This document discusses various topics related to impotence, sterility, and artificial insemination. It defines key terms like impotence, sterility, and frigidity. It outlines causes of impotency and sterility in males and females, including age, malformations, diseases, injuries, psychic factors, and operations. Examinations for evaluating impotency and sterility are described. The medicolegal importance of these topics in relation to issues like nullity of marriage, divorce, and contested paternity is covered. Artificial insemination techniques and sperm preparation methods are briefly outlined.

1. 1
IMPOTENCY AND STERILITY:-
IMPOTENCY-This means inability to perform or take part in sexual
intercourse.
STERILITY: - This means inability on the part of the male to procreate
or on the part of the female to conceive children.
FRIGIDITY :-Refers to women who are sexually coldie. the inability to
initiate or maintain the sexualarousalpattern in female.
PREMATURE EJACULATION:-Means ejaculationoccurs
immediately after penetration.
SEXUAL DYSFUNCTION:-Is an impairment either in desire for
sexualgratification or in the ability to achieve it. In the actof sexual
intercourse , the male partner is the active partner while the female
partner is passive partner. It is the male who has to develop and maintain
penile erectionsufficient enoughto accomplishthe act. Therefore, in
general, impotence refers more to male and sterility to female.
MEDICO LEGAL IMPORTANCE OF
IMPOTENCY AND STERILITY:-
CIVIL:-
⦁ Nullity of marrige and divorce.
⦁ Adultery
⦁ Contestedpaternity and legitimacy
⦁ Suit for adoption-where the allegedyfather pleads impotency or
sterility as his defense
⦁ Clain for damages where loss of the sexual function is claimed as the
result of assaultor accident.

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CRIMINAL: -
⦁ Adultery
⦁ Rape
⦁ Un-natural sexual offences
⦁ In caseswhere a sterile women puts forward a suppositious child to
claim property.
EXAMINATION IN CASE OF IMPOTENCY:-
Before examination, informed consentis obtained. The following things are
done,
1. Complete history of previous illness especiallywith reference to
nervous and mental condition and sexualhistory should be obtained.
2. The generalexamination followedby systemic examination should be
done.
3. The private parts must be examined for injuries or malformations.
4. The condition of testes, epididymis, cord& penis should be noted and
private parts testedfor sensation.
OTHER EXAMINATION-* Duplex USG
* Chemical stimulation
* Ateriography
Examination in caseof sterility:- [MALE]
1. Forthis, examination seminal fluid and spermatozoa is essential. semen
may be obtained either through the act of masturbation.
2.The sample of semenshould be examined as early as possible.
3.The individual to be examined should not do the sexualact for about a
week orso before examination.

3. 3
4.normal avg. sperm count is 100 million /ml and when it falls down below
60 million/ml it is called abnormal. This is impaired in sterility.
FEMALE: The development of ovaries, utreus, potency of fallopian tubes
and pH of vagina should be examined.
1.Usually the vagina defectis likely to be seen.
CAUSES OF IMPOTENCY & STERILITY IN MALE:-
I. AGE:- The powerof coitus commences earlierthan puberty though
spermatozoa are not usually found then. Accordingly, a boy is sterile but
not impotent before puberty.
II. MALFORMATION:- Absence of non development of penis
constitutes absolute impotence. Certain malformation of male external
genital such as intersexuality may prevent intercourse. Condition like
hypospadias and epispadias may prevent proper deposition of semen in
vagina & result in sterility.
III. LOCAL& GENERAL DISEASES:- Acute diseasesofthe penis
,such as gonorrhea ,syphilis etc. may cause temporary impotence. Large
hernia, elephantiasis or large hydrocele may impose a mechanicalobstacle
to coitus and produce temporary impotence. Diseasesmayresult in sterility
include mumps, testicular atrophy, diseases oftestes, epididymis.
IV. INJURIES AND ADDICTIONS:-Injury to head, spinal cord,
cauda equina may result in impotence. Chronic alcoholisim & addiction
to narcotics like opium cause impotence. Injuries to testicles will in time
cause sterility. Exposure to X-RAYS, without proper protection, may lead
to sterility.
V. PSYCHIC CAUSES:-Cases of impotence in male from
psychologicalcausesgreatlyoutnumber all other causes exceptatthe
extremes of life. Fearof impotence or fear of inability to complete the act
may also cause temporary impotence but soonis overcom.
Eg.-First night impotence
Emotional disturbance
Hypocondriasis
Timidity

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VI. OPERATIONS:-Partial a of amputation of the penis as a surgical
treatment for certain conditions of glans penis renders a male impotent.
Vasectomyrenders a male aterile but not impotent. Lithotomy operations
may sometimes cause sterility from injury to ejaculatoryducts.
Specific cause as follows,
 Varicocele:- It is an abnormal dilation of veins within the
spermatic cord. The effectof varicocele ontesticular function
appears to be the result in an increase in localrise of temperature.
 Endocrine disorders :- although rare, infertility in males may be
due to certain endocrine disorders. These are usually treatable.
Impotency associatedwith hyperprolactinemia is readily treatable.
Infections and male infertility: -
Acute and chronic genital tract infections are well-knowncausesof
infertility in men.
Episodes ofacute orchitis or epididymitis may result in permanent damage
to the testis or to obstruction in the efferent ejaculatoryducts.
C. trachomatis causes approximately50% of epididymitis in sexually active
men under age 35. Unilateral epididymal obstruction is seldomdiagnosed,
and its effecton fertility is largelyunknown. However, 80% of men with
unilateral ductal obstruction have antibodies to sperm, a potential cause of
male infertility. Appropriate assessmentofa semen sample including tests
like presence ofseminal Fructose, neutral alpha-glucosidase andpH go a
long way in differentiating betweenobstructive and non-obstructive
azoospermia.
Orchitis- mumps, tuberculosis, syphilis, pancreatitis
Epididymitis - gonorrhea, tuberculosis, chlamydiae, ureaplasmas,
Pseudomonas, coliform, and other bacterialinfections
Seminal vesiculitis - tuberculosis, trichomoniasis, other bacteria
Urethritis - gonorrhea, chlamydiae, ureaplasmas,
trichomoniasis

5. 5
OBESITY AND MALE INFERTILITY: -
The relationship betweenmale infertility and obesity has more concrete
evidence than solelystudies showing reduced fecundity among couples, one
of whom is an obese male. Although spermatogenesisand fertility are not
impaired in a majority of obese men, a disproportionate number of men
seeking infertility treatment are obese. There have been a number of
studies analyzing the relationship betweensemenquality and obesity, with
a common finding that there is an inverse correlationbetweenBMI and
quality of semenparameters.
ENVIRONMENTAL TOXICS: -
Mostenvironmental toxins are fat soluble and therefore accumulate in
fatty tissue. Their accumulation not only around the scrotum and testes,
but also elsewherein the body may disrupt the normal hormone pro fi le
because they are proven endocrine disruptors in male fertility. Since
morbidly obese males present with excessscrotalfat, environmental toxins
accumulating in white adipose tissue surrounding the scrotum may also
have a direct localized effecton spermatogenesis in the testes. Lipophilic
contaminants such as organochlorines,organic compounds containing at
leastone covalentlybonded chlorine atom whose uses are controversial
because ofthe often toxic effects of these compounds on the environment,
are associatedwith decreasedspermproduction and thus decreasedmale
reproductive potential, even if fat is not localized in the scrotalarea. Other
toxic species that may induce abnormal spermatogenesisare ROS
discussedin the previous section. Despite reports that certain toxins can
negatively affectfertility, Magnusdottir et al. found that poor semen
quality was found to be associatedwith sedentarywork and obesity, but
not with increasedplasma levels of persistent organochlorines.
GENERAL FACTORS THAT AFFECT FERTILITY :-
There are many factors, whichaffect fertility in females. The first few
cycles after menarche and last few cycles before menopause are
anovulatory. Fertility in females is at its best in early 20s and declines
after the age of35. In male however, spermatogenesis is active after
puberty and only slight reduction occurs afterthe age of 60. Anxiety and

6. 6
stress are underestimated factors in infertility. These psychologicalfactors
can cause changesin neuroendocrine control of ovulation.
CAUSES OF IMPOTENCY & STERILITY IN FEMALE :-
The causes willbe same as those in male.
I. AGE :- Women is the passive agentin sexual act, there can be no limit
to the oldestage at which she should be potent to allow the act.
Menstruation is not a sign of bodily maturity but in most cases,it is merely
a sign of puberty and ovulation. As a rule, fertility ceasesatmenopause
with the cessationofmenstruation though an occasionalexceptionmay
occur. After menopause the womenwill be sterile but not impotent.
II. MALFORMATION :- Absence of vagina or one which is
rudimentary in characteris often found in casesofinter sexuality and is
the cause ofpermanent impotence in female. The conicalcervix & absence
of the uterus , ovaries or fallopian tubes produce sterility but not
impotency.
III. LOCAL & GENERAL DISEASES :- Local diseasesofthe
genital organs in female do not ordinarily produce impotency provided the
vagina is normal.
Eg.- Gonorrhea involving the cervix, uterus, ovaries , and fallopian
tubes , vaginaltumors produce temporary impotence. Diseasesofovaries,
rupture of perineum may cause sterility.
IV. INJURIES &ADDICTION :- As in male, occupational
exposure to lead , or exposure to X-Rays without proper
protection may lead to temporary or permanent sterility. Chronic
alcoholism and abuse of narcotics such as opium may also lead to
sterility.
V. PSYCHIC CAUSES :-Whereas in men, the impotence resulting from
psychologicalcausesis passive leading to non erection, in omen it is of an
active natue leading to spasmof vagina. The condition may be causedby
fear, disgust, or excessive inability of vaginalmucosa.

7. 7
VI. OPERATIONS:- Ligature of both in fallopian tubes or any operation
that disrupts the potency of both fallopian tubes results in sterility of the
female but not impotence.
The main causes as follows,
 Ovulatory Factors: - ovulatory disorders may be due to problems
at no. of levels. Common causes ofanovulation are PCODs
 Adenoma of pituitary and certainother diseasesofhypothalamus
and pituitary are also associatedwith anovulation. Other endocrine
systems are – thyroid, adrenal gland .
 Tubal factors: - This is the obstruction of the tube. This is usually a
sequelae ofpelvic inflammatory disease. PID canalso follow aseptic
induced abortion or as a post-partum infection. C.Trachomatis
salpingitis canbe seenin as many as 15% patients who undergo an
induced abortion.
 Immunologic causes: - Anti-sperm antibodies if present either in
female or male, cancause infertility. They actby preventing the
binding of sperm to zona pellucida or by decreasing the sperm
motility.

8. 8
STERILISATION: -
This is a procedure which renders a person sterile without any
interference with potency. The purpose for which it is employed are-
i. As a family planning measure
ii. As a therapeutic measure, for the health of the mother
*To limit the additional strain of looking aftera newborn
*If the act of delivery poses a danger to her very existence
iii. As a eugenic measure to prevent children with physical or mental
defects being born.
iv. For convenience whendone for any other purpose.
Sterilisation in male is effected by vasectomy. The operationis simple
after vasectomy, the patient is advised to refrain from intercourse for 2
months.
Sterilisationin female is affectedby tubectomy.
TREATMENT:-
In vitro fertilization may be an option for obese patients facing problems
such as erectile dysfunction or other purely physical fertility problems.
Although morbid obesity is associatedwith unfavorable IVF/ICSI cycle
outcome as evidenced by lower pregnancyrates in females, there is no

9. 9
evidence for a contributing male factorwhen assistedreproductive
methods are used. It is recommended that morbidly obese patients
undergo appropriate counseling before the initiation of this expensive and
invasive therapy. Fortunately, studies show that obesity in men may not
adverselyaffect the results of their partners who are undergoing in vitro
fertilization or embryo transfer.
Scrotallipectomy is a treatment option available for infertility in obese
men whose excessfataccumulation may be contributing to their infertility,
either through increasedscrotaltemperature or excess toxinaccumulation.
One- fifth of patients who were previously consideredinfertile and
underwent scrotallipectomy to remove excess fatwere able to achieve a
successfulpregnancy.
TREATMENT OF PID: -
There is controversyoverthe issue of outpatient versus inpatient treatment
of patients with acute salpingitis. Foreconomic and logisticalreasons, most
women are treated on an outpatient basis. The decisionfor hospitalization
is usually basedon the clinical severity of the illness, although criteria vary.
It seems reasonable to treat major pathogens such as N. gonorrhoeaeand
C. trachomatis in every patient. An antibiotic regimen that takes into
accountthe polymicrobial nature of the cause ofacute salpingitis must be
used. However, after treatment with different antibiotics, similar infertility
rates have been found. Women treated after 3 or more days of symptoms
had significantly more infertility than those treatedearlier. Better
recognitionand treatment of cervicitis and endometritis before salpingitis
develops is even more important in the prevention of infertility than the
treatment of salpingitis per se. Recommendedtreatment schedules for
uncomplicated salpingitis are shown as below:
For acute salpingitis ParenteralRegimenA-
 Cefotetan2 g, IV every 12 hours,
ParenteralRegimenB-
 Clindamycin, 900 mg, IV every 8 hours,
 Gentamicin loading dose IV or IM (2 mg/kg of body weight), followed
by a maintenance dose (1.5 mg/kg) every 8 hours. Single daily dosing
may be substituted.

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ARTIFICIAL INSEMINATION: -
It is defined as the deposition of semenin vagina, the cervicalcanal, or the
uterus by instruments to bring about pregnancy which is not attained by
sexualintercourse.
If the procedure is successful, the woman will conceive and carry a baby to
term in the normal manner. A pregnancy resulting from artificial
insemination is no different from a pregnancy achievedby sexual
intercourse. There are a number of reasons whya woman would use
artificial insemination to achieve pregnancy. For example, a woman's
immune system may be rejecting her partner's sperm as invading
molecules. Womenwho have issues with the cervix – such as cervical
scarring, cervicalblockagefrom endometriosis, or thick cervicalmucus –
may also benefit from artificial insemination, since the sperm must pass
through the cervix to result in fertilization.
Donor sperm is increasinglyused where a single woman without a male
partner or a lesbian couple wish to have a biologicalchild. A couple where
one personis transgender and no longerhas gonads or never had gonads
may also use donor sperm to become pregnant.
PREPARATION:-
Sperm canbe provided fresh or washed. The washing of sperm increases
the chances offertilization. Pre- and post-concentrationofmotile sperm is
counted. Sperm from a sperm bank will be frozen and quarantined for a
period, and the donor will be testedbefore and after production of the
sample to ensure that he does not carry a transmissible disease. Forfresh
shipping, a semenextender is used.
If sperm is provided by a private donor, either directly or through a sperm
agency, it is usually supplied fresh, not frozen, and it will not be
quarantined. Donorsperm provided in this way may be given directly to
the recipient woman or her partner, or it may be transported in specially
insulated containers. Some donors have their own freezing apparatus to
freeze and store their sperm.
TECHNIQUES:-

11. 11
Semen used is used either fresh, raw, or frozen. Where donor sperm is
supplied by a sperm bank, it will always be quarantined and frozen, and
will need to be thawed before use. When an ovum is released, semenis
introduced into the woman's vagina, uterus or cervix, depending on the
method being used. Sperm is occasionallyinserted twice within a
'treatment cycle.
INTRACERVICAL INSEMINATION: -
Intracervicalinsemination (ICI) involves injection of unwashed or raw
semeninto the vagina at the entrance to the cervix with a needleless
syringe. Sperm supplied by a sperm bank will be frozen and must be
allowedto thaw before insemination. The sealedend of the straw itself
must be cut off and the open end of the straw is usually fixed straight on to
the tip of the syringe, allowing the contents to be drawn into the syringe.
Sperm from more than one straw cangenerally be used in the same
syringe. Where fresh semen is used, this must be allowedto liquefy before
inserting it into the syringe, or alternatively, the syringe may be back-
loaded.
Air must be expelled from the syringe which is then filled with semen. Any
further enclosedairmust be removed by gently pressing the plunger
forward. The woman lies on her back and the syringe is then inserted into
the vagina. Care is optimal when inserting the syringe, so that the tip is as
close to the entrance to the cervix as possible. A vaginal speculum may be
used to hold open the vagina so that the cervix may be observedand the
syringe inserted more accuratelythrough the open speculum. The plunger
is then slowly pushed forward and the semenin the syringe is gently
emptied deep into the vagina. The syringe (and speculum if used) may be
left in place for severalminutes before removal and the woman is advised
to lie still for about half-an-hour to improve the successrate. Ordinary
sexuallubricants should not be used in the process, but specialfertility or
'sperm-friendly' lubricants can be used for increasedease and comfort.
INTRAUTERINE INSEMINATION: -
Intrauterine insemination (IUI) involves injection of washedsperm into the
uterus with a catheter. If unwashed semenis used, it may elicit uterine
cramping, expelling the semenand causing pain, due to contentof
prostaglandins. (Prostaglandins are also the compounds responsible for
causing the myometrium to contractand expel the menses from the uterus,
during menstruation.) Resting on the table for fifteen minutes after an IUI
is optimal for the woman to increase the pregnancyrate.

12. 12
Unlike ICI, intrauterine insemination normally requires a medical
practitioner to perform the procedure. A female under 30 years of age has
optimal chances with IUI; for the man, a TMS of more than 5 million per
ml is optimal. In practice, donor sperm will satisfythese criteria. A
promising cycle is one that offers two follicles measuring more than 16 mm,
and estrogenofmore than 500 pg/mL on the day of hCG administration. A
short period of ejaculatoryabstinence before intrauterine insemination is
associatedwith higher pregnancy rates. However, GnRH agonist
administration at the time of implantation does not improve pregnancy
outcome in intrauterine insemination cycles according to a randomized
controlled trial.
IUI is a more efficient method of artificial insemination than ICI and,
because ofits generally higher successrate, is usually the insemination
procedure of choice for single women and lesbians using a fertility centre
and who are less likely to have fertility issues of their own. Enabling a
donor's sperm to be inserted directly into the womb will produce a better
chance of conceiving.Itis also a method used by couples using donor sperm
in a fertility centre.
INTRAUTERINE TUBOPERITONEAL INSEMINATION: -
Intrauterine tuboperitoneal insemination (IUTPI) involves injection of
washedsperm into both the uterus and fallopian tubes. The cervix is then
clamped to prevent leakageto the vagina, best achievedwith a specially
designeddouble nut bivalve (DNB) speculum. The sperm is mixed to create
a volume of 10 ml, sufficient to fill the uterine cavity, pass through the
interstitial part of the tubes and the ampulla, finally reaching the
peritoneal cavity and the Pouch of Douglas where it would be mixed with
the peritonealand follicular fluid. IUTPI can be useful in unexplained
infertility, mild or moderate male infertility, and mild or moderate
endometriosis. In non-tubal sub fertility, fallopian tube sperm perfusion
may be the preferred technique over intrauterine insemination.
ADVANTAGES:-
Diseasecontrol. This is accomplishedby preventing skin contactsuch as in
natural service. The most important diseasesit protects againstare
transmissionof the herpes virus- equine coitalexthanema - and contagious
equine metritis, which is causedby a bacteria. In addition antibiotics can

13. 13
be added to the semenat the time of insemination or collectionand reduce
or totally eliminate breeding the mare with any bacteria at all.
Decreaseschances ofinjury. Semenis generally only collectedeveryother
day in an AI programme, so there is much less chance for injury. In
addition, semencan be collectedon a phantom and a mare in heat may not
even be needed. Notonly does this almost eliminate injury to the mare (if
she didn’t want to get served) and stallion but also it dramatically reduces
the chances ofinjury to those staff involved in the breeding shed. It may be
in future that farms could be in legaltrouble when staff are hurt and AI
could have been used.
Semen canbe collectedfrom stallions with problems. Eachyear stallions
are either injured or have trouble breeding due to inherent libido (sexual
behavior) problems. Because semenonly needs to be collectedeveryother
day it reduces the effects of breeding pressure and injuries.
Semen is evaluatedeachtime it is collected. With natural service we are
flying a bit blind because it is not until pregnancyrates are establishedcan
we assume that the semenwas OK at the time of breeding. With AI we can
look and measure parameters relatedto fertility every time we collect. One
way to look at reproduction is to say that when we feel the testicles we are
"feeling the future" and when looking at semen we are "looking athistory"
as one represents potential and the other the recentevent of semen
production.
DISADVANTAGES: -
⦁ Specializedequipment is needed. An artificial vagina (AV),
thermometers, warmed containers and equipment non-spermicidal geland
equipment to measure motility (warmed stage microscope)andsperm
concentrationare all necessaryfor AI to be practisedproperly. Well
equided laboratory is needed.
⦁ Technicalexpertise is needed. Personnelneed to know how to make the
AV so that it is right for the stallion and then how to collectand process the
semenproperly.
⦁ Incorrectly practicedAI can cause problems. You would be surprised
to learn just how often the wrong lubricating gel is used in the AV and that
there have been weeks before anyone realisedthat the pregnancy rates
were disastrous.

14. 14
CONCLUSION: -
The best hope for reducing the incidence of infertility relatedto infection
lies in prevention and early detectionand treatment of newly acquired
asymptomatic or mildly symptomatic infections. The importance for the
preservationof future fertility of avoiding high-risk sexual behaviour and
the mandatory use of condoms must be stressed. Concomitantly, there must
be an increasedawarenessby health care providers and consumers of the
need for intensive screening using the latestand most effective molecular
techniques followedby early effective treatment if positive.
AYURVEDA AND INFERTILITY: -
According to Ayurveda, infertility exists when a healthy couple is unable to
achieve pregnancyafter two or more years or fail to conceive for several
years after the first delivery. Ayurveda has treated infertility for several
thousand years without the help of modern advances in medicine.
Ayurvedic physicians have had to explore the human system in different
ways without any tools. They closelywatchedwhatthe human body did
naturally and applied this accordinglycoming up with different reasons as
to why a woman gotpregnant and why she could not become pregnant.
Ayurveda gives infertile womenor couples the ability through treatment to
become fertile and to improve the overallhealth to be able to conceive
naturally without the use of Westernmodalities or in coordinance with
Westernmedicine.
AYURVEDIC ETIOLOGY OF INFERTILITY: -
According to Maya Tiwari, “Women’s fertility depends on nature’s rasa
and when these Rasas are depleted, sterility, dryness, loneliness, and
isolationare bound to set in. In order to conceive a healthy child, one
should be “swastha”orfully healthy oneself. This optimum state of health
provides the fertile ground for the embryo to implant and grow.”
According to the Sushruta Samhita, Vandhya is a womanwho has lost her
Artava (menstruation) which means loss of ovulation or sterility. Vagbhata
explains that the congenitalunder-development or deformity of female
genital tract is the cause of Vandhyatwa. Bhela stated that Vata is
responsible for Vandhya.
However, infertility rarely involves only one Dosha. Those with Pitta
nature and a history of Pitta vitiation may experience infertility secondary
to past salpingitis resulting in scarring of the fallopian tubes inhibiting the

15. 15
descentof the ovum or ascentof the sperm. Excessheatmay also result in
the depletion of Shukra Dhatu.
“Those with Kapha nature experience the strongestand healthiest
reproductive system because ofthe dominant waterelement in their
constitution that supports Shukra Dhatu. Infertility in those with Kapha
Sirisha Karamchedu Page Women’s Infertility- An Ayurvedic Perspective
20 nature is less common, although Kapha can obstruct the Artavavaha
Srota and is provoked by a cold, heavy and oily diet along with a sedentary
lifestyle.
When Kapha Dosha is predominant, fallopian tubes may thicken; uterine
fibroids or cysts may develop, and often involves Pitta and Vata
displacements.” Scartissue is due to Pitta pushing Kapha. A case of
recurrent miscarriage is often diagnosedas a Pitta condition of excessive
movement of the Apana Vayu. Although this condition may be seenas high
Pitta, there is still an underlying Vata imbalance. When yoni is affectedby
various Doshas, various types of female diseases(yoni-roga)result. This
disordered genitaltract cannot receive the sperm and sterility results
Inability to conceive canalso be due to too much Ama (toxin createdwhen
undigested food forms in the stomach)in the system. Ama can circulate
throughout the body, building up in the bodily tissues. Ama can cause
abnormalities in the function of the bodily tissues and form due to
unbalanced Agni, eating disorders, emotional, physical or mental abuse.
Ama can form from an imbalance with any of the three Doshas.
DIETRY MANAGEMENT: -
Eating whole foods not only provides fiber that influences hormonal levels
but also provides all nutrients for the health of the body. Processed
carbohydrates, antibiotic and hormone laden meat and milk, excessstarch,
and canned produce destroyfertility. Foodsuch as ghee, milk, nuts, dates,
sesame seeds, pumpkin seeds, saffron, honey, and avocados helpreplenish
and build Ojas. Fresh, organic fruits and vegetables, whole grains, protein
from plant sources like beans, and peas, sweet,juicy fruits such as
mangoes, peaches, plums, and pears, asparagus, broccoli, spices suchas
ajwain powder, cumin (purifies the uterus in women and the genitourinary
tract in men), turmeric (to improve the interaction betweenhormones and
targetedtissues), and black cumin boostfertility. Rootvegetables,grains,

16. 16
arugula, watercress,onions, garlic, chives improve circulationand nourish
the blood.
The following substances cause, increaseandexacerbate female infertility,
and must therefore be avoided- foods containing preservatives and other
chemicals, suchas artificial sweeteners,diet high in fat, Monosodium
Glutamate (MSG)and other artificial flavoring and coloring (Nutra Sweet
etc.), excess caffeine andalcohol, tobacco,smoking, soda, refinedcarbs,
such as white bread, pasta and rice, and meat. It is vital to include a wide
range of foods in the diet to ensure the body is getting all the nutrients it
needs to aid conception. Eating regular and balancedmeals builds overall
health. Ayurveda recommends not to eatthe same thing every day, and to
try new vegetables and fruits as often as possible
TREATMENT:- (herbs)
o Vata- shilajith purifies the reproductive sysytem.
Reproductive tonic like- shatavari, wild yam, vidari kanda,
Ghee, milk.
o Pitha- vidari kanda, shatavari, bhrami to coolthe mind. Bala
normalize thr Ph of vaginal secretions.
o Kapha- strong herbs which clears the obstruction like guggulu
Haridra, manjista.
o Tridosha- pahla ghrita for 2 days
Vanga bhasma 10mg/day
BODY THERAPIES: -
Ayurvedic body therapies such as- Abhyanga, Shirodhara, marma
therapy, chakra balancing, Nasya, Basti, Pinda Svedana, and Visesh
help in releasing tension, impurities and trapped energy within the
body. They also nourish the body, strengthen the immune system, and
revitalize the mind. Rejuvenationtherapies are beneficial in reducing
stress, pacifying Vata and nourishing all dhatus of the body.
Aromatherapy: -
♦ Works as an aphrodisaic for couples.
♦ Regulates menstrualcycle.
♦ Promotes healthy reproductive system.

17. 17
SEXUAL DHARMAS: -
According to Maya Tiwari, “Forhealth, wealth, virility, and vitality,
sexualcohabitation should occur during harmonically auspicious time.
The opposite results hold true when sexualactivities are performed
during the poorly aspectedtimes of year.” [27] Sirisha Karamchedu
Page Women’s Infertility- An Ayurvedic Perspective 37 Figure 24
Auspicious time and conditions for cohabitationPosture is also crucial
for conception. The best posture for women is to lie comfortably on her
back and prone position for a man during sexual activity. [27] The key is
to get the sperm as close as possible to the cervix, and to remain there
for as long as possible.
CONCLUSION: -
Infertility has increasedmassivelyin the past decade and this is due to
the result of a combination of environmental, social, psychological, and
nutritional factors. Today, the modern medicine can find out what
exactly is dysfunctional in an individual through severaldiagnostic tests
and examinations. Using these tests, the treatment focuses oncorrecting
the dysfunction. However, modern medicine treatments are not focused
to the individual but are to what the dysfunction of the body is. Also,
they fail to incorporate in their therapeutic approaches, the immune,
digestive, circulatory and nervous systems, all so essentialforthe
process offertilization. Infertility is managed only by looking at the
reproductive system components. The treatments can be rather invasive,
inhumane; canbe disappointing and extremely expensive with no
guarantee of a pregnancyand with potential side effects.