Sub-fertility in Poly cystic ovarian syndrome and role of Ayurveda : A case report

Abstract

Introduction

PCOS is the most common endocrine disorder of reproductive age group women, with a prevalence rate of 15% and 40% of subfertility and infertility respectively. Subfertility is more inclined due to obesity, ovulatory defects, quality of oocytes, and endometrial receptivity. Even when ovulation is restored, there is altered cellular endometrium affecting the endometrial receptivity at the time of implantation which is likely to be associated with subfertility and increased miscarriage rates. Patients with PCOS have defective expression of uterine receptivity markers. Some previous researches have established that endometrial inflammatory response and scratching can improve uterine receptivity. So, it was planned to see the effect of Uttarabasti (intrauterine instillation of drug) on the endometrial receptivity in a case of PCOS. Objective-To evaluate the efficacy of uttarabasti to improve endometrial receptivity in a sub fertile PCOS patient.

Material and methods- A diagnosed PCOS women, aged 28 years desiring conception since 1year of active married life was selected and given bio purification followed by Phalaghrita Uttarabasti (3-5 ml) after stoppage of menses for 5 days consecutively for 2 cycles. Uterine Bio Physical profile with Applebaum’s score was done on day 22^nd after procedure during each menstrual cycle and assessed for the changes.

Result- Uttarabasti enhances Uterine scoring system of reproduction in the patient from score 10 to score 18 which is associated with increased chances of conception by improved endometrial receptivity.

Conclusion-Intrauterine instillation of drug may improve endometrial receptivity in patients of PCOS. This modulation can be better understood by the use of other markers of receptivity in future research to establish such clinical efficacy.