International Journal of Research and Review DOI: https://doi.org/10.52403/ijrr.20210837 Vol.8; Issue: 8; August 2021 Website: www.ijrrjournal.com Review Article E-ISSN: 2349-9788; P-ISSN: 2454-2237 Understanding the Concept of Tubal Blockage in Ayurveda Trupti Acharya Associate Professor, Dept of Prasuti Tantra Evam Stree Roga, Shobhit University, Kunwar Shekhar Vijendra Medical College & Research Center, Gangoh, Saharanpur, U.P. ABSTRACT The incidence of infertility in any community varies between 5 and 15%. 3 Infertility is the failure to naturally conceive a child even after one or more years of regular TUBAL BLOCK (INFERTILITY) IN unprotected coitus or to carry a pregnancy to AYURVEDA full term. The situation gets gloomier as it is a The way to define the disease or the problem often involving multiple factors, the diagnosis and treatment of which puts the family pathogenesis in Ayurveda is entirely to physical and mental stress in addition to the different from western medical science, and financial expenses it involves. Tubal blockage is is based more upon the first vitiation of one of the important factors for infertility and it Doshas, i.e. the pathogenesis of disease needs to be reviewed from the ancient texts. In from commence. Taking this Ayurvedic this present article attempt has been made to view, here an effort has been made to review the tubal blockage in Ayurvedic texts. describe the Ayurvedic view regarding tubal blockage in terms of Keywords: Infertility, Vandhyatva, Ayurveda, A) Prakriti, (Doshas; root cause), Tubal blockage B) Adhishthana, (Dushya; seat), C) Linga (Lakshanas; features) INTRODUCTION D) Ayatana. (Ahara Viharadi Nidanas). Infertility is also defined in specific terms as the failure to conceive after a year A) PRAKRITI (SANNIKRISHTA of regular intercourse without contraception KARANA OR ROOT CAUSE) according to modern science. Causes of According to Ayurvedic point of infertility include ovulation problems, tubal view, the root or ultimate cause of any blockage, age-related factors, uterine disease is the vitiation of either one or more problems, previous tubal ligation, 1 of the three Doshas by one or more of their endometriosis. According to WHO, Gunas.4,5,6 All the three Doshas can be positive reproductive health of a woman is a assumed responsible for Vandhyatva by state of complete physical, mental and causing structural or functional social wellbeing and not merely absence of abnormalities in Artava Bija Vaha Srotas disease related to reproductive system and i.e. fallopian tube. Vitiation of Vata can be functions. It is observed that 50% of normal considered the most important factor for couple achieve conception within three tubal infertility as it is responsible for months of regular unprotected intercourse, Dhatugati7, Cheshta8 & Garbhakriti9. 75% in six months and 80-85% conceive 2 Chakrapani has considered Vata the Nimitta within a year. Infertility is termed primary Karana of Garbha by saying “Bhetta Karta; if conception has never occurred and Etam Cha Sharir Utapatti Kale”10 Kapha secondary if the patient fails to conceive can be considered another Dosha after having achieved a previous conception. responsible for causing tubal block for its International Journal of Research and Review (ijrrjournal.com) 272 Vol.8; Issue: 8; August 2021 Trupti Acharya. Understanding the concept of tubal blockage in ayurveda. Avarodhaka and Shophajanaka properties. factors for conception. So, if the Ashaya is If Kapha gets vitiated with its Sthira11 guna, not Sampad, it can mean the abnormality it can lead to blockage. Acharya Sushruta either in uterus or in tube in the form of has also stated that Puya or suppuration12 is block. When Doshas are localized in not possible without Kapha, while Acharya fallopian tube, it leads to tubal block. Vagbhata considers Kapha responsible for Shopha or inflammation. These Shopha & C) LINGA (LAKSHANA: CLINICAL Puya are, of course, the most important FEATURES) causative factors of tubal infertility by Acharya Charaka17 has not producing tubal block. Though Vata & mentioned Vandhyatva in such a way but if Kapha seem to be most significant for we go through the literature the Sapraja causing tubal blockage, but the role of Pitta Vandhyatva can be considered as a cannot totally be neglected here, as it is said consequence of tubal infertility, because the to be responsible for Paka. 13Most of the post – partum infection of reproductive tubal blockages are the consequence of organs can cause tubal blockage. urogenital infection and thus, vitiation of Acharya Harita18 has explained 6 Pitta can be taken here. Hence, tubal types of Vandhyatva out of them infertility is not the manifestation of Kakavandhya and Anapatya are the vitiation of any specific Dosha, rather secondary and primary types of infertility, sometimes interplay of multiple Doshas and and tubal blockage can lie behind these sometimes the sequel of vitiation of single disorders along with several other possible Dosha. causes. Dhatukshaya can be considered either as tuberculosis affecting reproductive B) ADHISHTHANA (DUSHYA: SEAT) organs or may indicate a condition of Garbhashaya is the Adhishthana of emaciation along with reduced immunity this disease entity and the seat of Doshic making her susceptible for recurrent vitiation too. On the basis of various infections. Both the above condition may references given in classics, Adhishthana finally lead to occlusion of tubal lumen can be defined in various terms but the causing Vandhyatva. Garbhasamkocha ultimate one is Garbhashaya (uterus) only. seems to be nearer to tubal infertility, Acharya Sushruta has considered four because coitus before the age of menarche is factors essential for the conception. These the reason of infertility here. It denotes that factors are; Ritu (proper time i.e. ovulatory a girl, who was normal previously, becomes period), Kshetra (genital organs especially infertile due to coitus at an improper age. uterus), Ambu (nourishing substances) and Coitus is a responsible factor for altering the Bija (gametes). Acharya Ghanekar has also vaginal pH, which makes it prone to considered Garbhashaya or Garbhashaiya bacterial growth and infection. This as Kshetra for Garbhadhana, though he has infection, if ascends towards the upper also taken it as Stree in a broader sense.15 genital tract is known as Pelvic Fallopian tubes are the part of uterus itself, Inflammatory Disease (PID), and if not thus, is definitely the component of the treated properly, may cause tubal blockage Kshetra here. Hence, the Kshetra stated by Acharya Sushruta can be considered as the Tubal blockage in Yoni Vyapadas Adhishthana of vitiation of Doshas.. While Tubal blockage is a common describing the factors, which are essential to complication of Pelvic inflammatory disease be in proper and healthy state for conception i.e. infection of upper genital tract. Acharya and partum, Acharya Charaka has clearly Charaka19 and Vagbhata20 have considered mentioned term Ashaya other than the Asrik infertility as a complication of all the or Bija16. It clarifies the need for normal Yonivyapadas. Thus, tubal blockage can be function of both the ovulatory and uterine taken as complication of those International Journal of Research and Review (ijrrjournal.com) 273 Vol.8; Issue: 8; August 2021 Trupti Acharya. Understanding the concept of tubal blockage in ayurveda. Yonivyapadas, which are compared with any infection, if leads to infertility, is due to PID on the basis of their symptomatology. tubal blockage. 1. Paittika or Pittala- is compared with the 4. Paripluta 33,34,35 It is again a condition infection of reproductive organs.21,22,23,24 very similar to the preliminary stage of tubal 2. Tridoshaja or Sannipatiki This blockage, because all the features given are Yonivyapad is considered as acute infective suggestive of its similarity with Pelvic disorder of reproductive system either Inflammatory Disease. developed due to infection of reproductive 5. Upapluta 36,37 This Yonivyapad again system itself or as a consequence of disorder refers to condition of genital tract infection of another system,25,26,27,28 for its characters with Pandu, Satoda, Shweta & Pichhila like Burning sensation with pain, yellowish Srava with dominance of Kapha & Vata and white unctuous vaginal discharge As leading to Shopha and Vedana. In this this condition is a clear cut description of Vatakaphajanya Avarodha as well as mixed type of severe genital tract infection, infection can cause the tubal blockage. it may definitely lead to infertility as a 6. Vipluta38 Acharya Sushruta has consequence by producing tubal block as a considered Vipluta a disorder characterized complication. by Nitya vedana (continuous pain), and 3. Aticharana Here Acharya Charaka & indicated it as a Vatika disorder. If infertility Vagbhata have given features of Shopha, is assumed as a complication of this Supti & Ruja due to Ativyavaya, while condition left untreated, there can be several Acharya Sushruta has clearly indicated the pathologies regarding different type of infertility by saying Yasya Bijam Na ovulatory, uterine and other factors. Tubal Vindati. The disease Aticharana appears to blockage undoubtedly can be one of those be analogous to vaginal inflammation pathologies by causing Sankocha (stenosis) caused by excessive coitus associated with of tubal lumen because of increased infertility.29,30,31,32 It can be considered a Rukshatva of aggravated Vata. condition very nearer to tubal infertility, as D) NIDANAS (ETIOLOGICAL FACTORS) Table no 1: Tubal blockage caused by Nija Hetu (internal factors) Doshas Nidanarthakar roga Nidanas Vikriti Nimitta Vata Aticharana Ativyavaya Shopha Agantuja Vipluta Sankocha Nija Pitta Pittala Yonivyapada Pittaja Ahara Paka Nija Pittaja Artavadushti Pittaja Ahara Paka Nija Vihara Pittaja Asrigdara Pittaja Ahara Paka Nija Kapha Kaphaja Artava Kaphaja Ahara Shopha Nija dushti Vihara Kaphaja Asrigdara Kaphaja Ahara Shopha Nija Vata Pitta Paripluta Vega Dharana (Kshavathu Shopha Paka – Nija Udgara) Agantuja Rogas (External factors) which Kakavandhya: Secondary infertility told by can cause tubal blockage Acharya Harita can be explained in similar Sapraja: This condition seems to be manner.