What is infertility
• Failure to conceive after one year of regular sexual attempt without contraception.
• Sterility is the inability to conceive whereas infertility is the failure to conceive. Infertility is reactive term and sterility is absolute.
Factors of Fertility
• ACC. To Ayurveda Four factors- Ritu, kshetra,Ambu,bija
• Ritu- phase of kappa (ovulation).
• Kshetra - healthy uterus and female genital tract which will facilitate the entry of sperm.
• Ambu -Nutritional elements and hormones.
• Bija - Ovum and sperm.
• Any problem in any of these four factors -infertility
DISORDERS OF RITUKALA
• Ritukala is a period of kapha-pitta predominance. If it affected by vata or pita-sub fertility.
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DISORDERS OF AMBU (nutritional fluids)
• Can causes infertility
• After conception may cause amniotic fluid problems, nutritional insufficiency
DISORDERS OF BIJA (ovum or sperm)
• Artava dosa or Sperm dosa can cause sub fertility
DISORDERS OF KSHETRA (female genital track)
• Margavarodhab (Obstruction in Fallopian tubes), Vyapanna yoni/ garbhasaya (Uterine,cervical or vaginal pathology causing hostility spermatozoa).
PRIMARY-SECONDARY INFERTILITY
• primary- -Conception has never occurred.
• Secondary- -fail to conceive after having produced a child or had an undoubted miscarriage.
• One – child infertility is relatively common.
CAUSES OF INFERTILITY
• Male defects 40%
• Female defects 50%
• Unexplained infertility 10%
CAUSES OF MALE INFERTILITY
• Systemic defects
• Coital dysfunction
• Sperm defects
• Pathological
1. SYSTEMIC DEFECTS
• Old age
• Obesity
• Tobacco (nicotine) smoking -leading to defective spermatogenesis
• Heavy alcoholism- leading to impaired sexual function
• Diabetes mellitus- impotency
• Excessive heat – defective spermatogenesis (furnace workers, tight under wears).
• Immunologic-. Presence of immobilising or agglutination anti sperm anti sperm antibodies.(not a common factor)
2. COITAL DYSFUNCTION
• Erectile impotency
3. SPERM DEFECTS
• Sperm defects – Oligozoospermia
• Sperm defects can be because of systemic causes mentioned above Drugs like anti hypertensives, anti-epileptics Endocrinal like hypothalamic hypogonadism, hypothyroidism.
4. PATHOLOGICAL CAUSES • Causative factor may be in the testes or in the duct.
• Mumps, orchitis
• Chromosomal
• Streak testes (azoospermia)
• Ductal occlusion
TO IMPROVE THE SPERMATOGENESIS
• general hygiene
• Exercise
• Spacing of coitus
• High protein and high vitamin diet
• Limit the consumption of alcohol and tobacco
• Take cold water or tepid water bath instead of hot water bath
• Discard tight underwear, electric blanket and excessive bed clothes.
• Follow proper food habits and timings.
• Drink boiled water.
• Lose weight if obese and gain weight if very thin.
• Quit smoking and alcohol.
• Do meditation to get relief from mental tension and anxiety.
MANAGEMENT OF MALE INFERTILITY
• Panchakarma
• Medication
HERBS
• Sukra sodhana gana (drugs which help in purification of seman or sperm)- -Kustia, elavaluka, katphala, Samudragupta phenacetin, Kalam a niryasa, iksu, kanda iksu, iksuraka, usira
• Sukra Janana gana (drug which help in formation of seman or sperm)- -jivika, rsabhaka, kakoli, vriksaruha, jatila, kulinga, Aswagadha, Kapilacchu
MEDICINES
• sukumara ghritam, Amrtaprasam, Asvagandhadi ghrita, Kusmanda ghritam, Vastyamayantakam ghritam, kalyanaka gritam, Asvaghandhadi lehyam, Satyavati lehyam, Madana Kameshwari, Chapyavanapasam, Shilajit rasayanam, Dasamularistam, Draksaristam, Asvagandharistam, Chandra Prabha Vatican kalyana Ghulam, Abhraka bhasma, Swarna bhasma.
CAUSES FOR FEMALE INFERTILITY • Systemic
• Sexual dysfunction
• Anovulation
• Pathological defects
SYSTEMIC • Age – above 35 years
• Obesity
• Tabacco smoking
• Psychological- mental disharmony between wife and husband and fear
• Immunological- presence of antisperm antibodies in the cervical mucus (an uncommon factor)
SEXUAL DYSFUNCTION
• Lack of libido
• Infrequent sex
• Vaginismus
• Dyspareunia
• Exhaustion
ANOVULATION
• Endocrine factors :
1. Amenorrhoea
2. Skipping menses
3. DUB
4. PCOs
5. Hypothyroidism
6. Hyper prolactinaemia
7. Hyper androgenise
8. Premature menopause
• DRUGS :
1. Anti epileptics
2. Antipsychotic drugs
PATHOLOGICAL DEFECTS :
• Vaginal causes : tight/ tender hymen
• Cervical causes : cervical stenosis, intracervical fibrous obstruction, cervical polyp.
• Uterine causes : Hypoplasia of the uterus, anomaly of the uterus, submucus fibroid/polyp or endometrial polyp.,T.B. Endometriosis
• Tubal causes : Inflammatory block
• Overran causes : endometriosis, chocolate cyst, Turner syndrome ( chromosomal)
CAUSES OF SECONDARY INFERTILITY
• More of less the same as that of primary infertility
• Some more causes
1. Scars and dhesions in the reproductive system
2. Endometrial tuberculosis
3. Pelvic endometriosis
4. Vaginal and cervical stenosis
5. Post MTP corneal block
6. Tubectomy
• Male defect – vasectomy
TREATMENT
• Take nutritious diet
• Drink boiled water
• Do de worming
• Take iron and frolic acid if HB% is < 11gm
• Gain weight if thin and lose weight if obese
• Do meditation for half an hour daily to. De stress the mind
• Stop tabacco or alcohol consumption
MANAGEMENT OF FEMALE INFERTILITY
1. Shodhana (purification therapy) such as Vamana, Virechana and Basti Karma shows remarkable results.
2. Shamana (pacification therapy).
MEDICINES
• Medicated ghees and oils. Narayana tailam, shatapuspa tailam, phala sarpis, kalyanaka ghritam, dadimadi ghrta, kalyanaka Gulam are commonly used.
• Ushna, kaphavatahara treatment is given for cystic ovarian disease (PCOS).
• Ayurveda the ancient Indian system of medicine—helps couple to have healthy children.
• Can causes infertility
• After conception may cause amniotic fluid problems, nutritional insufficiency
DISORDERS OF BIJA (ovum or sperm)
• Artava dosa or Sperm dosa can cause sub fertility
DISORDERS OF KSHETRA (female genital track)
• Margavarodhab (Obstruction in Fallopian tubes), Vyapanna yoni/ garbhasaya (Uterine,cervical or vaginal pathology causing hostility spermatozoa).
PRIMARY-SECONDARY INFERTILITY
• primary- -Conception has never occurred.
• Secondary- -fail to conceive after having produced a child or had an undoubted miscarriage.
• One – child infertility is relatively common.
CAUSES OF INFERTILITY
• Male defects 40%
• Female defects 50%
• Unexplained infertility 10%
CAUSES OF MALE INFERTILITY
• Systemic defects
• Coital dysfunction
• Sperm defects
• Pathological
1. SYSTEMIC DEFECTS
• Old age
• Obesity
• Tobacco (nicotine) smoking -leading to defective spermatogenesis
• Heavy alcoholism- leading to impaired sexual function
• Diabetes mellitus- impotency
• Excessive heat – defective spermatogenesis (furnace workers, tight under wears).
• Immunologic-. Presence of immobilising or agglutination anti sperm anti sperm antibodies.(not a common factor)
2. COITAL DYSFUNCTION
• Erectile impotency
3. SPERM DEFECTS
• Sperm defects – Oligozoospermia
• Sperm defects can be because of systemic causes mentioned above Drugs like anti hypertensives, anti-epileptics Endocrinal like hypothalamic hypogonadism, hypothyroidism.
4. PATHOLOGICAL CAUSES • Causative factor may be in the testes or in the duct.
• Mumps, orchitis
• Chromosomal
• Streak testes (azoospermia)
• Ductal occlusion
TO IMPROVE THE SPERMATOGENESIS
• general hygiene
• Exercise
• Spacing of coitus
• High protein and high vitamin diet
• Limit the consumption of alcohol and tobacco
• Take cold water or tepid water bath instead of hot water bath
• Discard tight underwear, electric blanket and excessive bed clothes.
• Follow proper food habits and timings.
• Drink boiled water.
• Lose weight if obese and gain weight if very thin.
• Quit smoking and alcohol.
• Do meditation to get relief from mental tension and anxiety.
MANAGEMENT OF MALE INFERTILITY
• Panchakarma
• Medication
HERBS
• Sukra sodhana gana (drugs which help in purification of seman or sperm)- -Kustia, elavaluka, katphala, Samudragupta phenacetin, Kalam a niryasa, iksu, kanda iksu, iksuraka, usira
• Sukra Janana gana (drug which help in formation of seman or sperm)- -jivika, rsabhaka, kakoli, vriksaruha, jatila, kulinga, Aswagadha, Kapilacchu
MEDICINES
• sukumara ghritam, Amrtaprasam, Asvagandhadi ghrita, Kusmanda ghritam, Vastyamayantakam ghritam, kalyanaka gritam, Asvaghandhadi lehyam, Satyavati lehyam, Madana Kameshwari, Chapyavanapasam, Shilajit rasayanam, Dasamularistam, Draksaristam, Asvagandharistam, Chandra Prabha Vatican kalyana Ghulam, Abhraka bhasma, Swarna bhasma.
CAUSES FOR FEMALE INFERTILITY • Systemic
• Sexual dysfunction
• Anovulation
• Pathological defects
SYSTEMIC • Age – above 35 years
• Obesity
• Tabacco smoking
• Psychological- mental disharmony between wife and husband and fear
• Immunological- presence of antisperm antibodies in the cervical mucus (an uncommon factor)
SEXUAL DYSFUNCTION
• Lack of libido
• Infrequent sex
• Vaginismus
• Dyspareunia
• Exhaustion
ANOVULATION
• Endocrine factors :
1. Amenorrhoea
2. Skipping menses
3. DUB
4. PCOs
5. Hypothyroidism
6. Hyper prolactinaemia
7. Hyper androgenise
8. Premature menopause
• DRUGS :
1. Anti epileptics
2. Antipsychotic drugs
PATHOLOGICAL DEFECTS :
• Vaginal causes : tight/ tender hymen
• Cervical causes : cervical stenosis, intracervical fibrous obstruction, cervical polyp.
• Uterine causes : Hypoplasia of the uterus, anomaly of the uterus, submucus fibroid/polyp or endometrial polyp.,T.B. Endometriosis
• Tubal causes : Inflammatory block
• Overran causes : endometriosis, chocolate cyst, Turner syndrome ( chromosomal)
CAUSES OF SECONDARY INFERTILITY
• More of less the same as that of primary infertility
• Some more causes
1. Scars and dhesions in the reproductive system
2. Endometrial tuberculosis
3. Pelvic endometriosis
4. Vaginal and cervical stenosis
5. Post MTP corneal block
6. Tubectomy
• Male defect – vasectomy
TREATMENT
• Take nutritious diet
• Drink boiled water
• Do de worming
• Take iron and frolic acid if HB% is < 11gm
• Gain weight if thin and lose weight if obese
• Do meditation for half an hour daily to. De stress the mind
• Stop tabacco or alcohol consumption
MANAGEMENT OF FEMALE INFERTILITY
1. Shodhana (purification therapy) such as Vamana, Virechana and Basti Karma shows remarkable results.
2. Shamana (pacification therapy).
MEDICINES
• Medicated ghees and oils. Narayana tailam, shatapuspa tailam, phala sarpis, kalyanaka ghritam, dadimadi ghrta, kalyanaka Gulam are commonly used.
• Ushna, kaphavatahara treatment is given for cystic ovarian disease (PCOS).
• Ayurveda the ancient Indian system of medicine—helps couple to have healthy children.