Tubal Blockage Research Articles

A Retrospective Study of Leparoscopic Evaluation of Tubal Factors in Case of Infertility

Background: Tubal factor infertility accounts for a large portion of female factor infertility. The most prevalent cause of tubal factor infertility is pelvic inflammatory disease and acute salpingitis. Tubal factor infertility accounts for approximately 25-35% of cases of female infertility. The aim of this study was to determine the role of leparoscopic evaluation of Tubal factors in case of infertility. Methods: A retrospective study was carried out at Department of Gynae and Obstetrics UHC, Dhamrai, Dhaka, Bangladesh from January to December 2023. 55 patients were selected for laparoscopic evaluation. Inclusion criteria were patients with no prior pelvic surgery, normal bimanual pelvic examination, normal semen parameters of partner and no ovulatory dysfunction. After obtaining thorough history & detailed examination, patients were informed about the procedure and written informed consent was taken. Results: 55 patients underwent laparoscopy during the study period. Most patients 10 were in the age group of ˂20 yr, 15 were between 21-30 yr & 20 were 31- 40 yr of age and 10 were between 36 – 40 yrs of age. Among these 55 patients 24 patients had primary infertility while 31 had presented with secondary infertility. Diagnostic laparoscopy revealed normal pelvic organs in 9 (16.3%) cases, Chronic pelvic inflammatory disease in 3 (5.4%), endometriosis in 13 (23.6%) and congenital anomalies of uterus in 1(1.8%) cases. 7.2% cases had bilateral tubal block, 27.3% had unilateral block and in 7.2% cases though the tubes were found patent significant peritubal adhesions were noted. Tubal pathology was detected in 55.5% cases of primary infertility and 42.1% cases of secondary infertility. Among those who had tubal pathology, nonspecific pelvic inflammatory disease was noted in 33.3% and genital tuberculosis was diagnosed in 2.7% cases. The most common complications were pyrexia, shoulder tip pain, nausea and vomiting. Conclusion: Laparoscopy is a safe and effective diagnostic tool in evaluating tubal status of infertile patients. Laparoscopy and chromopertubation test should be recommended as a first step in the investigation of infertile women with tubal factor.

AYURVEDIC MANAGEMENT OF BILATERAL TUBAL BLOCK-A CASE STUDY

Infertility has been recognised for many millennia. It leads to social ostracism, which is condoned by deep-seated religious beliefs in many situations. The Koran states, ‘He makes whom he pleases barren’. Surely, he knows power. Almost all religions share the Hindu belief that infertility is due to karma, and hence, there is a sense that the inability to conceive is some punishment. [1] Infertility, a multi-factorial disorder, is a major contributor to emotional disturbances and reduced quality of life. Out of many factors, tubal factors causing infertility account for about 25-30% of all cases of infertility [2]. Infections, abdominal surgery and diseases such as endometriosis can cause scarring at the inner lining of fallopian tubes. STDs, post-ectopic pregnancy and previous abdominal surgeries may cause tubal blockage. [3] The Fallopian tube is the Kshetra for Garbhadhana, as it carries the gamete before and zygote after fertilisation. Going through various signs and symptoms, we can understand that it is Vata-dominated Tridoshaja Vyadhi, Where Kapha Doshas also contribute to the formation of the block. Uttara Basti is a boom in treating blocked fallopian tubes. The drugs having Vata Kapha Shamaka and Tridoshaghna properties and drugs with Sukshma, Katu, Ushna and Pramathi properties help to remove the blockage and restore tubal functions. In the present case study, both Shodhana and Shamana chikitsa were adopted. The combination of Kshara, Kasisa Taila, and Phala Ghruta having Lekhaniya and Vata Kapha Shamaka property has proved beneficial in treating tubal blockage.

EFFICACY OF PHALAGHRITA UTTARABASTI IN THE MANAGEMENT Of VANDHYATWA WITH SPECIAL REFERENCE TO TUBAL BLOCKAGE- A CASE STUDY

Introduction: Vandhyatwa has been mentioned by various Acharyas in Ayurvedic classics using multiple terms. Acharya Charak explained factors responsible for Vandhyatwa (infertility), such as yoni dosha (gynaecological disorders), Mansika-Abhitapa (mental stress), Shukra-Artavadosha (disorders of sperm and ovum), Ahara-Vihara Dosha (food- and lifestyle-related disorders), Akalyoga (inappropriate timing), Bala-Kshaya (decreased strength). Two major factors which are associated with fertility problems are anovulation and defects in tubal patency. In the present article, there is a case study of ayurvedic management of infertility due to bilateral tubal blockage. Main Clinical Finding: A 29-year-old female patient reached the hospital complaining of a wants issue for five years. Diagnosis: Her hysterosalpingiography findings showed a bilateral fallopian tubal block. Interventions: 3 consecutive cycles of Uttarabasti were given with Phalaghrita for 3months along with oral medications (Tab. Shebless forte, Phalaghrita) and Anu taila nasya application. Outcome: The patient missed her period after four months of treatment, and the urine pregnancy test was found to be positive. Conclusions: Tubal patency (Kshetra) is an essential factor for conception.

An Ayurvedic Management of Bandhyatva Associated with Bilateral Tubal Blockage

In Ayurveda, infertility is addressed under the concept known as "Bandhyatava," which is described in ancient texts such as Charak Samhita, Sushrut Samhita, Ras Ratna Samuchya, and Harit Samhita. Acharya Sushrut described four crucial factors for fertility: Ritu (menstruation), Kshetra (functioning reproductive organs), Ambu (digestive juices) and Beej (healthy sperm and ovum). It occurs due to the vitiation of Vata dosha where Kapha dosha also contributes to the formation of blockage. Beeja Grahana is unable due to Sanga Strotodushti of Artavavaha i.e., tubal blockage which leads to failure of conception. Fallopian tube is an essential part of the Artavavaha Srotas as the Beej Samagam (ovum and sperm) takes place here. In the current case scenario, Bandhyatva is due to Tubal Blockage. A 37-year-old female patient was reported to PTSR OPD with the complaints of irregular menses with decreased duration and wants to conceive irrespective of unprotected sexual intercourse since 3 years. Her HSG scan suggestive of B/L fallopian tube cornual blockage. Aims and Objectives: To maintain the balance between the four factors to conceive through Sanshodhan therapy. Patients has been treated with Sanshodhan Karma followed by 3 consecutive cycles of Sahacharadi Taila Uttarbasti and 3 cycles of Phalghrita Uttarbasti along with Shaman Chikitsa. Results: After completion of treatment Bilateral Tubes were patent observed in Sonohysterosalpingography. Conclusion: This case study found that the treatment administered was highly effective in addressing infertility caused by tubal blockage.

Ayurvedic Management of Multifactorial Female Infertility – A case report

Introduction: Infertility is a medical condition that can cause psychological, physical, mental, spiritual, and medical detriments to the patient. “Infertility is defined as failure to conceive within one or more years having regular unprotected coitus. All types of female Infertility in Ayurveda are described under the heading of Vandhya. According to Acharya Sushruta, there are four factors responsible for creation of Garbha i.e. Ritu (Ovulatory period/ period for copulation), Kshetra (reproductive tract including Uterus, Fallopian tube, Ovary), Ambu (Nutritive fluid for fertilized ovum), Beeja (Shukra & Shonita i.e. Sperm & Ovum). Among these four factors tubal blockage can be considered as the deformity of Kshetra i.e. Kshetradushti and Low level of Anti mullerian hormone can be compared to Dhatukshayajanya Vandhyatav. Aim and Obejctive: This case study was done to treat multifactorial female infertility with Ayurvedic treatment protocol and provide better quality of life. Methodology: A female Patient of 28 years of age, came to OPD of Prasuti Tantra Evum Stree roga with complaint of inability to conceive since 2 years of unprotected intercourse. Patient was diagnosed with female infertility due to bilateral tubal blockage, and low AMH level treated by Ayurvedic intervention i.e. - Virechana Karma, Yuktaratha Basti (3 days) along with Uttarabasti with Apamargkshara Taila (6 days) and Nagakesara Choorna orally (after stopping of menstrual bleeding). Result: Female infertility cured after treatment and conception achieved. Discussion: Ayurvedic approach would be beneficial in conservative management of tubal blockage and has an effective result in female infertility.

The Blinking Test (Faheem’s Approach): A Promising Tool for Assessing Tubal Patency and Blockage

The Blinking Test (Faheem’s Approach): A Promising Tool for Assessing Tubal Patency and Blockage

Ayurvedic Management of Infertility W.S.R. to Tubal Blockage by Kshar Taila Uttar Basti: A Case Study

Ayurvedic Management of Infertility W.S.R. to Tubal Blockage by Kshar Taila Uttar Basti: A Case Study

Determining The Frequency of Tubal Blockage in Infertility Patients Undergoing X-Rays Hysterosalpingography

Background: Infertility is a complex global health issue, affecting millions of couples and necessitating detailed diagnostic evaluations. Among the various diagnostic procedures, X-ray hysterosalpingography (HSG) is pivotal for assessing tubal patency and identifying underlying causes of infertility. Objective: To determine the frequency of tubal blockages, particularly hydrosalpinx, in patients undergoing HSG at a tertiary care facility. Methods: This retrospective study was conducted at Allama Iqbal Teaching Hospital DG Khan from July 2022 to February 2024. A total of 210 female patients with consecutive infertility were included, excluding those with prior tubal surgeries. Data were extracted from medical records, focusing on demographics, clinical history, and HSG results. Results: The mean age of the participants was 32.35 ± 3.56 years, and the mean duration of infertility was 3.5 ± 2.1 years. Among the patients, 65% were nulliparous, and 35% were parous. Prior fertility treatments were reported in 75% of cases. Tubal blockage was identified in 45 patients (21.4%), with 25 (11.9%) exhibiting unilateral blockage and 20 (9.5%) bilateral blockage. Hydrosalpinx was the most common abnormality, occurring in 30 patients (66.7%). Conclusion: Tubal blockage, particularly hydrosalpinx, is a significant contributor to infertility, found in 21.4% of the study population. These findings emphasize the need for thorough tubal evaluations in infertility assessments.

Hysterosalpingography Investigation Versus Patients’ Radiation Dose Risk

Background: Hysterosalpingography (HSG) is a useful radiographic investigation involving the use of contrast medium for the management of infertility in females. It is however, not only a costly procedure but it is also a semi-invasive procedure and carries some radiation risks. One principle of radiation protection is justification of practice which means that the overall benefit of the procedure should outweigh the radiation risks. The aim of this study was to determine justification of HSG procedure by assessing the rate and pattern of pregnancy success among infertile women who underwent HSG procedures at a tertiary hospital in South Eastern Nigeria between 2016 and 2020. Methods: a retrospective cross-sectional study of a sample of 222 women, aged 20-46years (mean 32,55 ±8,16years) who underwent HSG examination at the hospital between 2016 and 2020 was made. The data of eligible subjects were collected from the archives of radiology department of the hospital. Results: The result showed that 121 (54,5 %) out of 222 of the patients achieved pregnancy with proper follow up infertility management. Of the 121, 48(39,67 %) were in the 25-29 years age group and 35(28,93 %) in the 30-34years age group. The commonest pathology found was uterine fibroid 71(32,0 %), followed by tubal blockage, 42(18,92 %) while the least occurring pathology was salpingitis isthmica nodosa 1(0,45 %). Conclusion: there was a strong positive correlation between the age of patient, the HSG findings and the rate of pregnancy success. The procedure is justified in all the age groups except for the >45years group

An overview of the clinical profile of infertile patients who underwent hysterosalpingography

Background: Infertility is a prevalent medical issue that can arise from challenges in male or female or both partners. Pivotal contributing factors to female infertility include dysfunction, tubal issues, and peritoneal factors. Hysterosalpingography (HSG) holds significant importance in assessing abnormalities associated with the uterus and fallopian tubes. Aims and Objectives: This study aimed to assess the clinical profile and hysterosalpingographic findings of women with infertility who visited the department of radiodiagnosis for HSG. Materials and Methods: This is a cross-sectional study, where consecutive convenience-based sampling was used, with ethical clearance in place. Sixty-three infertile women of reproductive age were recruited for the study and were referred for HSG by the Department of Obstetrics and Gynecology. Results: The majority of the participants had primary infertility (71.88%) and was in the 31–35-year age group with the majority having 3–6 years of infertility and endometriosis. On HSG uterine pathology was found in 9.37% of participants and unilateral and bilateral tubal blocks were seen in 18.75% and 14.06% of cases approximately. Conclusion: HSG is a minimally invasive procedure, secure, and plays a crucial role in diagnosing uterine and tubal factors contributing to infertility.

Hysterosalpingographic Findings Among Ghanaian Women with Infertility: A Five-year Trend Analysis.

To understand the pattern of hysterosalpingographic (HSG) findings and annual trends among Ghanaian women with infertility over a five-year period. We retrospectively evaluated the hospital medical records of women with infertility who underwent HSG at a major tertiary center in Ghana between January 2018 and December 2022. The data was statistically analyzed. The subjects comprised of 2324 Ghanaian women diagnosed with clinical infertility. HSG identified 1685 (72.5%) with primary infertility and they were also younger women with a mean age of 32.2±4.5 years. The remaining 639 (27.5%) women had secondary infertility and were older (34.2±5.3 years; p < 0.001). Primary infertility rate decreased with increasing age (p < 0.001). Bilateral tubal blockage was seen in 701 (41.6%) women with primary infertility and 365 (57.1%) women with secondary infertility. Hydrosalpinx was present in 236 (10.2%) women, fimbrial adhesions in 444 (19.1%), Asherman's syndrome in four (0.2%), and bilateral beaded tubes/tubercular salpingitis in five (0.2%). HSG was unable to detect infertility-related abnormalities in 513 (22.1%) women despite their clinical infertility. The majority of patients (1502; 64.6%) had tubal blockage: bilateral in 1066 (45.9%) and unilateral in 436 (18.8%). Infertility rates among Ghanaian women increased at an accelerating rate over the years. Primary infertility was significantly more prevalent among younger women. Tubal and cervical abnormalities were the most prevalent HSG findings.

ROLE OF TRIVIDHA AUSHADHA IN THE MANAGEMENT OF INFERTILITY DUE TO BILATERAL TUBAL BLOCKAGE AND ABNORMAL ENDOMETRIUM RECEPTIVITY ALONG WITH THE PREVENTION OF CONGENITAL ANOMALY: A CASE STUDY

Introduction: Infertility is the failure to naturally conceive a child even after one or more years of regular unpro-tected coitus. Primary infertility (absence of prior conception) and secondary infertility (infertility following at least one previous conception) are two categories under which infertility can be classified. Here, it is the case of secondary infertility caused by tubal and endometrial factors. Tubal factor and Endometrial factor come under four essential factors for conception described by Acharya Sushruta, i.e. Ritu, Kshetra, Ambu, Beeja as if the Kshetra is not formed correctly, it causes vandhyatva. In this case study, Ayurvedic management successfully treated secondary infertility caused by tubal and endometrial factors. Main clinical finding: A married Hindu female patient of 29 years of age visited OPD of the National Institute of Ayurveda, Jaipur, on 3 March 2021 with a chief complaint of wants issue since 1-year Diagnosis: Her HSG scan on 25 Feb 2021 suggestive of bilateral fallopian tube blockage. Her USG scan is suggestive of a simple cyst in her right ovary of size 31x19mm and endometrium thickness of 4mm on the 12th day of menses. Inter-ventions: Treatment given was Daivavyapashraya, Yuktivyapashraya (Ksheera basti, Uttarbasti and Yoga basti along with oral medication), and Satvavajaya. Outcome: She conceives after taking 20 months of treatment and delivered a healthy male child of weight 3.04kg on 21 July 2023 without any congenital anomaly. Conclusion: This case study shows the efficacy of Uttar Basti for treating bilateral tubal blockage and Ksheera Basti for en-hancing endometrial receptivity. It also highlights the significance of Daivavyapashraya, Yuktivyapashraya, and Satvavajaya Chikitsa in the management of infertility and the prevention of congenital anomalies.

Effect of Uttar Basti in Management of Tubal Block

Infertility is a condition of reproductive system that causes people to be unable to get pregnant (conceive). It has been considered the second biggest reason for female infertility Infections, abdominal surgery, and diseases such as endometriosis can cause scarring at the inner linings of fallopian tubes. According to Acharya Susruta, four factors essential for conception are Ritu (season), Kshetra (reproductive system), Ambu (nourishing Substances) and Beeja (ovum and sperm). All these terms have broad are compared with the Artavavaha (Artava-bija-vaha) Srotas, blocking of fallopian tubes is compared with the Sanga Srotodushti of Aartavavaha Srotas.&#x0D; The goal of this study was to determine Uttar Bastis potential as a more affordable and safe solution for treating tubal obstruction. The present paper is based on a clinical success story of the treatment of primary infertility due to tubal blockage. After the 1-month of procedure improvement in general condition was reported. On completion of the second month patient reported amenorrhea in subsequent month and went for UPT which was positive. On USG (after 3 weeks) a single well-defined gestational sac with foetal cardiac activity was seen. The result obtained in this single case study was quite encouraging with minimum invasion and side effects as well as cost-effective. So, the treatment protocol can be followed for patients of infertility due to corneal end tubal block. Success was achieved with Uttar Basti and some supportive Ayurvedic formulations.

The Treatment of Tubal Inflammatory Infertility using Yinjia Tablets through EGFR/MEK/ERK Signaling Pathway based on Network Pharmacology.

<p>Background: Salpingitis obstructive infertility (SOI) refers to infertility caused by abnormal conditions such as tubal adhesion and blockage caused by acute and chronic salpingitis. SOI has a serious impact on women's physical and mental health and family harmony, and it is a clinical problem that needs to be solved urgently. <p> Objective: The purpose of the present study was to explore the potential pharmacological mechanisms of the Yinjia tablets (Yin Jia Pian, YJP) on tubal inflammation. <p> Methods: Networks of YJP-associated targets and tubal inflammation-related genes were constructed through the STRING database. Potential targets and pathway enrichment analysis related to the therapeutic efficacy of YJP were identified using Cytoscape and Database for Annotation, Visualization, and Integrated Discovery (metascape). E. coli was used to establish a rat model of tubal inflammation and to validate the predictions of network pharmacology and the therapeutic efficacy of YJP. H&E staining was used to observe the pathological changes in fallopian tubes. TEM observation of the ultrastructure of the fallopian tubes. ELISA was used to detect the changes of IL-6 and TNF-α in fallopian tubes. Immunohistochemistry was used to detect the expression of ESR1. The changes of Bcl-2, ERK1/2, p-ERK1/2, MEK, p-MEK, EGFR, and p-EGFR were detected by western blot. <p> Results: Through database analysis, it was found that YJP shared 105 identical targets with the disease. Network pharmacology analysis showed that IL-6, TNF, and EGFR belong to the top 5 core proteins associated with salpingitis, and EGFR/MEK/ERK may be the main pathway involved. The E. coli-induced disease rat model of fallopian tube tissue showed damage, mitochondrial disruption, and increased levels of the inflammatory factors IL-6 and TNF-α. Tubal inflammatory infertility rats have increased expression of Bcl-2, p-ERK1/2, p-MEK, and p-EGFR, and decreased expression of ESR1. In vivo, experiments showed that YJP improved damage of tissue, inhibited shedding of tubal cilia, and suppressed the inflammatory response of the body. Furthermore, YJP inhibited EGFR/MEK/ERK signaling, inhibited the apoptotic protein Bcl-2, and upregulated ESR1. <p> Conclusion: This study revealed that YJP Reducing tubal inflammation and promoting tissue repair may be associated with inhibition of the EGFR/MEK/ERK signaling pathway.</p>.

Fertility with Ayurveda - A Single Case Study on Treatment of Primary Infertility due to Tubal Blockage with Polycystic Ovarian Syndrome

Infertility associated with Polycystic Ovarian Syndrome (PCOS) is a major cause of concern in the present generation among the reproductive age groups due to unhealthy lifestyles in the modern era. This is a case report of an infertile couple who had not been able to conceive for 4 yrs. The female was diagnosed with PCOS with left tubal blockage. The objective of the present treatment included Ayurvedic management of PCOS, ensuring regular ovulation and thereby helping to develop healthy pregnancy and successful childbirth. Based on Ayurvedic science this case was diagnosed as Vandhyatva (Infertility) due to Nashtartava (that can be related with Polycystic ovarian disease) And Tubal blockage that can be related with Artava Vaha Strotosangha. This research paper presents a case study of the effectiveness of a comprehensive Ayurvedic treatment approach involving Uttarbasti with Kasisadi Tail along with oral medicines i.e., Pushpadhanva Ras and Kanchnar Guggulu as major medications in the successful treatment of a primary infertility patient having history of Polycystic Ovarian Syndrome (PCOS) And Tubal blockage. In Ayurveda primary infertility can be correlated with Anapatya type of Vandhyatava and its causative factor PCOD can be correlated with Nashtaartava as per Sushrut and Pushpaghnijataharni as per Kashyap and tubal blockage as Sanga variant of Artavavaha Strotodushti. Treatment plan included both Shodhana (Purification) and Shamana (mitigation) therapies. The outcome of the Ayurvedic intervention was the conception of the patient within 1 year of treatment.

AYURVEDIC MANAGEMENT OF PARIPLUTAA YONIVYAPAD W.S.R. TO BILATERAL TUBAL BLOCKAGE: A CASE STUDY

Tubal blockage is the second most common cause of female infertility. Acharya Charaka and Vagbhata have considered that complications of Yonivyapad lead to infertility. A common complication of PIDs (Pelvic In-flammatory Diseases) is tubal blockage; hence, tubal blockage can be co-related with Paripluta Yonivyapad, which is caused by Vata and Pitta Dosha is similar to the preliminary stage of the tubal block as all its symptoms are suggestive of PID. The methodology used was a single-armed, open-labelled case study of a subject of 34 years old female. Her history revealed early pregnancy loss, posterior wall intramural fibroid followed by infer-tility due to bilateral tubal blockage and also had dyspareunia. She was advised to undergo surgical manage-ment, but she refused and then approached our hospital. After thorough examinations, she was treated with Ayurvedic medications followed by Uttarabasti, having Shophaghna, Shulahara, Rasayana, Tridoshahara and Pramaathi actions. As a result, she successfully got conceived. It concludes that Ayurvedic management is suc-cessful and safe, so an effort has been made to share the protocol for the advancement of Ayurvedic science for the welfare of mankind.

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

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 &amp; fetus), Beej i.e. Shukra and Shonita (Sperm &amp; 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.

Sonohysterography Assessment of the Structural Abnormalities of the Uterus in Women with Infertility in Ethiopia

Background: Female factor infertility is associated with a high incidence of the uterine cavity and fallopian tube pathology in developing countries with a high prevalence of STDs, therefore various methods are available for structural evaluation of the female reproductive system, among them is saline infusion sonohysterography (SISHG). The study aimed to assess the role of SISHSG in female infertility evaluation in areas where the gold standard investigating modalities are not readily available.&#x0D; Methods: A hospital-based cross-sectional study was carried out in Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia, between January 2019 to August 2019 G.C. SISHSG consists of instillation of saline into the endometrial cavity with simultaneous pelvic ultrasonography (US). Fifty consecutive female patients referred to the Radiology Department for SISHSG are included in the study. Sensitivity, specificity, positive and negative predictive values were calculated for 26 patients who had both SISHSG and conventional HSG.&#x0D; Result: The majority of the patients were in the age group of 35-40(38%) and 34 (68%) had secondary infertility. The commonest abnormalities detected were uterine myoma 10(20%), Asherman syndrome/cervical stenosis 7 (14%), and tubal blockage 6(10%). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of SISHSG in normal study, Asherman syndrome/cervical stenosis and chronic endometritis was 100%, as compared to the gold standard conventional HSG. For bilateral tubal blockage the SISHSG had 50% sensitivity, 90% specificity, 66.7% PPV and 81.8% NPV, however, for unilateral tubal blockage SISHSG had low sensitivity 33%.&#x0D; Conclusion: SISHSG is readily available, easy-to-do, safe and radiation-free procedure and has high sensitivity and specificity in detecting uterine cavity abnormality. We advocate its use as a first step of investigation modality in the evaluation of female infertility.

A Comparison of Hysterosalpingographic Results in Individuals Experiencing Primary and Secondary Infertility: A Prospective Approach

Introduction: In order to examine the uterine and fallopian tubes in women suffering from infertility, Hysterosalpingography (HSG) technique is commonly used in process of different investigations. The technique is used to assess any blockages in the tubes or normal morphology of the uterus. This study aims to compare the HSG results in a study population having primary and secondary infertility.&#x0D; Materials and Methods: We conceded a one-year prospective study at Islamabad Diagnostic Center in Islamabad, Pakistan after getting institutional review board approval. The study duration was from July 1, 2022 to June 30, 2023. Sample size was calculated using online software “Raosoft” which estimated it to 242. All the patients who gave informed consent and having primary and secondary infertility were enrolled. Demographics of the patients including age, duration of infertility, and the presence of tubal and uterine abnormalities, were collected by reviewing clinical notes and X-ray findings.&#x0D; Results: Among 242 enrolled patients with infertility, the ratio of primary infertility was 70.27% (n=170) and that of secondary infertility was 29.75% (n=72). In both the groups, fallopian tube blockage was observed as a major abnormality that affected 20.00% (n=34/170) of patients with primary infertility and 30.55% (n=22/72) of patients with secondary infertility. Unilateral tube blockage was observed in 26.47% (n=9/34) whereas, bilateral blockage was observed in 29.41% (n=10/34) patients with primary infertility. 23.52% (n=8/34) of patients got affected with Bilateral hydrosalpinx, whereas unilateral loculated spill was perceived in 8.82% (n=3/34) of. In patients with uterine congenital abnormalities, 5.88% (n=2/34) had a bicornuate uterus, 2.94% (n=1/34) had a unicornuate uterus, and 2.94% (n=1/34) had uterine didelphys.&#x0D; Conclusion: In order to examine the uterine and fallopian tubes in women suffering from infertility, Hysterosalpingography (HSG) technique is commonly used. The technique is used to assess any blockages in the tubes or normal morphology of the uterus. In this study, fallopian tube abnormalities were most predominant among barren women. So, taking deterrent actions and efficiently management of pelvic infections are indispensable in plummeting the manifestation of infertility resultant of the tubal issues.&#x0D; Keywords: Hysterosalpingography, Infertility, Subfertility, Tubal blockage&#x0D; &#x0D;

Optimising Rehabilitation Strategies for Postpartum Elderly Gravida with In Vitro Fertilisation Conception

Optimising Rehabilitation Strategies for Postpartum Elderly Gravida with In Vitro Fertilisation Conception