Role of virechana & ayurvedic herbal preparetions in infertility - A case...

[Full title: Role of virechana & ayurvedic herbal preparetions in infertility - A case report]

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[Find the meaning and references behind the names: Sharma, Shyam, Ayu, Main, Adi, Rasa, Rashmi, Market, Med, April]

53 Journal of Ayurvedic and Herbal Medicine 2017; 3(2): 53-56 Case Report ISSN: 2454-5023 J. Ayu. Herb. Med. 2017; 3(2): 53-56 April- June © 2017, All rights reserved www.ayurvedjournal.com Received: 22-04-2017 Accepted: 19-06-2017 *Corresponding author: Dr. Rashmi Sharma Assistant Professor, Department of Prasuti Tantra & Stree Roga, University College of Ayurveda, Dr. S. R. Rajasthan Ayurved University, Jodhpur, Rajasthan India Email: vd_rashmi 11[at]yahoo.com Role of virechana & ayurvedic herbal preparetions in infertility - A case report Rashmi Sharma 1 , Radhey Shyam Sharma 2 1 Assistant Professor, Department of Prasuti Tantra & Stree Roga, University College of Ayurveda, Dr. S. R. Rajasthan Ayurved University, Jodhpur, Rajasthan, India 2 Vice-chancellor, Dr. S. R. Rajasthan Ayurved University, Jodhpur, Rajasthan, India ABSTRACT Infertility primarily refers to the biological inability of a person to contribute to conception. In Ayurveda infertility may be correlated with Vandhyatva or with Vandhya Yonivyapada. Virechana Karma mainly indicated in the treatment of all the Yonirogas & also plays an important role in the management of various Stree Rogas. The present case report revealed Shodhan effect of Virechana Karma along with Granthihara properties of Kanchanar Guggulu , Varunadi Kashaya and Artavajanana, Yonidoshahara, properties of Pushpadhanva Rasa in a known case of secondary infertility. The trial drugs were procured from the local market. Virechana Karma along with this drugs found to be improved remarkably the functions of female reproductive system. After this treatment successful conception is achieved in that patient Keywords: Ayurveda, Infertility, Virechana Karma, Granthihara , Artavajanana drugs. INTRODUCTION Infertility is defined as failure to achieve a clinical pregnancy after 12 months (1 year) or more of regular unprotected sexual intercourse. Women who are able to get pregnant but then have repeated miscarriages are also said to be infertile. Infertility is of two types- Primary and secondary. Primary infertility: It denotes those couple who have never had a child. Secondary infertility is failure to conceive following a previous pregnancy. The causes of infertility can be divided into: Male factor-35 %, female factor-40 %, combined factors (male & female)- 10-15 %, unexplained- 10-15 %. Causes of female infertility are ovulatory factors (PCOD), luteal phase defect (LPD), tubal factors (tubal blockage, infection), uterine factors (fibroid, endometriosis), cervical factors (PID, polyp, infections, stenosis), vaginal factors (atresia, infections), advance maternal age, environmental factors (toxins, physical agents, smoking etc.) and unexplained. Diagnosis of female infertility is done by laboratory tests such as Hormonal study (serum FSH, LH, Estradiol, SHBG (sex hormone binding globulin), Prolactin and Cortisol), Thyroid profile, Lipid profile, Glucose tolerance test and non laboratory tests such as ultrasound (pelvis), Hysterosalpingography (HSG), Hysteroscopy and Laparoscopy. The treatment of infertility is mainly done by Hormonal treatment (combined oral contraceptive pills), ovulation induction drugs ( clomiphene citrate, Human menopausal gonadotropin (hMG), follicle stimulating hormone (FSH), Human chorionic gonadotropin (hCG), Metformin (anti-diabetic), Bromocriptine (anti-prolactin) , life style modifications (exercise), surgical treatment (ovarian drilling, fimbrioplasty, salpingostomy and hydrotubation etc.) and also by assisted reproductive technology (ART) such as In-vitro fertilization (IVF), GIFT (gamete intra fallopian transfer), ZIFT (zygote intra fallopian transfer). Women who is taking infertility treatment have a higher risk of developing multiple pregnancies, ovarian hyper-stimulation syndrome, ectopic pregnancy, various psychological disorders (anxiety, depression) etc. According to Ayurveda, important factors for conception are Rutu (fertile period), Kshetra (uterus & reproductive organs), Ambu (proper nutrient fluid), Bija (Shukra-Shonita) & normalcy of Hridya (psychology). In Ayurveda, infertility can be correlated with Vandhyatva or with Vandhya Yonivyapada. Acharya Charaka describe Vandhyatva as Beejadoshaja Vyadhi (congenital malformations and deformity of female reproductive system) while Sushruta describe Vandhya in 20 Yonivyapada and considers aggravated Vata as a main responsible factor. Vandhya is described as women having lost her Artava (menstrual fluid) which results in loss of ovulation or sterility. Chikitsa of infertility is done by Sanshodhana Karma (Vaman, Virechana adi Panchakarma) and Prayoga of various Artavajanana drugs such as Phal Ghrita, Phalkalyan Ghrita, Chandraprabha Vati, Shatpushpa,

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[Find the meaning and references behind the names: Bala, Raja, Long, Pushpa, Heart, Sneha, Good]

J Ayu Herb Med ǀ Vol 3 Issue 2 ǀ April- June 2017 54 Shatavari and Lashuna Kapla etc. In present case study, virechana Karma is selected as Sanshodhana Chikitsa and Kanchanar Guggulu , Varunadi Kashaya and Pushpadhanva Rasa is used as Shamana Yoga for the management of infertility. Virechana Karma helps in Strotasa- Shudhi (cleaning or removing obstructions in the channels) along with this Shamana Yoga (Kanchanar Guggulu , Varunadi Kashaya and Pushpadhanva Rasa) is having Granthihara, Bhedaneeya, Lekhaneeya , Vrushya, and Deepaniya properties. CASE REPORT A female subject aged 26 years, married 5 years back, anxious to conceive, housewife, was examined in the hospital (OPD) on 2-12-2015 (OPD No.52312/15-16) for infertility. She had no previous history of secondary amenorrhea, tuberculosis, mumps, syphilis, gonorrhoea, and exposure to radiation or any toxin or chemical agent. She had history of one spontaneous abortion of 14 weeks in March 2014, D & C done at hospital and from January 2016 she had history of PCOD for that she took Ayurvedic treatment for 9 months from the same institute. After this treatment her sonography reports on 26-10-2016 showed early intra uterine pregnancy with normal cardiac activity. On examination, the body proportion was found to be obese with normal secondary sexual characters, were belonging to Kapha-Vata prakruti and Medasara. There was no any abnormal finding seen in the physical and pelvic examination (per speculum & per vaginum). Table 1: Medicines used for Virechan Karma S. No Name of the Drugs Days Dose 1 Snehapana with Bruhata Shatavari Ghrita & Phala Ghrita 6 days Starting from 30 ml then increased gradually up to Samyak Sneha-Siddhi Lakshan (170 ml) 2 Abhyanga (with Mahanarayan Tail) followed by Sarvanga Swedan 3 days - 3 Virechan (with Abhyadimodaka + Erenda Tail + Kutaki Churna + Trivrutta Churna As per Koshta and Bala of Rugna *Before Snehapana, Agnitundii Vati (2 tds) + Panchakola phanta (15 ml bd) is given for three days (for improving Agni-Deepna & Pachana property of patient) Table 2: Shamana Yoga Name of the drugs Dose Anupana Kanchnar Guggulu 250 mg Jala Varunadi Kashya 15 ml Jala Pushpadhanva Rasa 250 mg Jala *Twice daily Treatment The treatment was carried out with Virechan Karma along with following medicines (Table 1 and 2). During this period the patient was advised to take Samayaka ahara (nutritive diet like milk, fresh fruits and vegetables, almonds etc.) and avoid Amla, Lavana,Vidahi (Spicy) and Snigdha (oily) ahara . After the treatment, the sonography report on 26-10-2016 showed early intra uterine pregnancy with normal cardiac activity. OBSERVATION & RESULT The patient had followed the Ahara & drug restriction strictly. The finding of sonography after treatment is: Single regular gestation sac with good decidual reaction is seen in upper part of uterus, measuring 22 × 11 mm, Yoke sac seen. CRL -05 mm, 6 weeks 1 day of gestation Cardiac activity present Foetal heart rate (FHR)-127/m Internal or closed Table 3: Results of Sonography (Pelvis) Particulars Before treatment (25-1-2016) Uterus Normal in size Myometrium Ecotexture is normal Endometrium Is normal, no mass see, thickness- 8.5 mm Right ovary Multiple small size follicles with prominent ovarian stroma Left ovary Multiple small size follicles with prominent ovarian stroma Cul de sac No free fluid is seen Table 4: Results of Sonography (obstertics) Particulars After treatment (26-10-2016) Yolk sac Present Foetal pole Present Foetal cardiac activity (FCA) Present Foetal heart rate (FHR) 147 BPM CRL 1.16 cm Gestational age 7 weeks 3 days DISCUSSION & PROBABLE MODE OF ACTION Infertility has been long standing problem since ancient period but it is most burning issue now a days because of improper lifestyle. This condition not only affects the couple physically but also disturbs them socially and emotionally. The disturbance in hormonal mechanism, obstructions, infections, psychological disorders etc. is the main cause of female infertility. Panchalkarma and Ayurvedic herbal medicines acts at root level can bring back deviations of hormonal system back to normalcy. Virechana Karma has direct effect on Agnisthana (hampered Agni is one of the initiating factors information of vitiated Raja). It pacifies the vitiated Kapha and Vatadosha and removes vitiated excessive Pitta & thus do Raktashodhan. It does the quality of Strotovishodhana, so it will help in destroying the disease from its root rather than temporary relief from Artava Vikaras (menstrual disorders). So Virechana therapy will be beneficial Shodhana therapy in menstrual disorders, for vanishing disease permanently and maintaining healthy menstrual cycle and we can counter the adverse effects over reproduction by avoiding menstrual disorders. Granthihara and Bhedana properties of Kanchanar Guggulu and Varunadi Kashya along with Vrushya and Deepaniya properties of Pushpadhanva Rasa act on reproductive system and improve the functions of ovary and Artava . ( antah-pushpa (ovum) and bahi-pushpa (menstrual blood).

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[Find the meaning and references behind the names: Shri, Ravi, Sara, Sudha, Dutt, Nil, Rao, Prakashan, Mishra]

J Ayu Herb Med ǀ Vol 3 Issue 2 ǀ April- June 2017 55 CONCLUSION Virechana karma is the radical purification that eliminates waste products, toxins and aggravated Doshas from the body. As aggravated Doshas are the primary cause of disease, this method is the most direct for curative purposes. Along with purification Virechana Karma cleanse all the body tissues and to bring about the harmony of tridosha Bhedaneeya, Lekhaneeya, Arbuda, Garnthihara properties of Kanchanar Guggulu and Varunadi Kashya Vrushya & Deepaniya properties of Pushpadhanva Rasa helps in improving the proper functions of Artavaagni which regulates the menstrual cycle and further helps in conception. The present study reveals the effective management of infertility by Shodhana and Shaman yoga. Consent Before staring treatment consent of the patient is taken along with proper advice and counselling. USG Report Scanned copies of USG (before & after treatment) as a supplement file. Acknowledgement The author is thankful to Prof. Radhey Shyam Sharma, Vice-chancellor, Dr. S. R. Rajasthan Ayurved University, Jodhpur for continuous encouragement for the short clinical study. Source of support – Nil. Conflict of interest – None declared. REFERENCES 1 Acharya Vidhyadhar Shukla & Prof. Ravi Dutt Tripathi (editors), Charaka Samhita, "Vaidyamanorama" Hindi Commentary, Chaukhamba Sanskrit Prathisthan, Delhi, 2005 Ch. Sh.2/5, p.703-704. 2 Kaviraj Ambikadatta Shastri, Sushruta Samhita, “Ayurvedtatvasandipika” Hindi Commentary, Chaukhambha Sanskrit Sansthan, Varanasi, 2010, Su. Utt.38/10, p.157. 3 Shri Satyapala Bhigacharya, Kashyapa Samhita, Vidyotini Hindi Commentary, Chaukhambha Sanskrit Sansthan, Varanasi, 2004, Ka. Sidhi 2/ 5,6,7,13, p.150-151. 4 Dutta D.C., Text book of Gynecology, 5 th edn., Jaypee Brothers Medical publishers (P) Ltd., Kolkata, 2013, p. 222-247. 5 V. G. Padubidri, Gynecology, Review Series, 3 rd edn., Elsevier, New Delhi, 2006, p. 81-93. 6 Textbook of Gynecology, Kamini A. Rao., 1 st edn., Elsevier, New Delhi, 2008, p. 199-203. 7 Hacker & Moore’s, Essentials of Obstetrics’ & Gynecology, 5 th edn., Elsevier, New Delhi, 2010, p. 373-378. 8 Sudha Salhan, Textbook of Gynecology, 1 st edn., Jaypee Brothers Medical publishers (P) Ltd., New Delhi, 2011, p. 130-137. 9 Premvati Tewari, Ayurvediya Prasuti Tantra Evam Stri-Roga, Part II, 2 nd Ed., Chaukhamba Orientalia, Varanasi, 2000, Panchampadhaya, p.272-304. 10 Prof. Sidhinandana Mishra, Bhaishajya Ratanavali, “Sidhiprada” Hindi Commentary, Chaukhamba Surabharati Prakashan, Varanasi, 2007, Amavatarogadhikara, p. 596-597. 11 Vaidya Ramraksha Pathak, Ayurveda Sara-Sangraha, 12 th Edn., published by Shri Baidhynath Ayurved Bhavan Limited, Nagpur, 2000, Rasa Rasayan Prakarana, p.341-342. 12 Dr. Brahmanand Tripathi, Sarangadhara Samhita with Dipika Hindi Commentary, 2 nd Ed., published by Chaukhamba Surbharati Prakashan, Varanasi, 1994, Sh.Madhyama.Kh.7/95-100, p.207-208, Sh.Madhyama.Kh.2/128-130, p.152. 13 Dr. Brahmanand Tripathi, Sarangadhara Samhita with Dipika Hindi Commentary, 2 nd Ed., published by Chaukhamba Surbharati Prakashan, Varanasi, 2001 , Sh.Uttar.Kh.4/27-33. HOW TO CITE THIS ARTICLE Sharma R, Sharma RS. Role of virechana & ayurvedic herbal preparetions in infertility - A case report. J Ayu Herb Med 2017;3(2):53-56.

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