AYURVEDIC MANAGEMENT OF OLIGOASTHENOSPERMIA THROUGH SHAMANA CHIKITSA, VIDDHAKARMA AND BASTI: A CASE REPORT

Abstract

Background: Oligoasthenospermia refers to a reduced sperm concentration together with reduced sperm motility and is one of the more commonly identified findings in male infertility. In Ayurveda, such conditions are described under Shukra Dushti and Shukra Kshaya, broadly referred to as Shukralpata and are understood to arise from vitiation of Pitta, Kapha or Vata dosha along with disturbance of Shukra dhatu.

Case Presentation: A 37 years old male patient presented with a 4-5 years history of Krucchavyavayata with early ejaculation along with Daurbalya (weakness), constipation, bloating, Hritkanthadaha (burning sensation), Alpanidra (reduced sleep) and other associated complaints. Semen analysis showed oligoasthenospermia. The condition was clinically assessed as Shukralpata with features of Pitta-Rakta involvement and Apana Vayu disturbance. Multiple dietary and lifestyle factors including Ushna-Tikshna Ahara (hot and spicy food), alcohol intake, smoking, irregular sleep due to shift duty, curd intake and excessive intake of cold water were identified. Ayurvedic examination showed Kaphapittaja Prakriti and Kaphavataja Vikriti. The patient was treated for 45 days with Nidana Parivarjana (avoidance of causative factors), Viddhakarma (Therapeutic bloodletting by puncturing) and internal Ayurvedic medicines. Viddhakarma was performed twice weekly for 3 weeks. The internal medicines were planned in phases with Pitta-pacifying (pacification of Pitta), Anulomana (elimination), Rasayana (rejuvenative therapy) and Brimhana (nourishing therapy) objectives followed by Yogabasti (therapeutic course of Basti consisting of Niruha and Anuvasana Basti).

Outcome: On repeat semen analysis performed after treatment, sperm concentration increased from 3 million/mL to 83 million/mL, total sperm count per ejaculate increased from 7.5 million to 207.5 million, total motility improved from 10% to 60% and viability improved from 50% to 82%. Progressive motility increased from 0% to 27%.

Conclusion: This case suggests that an individualized Ayurvedic approach combining Nidana Parivarjana, Shamana Chikitsa (Palliative treatment), Viddhakarma and Basti may be useful in the management of Shukralpata.