An Ayurvedic Management in Primary Infertility Associated with Anovulatory Cycle with Diminished Ovarian Reserve: A Case Report

Infertility, defined as the inability of a sexually active couple to conceive after one year of regular, unprotected intercourse, affects a significant portion of the population. Among the various causes of female infertility—ovulatory dysfunction accounts for approximately 35% of cases. In Ayurveda, this condition can be correlated with "Ksheenartava," This case study explores the efficacy of an Ayurvedic intervention, Rasnadi Churna Basti, in the management of infertility due to anovulatory cycles with diminished ovarian reserve. A 29-year-old female with primary infertility and a married life of 2.5 years presented to the Stree Roga evum Prasuti Tantra outpatient department at AIIA, New Delhi. Despite having regular menstrual cycles, she was diagnosed with Bilateral Polycystic Ovarian Disease (PCOD) via ultrasonography and had a history of anovulatory cycles as confirmed by transvaginal ultrasound (TVS). Her Anti-Müllerian Hormone (AMH) levels were low, indicative of diminished ovarian reserve, though other hormonal assays were within normal limits. The patient had been previously advised to pursue IVF with donor oocytes and intracytoplasmic sperm injection (ICSI) at a reputed hospital in Delhi. Ayurvedic treatment plan was initiated, beginning with Deepana-pachana & Koshtha shuddhi (therapeutic purgation) followed by Rasnadi Churna Basti (medicated enema) administered post-menstruation for three consecutive cycles. TVS was performed during each cycle to monitor follicular growth and ovulation. After completing three cycles of Rasnadi Churna Basti, the patient resumed ovulation, as evidenced by TVS and during the follow-up period, she conceived naturally. This case demonstrates the potential of Rasnadi Churna Basti as a safe, effective, and cost-efficient treatment for Infertility caused by anovulatory cycles, particularly in cases with diminished ovarian reserve.