AYURVEDIC MANAGEMENT OF PID-RELATED TUBAL BLOCK AND PYOSPERMIA: A HOLISTIC APPROACH TO RESTORING FERTILITY IN A COMPLEX INFERTILITY CASE

Infertility involving combined female and male factors is especially complex when structural pathology, chronic genital tract infections, and infection-related sexual dysfunction coexist.[1] Pelvic inflammatory disease (PID) contributes to tubal obstruction, recurrent vaginitis, pelvic pain, and dyspareunia; persistent inflammatory vaginitis may lead to secondary vaginismus, reducing coital frequency and natural conception potential.[2,3] In men, pyospermia with oligoasthenoteratospermia and erectile dysfunction further aggravates subfertility.[4] Ayurveda provides an integrative framework addressing reproductive tissue health, genital tract immunity, inflammation, and sexual well-being.[5] This case report describes a couple with three years of primary infertility. The 32-year-old female had PID-related left tubal block, recurrent vaginal and urinary tract infections, intramural fibroid, and chronic pelvic pain. Vaginismus was secondary to inflammatory vaginitis rather than a primary psychosexual disorder, resulting in painful intercourse and functional infertility. The 36-year-old male partner presented with oligoasthenoteratospermia with pyospermia, erectile dysfunction, and reduced libido. Two prior intrauterine insemination (IUI) cycles had failed. An Ayurvedic protocol comprising infection-focused reproductive cleansing, targeted formulations, lifestyle modification, and counselling was implemented. Resolution of vaginitis resulted in reversal of secondary vaginismus, improvement in pelvic and seminal parameters, and restoration of painless intercourse. The couple conceived naturally and presented in six months with a positive urine pregnancy test and appropriately rising serum β-hCG levels. This case emphasizes infection-driven secondary vaginismus as a reversible contributor to infertility and highlights the potential of integrative Ayurvedic management in complex PID-related tubal and severe male factor infertility.