Women's Infertility- An Ayurvedic Perspective

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Ayurveda and Infertility

According to Ayurveda, infertility exists when a healthy couple is unable to achieve pregnancy after 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 closely watched what the human body did naturally and applied this accordingly coming up with different reasons as to why a woman got pregnant and why she could not become pregnant. Ayurveda gives infertile women or couples the ability through treatment to become fertile and to improve the overall health to be able to conceive naturally without the use of Western modalities or in coordinance with Western medicine.

Ayurveda

Ayurvedic medicine or Ayurveda originated in India several thousand years ago. The term “Ayurveda” combines two Sanskrit words- "Ayus", meaning life and "Veda”, meaning pure knowledge or science. The term "Ayurveda" thus means 'the knowledge of life' or 'the science of life'. According to the Charaka Samhita, "Ayus" is not just limited to describe the physical manifestation of life but is an integration and balance of mind, body, senses and the spirit. This brings a deep communion with the spirit of life, the manifestations within our entire psychophysical system and is believed to help prevent illness and promote wellness. Ayurveda can be considered as the knowledge of the totality of life, the cosmic blueprint or orderliness that underlines and governs the function and evolution of everything in the universe, including our human physiology.

 

According to the Sushruta Samhita, “An ideal healthy person is an individual who has a balanced constitution. People who have a balanced condition from birth are able to digest the correct amount of food and maintain proper elimination. Their systems and organs function normally and they have a happy state of mind.” Ayurveda is the art of daily living in harmony with the laws of nature and defines a healthy person as one who is established in the Self (higher-self), who has balanced Doshas, balanced Agni, properly formed Dhatus, proper elimination of Malas [wastes], well-functioning bodily processes, and whose mind, soul and senses are full of bliss.

 

Key foundations of health - universal interconnectedness (relationship among people, their health and the universe), prakriti (person’s unique combination of physical and psychological characteristics and the way the body functions to maintain health), and Doshas (control the activities of the body).

 

 

Ojas is the essence of all of the bodily tissues and directly influences physical, mental, emotional, and spiritual life of a person. It is the body’s natural immunity, and it is the sustainer of life. If Ojas is low, perfect health is impossible – it is difficult for a person to ward off disease, or attain the higher states of bliss and consciousness.

 Ayurvedic interpretation of the female reproductive system

‘Shroni’ means the pelvis. Female pelvis is 24 Angulas and is heavier than the pelvis of the male. There are three characteristic Srotas (capillaries) in women’s body –

·         Rajovaha Srota - includes uterus, cervix and vagina along with their blood supply

·         Artavaha Srota - includes ovary and fallopian tube along with their blood supply

·         Stanyavaha Srota - includes breast tissue along with its blood supply

 

 

‘Ashaya’ means any recipient viscus. ‘Garbhasaya’ means uterine cavity and is situated behind the ‘Bhagasthi’ (symphysis pubis) and a little above the bladder. It is surrounded by coils of intestines and is placed between small intestine (‘Pittashaya’) and large intestine (‘Paquashaya’). ‘Yoni’ includes all the female genital organs. Embryology is known as ‘Atulyagotriya’.

 

Female Reproductive System

Ayurvedic medicine that deals with issues of infertility is called ‘Vajikarana’. The word “Vaji” means “horse,” so Vajikarana means “to make one potent like a horse.” The Ayurvedic term for the diseases of the female reproductive system is Guhyaroga. Garbharoga is the term for the diseases of the uterus. Diseases of the vagina (Yoni in Sanskrit) are called Yoni Vyapat. [

Ayurvedic perspective on women’s fertility

“True healing of any condition, ‘Prakriti Sthapana’, means to restore the mind, body, and spirit to their naturally balanced states.” -Charaka Samhita

 According to Ayurveda, conception takes place due to healthy sperm, healthy ovum, and a healthy uterus. For both men and women, reproductive health depends on the health of the Shukra Dhatu, or reproductive tissue. In women the Shukra tissue produces the ovum as part of the monthly cycle, and in men the semen is formed due to sexual stimulation.

The Shukra Dhatu itself is created as part of a long chain of metabolic transformations, starting with the digestion of food and including the transformation of food to nutrient fluid, blood, muscle, fat, bone, bone marrow and finally, to Shukra tissue. Healthy Shukra Dhatu, then, according to Ayurveda, depends on the health of all the other tissues in the body.

Charaka Samhita summarized the description of conception as follows: “When normal semen is introduced into the healthy vagina during a well-developed proliferative phase which is accompanied with ovulation, then the coitus becomes a fruitful one and conception results.” In Harita’s opinion, when sperm is encircled by ovum in a proper type of intercourse, conception takes place. Kasyapa also expressed the same opinion – “As soon as the Beeja (ovum and sperm) enters, it is surrounded by Rakta.” This sutra explains that the fertilized ovum gets encircled by blood as soon as it enters uterus.

 

Sushruta Samhita described the physiological changes occurring during intercourse, “Teja is produced during contact and this stimulates Vatodeerana. Teja along with Vata causes secretion of Shukra. Shukra travels to Yoni and unites with Artava. The resulting product of union of Agni and Soma then travels to Garbhashaya.” Bhava Mishra explained that the physical contact of penis and vagina gives rise to increase in the bodily heat which along with Vata causes secretion of semen. The semen is dropped on vagina from penis. From vagina, it is taken to the uterus and meets the ovum. Fertility begins with menarche and ends with menopause. Upon ovulation, the ovum is viable for fertilization for approximately 24 hours. Sperm are viable for up to 72 hours following ejaculation, though most die after 24 hours. Hence, pregnancy can occur up to three days after intercourse if ovulation takes place.

Ayurvedic etiology of infertility

 

Women’s fertility depends on nature’s rasa and when these Rasas are depleted, sterility, dryness, loneliness, and isolation are bound to set in. In order to conceive a healthy child, one should be “swastha” or fully healthy oneself. This optimum state of health provides the fertile ground for the embryo to implant and grow.

 

Types of infertility as written in classical texts

 

According to the Sushruta Samhita, Vandhya is a woman who has lost her Artava (menstruation) which means loss of ovulation or sterility. Vagbhata explains that the congenital under-development or deformity of female genital tract is the cause of Vandhyatwa. Bhela stated that Vata is responsible for Vandhya.

 

Causes of sterility

 

Menstrual cycle is an indication of the state of the health of the female and can be affected by many factors, such as excessive physical exercise, diet, life-style, stress, emotional instability. Any of these can create an imbalance of the Ojas, Doshas (Vata, Pitta and Kapha) and Dhatus.

 

 

Anatomical co-relations of causes of infertility by Doshas

 

 

Vata is the most easily disturbed Dosha, depletes Shukra Dhatu, causes functional defects in the egg and difficulties with implantation and is often responsible for infertility. Those with a Vata nature and imbalance are the most likely to have difficulty with conception. Vata imbalance occurs when there is excessive exercise, fear, anxiety or stress due to trauma, excessive fasting as is the case in eating disorders or diet including cold, light and dry substances. 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 descent of the ovum or ascent of the sperm. Excess heat may also result in the depletion of Shukra Dhatu. Those with Kapha nature experience the strongest and healthiest reproductive system because of the dominant water element in their constitution that supports Shukra Dhatu. Infertility in those with Kapha 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. Scar tissue is due to Pitta pushing Kapha. A case of recurrent miscarriage is often diagnosed as a Pitta condition of excessive movement of the Apana Vayu. Although this condition may be seen as high Pitta, there is still an underlying Vata imbalance. When yoni is affected by various Doshas, various types of female diseases (yoni-roga) result. This disordered genital tract cannot receive the sperm and sterility results.

 

Disorders of physiology of conception

 

According to Ayurveda, just as proper season, good field, enough supply of water and minerals and good seed are essential to produce a good crop, the Rutukala, Kshetra, Ambu and Beeja are essential factors of conception. Imbalance of any of these features leads to infertility.

 

 

 

Factors affecting fertility in woman

 

For example, Rutukala is a period of Kapha-Pitta predominance and when affected by Vata or Pitta causes subfertility. Disorders of Ambu can cause issues in amniotic fluid and nutritional insufficiency after conception. Disorders of Beeja can also cause subfertility. Disorders in Kshetra can cause margavarodha (obstruction in fallopian tubes), Vyapanna yoni or Garbhasaya (uterine, cervical or vaginal pathology causing hostility to spermatozoa). Inability to conceive can also be due to too much Ama (toxin created when 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. Undiagnosed celiac syndrome has also been identified as a cause of infertility, because lack of proper absorption and assimilation ultimately leads to impaired nutrition of Artava Dhatu. Smoking is a form of prajnaparadh that can significantly impair fertility, as is excess caffeine consumption, which can exacerbate the impact of other causes of infertility. Previous cancer treatment can be a cause of infertility since radiation and chemotherapy can damage the Artava Dhatu, killing oocytes and leading to premature ovarian failure and infertility.

Postponement of pregnancy until after the age of thirty five is increasingly common in contemporary society, and is accompanied by increased risk of infertility.

 

Hormonal and emotional imbalances can also be a cause of infertility. According to Charka, abnormalities of yoni, psychology, Shukra, Artava, diet and mode of life, coitus at improper time and loss of bala (strength) cause delay in achieving conception in an otherwise fertile woman. A balanced and happy mind is a major part of the Ayurvedic definition of health. [80] A person’s reproductive organs could seem to be functioning properly, but if the person is unhappy or unsound of mind, the body may reject pregnancy. According to Ayurveda, body and mind must both be treated with equal importance.

 

 

Karma can also be an important factor in a person’s ability to conceive. According to the Charaka Samhita, “Abnormalities of atman and sattwa or influence of misdeeds done by the couple in their previous life can cause infertility. Therefore, some practitioners recommend their patient get a Jyotish reading to find out the appropriate time for begetting children or of their chart are interpreted to say it may not be right for them in this lifetime.” Conception occurs only when an individual soul is ready for rebirth, i.e. to undergo the fruits of actions of his past lives.

 

 

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