Ayurvedic management of Female Infertility:

Female Infertility and its Ayurvedic treatment:

Ayurvedic synonyms of female infertility:
Vandhya, Vasha, Avatoka, Avakeshi, Stravad garbha, Aphala

Definitions (according to different Ayurvedic classics):

• ‘Vandhya’-  The word ‘Vandhya’ is derived from the root “Vandh” with “Yak” Suffix, which means barren, unproductive, fruitless and useless.
• ‘Vandhya’-  The woman in whom there is a hindrance of any kind to the normal process of conception is called ‘Vandhya’.
• ‘Vandhya’- A woman, in whom ‘Artava’ (menses) has been destroyed, is termed as ‘Vandhya’.
• ‘Vasha’ –  A woman who does not conceive is called ‘Vasha’.
• ‘Avatoka’-  A woman who has missed abortion is called ‘Avatoka’.
• ‘Avakeshi’-  A woman who is devoid of ‘Putrasukha’ and ‘Prasavasukha’ is called ‘Avakeshi’.
• ‘Stravad Garbha’-  A woman who miscarries frequently is termed as ‘Stravad Garbha’.
• ‘Aphala’-  A woman without progeny is ‘Aphala’.

Classification:
The Classification of Vandhyatva has not been given seperately in any classics except ‘Harita Samhita’ (Textbook of Ayurveda written by Sage Harita). ‘Harita’ has described six types of ‘Vandhya’ (Female infertility) with special clinical features. (1) Kakavandhya -The woman who has one child but second time she is not conceived. (2) Anapatya – The woman who has no child or primary infertility. (3) Garbhasravi – The woman who has repeated abortion. (4) Mritvatsa – The woman who has repeated departed births. (5) Balakshaya – Infertility due to loss of ‘Bala’ (strength).
(6) Unexplained – Infertility due to idiopathic cause.

Factors responsible for female infertility:
Many factors are responsible for ‘Vandhyatva’(female infertility).
These are classified into two types. [A] Essential factors,  [B] Causative factors
[A] Essential Factors for Infertility:
Under this heading first we should know about the basic needs for the process of fertilisation, so we can better evaluate the causes which disturb the entire process of fertilisation, resulting in infertility.
Basic requirements for process of fertilisation:
For the achievement of conception and for better understanding of the entire process of fertilisation, Sushruta (School of Ayurvedic surgery) has given simile with the germination of a seed by saying that,
ध्रुवं चतुर्णाम्… (Sushruta Samhita Chapter 2/ Verse 33)

• Rhitu:  Rutu means Rajaha-Kala i.e. Ovulation period.
  Deposition of the sperms in the upper vagina should be in appropriate time of the female cycle.

• Kshetra: Anatomically and physiologically adequate reproductive organs.
  Vagina must be healthy. Cervix and its secretion are also permitted to pass sperms. The ovarian duct must be patent and sufficient cilliary movement is present. The uterus must be capable of supporting implantation and foetal growth throughout pregnancy.

• Ambu: Proper nourishment to genital organs, adequate hormonal level and proper nutrition is required for genital organs.

• Beeja: The adequate ovum & sperms and the female ovulation mechanism must be normal. The male must produce an adequate number of normal sperms.

In the practice so many cases are seen, in which all above factors are fulfilled, yet pregnancy cannot take place. This condition is known as idiopathic Vandhyatva. This condition can be explained by the ‘Atmaja’ and ‘Satvaja Bhavas’ of Sage Charaka described in Charaka Samhita (A Textbook of Ayurvedic medicine). Thus, any abnormality in these essential factors, cause ‘Vandhyatva’ (Infertility).

[B] Causative Factors for Infertility:
Without ‘Vāta Dosha’ the ‘Yoni’ never gets spoilt. ‘Vāta’ is the prime causative factor of ‘Vandhyatva’(Infertility).

• YONI PRADOSHAT:
  The word “Yoni” refers to entire reproductive system. Thus under this heading, congenital or acquired disease of anatomic components of reproductive system i.e. Vagina, cervix, uterus, fallopian tubes can be included.
  It includes, a) Yonivyapada: All twenty Yonivyapada (gynecological disorders), if not treated properly cause infertility. b) Injury to ‘Artava-vaha Srotas’: ‘Artava-vaha Srotas’ means organs related with the menstrual cycle, when damage by injury results in infertility. c) Yoniarsha: ‘Yoniarsha’ means any unwanted growth on cervical region produces infertility by destroying the menses. d) Garbhakosha bhanga : Word ‘Bhanga” also refers to prolapse of uterus or its retro-displacement, is one of the cause of infertility. e) Bhaga sankocha : During coitus with a girl before her menarche (very young girl), deep lacerations or tear of vulva and vagina may take place. Healed scars of these ulcers may produce constriction of vagina; thus, hamper proper penetration of penis during coitus resulting into incomplete coitus, a cause of infertility. f) Sphalita Mutratva: ‘Sphalita mutratva’ in girls is also responsible for ‘Vandhyatva’ i.e. partial obstruction or spasm of urethra, for which the most common cause is gonorrhoeal urethritis, because gonococci causes inflammation of reproductive system along with urinary system. Gonorrheal salpingitis is very common cause of infertility. g) Utkshipta Yoni: Upward displacement of cervix in cases of retro flexion of uterus is one of the cause of infertility. h) Aticharana Yoni vyapata:  Sushruta says that this disease is caused by excessive coitus. It appears to be analogous to vaginal inflammation due to excessive coitus associated with infertility.

• MANSIKA ABHITAPA (stress indused infertility):
  Normal psychology of the Couple is very important for achievement of pregnancy. Fear of doing sex, marital disharmony and infrequent coitus affect the fertility.

• BEEJADUSHTI : When in Ovum, the gene concerned with uterus is damaged, the progeny becomes sterile.

• ARTAVA DUSHTI : The word ‘Artava’ refers to ovum, menstrual blood, and ovarian hormones. Abnormality of ovum and ovarian hormones may produce infertility.

• AHARADOSHA : Dietetic abnormalities cause infertility in two ways: 1) By producing loss of ‘Dhatus’ (nutrition to the tissues) and that of ‘Dhatvagni’ (Metabolism), thus they influence hormones. 2) By vitiating ‘Doshas’ which cause various gynecological disorders, leading to infertility.

• VIHARA DOSHA : Abnormal mode of life and suppression of natural urges aggravate ‘Doshas’, which produce various gynecological abnormalities.
  Other than the supine posture of the women during coitus, discharge of semen on ‘Samirana Nadi’ or outside the vagina comes under defective practice. In all these conditions probably semen is not properly deposited inside the vaginal canal. Thus sperms fail to enter uterus causing infertility.

• AKALA YOGA : The word “Kala” refers to period of age and ‘Rutukala’ (ovulation period) both. In adolescent girls & old ladies due to premenarche and menopause stage respectively and before or after ‘Rutukala’ (ovulation period) due to absence and destruction of ovum respectively, the conception does not take place.

• BALA KSHAYA : ‘Bala’ refers to physical strength and capacity to become pregnant. Here, infertility due to ‘Bala kshaya’ (loss of strength) may be due to unknown origin or premature aging or any systemic disorder.

Ayurvedic Management of ‘Vandhyatva’ (Female infertility):
Diet:
1. The women who consume ‘Lasuna’ (Garlic) never remain infertile.
2. Milk is beneficial for Vandhya and also helps to achieve pregnancy.
3. Meat increase ‘Retas’(ovum) and ‘Shukra’ (sperm count), which is  beneficial for Vandhya.
4. Vegetables i.e. Root of Surana, Vandhya-karkotaki and Devadali are also beneficial.
5. Food articles having salt, sour and pungent in taste, habit of smoking and consumption of alcohol should be avoided.
6. One should follow the ‘Ayurvedic life style’ given on the home page of this site.

The treatment has been divided into two types.
Shodhana Chikitsa: (Treatment of Body Purification):
‘Panchakarma therapy’ (Treatment therapy for body purification and rejuvination) should be done first. Particularly ‘Basti’ (medicated enema) is the treatment of choice due to its wide range and effectiveness on ‘Vata Dosha’.
Specific ‘Panchkarma treatment’ for infertile is ‘Uttar Basti’.
‘Uttar Basti’:
Basti which is given through the Uttar Marga i.e. urinary or vaginal route and it is superior in qualities thus it termed as Uttarbati. Uttarbasti should be given consecutively three days in increasing dose of Ayurvedic herbal oils and ghee (clarified butter). It should be stopped for 3 days and again repeated for three days continuously.
Shamana Chikitsa: (Conservative management):
The authentic Ayurvedic texts have given some specific Ayurvedic formulations which can be achieved tremendous benefit in case of female infertility. Amongst them, some are given below with their reference texts.

• Mahanarayana taila (Sharangdhar samhita- M. 9/101 to 111)
• Shatavari taila (Sharangdhar samhita- M. 9/ 133 to 138)
• Shatapushpa taila (Kashyap samhita- K. 5/23 to 25)
• Shatapaki Taila (Susrut samhita- Chi. 38/89)
• Yogaraja guggulu (Sharangdhar samhita- M. 7/56 to 62, 63)
• Shamim Ashvattha ghrita (Atharvaveda 6/2/11/1)
• Shatavari Ghrita (Kashyap samhita- K. 5/26)
• Phalagrita (Sharangdhar samhita- M. 9/80 to 87)
• Lasuna Ghrita (Kashyap samhita- K. 2/93 to 97)
• Maharashnadi Kwatha (Sharangdhar samhita- M. 2/90 to 94, 96)
• Dashmoolarista (Sharangdhar samhita- M. 10/77 to 92)
• Pugapaka (Yoga Ratnakar)