MANAGEMENT OF FEMALE INFERTILITY (LOW OVARIAN RESERVE) W.S.R TO ANOVULATORY FACTOR BY KALA BASTI AND UTTAR BASTI- A CLINICAL CASE STUDY

1. Second Year Ph.D. (Ayu.) Scholar, Department of Streerog & Prasutitantra, I.P.G.T. & R.A., G.A.U., Jamnagar, Gujarat, India. 2. Associate professor Department of Streerog & Prasutitantra, I.P.G.T. & R.A., G.A.U., Jamnagar, Gujarat, India. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History

Infertility i -The inability of a couple to conceive after one year of unprotected intercourse.The female factors for infertility are ovulatory factors(35%),tubal factors(30%),endometrial factors(21%),uterine factors(14%).Here in this case study I selected a case of infertility having anovulation due to low ovarian reserve. In the modern medicine they have not any particular treatment instead of giving hormonal therapy.According to ayurvedic classics Artav is the Updhatu of Rasa Dhatu and again Artava has all the qualities of Shonita(Rakata). Under Artava;menstrual blood and Ovum are included. Drugs used in the treatment of the patient mentioned by Charkacharya may have properties of both Rasa & Raktshodhan and also helps in the formation of raja(ovum) and normalization of menstrual cycle. So 1 patient has been selected having infertility for 3 years with secondary amennorhoea and very low ovarian reserve (low AMH -<0.010).So here management with kala basti and uttar basti selected and it has been proved to be a very very effective treatment modality to treat anovulation.

Introduction:-
Infertility-The inability of a couple to conceive after one year of unprotected intercourse.It is of two types.Primary infertility-refers to couples who have not become pregnant after at least 1 year having sex without using birth control methods and Secondary infertility-refers to couples who have been able to get pregnant at least once, but now are unable .According to Acharya Sushruta ii , four essential factors are required for healthy conception, which are proper fertile period, physiologically adequate and healthy internal organs of reproduction, the proper nourishment -to the developing zygote or fetus, the activated ovum and spermatozoa. Fulfillment of all the above essentials ensures the fullness of the motherhood. Any short come of the above factors impedes the conception and thus the motherhood of a woman. Among them Beeja is the core stone of the female reproductive process and in its absence conception cannot achieve despite of all the other factors. Here the Beeja is taken as Antahpushpa i.e. ovum. So anovulation can be included under Beeja Dushti.so in our classics the basti is well defined by acharyas and it is well acting for the anuloman of apan vayu which is the main vitiating factor genital system physiology.so here we selected the basti treatment for the infertile patient with low ovarian reserve.

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Drug review:-We used here kala basti iii and uttar basti.-drugs selected in both bastis are anubhutta yoga used in our opd and ipd.

So ingredients of kala basti are-
 Ingredients of uttar basti-uttar basti was also given by dashmoola taila.

Morning
Case study:- 3 and 1/2 years before ie.Before marriage patient felt healthy but immediate after one month of marriage Pt. suffered from irregular periods since 3 years(i.e. periods came after every 6 months and 4 months) and are anovulatory periods, mild pain in abdomen .Duration of Her first menses after marriage was of 10 days and after 15 days her next menses came again.then after that no periods till 4 months.For the same symptoms pt. took the allopathic medicine for one and half year. Pt. treated with hormonal therapy tab.Ecosprin,ovabless,fertibex,ubiphene,progynova,ovacare,deviry,dexona etc.But pt had no improvement from these Complaints. So for ayurvedic treatment patient came in our opd one year before on 12/09/2015 and we did all the relevant investigations in which the -Serum T.S.H-6.999uiu/ml,Serum FSH-20.7miu/ml and AMH-<0.010 ng/ml (very low AMH value is the indicator of infertility)and in allopathy its is vey difficult to improve that.They even prescribe HCG injectables of 5000iu.so we started her treatment for infertility and irregular menses.And we planned for kala basti and uttar basti till the normalization of her cycle and an approach towards the increase of AMH level and ovarian reserve.

Conclusion:-
we can conclude that, as compare to modern view, the holistic approach of Ayurvedic system of medicine because Vasti alone is considered as the major procedure for the anulomana of Vata.Apana Vayu plays an important role along with Vyana gives better relief to the patient from amenorrhoea and infertility. Taila is the best drug for Vata. The function of Anuvasana Vasti is Vatanulomana, thus, it performs its normal function properly. Dashamoola Taila has Tridoshaghna, Parshvashulahara, and Shothahara properties. So it normalize the apan vayu and anuloman occurs and menses became normal.