RESTORATION OF OVULATORY CYCLES AND NATURAL CONCEPTION IN PCOS-ASSOCIATED SECONDARY INFERTILITY: AN AYURVEDIC CASE REPORT
DOI:
https://doi.org/10.5281/zenodo.23716803Keywords:
Polycystic Ovary Syndrome (PCOS); Secondary Infertility; Artava Kshaya; Uttara Basti; Virechana; Vandhyatva; Case Report.Abstract
Background
Polycystic Ovary Syndrome (PCOS) is a multifaceted neuro-endocrine-metabolic disorder characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. In reproductive-aged women, PCOS is the leading contributor to anovulatory infertility. In Ayurveda, this presentation correlates with Artava Kshaya / Pushpaghni Revati (Jataharini) and Vandhyatva (infertility) rooted in Kapha-Vataja Sroto-avarodha (channel obstruction) and impaired Dhatvagni.
Case Presentation
A 29-year-old female presented to the outpatient department with complaints of delayed, oligomenorrheic menstrual cycles (cycle length 60–90 days, flow lasting 1–2 days), progressive weight gain (BMI: 28.4 kg/m²), facial hirsutism, and an inability to conceive for 2.5 years following the birth of her first child (secondary infertility). Transvaginal ultrasonography (TVS) confirmed bilateral polycystic ovarian morphology, and endocrine profiling demonstrated an inverted LH:FSH ratio (2.3:1) and hyperinsulinemia. Semen analysis of the spouse was normal.
Intervention
A structured, phased Ayurvedic protocol was instituted: initial metabolic detoxification and channel cleansing (Deepana-Pachana and Kostha Shodhana via Virechana Karma), followed by targeted herbal formulations (Kanchanara Guggulu, Pushpadhanva Rasa, Varunadi Kashaya, and Shatapushpa Churna) aimed at clearing Avarodha, augmenting Agni, and stimulating the follicular microenvironment. Intrauterine administration of Phala Ghrita (Uttara Basti) was administered post-menstruation for three consecutive cycles.
Outcome
Within four months of intervention, the patient established regular, spontaneous 30–32 day menstrual cycles with physiologic flow (3–4 days). Serial follicular monitoring confirmed follicular maturation leading to spontaneous ovulation (dominant follicle measuring 21 × 19 mm with subsequent rupture). In the fifth month, the patient missed her menstrual period; a urine pregnancy test and subsequent obstetric ultrasonography confirmed a viable single intrauterine gestation with cardiac activity.
Conclusion
Sequential Ayurvedic intervention incorporating systemic bio-purification (Shodhana), targeted ovulatory stimulants (Shamana/Artavajanana), and local organ-specific therapy (Uttara Basti) reversed ovarian channel obstruction, restored hypothalamo-pituitary-ovarian axis physiology, and facilitated successful natural conception in chronic PCOS-associated secondary infertility.
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References
Teede HJ, Tay CT, Laven JSE, Dokras A, Moran LJ, Piltonen TT, et al. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Eur J Endocrinol. 2023;189(2):G43–G64.
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19–25.
Acharya YT, editor. Charaka Samhita of Agnivesha, Chikitsa Sthana; Yonivyapad Chikitsitam: Chapter 30, Verse 15–24. Varanasi: Chaukhambha Orientalia; 2014. p. 634–637.
Shastri AD, editor. Sushruta Samhita of Maharshi Sushruta, Sharira Sthana; Shukrashonita Shuddhi Shariram: Chapter 2, Verse 21–25. Varanasi: Chaukhambha Sanskrit Sansthan; 2018. p. 14–16.
Upadhyaya Y, editor. Ashtanga Hridaya of Vagbhata, Sharira Sthana; Angavibhaga Shariram: Chapter 1, Verse 7–11. Varanasi: Chaukhambha Prakashan; 2017. p. 365–367.
Baria HP, Donga SB, Dei L. Clinical evaluation of Phala Ghrita Uttarabasti in the management of female infertility. Ayu. 2013;34(2):160–165.
Anila M, Sruthi LR. A case study on OPD level management of infertility due to PCOS with Ayurvedic medicines. Int J Ayurveda Pharma Res. 2023;11(4):78–82.
Dayani G, Sharma R, Gheewala N. Role of Samshodhana Karma in the management of PCOS associated secondary infertility: A case report. J Ayurveda Integr Med Sci. 2024;9(2):182–187.
World Health Organization. Infertility prevalence estimates, 1990–2021. Geneva: World Health Organization; 2023.
Legro RS, Ardaens Y, Cortet-Rudelli C, Dewailly D. Polycystic ovary syndrome: Diagnosis and management. In: Jameson JL, De Groot LJ, editors. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia: Saunders Elsevier; 2016. p. 2351–2368.
Sharma PV, editor. Dravyaguna Vijnana (Vegetable Drugs), Vol. II. Varanasi: Chaukhambha Bharati Academy; 2015. p. 231–235, 542–546.
The Ayurvedic Pharmacopoeia of India. Part I, Vol. II & IV. New Delhi: Ministry of AYUSH, Government of India; 2007
