A case report on the management of Primary infertility with female genital tract infection and Oligoasthenozoospermia

Infertility is commonly defined as the inability to conceive after one or more years of regular unprotected intercourse. Various factors can contribute to infertility, stemming from either the male/female, or both partners. This case report presents a case of multifactorial infertility in a couple with a marital history of more than three years. The female partner had a history of recurrent genitourinary infections, while the male partner exhibited a low sperm count. There was a history of ovulation induction (5–6 cycles) and two failed cycles of Intrauterine Insemination for conception. Owing to the prior unsuccessful events of conception, the couple opted for Ayurveda management. The initial treatment plan adopted for the female partner included Shamana (~palliative medications) and Yogabasti (~course of eight therapeutic enemas) along with Uttarabasti (~intraurethral douching) for three cycles. The male partner was prescribed oral medications for oligoasthenozoospermia initially. After three months of treatment, particularly Uttarabasti , Hysterosalpingogram revealed bilateral patent tubes. The patient conceived within three months of medication, but at 11 weeks, a missed abortion was diagnosed, and suction evacuation was performed. The couple was counseled on the necessity of Shodhana (~major purification therapy), and both underwent Virechana (~therapeutic purgation therapy) followed by oral medications. After five months of management, the patient conceived and delivered a full-term healthy baby. The case report underscores the promising approach of Ayurvedic management in treating multifactorial infertility without resorting to assisted reproductive technology, and accomplishing successful conception.