for the use only of a registered medical practitioner or s hospital or s laboratory.
TRIAL OF ALOES COMPOUND AND LEPTADEN IN
UNEXPLAINED INFERTILITY
Dr. T. K. MOHANALAKSMI, M.O., D.G.O., M.P.H., (U.S.A.), F.M.M.C.
Professor of Microsurgery,
Kilpauk Medical College Hospital, Madras-600 010.
The use of aloes in medicine dates back to the 4th century B.C. Aloes compound is thought to help stimulate physiological and timely ovulation and ensure proper quality and quantity of cervical mucus; ensures implantation of the fertilized ovum and enhance fertility index.
For centuries in India and abroad, Aloes and Myrrh; Kasis (an easily assimilable form of iron) were used in menstrual disorders. Aloes compound had been tried in infertility cases ever since 1966. But a combination of Aloes compound and Leptaden for unexplained infertility had not been tried by many.
The action of Leptaden in preventing abortion is by inhibiting the biosynthesis of PGF ia by uterine musculature. It helps implantation of a fertilised ovum, improves the environmental factors important for nidation and helps sustenance of pregnancy till full-term live birth.
INTRODUCTION
Though India is a populous country, we do have infertility problems. In any teaching institution, out of all gynec. cases, 10-15% form infer tility cases. Of these, 15-20% couples have no apparent cause for infertility and still fail to conceive. They may be designated as a couple with low “fertility index”.
The use of Aloes in medicine dates back to fourth century B.C. It is a genus of about 160 species of xerophytic plants indigenous to East and South Africa. In the course of time several species have been introduced in different parts of the world and used all over Europe, West Indies and Asia including India., Japan and China. Aloes compound helps to stimulate physiological and timely ovulation and ensures proper quality and quantity of cervical mucus. It ensures the implantation of the fertilised ovum and enhances the fertility index.
Aloes compound and Leptaden are two ayurvedic drugs used in this study.
A trial of Aloes compound and Leptaden was carried out in cases of confirmed unexplained infertility for a period of one year. Aloes compound was given in dosage of 2 tablets twice daily for 14 days from the first day of the period and Leptaden two tablets twice daily from 15th day onwards till the next period A thorough evaluation of the husband and wife was done including laparoscopy to rule out any other cause of infertility. After having confirmed that they were unexplained infertility cases, 47 cases were taken up for trial. Out of drug for more than 3 cycles were taken for trial. Of the 47 cases, 8 cases had taken the drug for 1 cycle only. 12 cases had taken the drug for 2 cycles. 27 cases had taken it for more than 3 cycles; 20 had drugs for 3-5 cycles and 7 had drugs for 6-10 cycles. So only 27 cases were taken for analysis.
AGE DISTRIBUTION
66.6% of cases were between 21-25 years of age, 18.5% of cases were between 26-30 years of age, 11.1% of cases were between 31-35 years of age Only 3.7% of cases were below 20 years of age.
MENSTRUAL HISTORY
The menstrual history was normal in 23 cases and 4 patients had irregular cycles. HPE of endometrium showed secretory phase in 23 cases and the proliferative phase in 4 cases
LAPAROSCOPIC FINDINGS
On laparoscopy all the cases had patent tubes, 4 cases were following tuboplasty Polycystic ovaries were present in four cases.
HUSBAND EVALUATION
Semen analysis was normal in all cases except two. One had oligospermia and one had decreased motility of sperms. Both of them received tablets Fortege. One patient took tabs Fortege for 1 month only and the other for 3 months.
PREGNANCY OUTCOME
There were 9 intrauterine pregnancies reported in these 27 cases and 4 delivered healthy babies at term. 3 pregnancies are continuing and 2 patients aborted.The pregnancy rate is 9 out of 27 cases; that is 33.3%
Corrected pregnancy rate deleting the 4 tuboplasty cases is 9 out of 23 cases; i.e. 39.1% .
PREGNANCY OUTCOME RELATED TO MARITAL STATUS
Among 9 patients who conceived, 7 cases were between 21-25 years of age, 1 between’ 26-30 and 1 patient below 20 years of age.
5 cases were married for 3-5 years, 2 cases were married for 6-10 years and 1 case was married for more than 10 years. One case was married for less than 2 years.
DISCUSSION
For centuries in India and abroad, Aloes and Myrrh; Kasis (an easily assimilable form of iron) were used in menstrual disorders. Before the advent of hormonal age, for the menstrual disorder, Aloe’s et myrrh and Aloes etferi had been used.
Aloes compound had been tried in infertility cases ever since 1966. But a combination of Aloes compound and Leptaden for unexplained infertility had not been tried by many.
Aloes compound 2 tablets twice daily from first day of the period till the 14th day helps to stimulate physiological ovulation. Not only it stimulates ovulation, it has an action on cervical mucus. The quality and quantity of cervical mucus is altered in such a way that it facilitates better forward movement of sperms. The action of Leptaden 2 tabs bd in the second half of the cycle enables the implantation of the fertilised ovum.
Some researchers have used Leptaden 2 tabs bd throughout pregnancy to prevent abortion. But in our research, we have not used Lep taken during pregnancy.
Of the total 23 cases, we had 9 pregnancies, of which 2 were abortions. Maybe if we had used Leptaden, we could have prevented those 2 abortions.
The action of Leptaden in preventing abortion is by inhibiting the biosynthesis of PG F 20: by uterine musculature. It helps implantation of a fertilised ovum, improves the environmental factors important for nidation and helps suste nance of pregnancy till full-term live birth. It has helped in continuing pregnancy in cases of habitual abortions ranging from 4 to 10.
In this trial, we had used only Aloes com pound and Leptaden during menstrual cycles and we have a success rate of 39.1% pregnancies.
CONCLUSION
Of the 47 cases of trial, only 23 cases had taken the drug for more than 3 cycles, and these were taken up for study. We had a total 9 pregnancies out of these 23 cases ; i.e. 39.1%. Of these 39.1% pregnancies, we had 44.4 % live birth, 33.3% continuing pregnancy and 22.2% abortion.
Hence on conclusion, if Aloes compound and Leptaden are tried in unexplained infertility cases with a complete one year duration with proper supervision and Leptaden continued during pregnancy , the success rate will be very good.
REFERENCE
- Clinical evaluation of infertility associated with irregular menstrual cycles treated with an indigenous preparation by Dr. C. L. Jhaveri (Bombay) from “Proceedings of XV All India Obstetrics and Gynecological Conference”, New Delhi, 1972: pp 138-142.
Indian Journal Of Clinical Practice Vol. 5, No. 5, pp 66-68,0ctober 1994