A case discussion on Female infertility , and its managements through modern medicine and Ayurveda Medicine.

1. FEMALE INFERTILITY
due to tubal blockage
(A CASE PRESENTATION)
DR.SHRUTHI ARUN
BAMS, M.S OBG (AYU)

2. INTRODUCTION
Female infertility is the
inability to achieve
pregnancy after repeated
intercourse for one year

3. CAUSES FOR FEMALE INFERTILITY

4. TUBAL BLOCKAGE
 Fallopian Tubes are also known as oviducts, uterine
tubes, and salpinges (singular salpinx).
 Blocked fallopian tubes are unable to let
the ovum and the sperm converge, thus
making fertilization impossible

5. CAUSES FOR TUBAL BLOCKAGE
 Infections: PID, Endometriosis, nfections
after childbirth and intraabdominal infections
including appendicitis and peritonitis.
 Distal tubal occlusion (affecting the end towards
the ovary) is typically associated
with hydrosalpinxformation and often caused
by Chlamydia trachomatis.
 Adhesions : render it dysfunctional by distorting or
separating it from the ovary
 As a method of contraception

6. EVALUATION:
 HSG
 Sonography can demonstrate tubal abnormalities such as
a hydrosalpinx indicative of tubal occlusion
 Laparoscopic chromotubation
TREATMENT
 Surgery
 IVF

7. IN AYURVEDA

8. CASE STUDY ON TUBAL
BLOCKAGE
 Name of the patient : Mrs.Vidhya
 Age: 32 years
 Sex : Female
 Present complaint : Inability to conceive 1 ½ years.
 Married for 1 ½ years
 Non consanguineous marriage

9. Personal History
 Appetite : Good
 Diet : mixed diet (veg+ non veg)
 Bowels: regular
 Sleep : sound sleep
 Allergies : absent
 Bladder : clear
 Addictions: nothing
 Occupation : house wife

10. MENSTRUAL HISTORY
 Menarche : at the age of 15
 LMP: 10-06-15
 Interval : 28-30 days/ regular cycles
 Duration of bleeding : 4-5 days
 Associated complaints : low back ache

11. Past Medical History
 Appendicectomy for Appendicytis 4 years ago
 3 cycles of OI failed

12. Physical Examination
VITAL DATA:
 Pulse : 76 b/m
 RR : 18
 BP : 120/80
 Height : 4.6
 Weight : 58 kgs
SYSTEMIC EXAMINATION :
 CNS : NAD
 CVS : NAD
 RS : NAD
 P./A : Soft , No tenderness, No organomegaly

13. LABORATORY INVESTIGATIONS
 Hysterosalpingogram revealed Bilateral isthemic
tubal block
 Follicular study : (TAS+ TVS)
Uterus :
Anteverted, normal in size , measures 7.0 x 4.3 x 4.1
cm
Normal myometrial echotexture
Endometrium : 11mm thickness
Both ovaries : normal in size , shape, echotexture

14. Ashta vidha Pareeksha
 Nadi : 76b/m
 Mootra : prakruta
 Mala : prakruta
 Jihwa: lipta
 Shabda : Prakruta
 Sparsha : Prakruta
 Drik : Prakruta
 Aakriti : madhyama

15. Diagnosis
 Primary infertility
 Bilateral tubal blockage
 Anapatya ???????

16. CHIKITSA
TREATMENT PLAN
 YOGA BASTI
 UTTARA BASTI
 AVAGAHA
 INTERNAL MEDICINES

17.  Sneha vasti : Satpala ghrta – 80 ml
 Kashaya vasti :
Indukanta kwatha – 350ml
Satpala ghrta – 80ml
Makshika – 30ml
Shatapushpa – 30g
Lavana – 10g
SNEHA VASTI SNEHA VASTI KASHAYA VASTI SNEHA VASTI
KASHAYA VASTI SNEHA VASTI KASHAYA VASTI SNEHA VASTI
YOGA VASTI : 8

18.  UTTARA VASTI – 4 with Ketakimooladi taila
 AVAGAHA SWEDA – 4 Dashamoola QC
INTERNAL MEDICINES
 Satpala Ghrta : 1tsp BD in empty stomach
 Indukanta QC : Made to kashaya : 75 ml BD before food
 Draksharishtam + Lohasavam : 30ml BD after food
 Dashamoolaharitaki lehya 1tsp bd

19. MEDICINES ON DISCHARGE
 Indukanta QC : made to kashaya : 75ml BD, BF
 Chiruwalwadi ghrta : 15ml BD, BF
 Mandoora vatakam : 0-1-0 with buttermilk
 Punernavasavam : 25ml BD, AF
 Dhanwantaram Gutika : 2-0-2

20. FIRST FOLLOW UP
 LMP : 09-07-15
 Heavy bleeding first 3 days
 Dysmenorrhoea reduced
 MEDICINES :
 Chiravilwadi Ghrta : Day 1 – Day 14 : 15ml BD
Chitrakadi Vati : day 10 – day 14 ; 2 BD
Phala Sarpi : day 15 till next cycle ; 15ml BD
Dashamoola QC for Avagaha from day 4 – day 14

21. SECOND FOLLOW UP
 LMP : 30-08-15
 Heavy bleeding first 3 days
 Very mild Dysmenorrhoea
 Weight : 58.5 kg
 MEDICINES
Satpala ghrta : day 1 – day 14
Chiruvilwadi ghrta : day 1 – day 14
Punarnavasam : day 1 – day 12, 15ml BD
Phala Sarpi : day 15 till next week

22. THIRD FOLLOW UP
 LMP : 29-09-15
 Normal flow
 Slight clots, No Dysmenorrohea
 Weight : 58.5 kg
 MEDICINES:
Satpala Ghrta : day 1 – day 12
Chiruvilwadi ghrta : day 1 to day 14
Gokshura guggulu : 2-2-2 for 10 days