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Table of Contents
CASE REPORT
Year : 2021  |  Volume : 9  |  Issue : 1  |  Page : 45-48

Effective management of Kshinashukradushti (Oligoasthenospermia) with Ayurveda: a case report


1 National Ayurveda Research Institute for Panchakarma, Cheruthuruthi, Kerala, India
2 Central Ayurveda Research Institute for Hepatobiliary Disorders, Bhubhaneswar, Odisha, India
3 Amrita School of Ayurveda, Amritapuri, Kollam, Kerala, India

Date of Submission22-Sep-2020
Date of Decision22-Feb-2021
Date of Acceptance08-Mar-2021
Date of Web Publication16-Apr-2021

Correspondence Address:
P Binitha
National Ayurveda Research Institute for Panchakarma, Cheruthuruthi, Kerala.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JISM.JISM_92_20

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  Abstract 

Male factors are responsible for nearly 30% of infertility cases. Oligoasthenospermia is one of the main causes of male infertility. It includes low sperm count along with impaired sperm motility. The present case report delineate history of a 35-year-old male who presented with oligoasthenospermia leading to infertility even after 3 years of unprotected married life. The patient was administered with internal medications like Shaddharanachurnam, Sahacharadikwatham, Sahacharadisevyathailam, Kapikachuchurnam, and Kalyanakagulam for 4 months. After 4 months, semen analysis reports showed marked improvement in sperm count and an increase in sperm motility. The female partner came with a positive pregnancy report on the next cycle after 4 months of medication. The present findings and the effective management of Oligoasthenospermia with Ayurveda formulations without any adverse effect highlight the promising scope of traditional medicine in male infertility disorders.

Keywords: Ayurveda formulations, nfertility, oligoasthenospermia, traditional medicines


How to cite this article:
Binitha P, Ratha KK, Vahab R A. Effective management of Kshinashukradushti (Oligoasthenospermia) with Ayurveda: a case report. J Indian Sys Medicine 2021;9:45-8

How to cite this URL:
Binitha P, Ratha KK, Vahab R A. Effective management of Kshinashukradushti (Oligoasthenospermia) with Ayurveda: a case report. J Indian Sys Medicine [serial online] 2021 [cited 2021 Jun 14];9:45-8. Available from: https://www.joinsysmed.com/text.asp?2021/9/1/45/313705




  Introduction Top


Male infertility refers to abnormal sperm production along with the absence of normal sperm function which markedly affects the delivery of sperm. Among 40–50% of infertility in human, 7% are related to men.[1],[2],[3],[4] Commonly deficiencies in semen and seminal parameters used as the precise measure for the detection of male infertility.[5] It is characterized by decreased sperm count, motility, and irregular morphology.[6],[7] Eight types of Shukra Doshas (pathological disorders of semen) are mentioned in Ayurveda classics.[8] They are Vataja, Pittaja, Kaphaja, Kunapa, Granthi, Puti, Puya, and Ksheena.[9] Oligoasthenospermia can be assumed as Ksheenasuklam mentioned in Ayurveda. It is mentioned as a condition caused by vitiated Vata and Pitta. Here the Shukradhathu (Semen) is reduced both quantitatively and qualitatively.[10]


  Case report Top


A male patient aged 35 years attended the outpatient department, complaining of primary infertility even after 3 years of unprotected sexual life. The patient has been taking medicine for hypothyroidism for the last 2 years. The patient did not complain about sexual desire, erectile capacity, and any problem associated with ejaculation. The testes and rest of the physical examination were normal. The female partner has no complaint with her endocrine profile and patency of fallopian tube, and has regular ovulatory cycles. The patient history suggested that he was not suffering from pre- and post-testicular causes of infertility along with any sexually transmitted diseases. Severe oligoasthenospermia with a total sperm count of 11 million/mL with rapid progressive nil, slow progressive −38%, nonprogressive −6%, and immotile 56% were revealed on semen analysis. As the couples were not willing for artificial reproductive techniques (ART), they came for Ayurveda management.


  On examination Top


On scrotal examination the temperature, position and size of the testes were normal. No abnormality detected on internal genital organs and accessory glands on clinical examination [Table 1].
Table 1: Physical or local examination of the patient

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  Assessment criteria Top


The patient was assessed based on semen analysis before and after treatment. The female partner became conceived in the next cycle itself after 4 months of medication.


  Treatment Top


The patient was diagnosed as having Kshinasukradosha, with evidence of oligoasthenospermia, and he was undergone internal medicines for 4 months.


  Plan of treatment Top


Agni deepanam (improving digestion), Vathanulomanam (Paccifiesvatha), Suklavardana (Aphrodisiac), and Brihmanam (nourishing) were followed [Table 2].
Table 2: Treatment administered

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All medicines were procured from an authorized agency of Kottakkal Arya Vaidyasala except Kapikachuchurnam. The raw drug Kapikachu was collected and powdered and was given to the patient. No adverse drug reaction was detected.


  Results Top


The total sperm count (70 million from 11 million) and motility were increased after 5 months of treatment schedule. Before treatment sperm with rapid progressive movements was nil, it increased up to 15% initially and then to 30%. The female partner got conceived in the next cycle after 4 months of medication. [Table 3] shows the before and after the results of the semen analysis.
Table 3: Effect of Ayurveda management on semen analysis

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  Discussion Top


Oligoasthenospermia is a common presentation in male infertility of varied etiology. Though some reversal causes of the problem require ART, many of the cases with Oligoasthenospermia are not properly evaluated. Empirical therapy like hormonal therapy and nutritional supplements are in vogue without a definite outcome.[11] Ayurveda medicines are rarely clinically evaluated in such challenging conditions. Ayurveda classics explain a separate branch for aphrodisiac medicines (Vajikarana). This branch contains a special category of treatment modalities to improve the reproductive system and enhance sexual functions. These treatment modalities help to cure Sukradoshas and ensure a healthy progeny.

The principle of treatment for Shukra Dosha as mentioned in Ayurveda text is Snehana (oleation), Vamana (emesis), Virechana (purgation), Niruha (medicated enema with decoction) Anuvasana (medicated enema with oil),[12] and Shamana Aushadhi (palliative therapy) depending on the condition. Here Shamanaoushadhi was only selected as the treatment modalities to correct Jataragni (digestive fire) and thus Sukradhathwagni, pacify vitiated Vatadosha, and finally Brihmana of Sukradhathu.

Considering the condition as Kshinasukradushti, to correct Dhathwagnimandya Shaddharanachurna was chosen. All ingredients in the formulation are Deepana in nature and have an action in Amasayagathavatam (Vata affecting stomach and small intestine) which is involved in the pathogenesis of this condition. It was given for the first 2 weeks of medication to correct Jatharagni (digestive fire) and Shukradhathwagnimandyam.[13] After correcting agnivaigunya, further treatment aimed to pacify vata with SahacharadiKwatham and Tailam because vata is the main dosha involved in the pathogenesis along with Pitadosha. Sahacharadi Kwatham is typically indicated when vata (specifically Apana Vata) vitiated in the lower part of the body. Apanavata is responsible for the proper expulsion of Sukra.[14] The medicines administered at Apanakala (before lunch and dinner) directly act on Apanavata.[15] The Vatasamaka (Pacification of vata) action of formulation helped to improve the motility of sperms and proper expulsion of Sukra. Along with this, to nourish Sukradhathu, Kapikachu Churna (Mucuna pruriens) was suggested which is Vatasamanam (Pacifies Vata), Vrishyam (Aphrodisiac), Kaphanasakam (Pacifies Kapha), Pitanasakam (Pacifies Pitta), Rakthadoshaharam (purifies blood), Brihmanam (nourishing), Balyam (strengthening) was given. The drug is sweet and bitter and with heavy and unctuous properties. It is cold in potency and metabolic end effect as sweet. It is reported to be effective in increasing sperm concentration and motility.[16]M. pruriens stimulates spermatogenesis increases the weight of testicles, and enhances testosterone levels in the animal model.[17] To correct the spermatogenesis, Kalyanakagulam is administered, which is aphrodisiac and helps in spermatogenesis. It also helps to remove any obstruction in the pathway of the proper functioning of Shukradhathu. It also possesses Pumsavana (progeny creation) attributes.[18]

This case report consists of the unique presentation of a single case only. Moreover, a robust clinical trial is recommended to arrive at a definite conclusion.


  Conclusion Top


On the basis of biochemical parameters and features, the present case of oligoasthenospermia has been considered as Kshinasukradushti and the treatment principle of the same was followed which has shown appreciating result. But this is merely a single case report so the effectiveness of this treatment protocol cannot be claimed without further studies with a proper research design. It may be tried as an alternate way for the management of male infertility due to oligoasthenospermia who were not willing for ART.

Declaration of patient consent

The authors certify that they have obtained the patient consent form, where the patient has given his consent for reporting the case along with other clinical information in the journal. He understands that his name and initials will not be published and due efforts will be made to conceal his identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interests



 
  References Top

1.
Kumar N, Singh A Trends of male factor infertility, an important cause of infertility: A review of literature [Internet]. J Hum Reprod Sci 2015;8:191-6.  Back to cited text no. 1
    
2.
Brugh VM III, Lipshultz LI Male factor infertility: Evaluation and management. Med Clin North Am 2004;88:367-85.  Back to cited text no. 2
    
3.
Hirsh A Male subfertility. BMJ 2003;327:669-72.  Back to cited text no. 3
    
4.
Lotti F, Maggi M Ultrasound of the male genital tract in relation to male reproductive health. Hum Reprod Update 2015;21:56-83.  Back to cited text no. 4
    
5.
Cooper TG, Noonan E, von Eckardstein S, Auger J, Baker HW, Behre HM, et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update 2010;16:231-45.  Back to cited text no. 5
    
6.
McLachlan RI Approach to the patient with oligozoospermia. J Clin Endocrinol Metab 2013;98:873-80.  Back to cited text no. 6
    
7.
Grimes DA, Lopez LM “Oligozoospermia,” “azoospermia,” and other semen-analysis terminology: the need for better science [Internet]. Fertility and Sterility 2007;88:1491–4.  Back to cited text no. 7
    
8.
Vagbhata AH Arunadatta and Hemadri. Bhishagacharya Harishastri Paradakara Vaidya. Varanasi: Chaukhambha Orientalia; 2005. p. 956.  Back to cited text no. 8
    
9.
Tripathi B Sharangadharasamhita. Varanasi: Chaukambha Surabharati Prakashan; 2001. p. 86.  Back to cited text no. 9
    
10.
Vaidya Yadavji Trikamji Acharya.Charaka Samhitha of Agnivesha, Chikitsa Sthana. Chapter 30 verse 140. 4th ed. Varanasi: Chaukhambha Sanskrit Sansthan; 2012. p. 820.  Back to cited text no. 10
    
11.
Rocchietti March M, Isidori A New frontiers in the treatment of male sterility. Contraception 2002;65:279-81.  Back to cited text no. 11
    
12.
Srikantha Murthy KR,editor. Sushruta Samhita of Sushruta, Sharira Sthana. Chapter 2 verse 12. Reprint edition. Varanasi: Chaukhambha Orientalia; 2014. p. 21.  Back to cited text no. 12
    
13.
Sushrut SS JadavajiTrikamji. Chaukhambha Orientalia, Varanasi, Edition Reprint. 2012.  Back to cited text no. 13
    
14.
Paradakara HS Ashtanga Hrudaya with Sarvangasundara commentary of Arunadatta and Ayurveda rasayana commentary of Hemadri. Sootrasthana; chapter 12, verse 7–8.  Back to cited text no. 14
    
15.
Gupta A Ashtanga Samgraha. Varanasi: Chaukambha Sanskrit Sansthan; 2005.  Back to cited text no. 15
    
16.
The Ayurvedic Pharmacopoeia of India. Part IVolume I. Government of India Ministry of Health and Family Welfare, Department of AYUSH; 2004. p. 11-2.  Back to cited text no. 16
    
17.
Shukla KK, Mahdi AA, Shankwar SN, Ahmad MK Effect of Mucunapruriens on hormonal status and semen quality in infertile males. Contraception 2008; 78:194.  Back to cited text no. 17
    
18.
Vaidya YG Joshi. Editor. Charakasamhita of Charaka. Vol II. Kalpasthaana Chapter 7 verse 45. Pune: VaidyamitraPrakashan; 2005. p. 73.  Back to cited text no. 18
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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  In this article
Abstract
Introduction
Case report
On examination
Assessment criteria
Treatment
Plan of treatment
Results
Discussion
Conclusion
References
Article Tables

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