A male patient aged 56 years attended the outpatient department, presenting with the complaints of no issues since 7 years of married life with the second wife who is 35 years old. However, he has a son from his divorced first wife who is healthy. The patient did not report any problems with erections, orgasm, or ejaculation and he was not taking any medication for any systemic disorders like hypertension, diabetes mellitus etc. On physical examination, testes were in normal position. Rest of the physical examination was normal. Initial history of the female partner suggested regular ovulatory cycles and revealed no problems with her endocrine profile or the patency of her fallopian tubes. There was no history in the patient suggestive of sexually transmitted diseases, mumps, tuberculosis, filariasis, epididymo-orchitis, herniorrhaphy/herniotomy and chronic persistent genital infection, paraparesis and exposure to gonadotoxins, for example, cigarette smoke, alcohol, alkylating agent, gossypol and pesticides. Semen analysis from the laboratory revealed no sperm motility and on viability testing, it was shown that there was 100% necrozoospermia. As the patient could not afford, other investigations such as antisperm antibodies could not be carried out.
Clinical examination revealed no abnormality (physical and systemic). During scrotal examination, temperature was found normal and no scar or swelling was noticed. Position and size of the testes was normal in nature. Epididymis was palpable with swelling, spermatic cord was thickened and prostrate was normal during the examination. Table 1 shows the details of physical examination of the patient.
The patient was assessed based on sexual functional parameters and semen analysis before and three and half months after the treatment. Details of the investigations carried out before and after the treatment are given in Table 2.
According to Ayurveda, the patient was diagnosed as having Vatika Shukra Dosha, with investigations showing evidence of necrozoospermia. He was treated for a period of 3 1/2 months.
Purva Karma like Langhana, Deepana, Pachana and Snehapana were not followed as the patient was not having Ama Lakshana assessed during the examination. So, 50 ml of Eranda Taila (castor oil) was administered at 7.30 AM for the purpose of Koshtha-Shuddhi (purgation) along with warm water, and the patient reported six Vegas (passed stools six times) during that day. He was advised to take light semi-solid diet and avoid exertion for 3 days.
Phala Ghrita 15 ml with milk in the empty stomach once daily
Chandraprabha Vati - 500 mg, Vati one tablet twice daily after food with water
Shilapravang Vati - (250 mg), one Vati twice daily after food with milk
Arogyavardhini Vati - (500 mg), one Vati twice daily after food with water.
Chandraprabha Vati and Arogyavardhini Vati were procured from IMPCL and dispensed through OPD. Phala Ghrita (Arya Vaidya shala, Kottakal) and Shilapravanga (Sri Dhootapeswar Ltd) were prescribed from outside.
All the above medicines were given for 3 months. Arogyavardhini Vati was replaced by Sarivadi Vati after a month and continued for 2 months. No adverse drug reaction was reported during the treatment which was confirmed during follow up visits.