A CASE REPORT ON MANAGEMENT OF FEMALE INFERTILITY DUE TO LOW ANTI MULLERIAN HORMONE WITH AYURVEDIC TREATMENT PROTOCOL
DOI:
https://doi.org/10.55718/kja.189Keywords:
Antimullerian hormone, Diminished ovarian reserve, Dhatukshayajanya vandhya, Musthadi Rajayapana VastiAbstract
Complex series of events that are inevitable for a successful pregnancy include the formation of healthy sperm and ovum, their development and maturation, ovulation, fertilisation, transportation of fertilised ovum into the uterus, and implantation into a receptive uterine cavity. The recent trend of delaying conception may be associated with declining ovarian reserve, increasing the need for IVF with donor ovum. Anti mullerian Hormone *AMH+ is considered a surrogate marker for ovarian reserve and an indicator of healthy ovulation. So the reduced level of AMH is a great concern in the field of infertility management. Ayurveda emphasizes four main factors viz Rithu (ovulation), Kshetra (functional reproductive organs), Ambu (represents proper nutrition after fertilization, that can be correlated with corpus leuteal function upto the establishment of placenta and then onwards placental function), and Beeja (healthy sperm and ovum) which are essential for conception. Infertility due to Diminished ovarian reserve (DOR) can be considered under Dhatukshayajanya Vandhya explained in Harita Samhita.
This case study focuses on a 27 year old female patient who approached came to OPD with complaints of inability to conceive even after 8 years of unprotected sexual life. A thorough history taking revealed that all infertility investigations were normal with the exception of the AMH count, which was found to be reduced. She was given medications for Agni deepana and Dhatuposhana as well as Panchakarma treatments, including Musthadi Rajayapana Vasti and Uttaravasti. With the abovementioned treatments for 3 courses, the patient approached our OPD, 2 months after discharge with the complaint of secondary amenorrhoea. The urine pregnancy test was found to be positive and the patient was advised for proper antenatal care and timely follow-up. She delivered a full-term healthy female baby on 14.9.23.
References
Howkins &Bourne. In: SHAW’S Textbook of Gynecology. 16th ed. New Delhi: elsevier; 2015. p.66.
Hoffman, Schorge, Schaffer, Halvorson, Bradshaw and Cunningham. Williams Gynecology. In: 3rd ed. China: McGraw-Hill Companies; p.471.
Prof. Srikanthamurthy K.R. Illustrated Susruta Samhita. Vol. 1. Varanasi: Chaukhambha Orientalia; p.26 .
Hariharaprasad T, editor. 1st ed. Varanasi: Chaukhamba Krishnadas Academy; 2005. Harita Sa?hita, TriteeyaSthana; p. 448. Ch. 48, Ver. 1-4.
Srikantha Murthy KR, editor. Chikitsasthana. In: Vagbhata’s Ashtanga Hridayam. Vol 2, Varanasi: Chowkhambha Krishnadas Academy; 2009. p.406.
K. V . Krishnan Vaidyan S.Gopala Pillai , editor. In: Sahasrayogam, Sujanapriya Commentary. Mullakkal ,Alappuzha: Vidyarambham Publishers; 2013. p.78.
Srikantha Murthy KR, editor. Kwathaprakarana. In: Sarangadharasamhita Madhyama khanda. Varanasi, India: Chaukhambha Orientalia; 2017. p. 66.
Srikantha Murthy KR, editor. Arishta prakarana. In: Sarangadharasamhita Madhyama khanda. Varanasi, India: Chaukhambha Orientalia; 2017. p. 143.
Shastri SKA, editor. In: Bhaisajya Ratnavali of shri Govinda Dasji ,Volume II. Varanasi, India: Chaukhambha SanskritSansthan; 2009. p. 75.
Sreekumar T, editor. Annaswarupa vijnaneeyam. In: Ashtanga Hrdaya, Vagbhata Thrissur: Harisree hospital; 2013. p. 178.
Sreekantamurthy KR. Vagbhata’s Ashtanga hridayam, vol 1.7th ed. Varanasi: Chowkhambha krishnadas Academy;2010.p.202.
Srikantha Murthy KR, editor. Uttara Sthana. In: Vagbhata’s Ashtanga Hridayam. Vol 1, Varanasi: Chowkhambha Krishnadas Academy; 2009. p.326.
Srikantha Murthy KR, editor. ChikitsaSthana. In: Vagbhata’s Ashtanga Hridayam. Vol 2, Varanasi: Chowkhambha Krishnadas Academy; 2009. p.398.
Srikantha Murthy KR, editor. ChikitsaSthana. In: Vagbhata’s Ashtanga Hridayam. Vol 2, Varanasi: Chowkhambha Krishnadas Academy; 2009. p.265.
Srikantha Murthy KR, editor. SareeraSthana. In: Vagbhata’s Ashtanga Hridayam. Vol 1, Varanasi: Chowkhambha Krishnadas Academy; 2009. p.387.
Murthy KR, editor. Kalpa Sthana. In: Vagbhata’s Ashtanga Hridayam. Vol 1, Varanasi: Chowkhambha Krishnadas Academy; 2009. p.558.
R. K Sharma Bhagwan Dash, editor. In: Charaka samhita Vol 5,ChikitsaSthana. Varanasi: Chaukhambha Sanskrit Series Office; 2013. p. 610.
Shastri VSA. Pradararogachikitsa prakaranam. In: Bhaishajya Ratnavali. Varanasi, India:Chaukhambha Orientalia; 2014. p. 357.
K.V. Krishnan Vaidyan S.Gopala Pillai , editor. In: Sahasrayogam, Commentary. Mullakkal ,Alappuzha: Vidyarambham Publishers; 2013. p.135.
K.V. Krishnan Vaidyan S. Gopala Pillai , editor. In: Sahasrayogam, Sujanapriya Commentary. Mullakkal ,Alappuzha: Vidyarambham Publishers; 2013. p.92.
Srikantha Murthy KR, Shastri KA., editors. Vol. 2. Varanasi: Chaukhambha Orientalia; 2012. Sushruta. Sushruta Samhita, ChikitsaSthana, Niruha Krama Chikitsitham, 38/96-101. Reprint ed. 379.
Aravattazhikathu K.V. Krishnan Vaidyar, S. Gopalapilla,, Sahasrayogam Sujanapriyavyakhyana, Vidyarambham publications Kollam; 1992: 50
Acharya Vagbhata, Ashtanga Hridaya, ChikitsaSthana, Edited by Pt. Hari Sadasiva Shastri Paradakara, Published by: Chaukhambha Sanskrit Sansthan, Varanasi, 14/31-33, Pg-687
B.Syamala. Arogya rakshakalpadrumam- Vatarogachikitsa. Thrissur: Samrat Publishers; 2000. p.64.
Sahasrayogam English translation by Dr. K. Nishteshwar, Chaukhamba Sanskrit Orientalia, Varnasi, Edition 2006, Lehyamprakarana,pp-254,pg-540.
D Sreeman Nambootiri, Chikitsa Manjari Vol I & II Vishoochikachikitsa, 7th edition Vidyarambha publications, 2005; p.207.
Agnivesha, Charaka, Dridhbala, Charaka Samhita, ChikitsaSthana 16/52. Edited by Vd Yadavji Trikamji, reprint edition, Varanasi: ChaukhambaSurbharti Prakashana,2011, page no. 52.
K.V.Krishnan Vaidyan, S.Gopala Pillai , editor. In: Sahasrayogam, Sujanapriya Commentary. Mullakkal ,Alappuzha: Vidyarambham Publishers; 2013. p.226.
K V krishnavaidyan, S.Gopalapilla. Sahasrayogam. 32nd , 2013. Alappuzha: Vidyarambham publishers; 55 p.
Srikantha Murthy KR. Vagbhata’sAshtangahridayam. Vol. SariraSthana; 1. Varanasi: ChaukambhaKrishnadas Academy; 2018. 349 p.
PV Tewari. commentary on kashyapasamhitha, Siddhi Sthana, trilakshanasidhirnama Dwitiya adhyaya; chapter 2, verse 7, varnasi; Chaukambhavishvabharati oriental publishers;2008,266 p.
Dutta C. Charaka Samhita of Acharya Charaka,. Reprint edition. Vol. ChikitsaSthana, chapter 30, verse 30. Varanasi: ChaukambaSurabharathiPrakashana; 2004. 639 p.
Srikantha Murthy KR. Illustrated Susrutasamhita. Vol. ChikitsaSthana; 2, chapter 35, verese 3-4. Varanasi: Chaukambha Orientalia; 2017.
Dutta C. Charaka Samhita of Acharya Charaka,. Reprint edition. Vol. Siddhi Sthana, chapter 12, verse 12. Varanasi: ChaukambaSurabharathiPrakashana; 2004. p.731 .
Acharya YT. Acharya YT. 8th ed. Varanasi: Chaukhambha Orientalia; 2005. Susruta Samhita of Acharya Dalhana, ChikitsaSthana; p. 539. Ch. 37, Ver. 125. 8th ed. Vol. ChikitsaSthana; p. 539. Ch. 37, Ver. 125. Varanasi: Chaukhambha Orientalia; 2005.
