The Ayurvedic Perspective on Infertility

This is a small part of the group research paper I am writing as a part of my Ayurvedic courses.  Would love your feedback – just wanted to share!  My responsibility was to write about the Ayurvedic perspective on this disorder.  I may also share other sections of the paper if I get permission from my group members.

“Fertility depends on nature’s rasa; a fruitfulness, sweetness, wetness, happiness. When these rasas are depleted, sterility, dryness, loneliness, and isolation are bound to set in. The rishis predicted that the increase of fear in modern culture would result in the decline of the earth’s fertility.” – Maya Tiwari, “Women’s Power to Heal”

Dr. Chauhan of the Jiva Institute says that “Ayurveda considers begetting a child equivalent to planting a tree, for which we need four essential conditions — seed, field (soil), time and nourishment.”  It is important to remember that infertility, as with any other disorder according to Ayurveda, is a completely individual case. Infertility is not an independent disease, rather a cardinal feature of many imbalances.  Reproducing is one of the most important responsibilities we have as living beings.  In order to conceive a healthy child one should be “swastha” or fully healthy oneself. Ayurveda defines a healthy person as “one who is established in the Self, who has balanced doshas, balanced agni, properly formed dhatus, proper elimination of malas [wastes], well functioning bodily processes, and whose mind, soul and senses are full of bliss.” (Lad, p 275) This optimum state of health provides the fertile ground for the embryo to implant and grow.  If conception does not occur, there may be an imbalance in any of the above categories, making the cause of infertility sometimes difficult to determine.

Ayurvedic texts say that “failure to achieve conception of a couple of mature age, having normal coitus, during [the] appropriate period of menstrual cycle regularly for at least one year is termed as infertility.  It develops due to fault in either of the partner or both of them.” (Stri Roga, pp 262)  If there is a defect in either the egg or sperm, or any part of the male or female reproductive organs, it is possible that conception will be difficult.  There are three types of infertility that are written about in the classic texts.  “Vandhya” refers to absolute sterility, which cannot be cured.  “Apraja” is a term used to define the type of infertility that can be cured – with treatment; the woman is able to become pregnant. The third type of infertility is called “Sapraja,” defining the woman who becomes afflicted with infertility during her childbearing years after already conceiving one or more children.  It is known as secondary infertility.  We most often speak of infertility in relation to females, though the classics give many examples of treatment for male problems as well.

There are numerous causes for infertility.  As mentioned here by Dr. Douillard:  “Caraka and the other Ayurvedic authorities state that the suppression of natural urges, excessive sex and excessive physical exercise, along with an improper diet, are linked to the cause of female reproductive disorders…Basically, the Ayurvedic recommendation is to act in accord with how one feels. Ignoring this cycle is often at the root of [female reproductive issues.]” (Dr. Douillard, “PMS”)  His conclusion is that the reason why an excessive amount of female disorders plague the West and not the East, has much to do with the culture surrounding how women honor their menstrual cycle.  All Ayurvedic infertility treatments emphasize therapies which aim to regulate a woman’s natural cycle, because often a menstrual disorder is the main cause of the imbalance.

According to Ayurvedic physiology, it takes food 35 days to be transformed into our reproductive tissues.  When there is a defect in the reproductive organs, this means that shukra or artava dhatu is affected according to Ayurvedic anatomy.  Shukra and artava dhatus are the male and female reproductive tissues, respectively.  If shukra or artava are affected, then ojas will also be low. This can be detected by advanced Ayurvedic practitioners. Ojas is the essence of all of the bodily tissues. It is the body’s natural immunity, and it is the sustainer of life.  If ojas is low, perfect health is impossible – it is difficult for a person to ward off disease, or attain the higher states of bliss and consciousness.  Improper quality or quantity of artava dhatu can be one of the reasons a woman is unable to become pregnant.  “Susruta has enumerated amenorrhea, oligomenorrhoea and pain in vagina etc. symptoms due to decrease of artava.  Cakrapani has explained that these symptoms are caused by vayu aggravated due to decrease of artava responsible for proper nourishment of the reproductive system.” (Stri Roga, p. 265) To reiterate, Amenorrhea, oligomenorrhoea, and other disorders of the menstrual cycle are often the culprits of infertility.  These disorders occur when there is an imbalance of the doshas due to numerous factors like improper diet or lifestyle.

The vata dosha, being made up of the more subtle elements of air and ether, is the most easily disturbed, and its imbalance is most often the culprit when it comes to infertility. In fact, infertility is most commonly included as “one of the 80 diseases of vata.” (Stri Roga, p. 265) The vata dosha conducts respiration, elimination, motor skills and sensory functions. Vata dosha also governs the feeling of pain, fear, as well as creativity.  There are five sub-types of vata or vayu: prana, udana, samana, vyana and apana.  The downward moving energy of apana vayu governs the strength and function of the organs of elimination and reproduction.  When vata is out of balance, the symptoms shown are dryness in the reproductive organs, exhibiting as irregular semen or low sperm count,  irregularities of the menstrual cycle, pain in the lower back or abdomen, constipation, anxiety, etc.

The vata dosha becomes unbalanced when there is excessive exercise, fear, anxiety or stress due to trauma, excessive fasting as is the case in eating disorders, or a diet lacking the proper amount of fats and vitamins.  Apana vayu can even be disturbed when a person neglects to act upon their natural urges, which are some of the basic functions of this sub-dosha.

Infertility rarely involves only one dosha.  When kapha dosha is predominant, uterine fibroids or cysts may develop, “but often involve pitta and vata displacements also.” (Lambert, “Uterine Fibroids”)  A case of recurrent miscarriage is often diagnosed as “a Pitta condition of excessive movement of the downward moving air (apana).” (Frawley, pp 257)  Even though this condition may be seen as high pitta, there is still an underlying vata imbalance.  And again, treatment will differ depending on the patients current condition and health history, though it is important to treat the underlying doshic imbalance.

Inability to conceive can also be due to too much ama in the system. Ama is a toxin that is created when undigested food forms in the stomach.  Ama can circulate throughout the body, building up in the bodily tissues.  Ama can cause abnormalities in the function of the bodily tissues.  Ama can form due to unbalanced agni, eating disorders, emotional, physical or mental abuse.  Ama can form from an imbalance with any of the three doshas.  According to Ayurveda, anything one takes in through the sense organs must be digested, and sometimes there is an inability to digest our intake, resulting in the formation of ama.  If ama is present, this usually means that the patients agni, or metabolic fire, is not functioning properly.  Simple changes and herbals additions to diet can improve function of the agni.

Hormonal and emotional imbalances can also be a cause of infertility.  “Abnormalities of yoni, psychology, sukra, [artava], diet and mode of life, coitus at improper time and loss of bala [strength] have been included in the cause of delay in achieving conception in an otherwise fertile woman…normalcy of psychology has been been given highest importance for achieving conception.” (Stri Roga, pp 265)  At the time the classic texts were written, understandably microscopic hormones had not been discovered yet.  Some texts hint that the term ‘artava’ may correlate with estrogen.  A balanced and happy mind is a major part of the Ayurvedic definition of health. A person’s reproductive organs could seem to be functioning properly, but if the person is unhappy or unsound of mind, the body may reject pregnancy.  According to Ayurveda, body and mind must both be treated with equal importance.

In Ayurveda, karma can also be an important factor in a person’s ability to conceive.  This idea is one which may be difficult to accept for some who may not be familiar with this philosophy.  “Abnormalities of atma [soul] and sattwa [mind]…infertility due to influence of misdeeds done by the couple in their previous life…” (Stri Roga, pp 269) are as just a valid cause for infertility as are “curses of God or fate.” (Stri Roga, pp 269)  Some practitioners recommend their patient get a Jyotish reading to find out the appropriate time for begetting children or of their chart are interpreted to say it may not be right for them in this lifetime.

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