Management of secondary infertility with tubal and ovarian factors through Ayurveda: An experience

Infertility is a condition that has a significant impact on both the physiological and psychological well-being of a woman and her family. The achievement of conception hinges on the fertility of both male and female partners. Approximately 30% of cases are attributed to male partners, 30% to female partners, and another 30% to a combination of both, while the causes in the remaining 10% remain unexplained. Tubal factors, encompassing conditions such as tubal injury, blockage, or paratubal adhesions, contribute to infertility in approximately 30%–40% of cases. In Ayurveda, the fallopian tubes are understood with the concept of Artavavaha srotas (~fallopian or uterine tubes), and any blockage in these is equated to the Sanga sroto dushti (~obstructive deformity in the channels). In the present case, a 28-year-old married female of secondary infertility, diagnosed with bilateral tubal blockage, presented to the Outpatient Department of Prasuti Tantra Evum Stri Roga of Ayurveda Hospital. Her pelvic Ultrasonography revealed bulky ovaries with bilateral polycystic ovarian pattern, and the Hysterosalpingography (HSG) report showed bilateral tubal blockage. A holistic and comprehensive Ayurvedic treatment regimen incorporating Uttara basti (~ Basti administered through vaginal or urethral route) for three days along with Purvakarma (~preparatory procedures) such as Snehana (~oleation therapy), Swedana (~sudation therapy), Matra basti (~a form of unctuous enema), Niruha basti (~decoction enema), and Yoni prakshalana (~vaginal douching) in three consecutive cycles after cessation of menses along with oral medications was followed. During the last cycle of Uttara basti , HSG was done, which revealed patent bilateral tubes. The patient conceived after the third course of the management, followed regular Garbhini paricharya (~antenatal regimen), and delivered a healthy child vaginally without any complications. The case report inferred that the Ayurveda interventions, such as Niruha basti, Matra basti, and Yoni prakshalana as preprocedures along with Uttara basti and internal medicines, are efficacious in managing infertility associated with tubal and ovarian factors.