E-ISSN:2456-3110

Case Report

Needling Back Fertility

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 8 August
Publisherwww.maharshicharaka.in

Needling Back Fertility: Ayurvedic Intervention with Microinvasive Viddhakarma in Enhancing Semen Quality and Sexual Function in Oligoasthenozoospermia - A Case Report

Nidhish Kumar S1*, Anupama V2, Jana P3
DOI:10.21760/jaims.10.8.47

1* Nidhish Kumar S, Final Year Post Graduate Scholar, Dept of Prasuti Tantra Evam Stri Roga, Sri Kalabhyraveshwara Swamy Ayurvedic Medical College Hospital and Research Center, Bangalore, Karnataka, India.

2 Anupama V, Professor and HOD, Dept of Prasuti Tantra Evam Stri Roga, Sri Kalabhyraveshwara Swamy Ayurvedic Medical College Hospital and Research Center, Bangalore, Karnataka, India.

3 Papiya Jana, Professor, Dept of Prasuti Tantra Evam Stri Roga, Sri Kalabhyraveshwara Swamy Ayurvedic Medical College Hospital and Research Center, Bangalore, Karnataka, India.

Infertility is a significant global health issue, with male factors accounting for nearly 40% of cases. Among these, oligoasthenozoospermia - a condition marked by reduced sperm count and motility - poses a considerable challenge. This case report presents the successful Ayurvedic management of a 36-year-old male diagnosed with oligoasthenozoospermia and mild erectile dysfunction, correlating with the classical condition of Shukra Kshaya janya Klaibya. The patient, a software engineer with a stressful lifestyle, night shifts, and disturbed sleep, exhibited poor semen parameters and psychological distress. An integrative Ayurvedic approach involving Shodhana (purificatory therapies) including Virechana, Basti, and Uttara Basti, followed by Shamana Chikitsa with Rasayana, Vajikarana herbs, Viddhakarma, Yogic practices, and dietary modifications was adopted. Marked improvement was observed in semen parameters, erectile function, and overall well-being, with normospermia achieved and conception confirmed. This case highlights the potential of Ayurvedic protocols in addressing male infertility through holistic, individualized, and multi-modal interventions, emphasizing their relevance in contemporary reproductive healthcare.

Keywords: Male infertility, oligoasthenozoospermia, Shukra Kshaya, Ayurveda, Virechana, Basti, Vajikarana, Rasayana therapy, erectile dysfunction, integrative medicine

Corresponding Author How to Cite this Article To Browse
Nidhish Kumar S, Final Year Post Graduate Scholar, Dept of Prasuti Tantra Evam Stri Roga, Sri Kalabhyraveshwara Swamy Ayurvedic Medical College Hospital and Research Center, Bangalore, Karnataka, India.
Email: 		Nidhish Kumar S, Anupama V, Jana P, Needling Back Fertility: Ayurvedic Intervention with Microinvasive Viddhakarma in Enhancing Semen Quality and Sexual Function in Oligoasthenozoospermia - A Case Report. J Ayu Int Med Sci. 2025;10(8):283-289.
Available From
https://jaims.in/jaims/article/view/4568/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-06-15 2025-06-27 2025-07-07 2025-07-17 2025-07-27
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Not required 10.36

© 2025 by Nidhish Kumar S, Anupama V, Jana P and 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].

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Nidhish KS et al. Ayurvedic Intervention in Enhancing Semen Quality and Sexual Function

Introduction

Infertility is a growing global health concern, affecting approximately 15% of couples of reproductive age, with male factors contributing to 30–40% of these cases. Among the male infertility cases, nearly 30% are attributed to abnormal semen parameters, including oligozoospermia (low sperm count), asthenozoospermia (reduced motility), and teratozoospermia (abnormal morphology).[1] This condition not only impacts the physiological ability to conceive but also contributes significantly to emotional distress, strained interpersonal relationships, and social stigma.[2] In Ayurvedic literature, the concept of fertility is deeply rooted in the integrity and vitality of Shukra Dhatu. Shukra Sampat—the optimum quality and quantity of semen is considered essential for the successful formation of Garbha (embryo), when all contributing factors such as Ritu, Kshetra, Ambu, and Beeja are present in harmony.[3] A decline in the quality of Shukra referred to as Shukra Kshaya, can be equated to the modern clinical conditions of reduced sperm quality and function.

The pathogenesis of Shukra Kshaya is often linked to the vitiation of Vata and Pitta Doshas, which causes Dusti in the Shukravaha Srotas. Vata, being responsible for movement and control, when aggravated, may hinder the proper ejaculation, erection and motility of sperm, while Pitta, governing metabolism and transformation, may cause oxidative damage to sperm morphology and DNA integrity. These subtle imbalances can manifest not only as infertility but also as sexual dysfunctions like erectile dysfunction, further complicating the clinical picture.

Modern lifestyle factors such as poor dietary habits, chronic stress, sedentary routines, exposure to environmental toxins, and excessive screen time contribute to oxidative stress, a major cause of sperm damage at the cellular level. Ayurveda, being a holistic science, views such dysfunctions not merely as isolated pathologies but as systemic imbalances that require a comprehensive approach to treatment.

Ayurvedic management of male infertility emphasizes a two-fold approach:

1. Shodhana Chikitsa (bio-purification therapies) aimed at cleansing system and balancing doshas,

2. Shamana Chikitsa (pacifying therapies) utilizing Rasayana (rejuvenative herbs), Vajikarana, dietary regulations, lifestyle modifications, and psychological support.

This case report presents patient with oligoasthenozoospermia & mild erectile dysfunction, managed successfully through an integrative Ayurvedic protocol involving both Shodhana & Shamana therapies. Case highlights potential of Ayurveda in restoring male reproductive health, improving semen parameters, & enhancing overall vitality & quality of life.

Case Report

Patient Information: A 36-year-old male software engineer presented with a history of subfertility and reduced erection strength from six months. No history of testicular trauma and surgeries was reported. The couple had a history of one spontaneous abortion at two months post-conception five years prior. His lifestyle involved night shifts, high work stress, disturbed sleep, and mixed diet consumption.

Clinical Assessment

General and systemic evaluations were within normal limits.

Urogenital examination

  • Penis: Soft, non-tender,
  • Glans: Dark pinkish, no ulcer,
  • Urethral meatus: Center, non-discharge,
  • Scrotum: Rugae present, no scar mark,
  • Testis: Bilateral soft, non-tender,
  • Spermatic cord: Soft, movable, non-tender,
  • Femoral region: No swelling, non-tender,
  • Inguinal Region: No swelling, non-tender
  • Cremasteric reflex: Present.

Ayurvedic Evaluation

  • Prakriti - Vatakapha
  • Vikruti - Dosha - Vata Pittaja, Dushya - Rasa, Rakta, Shukra
  • Desha - Jangala
  • Bala - Madhyama
  • Sara - Madhyama

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  • Samhanana - Madhyama
  • Satva - Madhyama
  • Ahara Shakti - Madhyama
  • Abhyavarana Shakti - Madhyama
  • Jarana Shakti - Avara
  • Vyayama Shakti - Madhyama
  • Vaya - Madhyama

Nidana

Ahara - Katu, Rooksha Ahaara Sevana
Vihara - Ratri Jagarana and Atichinta
Roopa - Unable to conceive, Decreased erection strength

Samprapti:

Nidana
↓
Jataragni Mandya
↓
Ama and improper Rasa Dhatu formation
↓
Improper Shukra formation
↓
Shukra Dusti and Kshaya

Samprapti Ghataka

  • Udbhava Sthana - Amashaya
  • Sanchara Sthana - Shukravaha Srotas
  • Vyakta Sthana - Vrushana And Shishna
  • Adhishtana - Vrushana
  • Vyadhi Marga -Abhyantara
  • Sadhya Sadhyata - Yapya Sadhya

Laboratory Investigations

  • Hb: 12.5 gm%,
  • WBC: 9000/cmm,
  • ESR: 22 mm/hr,
  • FSH: 7.2 mIU/mL,
  • Testosterone: 600 ng/dL

Semen Analysis

  • Patient reported to us with a previous semen analysis dated 27/6/2023: Asthenospermia.
  • 8/11/2023: Oligoasthenozoospermia (Two semen analysis report in a gap of 3-6 month is ideally used for confirming)

Physical Examination27/6/20238/11/2023
Volume3ml3ml
Liquification time3o min30 min
ViscosityNormalNormal
Chemical Examination
FructosePresentPresent
PH7.08.0
Microscopic Examination
Total sperm count25.5 million/ml2 million/ml
Sperm motility
Rapid progressive30%20%
Non progressive20%30%
Immotile50 %50%
Sperm Morphology
Normal forms60%
Abnormal forms70 %40%
Pus cell3010-12/hpf
RBCNilNil
Epithelial cell1-2/hpf2-4 /hpf
AgglutinationNilNil

Sexual Health Inventory for Men score - 19

jaims_4568_01.JPG

Diagnosis

  • Modern: Oligoasthenozoospermia with mild erectile dysfunction
  • Ayurvedic: Shukra Kshaya janya Klaibya

Treatment Plan

Treatment Plan Based on the above Samprapti, here the medical line of treatment was planned to address the patients concern. To alleviate the effect of Dushita Vata and Pitta on Shukrotpatti, the best possible way is to reverse the Samprapti was by Nidana Parivarjana for breaking the root of Samprapti, scavenging body through Shodana and correcting the Vikruthi through Shamana Chikitsa, thereby helping to overcome the infertility issue in the present condition, which was addressed through the following methods.

Methods

A. Shodhana Chikitsa

1. Virechana was given.


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  • Deepana Pachana: Agni Tundi Vati 2 tid, after food with Ushna Jala Anupana given for three days.
  • Snehapana: Kalyanaka Ghrita was given for drinking in Arohana Krama started with 30 ml, and increased 30 ml each days for five consecutive days, on the 6th day morning, the Samyak Snigdha Lakshana was obtained.
  • Vishramakala: Followed by Snehapana, Sarvanga Abhyanga with Baspa Sweda for three days was given.
  • Virechana: On the third day of Vishramakala, after Sarvanga Abhyanga and Bashpa Sweda, patient was given Trivrit Lehya 90 grams at 8.00AM with Ushnajala Anupana. Patient had about 22 Vegas, he was hemodynamically stable after Shuddhi and initiated Madhyamashuddhi Samsarjana Karma for five days classically.

2. Basti was given

  • Erandamooladi Niruha Basti was given in Yoga Basti pattern
  • Anuvasana with Shatavari Ghrita - 120 ml
  • Niruha with Erandamooladi Kashaya
  • Uttara Basti with Phala Sarpi - 10-20ml on days of

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jaims_4568_04.JPG

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B. Shamana Chikitsa

After the completion of Samsarjana karma and obtaining of Prakrita Bala, the patient was advised the following Shamana Chikitsa

jaims_4568_06.JPG


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1. Sarvangasana - Yogik postures were advised for the first seven days for five minutes, then gradually increased to ten minutes per day once in the morning regularly.

2. Viddhakarma - using 28 and half needle, Viddhkarma was performed over the genital points thrice a week for 1 month.

3. Shukra Prasadana & Shukrala - Vanari Kalpa 2tsp tid with milk and T Addizoa one tid, till the desired results are obtained.

4. Pathya - Kshira, Masha, Aja Mamsa, Mudga, Unpolished rice.

5. Apathya - Ushna, Katu, Tikshna, Ati Lavana, Ati Vyayama

Results

The patient reported marked improvements in semen parameters (normospermia by 06/07/2024)

Physical Examination06/07/2024
Volume1 ml
Liquification time30 min
ViscosityNormal
Chemical Examination
FructosePresent
PH7.3 ml
Microscopic Examination
Total sperm count20 million/ml
Sperm motility
Rapid progressive60%
Non progressive10%
Immotile30%
Sperm Morphology
Normal forms55%
Abnormal forms45%
Pus cell3-4/hpf
RBCNil
Epithelial cell1-2 /hpf
AgglutinationNil

SIMHS Score revaluated - 23
UPT positive on 27/8/24
Erection strength, sleep quality, and psychological wellbeing. No adverse effects were noted

Discussion

Tri Upastambhas (Nidra, Ahara and Abrahmacharya) are very basic need of any living system for the survival and continuation of life, In Charaka Chikitsa Sthana Vajikarana Adhyaaya,

importance of parenthood has been explained beautifully. Here having children is not only to develop his generation, but it also matter of social respect & pride.[4] If couple doesn’t have progeny in specific time, then it leads to stress, & other social problems, mainly psychological issues would manifest. Modern system of medicine with its advancement of technological innovations, has went long way ahead in infertility care. But it is always unparallel with natural way of giving birth. In this regard Ayurveda offers wonderful treatment possibilities, without causing much distress to patient. Shukra Kshaya is disorder in which depletion of Shukra is observed both qualitatively & quantitatively, & which is major cause for infertility. To understand pathogenesis of Shukrakshaya it is important to know about formation of Rasa Dhatu, decrease of Rasa Dhatu finally leads to diminution of Shukra (sperm count). Formation of Rasa Dhatu is affected when there are Jatharagni Mandya along with vitiation of Apana, Vyana Vayu. Shukra Kshaya under Shukradusti in which Vatadosha along with Pitta undergoes vitiation, channel which carry Shukra undergoes Dushti due to factor like Ratri Jagarana, stress & Krodha. Virechana indicated in Yoni & Shukra Roga was performed. Virechana helps to relieve Shotha, it helps to remove Sthanikapitta & Rakta Dosha Dushti, & also helps to re-establish movement of Vata (Vatanulomana), which is very important in Dhatu Utpatti & crucial for proper absorption of Vajikarana Dravyas.[4] Erandamooladi Niruha Basti by virtue of its drugs processing properties like Vrushya, Vataharanam corrects impaired Vayu. Uttarabasti with Phalasarpi is considered as both Snehana & Shodana tackles Vata-Pitta Dusti at level of Shukra Dhatu there by normalising Reto pariksha.[5] Sarvangasana was advised initially for five minutes daily, followed by 10 minutes once daily. It mainly helps to regulate blood circulation in spermatic veins, thus helps to restore normal spermatogenesis.[6] Viddhakarma, minimally invasive procedure rooted in Ayurvedic Shalyatantra, offers targeted, localized detoxifica-tion & neurovascular stimulation modality.[6] In present case, Viddhakarma was employed at strategic sites:

1. Root of the penis (dorsal shaft region) - near the dorsal penile vein
2. Midshaft region - where neurovascular bundles travel
3. Scrotal septum - corresponding with perineal venous plexus and pudendal nerve pathways


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These sites were selected based on the understanding of penile and scrotal anatomy in relation to Srotas (channels) and Marma points involved in Shukravaha Srotas.[2] The dorsal penile vein is involved in venous outflow regulation, and its controlled stimulation may facilitate improved hemodynamics. Similarly, the scrotal septum is in proximity to the external pudendal vein and perineal nerve branches, which when stimulated may enhance local nitric oxide release and neuromuscular responsiveness, thus improving erectile capacity.[8] For Shukra Prasadana and Shukrala an herbal formula comprising of extracts of Withania somnifera, Tribulus terrestris, Mucuna pruriens, Chlorophytum arundinaceum, Asparagus racemosus, Sida cordifolia as key ingredients to increase the quality and quantity of Shukra Dhatu. Musali is a well-known drug for Shukrotpatti, has Madhurarasa and Sheetavirya, has Balya, Brimhana and Rasayana, Vajikarana property, it is extremely useful in Shukrakshaya.[9] All the above drugs are known Shukrotpadaka and Shukraprasadaka Dravyas. Along with all these medications it is very important to follow the Pathyaharas, and avoid all contra indicated Ahara which are antagonistic to the Utpatti of Shukra. With the above treatments, the semen analysis patient shows a remarkable progress in the quantity and quality of the semen.

Conclusion

This case demonstrated the effectiveness of a classical Ayurvedic management plan in a patient with oligoasthenozoospermia and mild erectile dysfunction. Integrating classical principles with modern diagnostics offers promising outcomes in male subfertility management. the treatment protocol followed in the present study which aimed not only correcting the report but also targeted the Dosha Dusti in Ayurveda Reto Pariksha Further clinical trials are warranted to substantiate these outcomes in larger sample sizes.

References

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jaims_4568_07.JPG
Reported on 27/6/23, Impression - Astheno Spermia


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jaims_4568_08.JPG
Reported on 08/11/23, Impression - Oligosthenospermia


jaims_4568_09.JPG
Reported on 06/07/24, Impression - Normospermia

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