DOI: 10.4103/jras.jras_175_25 ISSN: 2456-5601

Ayurvedic management of endometriosis-associated subfertility: A case report

Pragya Panthi, Neha Pandya, Hetal P. Baraiya, M. K. Sandhya
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Abstract

INTRODUCTION:

Endometriosis is a chronic inflammatory gynecological disorder characterized by the presence of endometrial-like tissue outside the uterine cavity. It is a major cause of chronic pelvic pain and subfertility due to pelvic adhesions, ovarian endometriomas, and impaired reproductive function. Although conventional management includes hormonal therapy and surgery, recurrence and persistent subfertility remain clinical challenges. Ayurveda employs individualized, multimodal treatment strategies tailored to the patient’s clinical presentation and underlying pathophysiological assessment.

PATIENT INFORMATION:

A 29-year-old married woman with a previous diagnosis of endometriosis presented with a 2-year history of subfertility and dysmenorrhea. She had a history of laparoscopic cystectomy for an ovarian endometrioma, followed by recurrence, and one missed abortion at 8 weeks’ gestation. Ultrasonography demonstrated bilateral ovarian endometriomas with pelvic adhesions, consistent with recurrent endometriosis. Based on clinical evaluation and imaging findings, the patient was diagnosed with endometriosis-associated subfertility. From an Ayurvedic perspective, the condition was assessed as Vandhyatva (subfertility) associated with Kshetra Dushti (functional impairment of the female reproductive system).

THERAPEUTIC INTERVENTION:

The patient underwent an individualized Ayurvedic treatment protocol over 8 months. Therapy included sequential Basti (therapeutic medicated enemas), comprising Matra Basti with Mahatiktaka Ghrita , followed by Yoga Basti and Kala Basti schedules using medicated oil and decoction enemas. Oral herbal formulations, including Manjisthadi Kashaya and Phalatrikadi Kashaya , were administered during the initial phase. Virechana (therapeutic purgation) using Trivrit Avaleha was subsequently performed, followed by oral administration of Saptasara Kashaya and Purana Guggulu . Two additional postmenstrual cycles of Anuvasana Basti with Dashamula Trivrit Taila were administered as maintenance therapy.

RESULTS:

Following 3 months of treatment, the patient reported complete resolution of dysmenorrhea. Pregnancy was confirmed after 8 months of individualized Ayurvedic intervention. The pregnancy progressed to term and culminated in vaginal delivery of a healthy neonate.

CONCLUSIONS:

This case adds to evidence on the use of Ayurvedic management in endometriosis-associated subfertility. Although findings from a single case cannot establish causality or efficacy, they provide a basis for further investigation through well-designed clinical studies.

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