Success story of Vajikarana - A Case Study

ISSN: 2456-3110 CASE REPORT Mar-Apr 2018 Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2018 | Vol. 3 | Issue 2 115 Success story of Vajikarana - A Case Study Srinath Ayli, 1 Prashanth A. S., 2 S. G. Chavan. 3 1 Post Graduate Scholar, 2 Professor and HOD, 3 Professor, Department of Kayachikitsa, Ayurveda Mahavidyalaya, Hubli, Karnataka, India. I NTRODUCTION Though population of the world is increasing day by day yet 20-30% population of the world are the victims of the infertility [1] In India, 1 out of 10 couples suffer from infertility and about half of cases, men Address for correspondence: Dr. Srinath Ayli Post Graduate Scholar, Department of Kayachikitsa, Ayurveda Mahavidyalaya, Hubli, Karnataka, India. E-mail: aylisrinath@gmail.com Submission Date : 27/03/2018 Accepted Date: 24/04/2018 Access this article online Quick Response Code Website: www.jaims.in DOI: 10.21760/jaims.v 3 i 02.12096 alone are the victims Fertility is the essential thing for the human being. It is an important factor to keep both the partners to lead the happy married life. Acharya Kashyapa while explaining about the importance of children; He says that ‘Aputrasya Gatirnasti’ , without progeny the person will not attain Moksha. Vajikarana is the specialized branch of Ashtanga Ayurveda deals with Shukra Dushti and Klaibya . Though it mainly concentrates on Shukra Dosha and Vandhyatwa (Infertility), but the basic aim of this therapy is to maintain the sexual potency, fertility and to procreate healthy progeny [2] in order to fulfill the four fold means of life i.e. Dharma, Artha, Kama and Moksha. [3] A couple may be considered as infertile if not conceived even after one year of regular sexual A B S T R A C T Ayurveda is a science of life and it has taken the foremost place in the management of lifestyle disorders. In a country like India where population is a burning problem, yet the infertility is much more serious problem which may become the basis of marital disharmony. The major Focus of fertility problems in the past has been the female patient but with the advancement of diagnostic technology, it was realized that males were also responsible for infertility. In general Male infertility factors are suspected of contributing to infertility in almost 40% of infertile couples. Out of many causes of male infertility Oligospermia and Azoospermia are the leading causes In the present case study, A 30 year old male patient (Registration No.16874/464) had visited Kayachikitsa OPD of Ayurveda Mahavidyalaya Hospital, Hubli with chief complaints of Unable to get a child since married life of 5 years and associated complaint was inability to maintain prolonged erection. On the b asis of patient’s complaints and semen analysis reports patient was diagnosed as Azoospermia and Beejopaghataja Klaibya/Nirbeeja according to Ayurvedic view. The patient was treated with Siddha Vrushya Yapana Basti and Bastanda Prayoga. By this treatment we could able to reverse the pathology from Azoospermia into Oligospermia and gradual progress helped to impregnant his partner. After 2 months of treatment, we could be able to achieve ultimate goal of Vajikarana i.e. Conception. His partner became pregnant with her first child after 5 years of continuous trying for a baby. The pregnancy progressed normally as per Masanumasika Garbha Lakshana without any problems. The couple were blessed with a healthy baby girl of 2.75 kg in October 2017. Currently the couple are enjoying the parenthood. This case report provides us a guideline that even Azoospermia can be successfully treated in Ayurveda with valid Chikitsa Siddhanta. Key words: Azoospermia, Oligospermia, Beejopaghataja Klaibya, Siddha Vrushya Yapana Basti, Bastanda Prayoga.

Srinath Ayli et.al. Success story of Vajikarana - A Case Study ISSN: 2456-3110 CASE REPORT Mar-Apr 2018 Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2018 | Vol. 3 | Issue 2 116 intercourse without any contraception. 40% of infertility is due to male sexual dysfunction. It is due to the factors like Oligozoospermia, Asthenozoospermia, Azoospermia etc [4] For successful fertility sperm count should be 40 mill/ml or more, [5] but studies have shown that if sperm cells are having good progressive motility besides of less sperm count (even less than 10 million/ml), there is probability of conception. There is no satisfactory treatment in modern medicine for these conditions as it is based on Hormonal therapy. This Hormonal therapy has got its own side effects and limitations. Even with the advancement of modern techniques, the success rate of conception is low; the cost of treatment is very expensive and common man cannot afford. So Ayurveda is the better option for these conditions. In Ayurveda terms like Kshina Shukra, Alpa Retas, Kshina Retas, Shukra Dosha are indicating towards Oligospermia and Bijopaghata, Ashukra Shandatva, Nirbeeja, Abeeja are indicating towards Azoospermia. In this case study, a success story of patient suffering from Azoospermia has been presented who was treated with Siddha Vrushya Yapana Basti procedure followed by Shamanoushadhi. C ASE R EPORT A 30 year old male patient (Registration No.16874/464), residing in Yallapur, visited Kayachikitsa OPD of Ayurveda Mahavidyalaya Hospital, Hubli on 19 th September 2016, presented with chief complaints of Unable to get a child since married life of 5 years. And other associated complaints were Inability to maintain prolonged erection, Less penile rigidity, Watery semen, Postcoital exhaustion, Early ejaculation of 3-4 min since 5 years. On the basis of patient’s complaints and semen analysis reports patient was diagnosed as Azoospermia and Beejopaghataja Klaibya/ Nirbeeja according to Ayurvedic view. History of Present Illness ▪ Patient was apparently normal 5 years back. After getting married he was unable to conceive his partner even after regular unprotected sexual intercourse and inability to maintain prolonged erection. ▪ He attained normal puberty and he was nondiabetic, non-hypertensive with good physical built. His appetite was normal, with regular bowel habits. He had a chronic history of tobacco chewing since 12 years. ▪ His partner was normal on clinical and Endocrinological investigations. She had regular menstrual cycles and no history of any reproductive tract disorders or any surgery. ▪ His semen analysis reveals 3 subsequent samples shows Azoospermia and one sample shows Oligo- Asthenozoospermia. ▪ Patient had consulted Endrocrinologists and taken Harmonal Therapy and got some relief in associated complaints. And even tried with ICSI but not satisfied because his partner didn’t get conceived. ▪ He came to Ayurveda Mahavidyalaya Hospital, Hubli for Ayurvedic management of Infertility. History of Past Illness ▪ No H/o any major illness in the past. ▪ No/H/o DM, HTN, Thyroid disorder, TB, Mumps ▪ No H/o Trauma, No/H/o Pelvic Surgery ▪ He did not have any kind of allergies with respect to food and medicines. Family History No significant family history found. Personal History ▪ Diet : Mixed ▪ Addiction : Tobacco chewing (Since 12 years) ▪ Sleep : 6-7 hours/Day (Undisturbed) ▪ Occupation : Horticulture ▪ Education : B.Com ▪ Bowel Habits : Regular 1 time/day

Srinath Ayli et.al. Success story of Vajikarana - A Case Study ISSN: 2456-3110 CASE REPORT Mar-Apr 2018 Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2018 | Vol. 3 | Issue 2 117 ▪ Micturation : 4-5 times/day General Examination ▪ Built : Well built ▪ Gait : Not Effected ▪ Clubbing/ Cyanosis/ Icterus/ Edema/ Lymphadenopathy : Absent ▪ Pallor : Mild Systemic Examination ▪ CVS : S 1,S 2+. No murmurs. NAD ▪ RS : NVBS, B/L Air entry equal, NAD ▪ CNS : Higher mental functions were intact. ▪ Sensory and Mental functions : Normal ▪ P/A : Soft, Non-tender, No organomegally on palpation. Reproductive System (Local Examination) ▪ Prepuce skin : Normal with both testes are distended. ▪ Proper hygiene maintained. ▪ Testicles : Hypoplastic gonads (Small Testicles noted on palpation), No tenderness ▪ Spermatic cord : No abnormality detected. ▪ No Vericocele, No edema, No redness ▪ Penis : No abnormality detected. ▪ Secondary sexual characters : Normal (Pubic hairs, Axillary hairs, Beards and Moustache) Vital Signs ▪ Pulse Rate : 82/min (With normal Rhythm and Volume) ▪ Weight : 78 kgs ▪ Respiratory Rate : 19 times/min ▪ Blood Pressure : 130/70 mm of Hg ▪ Temperature : 98.4 ̊ F A YURVEDOKTA P ARIKSHA Asthavidha Pariksha ▪ Nadi : 82/min (Sama Nadi) ▪ Mala : Regular 1 time/day ( No vit vibandha; Prakruta Varna, Gandha ). ▪ Mutra : 4-5 time/day ( Prakruta Varna, Gandha ) ▪ Jiwha : Nirliptata ▪ Shabdha : Prakruta ▪ Sparsha : Khara (Prakruta) ▪ Drika : Prakruta ▪ Akruti : Madhyama Dashavidha Pariksha ▪ Prakruti : Kapha-Vataja ▪ Vikruti : Dosha- Vata,Pitta Dushya- Rasa,Majja,Shukra ▪ Sara : Madhyama ▪ Samhanan : Madhyama ▪ Pramana : Madhyama ▪ Satmya : Madhura, Lavana, Katu Rasa ▪ Satwa : Madhyama ▪ Ahara shakti : Abhyavarana Shakti : Madhyama Jarana Shakti : Prakruta ▪ Vyayamashakti : Pravara ▪ Vaya : Madhyama Investigations Semen Analysis : On 01-06-2013 Sperm Count: NIL, Sperm Motility: NIL, Pus cells: 6-8 cells/hpf : Azoospermia Date: 02-09-2013: RBS: 101 mg/dl, SGPT: 70 IU/L, HBA 1 C: 5.30%, TSH: 3.10 mIU/ml, FT 4: 18.10 pmol/l, FSH: 7.64 mIU/ml, Prolactin: 10.20 ng/ml, Testosterone: 3.18 ng/ml.(All were WNL) Semen Analysis: On 06-12-2013

Srinath Ayli et.al. Success story of Vajikarana - A Case Study ISSN: 2456-3110 CASE REPORT Mar-Apr 2018 Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2018 | Vol. 3 | Issue 2 118 Sperm Count: 15 million/ml, Sperm Motility: 20%, Pus cells:2-3 cells/hpf : Oligo-Asthenospermia Semen Analysis : On 19-09-2016 Sperm Count: NIL, Sperm Motility: NIL : Azoospermia USG Scrotum: On Date: 19-09-2016 Impression: Small volume bilateral testicles and Small sized seminal vesicles. Roga Pariksha: Nidana Panchaka Nidana Atisevana of Amla, Lavana, Katu Aahara dravyas Atisevana of Ruksha and Ushna, Ativyayama Virudda Ahara-Vihara Poorvaroopa Phenila Shukra, Tanu Shukra and Ruksha Shukra. Roopa Linga Shaitilya, Glana Shishnata, Nirbeeja/Nirveerya, Mogasankhalpa, Maithuna Ashakta, Upashaya Vrushya, Brumhana Anupashaya Vata Vardhaka Ahara (Ruksha, Laghu, Katu) Vata Vardhaka Vihara (Ativyayama, Ativyavaya) Samprapti Ghataka ▪ Dosha : Tridosha with Vata-Pitta Pradhana (Vyanavata, Apanavata) ▪ Dushya : Rasa, Majja, Shukra Pradhana ▪ Agni : Shukra Dhatwagni ▪ Ama : Dhatwagni Janya Ama. ▪ Srotas : Rasavaha, Majjavaha, Shukravaha and Manovaha ▪ Sroto Dusti : Sanga. ▪ Adhisthana : Shukravaha Srotas (Vrushana and Medra) ▪ Udbhava Sthana : Pakwashaya. ▪ Vyakta Sthana : Apana Kshetra (Vrushana and Medra) ▪ Sanchara Sthana : Rasayani, Shukravaha srotas ▪ Vyadhi Swabhava : Chirakari ▪ Rogamarga : Abhyantara ▪ Sadhyasadhyata : Krichrasadhya M ATERIALS AND M ETHODS Treatment given ▪ Vanari Kalpa - (10 gms with luke warm milk at bed time) ▪ Tab Manmatha Rasa - (1 tablet with luke warm milk BD after food) ▪ Cap Rejuspermin - (1 capsule with warm water BD after food) ▪ Sri Gopala Taila (Local Application) ▪ Bastanda Siddha Paya (Twice in a week) ▪ Duration of treatment : 3 months Panchakarma ▪ Sarvanga Abhyanga with Mahamasha Taila ▪ Sarvanga Nadi Swedana ▪ Vrushya Yapana Basti (2 course of Kala Basti Schedule) 1 st course: From 19/09/16 to 04/10/16 - 16 days 2 nd course: From 20/11/16 to 05/12/16 - 16 days Siddha Vrushya Yapana Basti ▪ Madhu : 80 gms ▪ Saindhava Lavana : 3 gms ▪ Sneha dravya: Ashwagandhadi Ghrita 50 ml Phala Ghrita 50 ml ▪ Kalka dravya: Kapikacchu beeja Churna 15 gms ▪ Kwatha dravya: Bala moola Churna 20 gms Ashwagandha Churna 20 gms ▪ Avapa dravya: Ksheera 500 ml

Srinath Ayli et.al. Success story of Vajikarana - A Case Study ISSN: 2456-3110 CASE REPORT Mar-Apr 2018 Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2018 | Vol. 3 | Issue 2 119 DISCUSSION To produce progeny four things are necessary i.e. Ritu, Kshetra, Ambu and Beeja and presence of any Dushti in the above factors will lead into Shukradushti which is the prime cause of infertility In the present era, Modernization is affecting all aspects of human life in the form of diet, diurnal, climatic change and harmful irradiations contributing a lot in producing Shukra Dusti (poor quality semen) as a result, a vast population is being suffering from Male Infertility Out of many causes of male infertility Oligoasthenozoospermia and Azoospermia are the leading causes. According to WHO guidelines Oligoasthenozoospermia is the condition where the Sperm count is less than 20 million/ml or 40 million/Ejaculate and Sperm Motility less than 40%. And Azoospermia is a condition where semen contains no spermatozoa at all i.e. Zero sperm count [6] As per Ayurveda classics Garbhotpadana is a vital function of Shukra Dhatu. [7] If there is any form of Bijadusti (Shukra Dusti) ultimately results in failure of conception [8] Acharya Sushruta explained that there is vitiation of Apana Vayu and Vyana Vayu in the Shukradosha , because site of Shukra is the whole body and Apana Vayu is responsible for the proper expulsion of Shukra Dhatu. i.e. vitiation of Apana Vayu can impair the function of Shukra. Shodhana in Klaibya The main factors involved in the Samprapti of Klaibya are Bahudoshavastha particularly Prakupita Vata, Dhatukshaya in general and Shukra Kshaya in particular with involvement of Shukravaha Srotodusti and Manodosha. Hence in order to overcome Bahudoshavastha, Shodhana is must that too Sasneha Shodhana. Some scattered references which glorifies the importance of Shodhana in Klaibya . ▪ “Beejam Bhavati Karmukam” [9] ▪ “Prashasta Shukradosheshu Bastikarma Visheshata” [10] ▪ “Basti Prayogaat Shandopi Puman Bhavati Sarvasha” [11] ▪ “Ksheena Shukram Vajikaroti” [12] ▪ In Klaibya and Vandhyatwa , Basti may be given in the form of Niruha, Anuvasana, Uttara Basti and Yapana Basti. Basti removes obstruction in the path of Shukra Visarga , protects the body from Dhatu Kshaya. [13] Vanari Kalpa [14] ▪ Kapikachu Beeja Churna is Madhura, Tikta Rasa, Snigdha, Guru Guna, Sheeta Virya, Madhura Vipaka and Shukrala Prabhava . i.e., Vatapittahara, Balya, Brimhana, Vrishya . ▪ If we look at the Kapikachu carefully it resembles like the structure of male genital organ. Hence Samanya Vishesha theory of Ayurveda is beneficial in the treatment of Male infertility. ▪ Kapikachu contains L-dopa naturally. This L-dopa (contains MAO inhibitor hormones) helps the brain to release Dopamine. When this dopamine is secreted in optimum levels, it increases Testosterone and GH. So it is responsible for the elevated mood, increased libido and vitality. So it is said to be the best Vajikarana dravya in male infertility. It acts at the level of Pituitary hormones FSH and LH [15] (Eu.Jr.Int.Med-2010). Siddha Vrushya Yapana Basti ▪ Basti Karma is considered as the best treatment in Shukra Dosha by Charaka's statement ''Prashashtha-Shukradosheshu Basti Karma Visheshatha'' . ▪ The ingredients used in Preparation of Siddha Vrushya Yapana Basti are Bala, [16] Ashwagandha, [17] Kapikachu, [18] Ashwagandhadi Ghrita, Phala Ghrita along with Ksheera. Because these are specially attributed with the property of Vrushya, Shukrala, Brumhana, Rasayana, Dipana and Srotoshodhana which enhance the quality and quantity of Shukra . ▪ Most of the ingredients of Basti Dravyas are having Sheeta Virya, Madhura Vipaka, Balya, Snigdha and Vatapitta Shamaka properties. ▪ Therefore Yapana Basti by its own potency is able to expel morbid Doshas and establishes the

Srinath Ayli et.al. Success story of Vajikarana - A Case Study ISSN: 2456-3110 CASE REPORT Mar-Apr 2018 Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2018 | Vol. 3 | Issue 2 120 Dhatusamyata. It is said to possess best Brimhana and Rasayana effect which magnifies the quality of Rasa Dhatu and Dhatwagni . Ashwagandhadi Ghrita [19] ▪ The ingredients of this Ghrita are having Brumhana, Balya and Vrushya properties. Its indication in Ksheena Shukra and Vandyatwa has been explained. ▪ In the Phalashruti of this Ghrita, Acharyas have stated that by using this Ashwagandhadi Ghrita, Person becomes capable to perform sex even with one hundred women. It turns elderly into youthful and the person can even make a sterile woman pregnant. Phala Ghrita [20] ▪ Phala Ghrita is a commonly used and prescribed Ayurvedic polyherbal formulation in male and female infertility. In classics, Phala Ghrita has also been indicated in the management of Shukra Dosha and Vandyatwa. ▪ And has been attributed as Ayushya, Paushtika, Medhya and Pumsavana Karma. Due to the drugs like Ashwagandha, Shatavari, Gokshura, Punarnava which is processed in medicines like Manjistha, Daruharidra, Haridra, Priyangu and Goksheera . It has been attributed with Vrushya effect along with potency of penetration till Shukra Dhatu. Manmatha Rasa [21] ▪ The ingredients of Manmatha Rasa are having the properties like Vrushya, Balya, Shukrala, Srotoshodhaka, Shukrastambhaka and Vatapittahara. This Yoga is best Rasayana, Balya and Uttama Vajikarana. ▪ In the Phalashruti of this Yoga, Acharyas have mentioned that by using this Manmatha Rasa , the person becomes capable to perform sex even with one hundred women without losing his strength. He feels Kamadeva himself. He looks attractive, energetic as young as of 16 years. It also eliminates Dhvajabhanga. Rejuspermin Capsule ▪ The ingredients of this capsule are Ashwagandha, Kapikachu, Shatavari, Balamoola, Vasa, Vidarikanda, Shilajatu, Punarnava, Amalaki, Shunthi, Gokshura, Pippalimoola, Anantamoola, Guduchi and Sweta musali. ▪ All these ingredients are having Shukra Janaka, Shukra Pravartaka, Balya, Vayosthapaka, Shukra Sthambhana and Apanavata Dustihara properties. ▪ So it corrects ED by relaxation of the cavernosum muscles resulting in increased blood flow. It also promotes Spermatogenesis by improving testicular functions. Bastanda Prayoga [22] ▪ This is based on the Siddhanta - “Sarvadha Sarvabhavanam Samanyam Vruddhikaaranam” [23] Based on this, there is reference in Charaka Samhita like Rakta Raktena, Mamsam Mamsena. In the same way Shukram Shukrena in which testicles and semen of some animals and birds were used as Shukra Vruddhikara Dravya in olden days. (Eg: Nakra Retas acts as Shukra Vruddhikara Dravya if taken orally) [24] ▪ Basta means Aja (Goat) and Anda means Testicle i.e. we have used Goat testicle for therapeutic purpose in male infertility. ▪ Just like Kheera (Payasam), Bastanda pieces were cooked in Ksheera along with some Prakshepaka Dravyas like Ghrita, Shweta Tila, Kajutaka, Badam, Draksha. All the Prakshepaka Dravyas we have used were Brumhaniya, Balya and Vrushya. After Swanga Sheeta , we have to administer to the patient to take orally twice in a week. ▪ This Bastanda Yoga is master drug in treating Azoospermia and Progressive Oligospermia. This is Ativrushya because the properties of this contents are similar to that of Shukra Dhatu like Guru, Snigdha, Picchila Guna. Sri Gopala Taila [25] ▪ This Taila was used for local application which promotes blood flow to the groin and helps to achieve stronger erection.

Srinath Ayli et.al. Success story of Vajikarana - A Case Study ISSN: 2456-3110 CASE REPORT Mar-Apr 2018 Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2018 | Vol. 3 | Issue 2 121 ▪ The ingredients of this Taila are having Vatashamaka, Shukra Sthambhaka, Shukra Rechaka, Balya and Vrushya properties. ▪ It helps in Vaso-dilation of the penile tissue to allow the stronger erections and thus corrects ED. ▪ It helps staying powerful and prolongs Ejaculation time so that person will get maximum desired pleasure. ▪ It also helps to soothe and moisturize. Mahamasha Taila [26] ▪ It was used for Sarvanga Abhyanga in this patient because it is Brumhana, Balya, Pusthivardhana and Vatashamaka. Azoospermia ▪ In modern science, treatment of Azoospermia depends on the cause of obstruction or Nonobstruction. It is further categorized into Pretesticular, Testicular and Post-testicular azoospermia. Most of the times farmer two are Non-obstructive types and later one is usually Obstructive type of azoospermia. ▪ In recent years, a major advancement in technology like IVF with IUI, ICSI etc. In men with Post-testicular azoospermia (OA), IVF-ICSI or Microsurgery may be helpful for Retrograde Ejaculation. In men with Pretesticular and Testicular azoospermia (NOA), ICSI allows successful fertilization even with immature sperms and sperms are obtained directly from the Testicular tissues through techniques like TESA, PESA etc. Pathyapathya ▪ Advised to avoid salty, spicy and fried items in their routine diet ▪ Advised to avoid any sort of physical or mental exertion ▪ Advised to follow Abstinence during the course of treatment. O BSERVATIONS Subjective observation After Basti patient was feeling of lightness in body with improved appetite and no weakness was reported after Basti evacuation. Patient was also reported a feeling of general wellbeing, physical and mental fitness and improvement in vigour and dynamism after completion of Basti regimen. The results observed after the treatment were excellent i.e. Marked improvement in sexual parameters like Sexual Desire, Erection and prolonged Ejaculation time was also observed. Objective observation Significant improvement was observed in total sperm count (i.e. from 0 to 15 million/ml) and sperm motility (i.e. from 0 to 30% actively progressive sperms) after Basti schedule at the time of discharge from the hospital (Table 1). Table 1: Assessment of effect of treatment Assessment Parameter Before Treatment 19/09/2016 After Treatment 05/12/2016 (On day of discharge from hospital) Sperm Count NIL 15 million/ml Sperm Motility Sperms are not seen Actively motile-30% Sluggish motile-20% Non-motile-50% Pus cells 2 to 3 NIL Liquefaction Time 20 min 10 min Testosterone 2013-3.18 ng/ml 1 st course-4.72 ng/ml 2 nd course- ? (Not done) FSH 2013-6.73 mIU/ml 1 st course-7.07 mIU/ml 2 nd course- ? (Not done) Prolactin 2013-10.20 1 st course-12.79 ng/ml

Srinath Ayli et.al. Success story of Vajikarana - A Case Study ISSN: 2456-3110 CASE REPORT Mar-Apr 2018 Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2018 | Vol. 3 | Issue 2 122 ng/ml 2 nd course- ? (Not done) AZOOSPERMIA OLIGO-ASTHENOSPERMIA R ESULTS ▪ This case study showed that Siddha Vrushya Yapana Basti, Bastanda Prayoga and Vajikarana Yogas we used were containing Shukra Janaka, Shukra Vardhaka and Shukra Shodhaka properties. ▪ By this we could able to reverse the pathology from Azoospermia into Oligospermia and gradual progress helped to impregnant his partner. ▪ After 2 months of treatment, we could able achieve ultimate goal of Vajikarana i.e. Conception. His partner became pregnant with her first child after 5 years of continuous trying for a baby. ▪ The pregnancy progressed normally as per Masanumasika Garbha Lakshana without any problems. The couple were blessed with a healthy baby girl of 2.75 kg in October 2017. Currently the couple are enjoying the parenthood. Partner’s Investigations: After Treatment USG Abd and Pelvis Impression Early Obstetric Scan: On Date: 27- 02-2017, H/o LMP: 03- 01-2017 Early Intrauterine Live Gestation with Gestational age of 7-8 weeks. Cardiac Activity seen. FHR-156 bpm, USG EDD- 13/10/2017 On Date : 06/04/2017, H/o LMP : 03/01/2017 Single live intrauterine gestation with estimated gestational age of 13 weeks, 5 days with good cardiac activity. FHR- 160 bpm On Date : 08/06/2017, Single live intrauterine gestation of around 21 weeks 4 days. H/o LMP : 03/01/2017 Normal Amniotic Fluid Index. Fetal Body weight:447 gms+/-65 gms, USG EDD- 15/10/2017 On Date : 24/07/2017, H/o LMP : 03/01/2017 Single live intrauterine fetus of around 27 weeks 3 days. Adequate Amniotic Fluid. Fetal Body weight: 1 kg+/-100 gms USG EDD- 15/10/2017 CONCLUSION Male Infertility is mainly discussed under the heading of Klaibya and Purusha Vandhyatwa with some scattered references relating to the symptoms in Shukragatavata, Shukravrutavata, Shukra Kshaya and Sama Shukra conditions On the basis of the present study it can be concluded that the combined effect of Siddha Vrushya Yapana Basti, Bastanda Prayoga and other Vajikarana Yogas have shown excellent results in bringing about excellent improvement in sexual and seminal parameters in cases of Azoospermia and Progressive Oligo-asthenozoospermia. However, it needs through more extensive studies and greater span of time whether ultimate goal of Vajikarana i.e. conception is achieved in all cases of male infertility through this line of treatment The present case study highlights the efficacy of Siddha Vrushya Yapana Basti and Bastanda Prayoga . But study on larger sample size could yield a significant statistical results.

Srinath Ayli et.al. Success story of Vajikarana - A Case Study ISSN: 2456-3110 CASE REPORT Mar-Apr 2018 Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2018 | Vol. 3 | Issue 2 123 Before Treatment After Treatment Partner’s Obstetric USG Scans

Srinath Ayli et.al. Success story of Vajikarana - A Case Study ISSN: 2456-3110 CASE REPORT Mar-Apr 2018 Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2018 | Vol. 3 | Issue 2 124 REFERENCES 1 Hawkins and Bourne, Shaw’s Textbook of Gynecology, 12 th Edition, B. I. Churchill Livingstone, New Delhi , Page No. 157 2 Astanga Hridaya of Vagbhata with Sarvanga Sundari commentary of Arunadatta and Ayurveda Rasayana commentary of Hemadri, Edited by Pt.Hari Sadashivashastri paradhakara, Chaukhambha Sanskrit Samsthana, Varanasi, Reprint Edition-2010, Uttarasthana, 40 th chapter, Sloka no.1, Page no.940. 3 Charaka Samhita with commentary of Chakrapanidatta, Translated By Prof.K.R.Srikantha Murthy, Chaukhambha Orientalia, Varanasi, Reprint Edition 2013, Volume-I, Sutrasthana, 1 st chapter, Sloka No.15- 17, Page No.15 4 www.drmalpani.com/oligospermia.html as seen on 20/12/2015 5 Harrison’s Principles of Internal Medicine,Volume -I, edited by Anthony S Fauci and Kasper, Braunwald, Stephen L.Hauser, Loscalzo, 16 th edition-2005, Page No.280. 6 http://www.fertilityfriends.co.ukforumindex.phptopic= 82727.0 as seen on 03/03/2016 7 Charaka Samhita , Ayurveda Dipika’s Ayushi Hindi Commentary, Volume-II Edited by Vd.Harishchandra Singh Kushwaha. Choukambha Orientalia. Varanasi, Reprint Edition-2011, Chikitsasthana -15 th chapter, sloka no.16, Page No.383 8 Charaka Samhita of Agnivesha with Chakrapani datta’ Ayurveda Deepika commentary, By Dr.Ram Karan Sharma and Vaidya Bhagawan Dash, Chaukhambha Sanskrit Series Office, Varanasi, Volume- II,Shareerasthana, 4 th chapter, Sloka No.31, Page No.404 9 Kashyapa Samhita, by P.V.Tiwari, English translation, Choukhamba Sanskrit sansthana,Varanasi 1996.Siddhi sthana,2 nd chapter, 7 th shloka, Page No.266 and 267 10 Charaka Samhita , Ayurveda Dipika’s Ayushi Hindi Commentary, Volume-II Edited by Vd.Harishchandra Singh Kushwaha. Choukambha Orientalia. Varanasi, Reprint Edition-2011- Chikitsasthana -30 th chapter, sloka no.152, Page No.821 11 Bhela Samhita, English Translation with commentary By Dr.K.H.Krishnamurthy, Editor Prof.Priya Vrat

Srinath Ayli et.al. Success story of Vajikarana - A Case Study ISSN: 2456-3110 CASE REPORT Mar-Apr 2018 Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2018 | Vol. 3 | Issue 2 125 Sharma, Chaukhambha Vishvabharati, Varanasi, First Edition-2000, Siddhisthana, 6 th Chapter, Sloka No.33, Page No.554 12 Sushruta Samhita of Susruta with Nibandha Sangraha Commentary of Dalhanacharya, Edited By Vaidya Jadhavji Trikamji acharya and Narayan Ramacharya ‘Kavitirtha’, Chaukhambha Sanskrit Sansthana, Varanasi, Reprint Edition-2010, Chikitsasthana, 35 th Chapter, Sloka No.3, Page No.525. 13 Charaka Samhita , Ayurveda Dipika’s Ayushi Hindi Commentary, Volume-II Edited by Vd.Harishchandra Singh Kushwaha. Choukambha Orientalia. Varanasi, Reprint Edition-2011- Chikitsasthana -30 th chapter, sloka no.196-198, Page No.826. 14 Bhaishajya Ratnavali- Vidyotini Vyakhya edited by Kaviraj Ambikadattashastri, Choukamba Sanskrit Sansthana Varanasi.Volume-3, Vajikana Adhikara, Sloka No.271-275, Page No.549 15 N.S.Chauhan, D.K.Saraf et al, European Journal of Integrative Medicine, Effect of vajikaran rasayana herbs on pituitary-gonadal axis, Volume 2, Issue 2, June 2010, Pages 89-91. 16 Bhavaprakasha of Bhavamishra, Translated By Prof.K.R.Srikantha Murthy, Chaukhambha Krishnadas Academy, Varanasi, Reprint Edition-2004, Volume-I, Purvakhanda, Guduchyadi Varga, Sloka No.142-146, Page No.250 17 The Ayurvedic Pharmacopoeia of India, Government of India, Ministry of Health And Family Welfare, Department of Ayush, Part-I, Volume – I, Monographs, Page No.26-28; Wealth of India Volume-X, Page no.581-585 18 Watt.G.Dictionary of the Economic products of India, 6 Vols., Nava Bharat offset process, Delhi, India, reprint- 1962: List, P.H., and Hohammer L., Hager;s Handbuch der Pharmazeutischen Praxis, vols. 2-6, Springer- Verleg, Berlin,1969-1979: E-Book: Handbook of Medicinal Herbs page no. 228. 19 Bhaishajya Ratnavali- Vidyotini Vyakhya edited by Kaviraj Ambikadattashastri, Choukamba Sanskrit Sansthana Varanasi.Volume-3, Vajikana Adhikara, Sloka No.288-297, Page No.551 20 Astanga Hridaya of Vagbhata with Sarvanga Sundari commentary of Arunadatta and Ayurveda Rasayana commentary of Hemadri, Edited by Pt.Hari Sadashivashastri paradhakara, Chaukhambha Sanskrit Samsthana, Varanasi, Reprint Edition-2010, Uttarasthana, 34 th chapter, Sloka No.63-66, Page No.901. 21 Bhaishajya Ratnavali- Vidyotini Vyakhya edited by Kaviraj Ambikadattashastri, Choukamba Sanskrit Sansthana Varanasi. Volume-3, Vajikana Adhikara, Sloka No.96-103,Page No.526 22 Susrutha Samhita of Susrutha with Nibandha Sangraha Commentary of Dalhanacharya, and Nyayachandrika Panjika of Gayadasacharya. Edited by Vaidya Jadhavji Trikamji, Chaukhambha Sanskrit Sansthana, Varanasi, Reprint 2010 Edition, Volume-I, Chikitsasthana, 26 th Chapter, Sloka No.18-19, Page no.497 23 Charaka Samhita with commentary of Chakrapanidatta, Translated By Prof.K.R.Srikantha Murthy, Chaukhambha Orientalia, Varanasi, Reprint Edition 2013, Volume-I, Sutrasthana, 1 st chapter, Sloka No.44, Page No.21. 24 Charaka Samhita with commentary of Chakrapanidatta, Translated By Prof.K.R.Srikantha Murthy, Chaukhambha Orientalia, Varanasi, Reprint Edition 2013, Volume-I, Sutrasthana, 25 th chapter, Sloka No.40, Page No.371 25 Bhaishajya Ratnavali- Vidyotini Vyakhya edited by Kaviraj Ambikadattashastri, Choukamba Sanskrit Sansthana Varanasi. Volume-2, Vatavyadhi Adhikara, Sloka No.289-300, Page No.181. 26 Bhaishajya Ratnavali- Vidyotini Vyakhya edited by Kaviraj Ambikadattashastri, Choukamba Sanskrit Sansthana Varanasi. Volume-2, Vatavyadhi Adhikara, Sloka No.578-583 Page No.229. 27 https://www.malereproduction.com/maleinfertility/causes.php as seen on 20/01/2018 How to cite this article: Srinath Ayli, Prashanth A. S., S. G. Chavan. Success story of Vajikarana - A Case Study. J Ayurveda Integr Med Sci 2018;2:115-125. http://dx.doi.org/10.21760/jaims.v 3 i 02.12096 Source of Support: Nil, Conflict of Interest: None declared.

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