A Randomised Open-Labelled Comparative Clinical Study to Evaluate the Efficacy of Bṛhatyādi Yāpana Basti and Sahacarādi Yāpana Basti in the Management of Strī Vandhyatva with Special Reference to Aberrant Folliculogenesis

Background: Strī Vandhyatva (female infertility) is a major reproductive health concern, with ovarian factors contributing substantially to infertility. Aberrant folliculogenesis, characterized by impaired follicular development and anovulation, is an important ovarian cause of infertility. In Ayurveda, it may be correlated with Bīja Rūpa Ārtava Duṣṭi, predominantly involving Vāta and Pitta Doṣa. Yāpana Basti, with its Prajanana, Bṛṃhaṇa, and Vātānulomana properties, may support follicular development and reproductive function. Aim: To compare the efficacy of Bṛhatyādi Yāpana Basti and Sahacarādi Yāpana Basti in the management of Strī Vandhyatva with special reference to aberrant folliculogenesis. Materials and Methods: A randomized, open-label, parallel-group comparative clinical study was conducted in 30 women, randomly allocated into two groups of 15 each. Group A received Bṛhatyādi Yāpana Basti and Group B received Sahacarādi Yāpana Basti. Each intervention was administered for 9 days during the first treatment cycle, with assessment continued over a three-cycle study period. Follicular growth, ovulation, endometrial thickness, presence of fluid in the pouch of Douglas, and clinical parameters were assessed before and after treatment. Statistical analysis was performed using appropriate parametric and non-parametric tests, with p<0.05 considered significant. Results: Both groups demonstrated significant improvement in folliculogenesis and endometrial thickness. Folliculogenesis improved highly significantly in Group A (p=0.001) and significantly in Group B (p=0.004). Endometrial thickness showed significant improvement in Group A (p=0.004) and Group B (p=0.003). Between-group comparisons for folliculogenesis and endometrial thickness were statistically non-significant, indicating comparable efficacy. Clinically, Group A showed numerically better reproductive outcomes, including natural conception in 2 participants (13.3%), compared with none in Group B; however, this difference was not statistically established as superior. Conclusion: Both Bṛhatyādi Yāpana Basti and Sahacarādi Yāpana Basti demonstrated beneficial effects on folliculogenesis, ovulation, and endometrial thickness. While Bṛhatyādi Yāpana Basti showed comparatively better numerical clinical outcomes, the non-significant between-group differences indicate comparable therapeutic efficacy, and superiority of either intervention cannot be concluded from the present study. Keywords: Strī Vandhyatva, Aberrant folliculogenesis, Yāpana Basti, Bṛhatyādi Yāpana Basti, Sahacarādi Yāpana Basti