is a case report of a 45 years old male patient with 5.2 years of married life, presented with primary infertility with investigation report of complete absence of actively-motile sperm count, was diagnosed as Asthenospermia with Sperm concentration 95 million/ml and Immotile sperms 90%, Sluggishly motile 10% and actively motile 00%. He has no history of any addictions or any systemic diseases.

In Ayurveda the chief constituents of our body, throughout the life is maintained by -tridosa, dhatus and malas (दोषधातुमला मूलं सदा देहस्या).^[3] So long as they are in their normal quantity, qualities and function, maintain the health of the body and when they become abnormal, causes many diseases.^[4]

There are seven Dhatu, all Dhatus have their Prakrita Karma. Shukra is the important essence of the body, which is the Antim Dhatu (last Dhatu) among seven Dhatus. The specific function of Shukra is Garbhotpadan.^[5] Sukra is the Prasada Bhaga of Majja and from the Prasada Bhaga of Sukra Garbhautpatti occurs.^[6]

According to Charaka Samhita “The man alone without offspring looks like a single tree having single branch, shade less, fruitless and with foul smell”^[7]. Prakrita Karma of Shukra is Dhairya, Chyavana, Priti, Dehabala, Harsha and helps in production of progeny.^[8]

Charak Samhita and also in Sushrut Samhita explain about the Shukravaha Srotas & its Moolasthana (Vrisana, Sthana)^[9] (Vrisana, Sepha/Medra).^[10] Acharya Sushrut has proposed the following Shukradoshas - Vata, Pitta, Kapha, Shonita, Kunap, Granthi, Puti, Puya, Ksheena, Mutra, Purish, Retas.^[11]

Lymphadenopathy - Not palpable

Astavidha Pariksha

Nadi - Vata-Pittaja predominent
Mala - Mridukostha
Mutra - Samyak
Jihwa - Amayukta/Alpo-sama
Sabhda - Normal/Spasta
Sparsha - Normal body temperature (Anushna-Sheeta)
Drik - Samyak Dristi
Akruti - Madhyam

Samprapti

Materials and Methods

Deepan-Pachana

For Amapachana and Koshtha Shodhana 10gm Panchakol^[12] Churna mixed with 1 litre of Luke warm water to be consumed whole day for 7 days.

Shodhana Chikitsa

After Amapachana - Abhyantara Snehapana Start with Phala Ghrita for 7 days

Before treatment the Sperm count was 50.4 million/ml and after treatment, it increased to 82.7 million/ml and after 3 months of follow-up. Actively motile % increased from 50% to 58%.

Figure 1: Before Treatment Report

Discussion

Asthenospermia, is the reduced or poor sperm Mortality, a condition in which sperm have difficulty moving or reducing their ability to reach and fertilize an egg.^[15] Shukradushti Is the Causative Factor for The Infertility. Ksheenashukra is a type of Shukradushti, the Lakshana of Sukrakshaya is-Chirata Prashichate (Karmakartari)^[16] that means Takes long time to ejaculation or difficulty in ejaculation or we can consider that means reduce the sperm mortality. So, Sukra Kshaya/Sukra Ksheena can be correlated to Asthenospermia.

In this case study the treatment principle is follows as Sukrasodhana followed by Shukrajanan. Before Sukra Sodhana we have to maintain the Agni, if Agni is properly function Dhatupaka will be occur properly and Uttarattar Dhatu Poshan will be maintained and the Antim Dhatu, that is Sukra formed properly. Thats why we firstly gave Panchokol Churna, it is best Deepan-Pachan drug, contains Pippali, Pippali Mula, Chavya, Chitraka Mula and Sunthi. Rasa and Paka Properties of Panchkol is Katu and Ruchi Vardhak (Increase Appetite and Digestion). According to ancient it is best Deepan-Pachan Drugs for Amapachana and Agni Vardhana.^[17] So, it helps to increase and maintain the Agni and Dhatu Paka.

After proper Amapacana, Abhyantara Snehapana given with Phalagrita. In Astanga Hridaya mentioned, in male Infertility should be given Madhura Gana Ausadhiya Samskara with Ghrita or Milk.^[18]. So, in terms of increasing the Sperm Motility and sperm count by Using Milk/Ghrita Samskrita Madura-Ausadha like- Jeevaniya Gana Drugs. Sharangadhara, Vagabhata, Yogaratnakar and Bhavaprakash also mentioned Phalaghrita in the treatment of Vandhyatva. Sukra Kshaya is the Vata-Pitta aggravated disease.^[19]

In Sukrakshya the Ruksha Guna of Vata and Ushna Guna of Pitta is increased.^[20] In Phalagrita the ingredients like Manjistha, Kustha, Tagara, Meda, Kakoli, Satavari, Milk, Ghrita etc. Ghrita has Tridosh Shamak Guna,^[21] Milk is Vata-Pitta Shamaka and the other ingredients are Sukra Sodhak and some Sukra Janak. So, Phala Ghrita has Tridosha Samak, Rasayana and Vajikarana properties. So, this drug was selected for oral administration for Abhyantara Snehapana.^[22]

Declaration of Patient Consent

The authors certify that they have obtained all appropriate patient consent. The patient has given his consent for his clinical information to be reported in this journal. The patient was assured that his initials will not be published and due efforts will be made to conceal the identity.

References