Ayurvedic Management of Vandhyatva (Primary Infertility) w.s.r. to Tubal Blockage – A Case Report

Abstract

Introduction: Motherhood is a dream of all women’s and is complete after conception and child birth.Infertility is defined as a failure to conceive within one or more years of regular unprotected coitus1.Infertility affects approximately 5-15% of reproductive-aged couples in any community.Tubal blockage is one of the most common causative factors in female infertility.The prevalence is 19.1% in the fertility age group2.All types of female infertility in Ayurveda are described under the heading of Vandhya.It is among 80 types of Vata vikaras.During the period of Acharya Charaka, Infertile couples were considered as shade less, branchless, fruitless waste tree or like a lamp in picture or portrait which will not emit any light or brightness3.In Ayurveda, Infertility is termed as “Vandhyatva” and Vitiation of Vata is the prime factor for creation of disease. According to Acharya Sushruta, there are four factors responsible for creation of GARBHA i.e. Ritu (Ovulatory period/period of copulation), Kshetra (Reproductive tract including Uterus, Fallopian tubes, Ovary), Ambu( Nutritive fluid for fertilized ovum & fetus), Beej i.e. Shukra and Shonita (Sperm & Ovum)4. Among these four factors tubal blockage canbe considered as the deformity of Kshetra means Kshetradushti.Correlating fallopian tubes with the Artavavaha (Artava-beeja-vaha) Strotasa, its block can be compared as Sanga type of Strotodushti. Abnormality of tubes is generally of two types :- 1. Structural :- Anatomical blockage :- Due to Vitiation of VATA-KAPHA/ PITTA-KAPHA 2. Functional :- Defect in ciliary function of tube – Due to Vitiation of VATA. This condition is not described in Ayurvedic Classics as itself tubal blocks but blockages of fallopian tubes can be better correlated with Vandhyatva due to Artava bijavaha strotavrodha (Blockages in fallopian tubes) All three Doshas may be responsible for causing blockages but mainly Vata-Kapha pradhanata is more. Normalizing the Vitiated Vata-Kaphapradhana doshas leads to restoration of tubal function and easy conception. Several Ayurvedic interventions are advised such as Panchakarma (purification therapy) for vitiated Doshas in female reproductive organs, Snehapana (oral intake of medicated oil) followed by Virechana (medicated purgation) to produce quality ovum. Correlating fallopian tubes with the Artavavaha Srotas, its block is compared with the Sanga Srotodushti (obstructive pathology occurring in channels) of this Srotas. By virtue of the purification therapy and internal medication working synergistically might remove the Srotodusthti. Aim and Objective: To evaluate the efficacy of Ayurvedic treatment in the management of infertility. Case description: A Female patient of 27 years old, having complaint of scanty menses 1 year and failure to conceive since last 2 years came to OPD PTSR, ITRA, on May 2022 diagnosed as Anapatya (primary infertility) associated with bilateral tubal blockage. Diagnosis: Hysterosalpingography findings showed bilateral distal partial fallopian tubal block. Intervention: Virechana karma in first cycle followed by two cycles of Erandamuladi Niruha Basti for 8 days and uttarbasti for 6 days Saman Chikitsha with satpuspa choorana for two month. A six month protocol. Outcome: Within 6 months of treatment, patient got tubal spillage, conceive and then delivered a full term female baby weight 3.5 kg by LSCS . Conclusion: Ayurveda has a better treatment option for infertility special reference with tubal blockage in the form of Sodhana and Samana therapy. Keyword – Infertility, Shodhana therapy, Tubal blockage, Uttarabasti, Vandhyatva.