It’s a given, that, since the dawn of time, or civilisation, certain women couldn’t bear children. The sad part was they were ridiculed with spiteful tags and tabs which inferred that infertility was a flaw, a major fault. Worse still, it was only women that had to endure the brunt of such insults; they were subject, no less, to emotional and psychological agony for being barren.
It’s suggested that infertility was treated in Ancient Egypt, just as much as the ancient Greeks acknowledged infertility as a medical condition compelling diagnosis and meticulous treatment. It took ages for anatomy to reach its apogee, as also scientific progress and advancement, especially during the Renaissance in the treatment of infertility and change somewhat the age-old dogma that ‘stymied’ women who could not bear children. Yet, whatever the progress, infertility was, for the most part, considered the song of a woman’s burden. It was her womb that remained unproductive, so the responsibility was hers was a common riposte — any which way one looked at the whole picture.
It’s primarily the result of medical advance during the last century, what with the knowledge accrued about fertilisation, more so with the advent of the first test-tube baby, that women with infertility are recognised today as patients, not someone barren, or ill-fated. The forbidden ‘blanket’ is now a thing of the past, with focus aimed at infertility per se, its causes, diagnoses and treatment.
Definition
Infertility is defined as a failure to achieve clinical pregnancy after 12 months, or more, of regular unprotected sexual intercourse.
The primary causes for infertility may include excess weight, smoking, diet flaws, medical conditions, substance abuse, environmental pollutants, medications and family medical history. Certain infections may also have an effect on conception in couples.
Infertility is also representative of low number, or poor quality, of sperm in men, whereas in women, it occurs when they are not able to produce eggs regularly, or because their fallopian tubes may be damaged, or blocked, and the sperm cannot reach the eggs.
This article is keyed to Ayurvedic concepts and processes that are followed in the management and treatment of infertility.
The Ayurvedic View Of Infertility
Infertility, according to Ayurvedic tenets, occurs when a healthy couple is unable to achieve pregnancy after a few years, or fail to conceive after first delivery.
Ayurveda has been successful in treating infertility, for thousands of years, without the help of modern, or conventional, medicine, as it provides the natural, also holistic, ability to infertile women, or couples, through appropriate, or personalised, or bespoke, treatment to become fertile. This helps to improve the overall health of the woman, in question, enabling them to conceive without the aid of conventional treatment.
Ayurveda is the amalgamation of two Sanskrit words, ayus, meaning of life, and veda, meaning pure knowledge and science. According to the ancient Ayurveda text, Charaka Samhita, our mind senses integration and balance of mind senses body and spirit, called ayus. which is believed to prevent illness and promote balanced agni, also doshas, while the formed dhatus help in the proper elimination of malas [wastes], as also appropriate functioning of bodily processes. This, in turn, fine-tunes the mind and soul to experience not only homeostasis, but also bliss.
Ayurveda also celebrates universal interconnectedness, or relationship among people, their health and the universe. This includes —
- Prakiti. The unique combination of physical and psychological characters of the individual and the way the body maintains health and other functions.
- Doshas. The three life forces that manage, or control, activities of the body.
Causes Of Infertility
Infertility may be due to male, or female factors.
Causes of infertility in women include: ovarian, tubal, and age-related factors, uterine problems, PCOS, endometriosis, among others. Menstrual cycles are just as important, because they can be affected by factors such as diet, emotional distress, excessive physical exercise, lifestyle and stress which may cumulatively lead to the imbalance of the doshas, which are imperative to control the activities of the body — vata, pitta, and kapha.
Male infertility is usually caused by either compromised sperm production, or sperm transport. This may include certain infections, ejaculation problems, hormonal imbalance, defective sperm transference, tumours etc.
In Ayurveda, the primary cause of any abnormal function, in the body, is categorised as —
- Agnimandya, or vitiation of the digestive fire [agni] in the body
- Tridoshadushti, or vitiation of the three governing doshas, viz., vata, pitta, and kapha.
Management Of Infertility In Ayurveda
The treatment of infertility, in Ayurveda, is historically aimed at improving the overall health and quality of life [QoL] of the individual.
Dietary Management
Diet plays a vital role in the prevention and cure of disease. This leads to maintenance of good health.
- Annam brahmam. Food has been compared to god. It also sustains and nourishes life.
- Ojas building food. Milk, ghee, nuts, sesame seeds, dates, pumpkin seeds, honey, fresh organic fruits, vegetables from plants sources, beans, peas, sweet potato, and whole grain, which improves the interaction between hormones and targeted tissues
- Cumin, which purifies the uterus in women and genitourinary track in men
- Excess intake of alcohol, caffeine, tobacco, soda, smoking, red meat, refined carbohydrates, such as white bread and pasta can exaggerate the problem of infertility.
Panchakarma
- Ayurveda panchakarma treatment helps to eliminate ama [the antithesis of agni; raw; immature]; thus, it corrects agni
- Healthy agni contributes to healthy ojas. The main dosha involved in infertility is vata; so, vatanulomana, or correcting the function of vata, is fundamentally important in the treatment of infertility
- Agni, deepana, and amapachana. Ama formation triggers toxins, especially when undigested food, in the stomach, leads to agni.
Ayurveda panchakarma treatment eliminates ama, leading to healthy agni. This, in turn, contributes to healthy ojas.
Śodhana
This is prerequisite for suitable snehan [oleations]; sweda [sweating] is done prior to śodhana [detoxification].
The treatment modalities are as follows:
- Vamana, or emesis
- Virechana, or purgation
- Vasti, or medicated enema
- Utharavasti, or special enema administered through urethral and vaginal routes.
These are performed keeping in mind the individualised needs of the patient.
The therapies help to correct toxins of the body, including ovarian, tubular and uterine issues that may be the cause of infertility.
Ayurvedic treatment helps in releasing stress and tensions — the bugbear of infertility — and removing impurities from the body. This aids to nourish the body, mind, and soul, and also strengthen the immune system. The whole foray is not only aimed at reducing stress, but also nourishing all the dhatus of the body, while purifying vata.
This is not all. The right combination of herbs also helps in regulating the menstrual cycle and enhancing general health and wellness, aside from revitalising the sperm count, while enhancing sperm morphology and motility. Note: Reducing stress enhances sleep, controls anxiety, increases energy levels, balances the endocrine system and improves blood flow in the pelvic cavity. This fosters fertility.
Clinical Studies
Background. Treatment of female infertility has been growing globally in recent years. In spite of improvements in medical strategies and improved outcomes for infertile couples, treatment attempts remain largely unsuccessful. A growing number of patients pursue complementary and alternative medicine [CAM] treatment options, like Ayurveda, that offers a variety of in-patient and out-patient treatments for infertility.
Case report. A case of a 38-year-old woman with infertility of unknown origin is presented. She received 18 conventional fertility treatments in five different fertility centres and three different countries. After several complications, the patient quit conventional treatment and was admitted to an Ayurvedic out-patient clinic where she received complex Ayurvedic treatment; this included botanicals, dietary and lifestyle advice, manual therapy, yoga and spiritual elements. The patient became pregnant and gave birth to a healthy boy.
Conclusions. Ayurveda may be a useful complementary option in the case of futile conventional treatment attempts in female infertility. Nevertheless, the evidence base for Ayurvedic interventions remains weak and requires well-designed clinical trials. This case raises some questions, such as whether the exposure to a large number of assisted reproduction procedures can lead to more health problems than health benefits. The Ayurvedic approach to fertility strives first to improve the health of the patient leading to a higher likelihood of pregnancy. As this is a case report, we may not be able to exclude temporal factors stimulating pregnancy. However, the chronology suggests that this approach could be an important factor in eventual pregnancy.
- Christian Kessler, Elmar Stapelfeldt, Andreas Michalsen, Ingrid Kowalcek, Ludwig Kronpa, and Anand Dhruva. “The Effect of a Complex Multi-modality Ayurvedic Treatment in a Case of Unknown Female Infertility.” Forsch Komplementmed. 2015; 22[4]: 251-8.
Male infertility contributes for 50 per cent of infertility globally, and several aetiological [causative] factors contribute to it. Oligoasthenozoospermia [reduced sperm motility and count] and anxiety form a vicious cycle, resulting in male infertility. A man advised for assisted reproductive techniques, even after correcting seminal parameters, has poor success rate, if the symptoms of anxiety are left untreated. The signs and symptoms of oligoasthenozoospermia can be compared with kshina shukra of Ayurvedic classics. This present case report presents the role of an indigenous combination of drugs in improving the quantity and quality of semen, along with the reduction in anxiety levels through counselling. The patient with low sperm motility and volume was subjected to Ayurvedic management protocol of initial counselling, followed by śodhana treatment followed by the administration of Mashadi choornam for 90 days. A marked improvement was observed in seminal parameters and anxiety levels and the patient could undergo natural conception, a few months after the treatment, while focusing on an integrative approach.
- Vandana K Vasudevan, Parvathy Unnikrishnan, et al. “A Comprehensive Ayurvedic Treatment along with Counselling in Oligoasthenozoospermia with Previous Intrauterine Insemination Failure: A Case Report.” Journal of Ayurveda and Integrative Medicine, Volume 12, Issue 1, January-March 2021 [148-150].
