Ayurveda Therapeutic Approach for Infertility Associated with PCOS: A Case Study
CASE STUDY
Dr. Pooja Mangal
Final Year PG Scholar, Dept. of Prasutitantra and Streeroga, National Institute of Ayurveda (DU), Jaipur, https://orcid.org/0009-0000-0582-2773
Dr. Anjali Jain
Ph.D Scholar, Dept. of Prasutitantra and Streeroga, National Institute of Ayurveda (DU), Jaipur, https://orcid.org/0000-0003-1186-6865
Prof. (Dr.) B. Pushpalatha
Professor, Dept. of Prasutitantra and Streeroga, National Institute of Ayurveda (DU), Jaipur.
Dr. Poonam Choudhary
Senior Assistant Professor, Dept. of Prasutitantra and Streeroga, National Institute of Ayurveda (DU), Jaipur
Prof. (Dr.) K. Bharathi
Professor & Head, Dept. of Prasutitantra and Streeroga, National Institute of Ayurveda (DU), Jaipur.
Ayurveda Therapeutic Approach for Infertility Associated with PCOS: A Case Study
International Journal of Ayurveda360 | Volume 1 | Issue 6|
Journal Details:
- ISSN (ONLINE) : 3048-7390
- ISSN (PRINT) : 3048-7382
- Bimonthly Journal
HOW TO CITE THIS ARTICLE?
Mangal, P., Jain, A., Pushpalatha, B. P., Choudhary, P., & Bharathi, K. (2025). Ayurveda therapeutic approach for infertility associated with PCOS: A case study. International Journal of Ayurveda360, 1(6), 445-455. https://doi.org/10.63247/3048-7390.vol.1.issue6.3
Manuscript Received | Review Round 1 | Review Round 2 | Review Round 3 | Final Updated Received |
31/03/2025 | 08/04/2025 | 14/04/2025 | 22/05/2025 | 09/06/2025 |
Accepted | Conflict of Interest | Funding | Ethical Approval | Plagiarism Checker |
10/06/2025 | NIL | NIL | Consent Received | 11% |
Published: 15-June-2025
DOI: 3048-7390.vol.1.issue6.3
DOI Link: https://doi.org/10.63247/3048-7390.vol.1.issue6.3
Address for Correspondence: Dr. Pooja Mangal, Final Year PG Scholar, Dept. of Prasutitantra and Streeroga, National Institute of Ayurveda (DU), Jaipur. Email: dr.poojamangal@gmail.com
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ABSTRACT
Introduction:
Sedentary lifestyles have contributed to a rising prevalence of metabolic disorders such as polycystic ovarian syndrome (PCOS), particularly among women of reproductive age. PCOS is a leading cause of anovulation and infertility. In Ayurvedic terms, infertility associated with PCOS can be correlated with Vandhyatva due to Nashtartava, involving vitiated Vata and Kapha obstructing the Artavavaha Srotas.
Method:
This case report presents a 20-year-old female patient with delayed menstruation and primary infertility for two years. Transabdominal ultrasound confirmed an anovulatory cycle associated with PCOS. The treatment plan included two cycles of Yoga Basti, followed by one cycle of Madhutailika Basti, along with Shamana Chikitsa. Additional attention was given to Nidana Parivarjana (elimination of causative factors), lifestyle modification, and yoga therapy, based on Ayurvedic principles.
Results:
After completion of Shodhana and Shamana therapies, the patient’s menstrual cycle normalized, and she successfully conceived. This indicates a favorable outcome in restoring ovulation and fertility in PCOS through Ayurvedic management.
Discussion:
This case highlights the potential effectiveness of a comprehensive Ayurvedic approach—including Basti therapies and Shamana Chikitsa—in managing PCOS-related infertility. The integrative plan may have contributed to hormonal regulation, improved menstrual regularity, and enhanced fertility.
Keywords: Case report, Infertility, Madhutailika Basti, PCOS, Vandhyatva, Yoga Basti
FULL PAPER
Introduction
Infertility is defined as the failure to conceive after one or more years of regular, unprotected coitus [1]. It affects multiple dimensions of a woman’s life, including her physical, emotional, and social well-being [2]. Globally, the World Health Organization (WHO) estimates that 60 to 80 million couples face infertility [3], with prevalence varying by region—affecting approximately 8% to 12% of couples worldwide [4]. Among the various causes, ovulatory dysfunction contributes to nearly 25% of female infertility cases, with polycystic ovarian syndrome (PCOS) being a predominant endocrine disorder and a major cause of anovulation.
In Ayurveda, infertility is described as Vandhyatva, classified under Rasa Pradoshaja Vikara, with Vata being the primary causative Dosha. Acharya Sushruta enumerated the four essential components (Garbha Sambhava Samagri) necessary for conception—Ritu (fertile period), Kshetra (healthy reproductive organs), Ambu (adequate nourishment), and Beeja (healthy ovum and sperm) [5]. Disruption in any of these components can result in infertility. Ambu, in particular, corresponds to the post-fertilization nourishment provided by the corpus luteum and, later, the placenta. In addition to physical health, Acharya Charaka emphasized the importance of Soumanasya (mental calmness) for conception, recognizing the role of psychological well-being [6]. Acharya Vagbhata further highlighted the necessity of Shuddha Artava and Shuddha Shukra, as well as proper functioning of Garbhashaya, Hridaya, and Anila [7].
While classical Ayurvedic texts do not explicitly mention PCOS, its features align with Nashtartava, a condition involving Vata-Kapha vitiation and obstruction of Artavavaha Srotas. Accordingly, treatment should focus on Vata-Kapha-hara, Agni Deepana, Vata Anulomana, and Rasa Pradoshaja Chikitsa.
Case Report
A 20-year-old married female visited the Prasuti Tantra and Stri Roga OPD of NIA, Jaipur, in May 2023, with complaints of infertility for two years and irregular menstrual cycles for the same duration. Her cycles occurred every 40–60 days, with normal flow and mild lower abdominal pain. She was diagnosed with PCOS and an anovulatory cycle based on ultrasound. Previous allopathic treatment for six months yielded unsatisfactory results, prompting her to seek Ayurvedic management.
Demographic Data (Table 1)
Parameter | Detail |
Name of Patient | XYZ |
Age | 20 years |
Religion | Hindu |
Occupation | Housewife |
Education | B.Sc. graduate |
Date of First Visit | 14/05/2023 |
Husband’s Occupation | Government job (Air Force) |
Menstrual and Marital History (Table 2)
Parameter | Detail |
Menarche | 14 years |
Last Menstrual Period | 04/05/2023 |
Cycle Interval | 40–60 days |
Duration of Menses | 5–6 days |
Regularity | Irregular |
Clots | Present |
Color | Dark red |
Foul Smell | Absent |
Pain | Mild (lower abdomen) |
She was nulligravida, with no history of contraception use or prior surgery. Her husband’s semen analysis was normal.
Investigations
- CBC (19/08/2023): Hb 12.4 g/dL
- TSH: 1.14 µIU/mL
- Prolactin: 10.85 ng/mL
- AMH: 6.47 ng/mL
- LH: 21.08 mIU/mL
- FSH: 8.62 mIU/mL
- RBS: 82 mg/dL
- LFT, RFT: Within normal limits
- Blood Group: O+ve
Ultrasonography (29/03/2022):
- Polycystic ovarian morphology
- Normal-sized uterus (7.65 × 3.51 × 4.62 cm)
- Enlarged ovaries with multiple peripheral cysts (2–9 mm)
- Right ovary: 13.46 mL
- Left ovary: 12.00 mL
Therapeutic Intervention
- Nidan Parivarjana:
As emphasized by Acharya Sushruta, eliminating causative factors (Nidana Parivarjana) is the first step in treatment [8]. This included dietary modifications, avoiding Viruddha Ahara (incompatible foods), stress reduction, correcting irregular sleep patterns, and lifestyle improvements such as yoga and physical activity.
1. Nidanaparivarjana (Do’s & Don’ts) 5:00 am – wake up 6:10 am – go to toilet for potty 6:20 am – brush 8:00 – 9:00 am – household work 9:30 am – soaked moong dal, almonds taken 10:00 am – breakfast, lunch (3 chapatis, green vegetables like gheeya, turai, karela, tinda , patato×, kadhi ×, chhach ×, dahi ×, bhindi etc.) 10:30 am – 12:00pm – household work , medicine taken 12:20 pm – go to bath × 12:45 pm – tea & biscuits × 1:00 pm – 2:00 pm – phone use × 2:00 – 4:00 pm – diwaswapana × 4:15 pm – tea × 4:30 – 8:00 pm – household work 8:00 pm – dinner (3 chapatis, green vegetables like gheeya, turai, karela, tinda , kaddu, gobhi ×, baingan ×, patato×, kadhi ×, chhach ×, dahi ×, bhindi etc.) 8:30 – 10:30 pm – family time 10:30 pm – 5:00 am – sleep Rajaswalacharya – ü Jau ki roti/ jau ka daliya with apply lots of ghee. ü Shali rice ki kheer/ shali rice with ghee and milk, ghrit ü Avoid namak, mircha, spices ü Meetha fruits such as amalaki, anar, kela, papita,munakka etc. |
- Shodhan and shaman Chikitsa: The treatment plan for the patient included two cycles of Yoga Basti, followed by one cycle of Madhutailika Basti. These therapies were administered alongside Shaman Chikitsa.
Table 3: Treatment Progress and Visits
Date | Observations/remarks | Shaman Chikitsa. | Shodhan Chikitsa. |
14/05/2023 (1st visit) | 1. Anxious to conceive since 2 years 2. Delayed menstruation since 2 years | 1) Phalaghrita 10 gm BD with cow’s milk 2) Leptaden Tablet 2 BD with lukewarm water 3)Jatipjala Churna+mishri upto 10th day of menses | Yoga basti- Asthapana with Dasmool Kwath Anuvasana with Dashmool Tail |
04/07/2023 (2nd visit) | Same as above | Yoga basti- Asthapana with Dasmool Kwath Anuvasana with Dashmool Tail | |
17/08/2023 (3rd visit) | Same as above | Madhutailika basti (7day) with Dashmool Kwath, Eranda Tail as Sneha Dravya | |
September 2023 to February 2023 | Menstrual cycle is regular now | same as above | – |
24/04/2024 | Amenorrhea since 2 months UPT done, which was positive on 17/03/2024 LMP-16/02/24 EDD-22/11/24 | 1) Phalaghrita 10 gm BD with cow’s milk 2) Bala Beeja churna 4 gm BD with cow’s milk | – |
Follow-Up and Outcome
Following Ayurvedic Shodhana and Shamana Chikitsa, the patient’s menstrual cycles became regular. She subsequently conceived naturally and delivered a healthy male infant weighing 2.7 kg at 5:59 AM on 09/11/2024. This positive clinical outcome demonstrates the potential efficacy of Ayurvedic therapeutic approaches in the management of infertility associated with PCOS and highlights the promise of integrative medicine in reproductive health care.
Discussion
Although PCOS is not explicitly mentioned in classical Ayurvedic texts, its symptomatology closely aligns with conditions such as Nashtartava, which involves vitiation of Vata and Kapha doshas and obstruction of the Artavavaha Srotas. A thorough understanding of Dosha, Dushya, Srotas, and Prakriti is essential for diagnosis and treatment. The Ayurvedic therapeutic goal lies in Samprapti Vighatana—disrupting the pathogenesis that leads to disease.
Excessive indulgence in heavy, oily, sweet foods and sedentary lifestyle (Santarpana) leads to Kapha and Medo-dushti, which obstructs Artavavaha Srotas. This results in Agnimandya, Avarana of Vata, and ultimately leads to the manifestation of PCOS features such as delayed menstruation, anovulation, and infertility.
Shodhana & Shamana Chikitsa
The treatment protocol was planned in two phases:
- Shodhana (Purification Therapy):
- Basti was administered to balance Vata dosha, especially Apana Vata, which governs menstruation and ovulation [15]. According to Acharya Charaka, Basti is considered to be half of the treatment (Ardha Chikitsa) [16].
- Basti improves ovarian function by regulating the hypothalamic-pituitary-ovarian (HPO) axis, promoting follicular development and ovulation. Administered rectally, Basti may stimulate the parasympathetic nervous system and support hormonal balance [17].
- Shamana (Palliative Treatment):
A combination of classical formulations was used:
Mechanism of Action of Formulations
Phalaghrita:
Described by Acharya Vagbhata, Phalaghrita possesses Balya, Vatahara, Brihaniya, Garbha-dharana, Punsavanam, and Rasayana properties [18]. It strengthens reproductive tissues and supports ovulation. A comparative study on its efficacy with Clomiphene Citrate has demonstrated its role in stimulating follicular development [19].
Tablet Leptaden:
Composed of Jeevanti and Kamboji, this modern herbomineral formulation enhances endometrial receptivity and sustains the luteal phase. It inhibits the synthesis of prostaglandin F2α (PGF2α), thereby reducing the risk of miscarriage [20]. Its actions include Garbhasthapana, Shothagna, and Garbhashaya Shodhana [21].
Jatiphala Churna:
Jatiphala (nutmeg) is used for its Vata-Kapha hara, Agnideepana, Srotoshodhana, and Anulomana effects. It aids in Ama pachana, restores Apana Vata, and removes Avarana, thus supporting ovulation (Beejotsarga). Its Ushna and Teekshna nature makes it ideal for correcting menstrual irregularities due to Vata-Kapha imbalance [22].
Conclusion
Ayurvedic management through an integrative protocol involving Shodhana and Shamana Chikitsa effectively addressed PCOS-related infertility, culminating in successful conception and childbirth. This case reinforces the clinical relevance of Ayurvedic therapies in managing complex reproductive disorders.
By restoring Dosha balance, enhancing Agni, and strengthening Garbhashaya and Beeja, Ayurvedic treatment supports reproductive health. Individualized management based on Prakriti, combined with dietary and lifestyle modifications, offers a holistic, non-invasive, and sustainable approach to fertility care.
Continued research and systematic documentation of such integrative interventions are essential to expand the evidence base and promote their inclusion in mainstream reproductive medicine.
Conflicts of Interest
None declared.
Funding
No funding was received for this study.
Informed Consent
Informed written consent was obtained from the patient for publication of this case and associated clinical data.
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