Ayurvedic Management of Ksheena Shukra with Shamana Therapy

Male factors are responsible for about half of the couple infertility and oligozoospermia is a common abnormality in semen analysis. Deficient Shukra (reproductive tissue/semen) in Ayurveda is described in context of Ksheena Shukra (diminished semen), managed under Vajikarana-Rasayana (aphrodisiac and rejuvenation therapy). Reports describing sequential semen-parameter changes following Shamana (palliative) therapy without Shodhana (bio-purificatory) are limited. A 37-year-old married man presented with a history of inability to conceive for 11 years. He had no other comorbidities or fertility-directed therapy. The female partner had been worked up for infertility with no significant abnormality found. General and systemic examination was normal. Ashtavidha Pariksha (eight-fold clinical examination) revealed Vata-Pitta-pradhana (Vata-Pitta-predominant) constitution. Baseline semen analysis showed a volume of 1.0ml and occasionally 1–2 dead spermatozoa seen with no quantitative sperm concentration reported. The patient was given Ayurvedic Shamana therapy with Ashwagandha Churna, Shilaprawanga, Chandraprabha Vati and Chandanasava initially, and later Ashwagandhadi Compound Tablet, Ashwagandha Churna and Brahmiadi Compound Tablet along with Pathya-Apathya counseling. Sperm concentration increased from an unknown baseline to 16.0 million/ml and 58.0 million/ml over approximately 5.5 months. With progressive motility increasing from 50% to 65%, the total sperm count increased from 16 to 58 million/ejaculate. Semen volume was unchanged (1.0ml). The case demonstrates time association between Shamana Vajikarana-Rasayana therapy and improvement in several semen parameters in a patient assessed as having Ksheena Shukra.