View
2.551
Download
7
Category
Tags:
Preview:
DESCRIPTION
An Ayurvedic Approach to Infertility Management, Dr. Priyanka Gupta, Lecturer, I/c Head, Prasuthi Tantra & Streerog, MGACH&RC, Salod (MS)
Citation preview
1
An Ayurvedic Approach to Infertility
Management
Dr. Priyanka Gupta, Lecturer, I/c Head, Prasuthi Tantra & Streerog, MGACH&RC, Salod (MS)
2
It’s hard to wait round for some thing you know might never happen; but it’s even harder to give
up when you know it’s every thing you want
3
Ayurveda?• Ayurveda is a medicine and philosophy together to make
completeness of society• It cares the prophylaxis and
therapeutics too• The infertility is a problem even in
olden days tackled in many ways• The Infertility is given a priority in
society with a saying –“Aputrasya
Gatir
naasti”
‐
i.e.
without a child – there is no eternity –
For which they made a protocol of Eugenics
4
Ayurveda Knowledge of Genetics• Eugenics is the study of
methods of improving genetic
qualities by selective breeding
(especially as applied to
human mating)• Susruta
–
the father of surgery
has put forth many concepts
of –– Conjugation [days of selection
for a child],
– Pre Conception [food, attitudes,
psychological discipline, etc]
– Conception [nourishing,
modulating the Beeja
(Chromosome) /
Beejabhagaavayava
(genes)]
5
Ayurveda Meddlers of Genetics
• Ayurveda or ayurvedic
medicine is a system of traditional medicine native to the Indian
subcontinent. • Susruta
states that, the conjugation on even
days (4‐6‐8‐10‐12) gives rise a male baby and on the odd days (5‐7‐9‐11) to a female baby. [the day count is from the day of menstruation]
• To initiate Eugenics Ayurveda took the chrono‐ biology and chrono‐pharmacology as tools and altered successfully the release of the ovum
and quantity and quality of the semen in male.
6
DHAKA, 14th – 17th MARCH, 2011
• What happened?– XIII ASCON, ICDDR, at BANGLADESH
• For what?– Mainstreaming Traditional Medicine:
– Potential Role for Universal Health Coverage in the Indian Context
• What are declarations?
7
Declarations
• Ayurveda is in various forms • It includes the – Traditional Textual
aphorisms, Folk Practices, Home Remedies, and Complementary & Alternative Medicine, etc.
Increasingly being accepted in high income countries for its efficacy and low income
countries like India for its economical and usefulness.
• It is estimated (WHO) that 70% of world Global Atlas is using Traditional medicine
8
• The costs of modern conventional medicine are becoming difficult for even the developed countries to
bear, and TM tends to be less expensive. • The iatrogenesis
of modern medicine is increasingly
being recognized (a high proportion of hospital admissions in the USA)
• There is a real threat of resistance levels to antibiotics increasing to such levels that other regimens have to
be sought, and there are presently few lines of research for newer antibiotics.
Declarations
9
Today’s practice
• The frontiers of medical research and practice today include a large section on
herbal remedies, lifestyle determinants and therapies, body‐mind therapies,
interdisciplinary research such as psycho‐ neuro‐immunology. RCTs
have provided
evidence for efficacy of several herbal and other traditional therapies.
10
• Thus, multiple reasons for examining the potential role of TM ‐‐popular choice, a
scientific need, a financial need, equity requirements ‐‐
and thereby a public health
imperative.
Conclusions
11
INFERTILITY vis‐à‐vis VANDHYATVA
12
Typology of VANDHYATVA
13
• Before attempting to treat Vandhyatwa, it is essential to
know about the factors essential for conception according to
Ayurveda ‐
– 1‐
Ritu
(Age of couple & appropriate time of the menstrual
cycle ie, well developed proliferative
phase accompanied
with ovulation)
– 2‐
Kshetra
(A healthy body contains healthy womb)
– 3‐Ambu
(metabolic products as well as hormones supplied
for the growth of fetus )
– 4‐Beeja ( Healthy Sperm & Ovum
)
Factors of affecting Conception
14
Other considerable important Factors for conception
1. MANASOBHITAPAM (Psychological)
2. AHARADOSHAM (Diet)
3. VIHARADOSHAM (Mode of life)
4. BALAKSHAYAM (General health)
15
Diagnosis & Management• Ayuvedic gynaecologist follow the trend of ‘’Diagnosis
with modern diagnostic tools and treat with traditional Ayurvedic principles”.
• In any fertility work-up, both male and female partners are scrutinized
• If “pregnancy fails” to occur after a year of regular unprotected sexual intercourse – it is considered for Medical /Procedural management in Ayurveda.
• An analysis of the man's semen should be performed before the female partner undergoes any invasive testing
16
Diagnosis …• Medical History and Physical
Examination• The first step in any infertility work up is
a complete medical history and physical examination.
• patient's history of sexual activity, especially frequency and timing of intercourse.
• Menstrual history,
17
… Diagnosis …
• lifestyle issues (smoking, drug and alcohol use, and caffeine
consumption), • any medications being taken, and• a profile of the patient's general
medical and emotional health
18
Laboratory Tests–Hormonal Levels.
• Follicle ‐stimulating hormone (FSH)
• Luteinizing
hormone (LH)
• Prolactine• Thyroid profile
–Clomiphene
Challenge Test
–Tissue Samples
–Tests for Autoimmune Disease
19
Imaging Tests and Diagnostic Procedures
• Ultrasound (particularly a variation called saline‐infusion sonohysterography)
• Hysterosalpingography• Hysteroscopy• Laparoscopy• Combinations of these imaging
procedures may be used to confirm diagnoses.
20
Ayurvedic Approach to Infertility
1.
Nidana
Parivarjana
(avoidance of cause) – when it is able to be noticed – Papaya (ergot), Tulasi
(anti fertility), etc.
2.
Shodhana
(purification) – the obstructions (PCOD, Tubal
Block, etc)
either in the localized or generalized are removed
3.
Shamana
(pacification)
4.
Garbha
sthapaka
(establishment of pregnancy)
21
Ayurveda Shodhana/Panchkarma
• Ayurveda use modalities for Infertility • Snehana
(Internal unction),
• Nasya
(Nasal application) • Basti
(Medicated enema), and
• uttara
basti
(Utero‐vesical
douche ) • Usually these purification therapies are
followed by oral supplementations
22
Ovulatory
Factors
• A course of Progressive internal Unction (Arohan
krama
snehpana) followed by
purgation (Virechana)• Nasal application (Nasya)
shown
encouraging results with ‐ Narayan
taila,
Satpushpa
tail, etc. • Ovulatory
induction (Artava
Janana) – is
done with –
Phala
ghrit, Shatavari
ghrit, Rajahpravartani
vati, Pushpadhanva
ras,
etc.
23
Tubal
Factors
• Partial / complete tubal
block or adhesions / pelvic inflammatory disease are managed with
“Uttravasti”– Medicines used are –
• Kshar
tail, • Lashuna
tail,• Kaishor
Guggulu, • Triphala
Guggulu, • Guduchi, • Kutki
(Picrorrhiza
kurroa) and • Punarnava, etc.
24
Uterine Factors
• Endometrial Quality is improved with “Uttravasti”
–Medicines used are –• Aswagandha
ghrit,
• Ashoka
Ghrit, • Ksheerabala
(101) tail,
• Balatail, etc.
25
Cervical Factors• Cervical mucus pH / Sperm
penetration factors are handled with “Yoni Pichu”
(Vaginal
tampon) and “Yoni Dhavan” (Vaginal wash)
–Medicines used are –• Kshara
taila
(Vaginal tampon)
• Triphala
Kwath, (Vaginal wash)• Varunadi
Kwath, (Vaginal wash)
26
Ayurvedic Treatment• Female infertility accounts for 35‐40 % of overall infertility.
Treatment depends upon the specific identifiable cause
Ovulation disorder Chandraprabha
Vati,
Yograj
Guggulu,
Ashokarishta
and Dashmoolarishta.
Ashoka
(Saraca
indica),
Dashmool
(Ten Roots),
Shatavari
(Asparagus racemosus),
Aloes (Aloevera), Guggulu
(Commiphora
mukul),
Hirabol
(Commiphora
myrrha) and
Harmal
(Paganum
harmala)1
27
Ayurvedic Treatment• Female infertility accounts for 35‐40 % of overall infertility.
Treatment depends upon the specific identifiable cause
Ovulation problems
causeddue to polycystic
ovariansyndrome (PCOS)
Latakaranj
(Caesalpinia
crista), Varun
(Crataeva
nuevula),
Kanchnaar(Bauhinia variegata) and Guggulu. Thyroid gland disorders are treated –
Arogya
Vardhini,
Kanchnaar
Guggulu
and
Punarnava
Guggulu
28
Premature ovarian failure
(POF)
Ashoka, Dashmool, Chandraprabha, Shatavari, Guduchi, and Jeevanti(Leptadania
reticulata).
These medicines can be given in addition to
hormone replacement therapy
29
Cervical mucus
Vata (Ficus bengalensis),Ashwatha (Ficus religiosa), Udumbara (Ficus glomerata), Plaksha
(Ficus
infectora),
Shirisha
(Albizia
lebec),Haridra
(Curcuma longa),
Yashtimadhuk
(Glycerrhiza
glabra), Saariva
and
Manjishtha
(Rubia
cordifolia)
30
Women who are underweight
or have a small, undeveloped
uterus or cervix
Shatavari, Ashwagandha
(Withania
somnifera), Vidarikand
(Pueraria
tuberosa),
Ksheervidari
(Ipomoea digitata), Bala
(Sida
cordifolia),
Samudrashok
(Argyria
speciosa), Nagbala
(Grewia
hirsuta),
Shrungatak
(Trapa
natans) and Yashtimadhuk
31
Some women do
conceive, but are unable
to retain thepregnancy till full‐term
Guduchi, Kantakari
(Solanum
xanthocarpum),
Brihati
(Solanum
indicum),
Gokshur
(Tribulus
terrestris),
Bhrungraj
(Eclipta
alba),
Yashtimadhuk,Pippali
(Piper longum),
Bharangi
(Clerodendrum
serriatum),
Padmakashtha
(Prunus
cerasoides),
Rasna
(Pluchea
lanceolata) and
Manjishtha
. U Wennerholm, C Bergh. 11844355 Hum Fertil; 2000, 3, 52–64.
. E Hughes, D Fedorkow, J Collins, P Vandekerckhove. The Cochrane Library, 2004,1, 241.
. IS Tummon, LJ Asher, JSB Martin, Fertil
Steril; 1997, 68, 8–12. A Mundewadi, Female Infertility, Ayurvedic Herbal Treatment. 2009, 3, 121‐125.. A Mundewadi, Female Infertility, Ayurvedic Herbal Treatment. 2009, 5, 141‐145.
27. J Abdulmubeen
"Female Infertility, Ayurvedic Herbal Treatment, 2008, 7, 111‐115.. DM Eisenberg, RB Davis, SL Ettner. JAMA; 1998, 280, 1569‐75.
32
Beneficial Effects of Panchakarma Therapy
• PKT removes the toxic materials– (1) the gross level, where various organs
and systems of the body are thoroughly cleansed
– (2) the cellular level, where purification and cleansing of the body is produced at the level of cells, cell membranes, and
molecules.
• PKT helps in rejuvenation and revitalization of Reproductive system
33
STUDY OF UTTARAVASTHI WITH DHANVANTARI TAILA IN FEMALE INFERTILITY *
• Study proved that uttaravasti
with Dhanvantari
taila
shows
the conception rate as 75%.
• Major factors attended are –– Polycystic Ovarian Disease, – Tubal
block,
– Menstrual disorders and
– Anovulation
cycles
• The effect of the treatment on PCOD and tubal
block found
highly significant.
•Kamidi Vijaya Kumari et al, STUDY OF UTTARAVASTHI WITH DHANVANTARI TAILA IN FEMALE INFERTILITY, Int. J. Res. Ayurveda Pharm. 4(2), Mar – Apr 2013
34
Few more Studies
1. A clinical approach by Narayanatail
in Tubal
block
induced fertility Study proved that Narayana
tail uttaravasti
for 7 days (5ml) for six consecutive
sittings show 56% of success in 3‐6 months
2. Secondary infertility being treated with
Pushpadhanwa
ras
and Ojaswini
vati
along with Uttaravasti
got a success of 65% of fertility.
1. Anitha S, Uttaravasti – a clinical approach by Narayanatail in Tubal block induced fertility, Proceedings of RAV, Feb-2009
2. Susheela sharma (2008), Ayurvedic approach for the management of secondary infertility, Journal of Ayurveda, Vol-2, N2, 2008 (April-June)
35
Integrating Modern And Traditional Indian Medicine
• In Asia and Africa 80 per cent of people use traditional medicine
• India uses the Ayurveda / Herbal medicine vividly in all levels of Infertility
• Many cases of Infertility are not reported to the fertility centers and got treated at Village levels by herbal
practitioners • The reported complicated cases do require thorough
investigations of scientific parlance and a traditional expertise utilization
•Source:http://www.scidev.net/global/disease/feature/integrating-modern-and-traditional-medicine-facts-and-figures.html
36
Need of the Hour ‐• DMIMS (DU) have
multi faculty specialties, where old
roots and new technologies can
make the best management plans –
–Tradition to meet the technology
• Dr. Priyanka
Gupta
Recommended