Ayurvedic Management of Secondary Infertility Associated with Chronic Pelvic Inflammatory Disease

Abstract

Secondary infertility is defined as the inability to conceive following at least one prior conception. Pelvic inflammatory disease (PID), a spectrum of ascending infection and inflammation of the upper genital tract, is a significant cause of tubal pathology and subsequent infertility. This case report describes a 34-year-old female presenting with secondary infertility of four years’ duration, associated with recurrent vaginal discharge, pruritus, dysmenorrhea, dyspareunia, lower abdominal pain, and low backache. Gynaecological examination revealed cervical erosion, cervical motion tenderness, and adnexal tenderness suggestive of PID. Laboratory investigations showed elevated Antistreptolysin-O (ASO) titre and inflammatory markers, indicating a chronic inflammatory state. According to Ayurvedic principles, the condition was diagnosed as Paripluta Yonivyapad leading to Kaka Vandhyata, resulting from Vata–Pitta vitiation, Ama formation, and Srotorodha involving Artavavaha Srotas. Management included Samana Chikitsa with drugs possessing Pitta–Rakta shamana, Ama–Shotha hara, and Vatanulomana properties, along with Shodhana procedures such as Virechana and Vasti. Sthanika chikitsa including Yoni Prakshalana and Yoni Pichu was administered to address local pathology. The patient showed marked symptomatic relief, normalization of inflammatory markers, and subsequently conceived naturally, delivering a full-term healthy male baby. This case underscores the potential role of Ayurvedic interventions in the effective management of PID-associated secondary infertility.