As per Sushruta, the great Indian surgeon, Vandhya is described as a woman having lost her Artava (menstrual fluid) which results in loss of ovulation or sterility. As per Vagbhata, the congenital malformations and deformity of female reproductive tract are possible causes of Vandhyatwa. Bhela considers aggravated vata as responsible factor for Vandhya.
Ayurvedic anatomy of the female reproductive system
In Ayurvedic anatomy, ‘Shroni’ refers to the pelvis. Female pelvis is considered to be 24 Angulas. It is heavier as compared to the pelvis of the male. As per Ayurvedic anatomy, there are three Srotas (channels of circulation) in female’s body –
- Rajovaha Srota (channels of circulation dealing with menses): They include garbasahya (uterus), cervix and yoni (vagina) along with their blood vessels.
- Artavaha Srota (channels of circulation dealing with menses): They include ovary and fallopian tube along with their blood vessels.
- Stanyavaha Srota (channels of circulation dealing with milk): They include stanya (breasts) along with its blood vessels.
‘Ashaya’ refers to any organ. ‘Garbhasaya’ means uterus and is situated behind the ‘Bhagasthi’ (anatomically known as symphysis pubis) and a little above the bladder. ‘Yoni’ is used to describe the female genital tract.
Definition of Infertility
Infertility is defined as the inability to get pregnant after a year of unprotected intercourse.
Ayurvedic system of medicine has described Vandhyatva as equivalent for infertility. As per the modern medicine, consideration Vandhyatva correlates any major issue factor responsible for the incidence of infertility. As per Ayurveda principles, imbalance in Artvavahasrotas is the principle cause of Vandhyatva.
Incidence of Infertility
As per one estimate, as many as 10 percent of couples, are affected by infertility in America alone. Both men and women can be infertile. As per information form, the Centres for Disease Control, 1/3 of the infertility are due to female infertility. Similarly, rest of 1/3 of the cases are linked to male-infertility and in case of the remaining one, both partners can be the cause. In 20 per cent of cases, the reason for infertility cannot be determined.
An array of factors can be held responsible for female-infertility. Some common ones are enumerated below:
- Cervical reasons. Sometimes, due to anomaly in the cervical canal, sperms are not in a position to pass through the passage. Major causes include abnormal mucus production or a previous cervical operation. Cervical causes are treated with inseminations at intrauterine levels.
- Hormonal reasons. In some women, ovulation is a problem. Release of the hormones in a synchronised manner leads to the release of the egg from the ovary, the female sex organ and also the thickening of the endometrium (the inner lining of the uterus). Sometimes, these changes do not occur in coherent manner. The causes are detected by using pelvic surgeries, hormonal assays and above all, ovulation predictor kits.
- Injury to fallopian tubes. Injury to the fallopian prevents contact between the egg and spermatozoon. Infections of the pelvis, pelvic surgeries and endometriosis, leads to scarring and damage to the fallopian tube.
- Unexplained infertility. The cause of infertility will not be determined in approximately 20% of couples using the currently available methods of investigation.
- Uterine reasons. Anomaly in the makeup of the uterus; uterine-polyps and uterine–fibroids are other possible reasons.
As per Ayurvedic nidana (pathology), Artava chakra (menstrual-cycle) is an indicator of the state of the female’s heath. Artava chakra is affected by number of factors, including excessive physical exercise, diet, life-style, stress, emotional instability. These factors results in imbalance among three biological humours and Dhatus.
Investigations for Infertility
- Endometrial biopsy
- Hormonal profiling
- Seminal analysis (in case male infertility is suspected)
In the Ashtanga Hrdayam, twenty vaginal diseases have been dealt with. Yonivyapad are better addressed as gynaecological disorders.
- A study investigated efficacy of Dhanvantari Taila in patients diagnosed with infertility associated with dysfunctional uterine bleeding. Dysfunctional Uterine Bleeding is considered to be a major cause of incidence of infertility. The clinical study used dhanvantari taila as uttara vasti inside the uterine-cavity after completion of bleeding after that particular cycle. Patients were administered oleatin and Sodhana vasti (purification enema) including the Anuvasana and Niruhavasti. Then the patients were given uttara vasti containing Dhanvantari taila. Dhanvantari taila is a pacifier of three biological humours and was selected for the study. Study demonstrated that use of dhanvantari taila as uttara vasti was efficacious in the treatment of infertility with dysfunctional uterine bleeding.
- A study investigated efficacy of Kumari Taila Uttar Basti on the blockage of the Fallopian-tube as it has Vata- Kapha pacifying and emaciation properties. Patients in the reproductive-age group were included for the study. The study showed that in 80 per cent of the patients, tubal-blockage was cured after the treatment. 40% of the patients conceived within the follow-up period of 60 days. The results clearly prove the regimen as effective treatment for the tubal blockage, with no side-effects.
- A study investigated efficacy of Chitrakadi Ghritam in the treatment of infertility with Yonidosha. Fallopian tube block, polycystic ovarian disease, pelvic-inflammatory disease and endometriosis as main reasons of infertility. Results showed that the formulation, Chitrakaadi ghrita was effective for the treatment of Vandhyatva with Yonidosha. Action of Chitrakadi ghritam in treatment of female infertility was found to be significantly higher in the treated patients.
Ayurvedic medicine offers a wide range of formulations in the treatment of female infertility. Panchkarma has been reported to be useful in the management of female infertility. Utta vasti with Chitrakadi Ghritam, dhanvantari taila and Kumari Taila have been researched as efficacious remedies as far as treatment of female infertility is concerned.
- Bhaskaruni Subbalakshmi and Meera Madhukar Paranjape (2014). Effect of Chitrakadi Ghritam in the Management of Vandhyatva (Infertility) With Yonidosha. International Journal of Ayurveda and Pharma Research 2(1) 98-104.
- Kamidi Vijaya Kumari (2011). Clinical Evaluation of Dhanvantari Taila in the Management of Infertility with Dysfunctional Uterine Bleeding. IRJP 2(4) 108-109.
- Kamayani Shukla, Kaumadi Karunagoda, Nita Sata and Dei LP (2010). Effect of Kumari Taila Uttar Basti on fallopian tube blockage. Clinical Research 31(4) 424-429.