Aloes Compound* In the Management of Female
infertility
( A Comparative Study with Hormones & Ovulatory Agents)
By
Bishnu Charan Panda, M.D.• Obstetrician & Gynaecologist
Pradhan, M.D. Pathology Specialist.
H.K. Parida, M.S., Asst. District Medical Officer. District Headquarters Hospital, PHULBANI.
Mr. M. Das, M.A. (Statistics, Employment Officer, PHULBA NI 762 001, (Orissa)
Introduction
Although population explosion is almost threatening our economic existence in the present world, multifocal and multinational statistics show that 5% to 15% of all married couples are childless and infertile. Advanced studies in immunology. endoscopy and cytopathology have shown that the female factor is more responsible than the malefactor. It is now generally held that the female factor is responsible to the extent of 40%, and the malefactor is responsible to the extent of 30%. and both the partners are simultaneously defective to the extent of 30% in infertility. (Marshall 1978). According to the philosophy of Jeffcoate (1976), the greatest and the strongest desire in a woman is to be a mother. This is even more powerful than the desire for self-decoration or making an attractive career or a good house wife. There is a lot of emotional differences between pregnancy and motherhood. A woman may opt for an abortion, but once she begets a child, motherhood comes into play and it is the most powerful bondage.
Various drugs are used for female infertility, for example, clomiphene, Fertyl, bromocriptine, as ovulatory stimulating agents, FSH, HCG and progesterone as drugs of choice for hormonal treatment.
The unpredictability of the response, the side effects, multiple births and other hazards, the high cost and some times even their nonavailability are the disadvantages for the use of modern drugs in infertility.
An inexpensive non-hormonal Ayurvedic drug was selected for this study on Female Infertility. As our hospital is rural oriented, the authors found it worthwhile to try Aloes Compound, in these cases of Female Infertility.
Aloes Compound
Aloes Compound is indicated to correct irregular and scanty menstruation, to stimulate ovulation in anovulatory cases, and to improve Fertility Index in general.
Each tablet of Aloes Compound contains :-
| Aloes Indica | 70 mg |
| Hira Bol (Balsamo dendron Myrrha) | 70 mg |
| Kamboji (Breynia patens) | 30 mg |
| Manjishta (Rubia cordifolia) | 35 mg |
| Manjishta (Rubia cordifolia) | 35 mg |
| Kasis (Ferri sulphas) | 30 mg |
| Jeevanti (Leptadenia reticulata) | 30 mg |
Materials & Methods
The study was conducted during 1979-1980 on sixty women of Primary or Secondary Infertility who attended the Post-partum Centre, District Hospital, Phulbani. Only those women whose husbands were found normal (semen analysis) were included in the trial. The women were divided into two groups, each Group consisting of 30 cases, comprising 10 cases of Primary Infertility and 20 cases of Secondary Sterility.
The hormonal group received any one of the following drugs:-
Fertyl, FSH, HCG or progesterone. The trial group received Aloes Compound only. The treatment was continued till conception or to a maximum period of 12 months, and if no conception took place within I2 months of treatment, the case was assessed as no Response.
Aloes Compound was discontinued when pregnancy was suspected. Pregnondex-20 test of urine was done to confirm pregnancy.
Age Distribution
The largest number of patients, namely 26 cases (43.33 %) were in the age group 0of 26-30 Yrs.
(Table 1)
Literacy Status
26 patients (43.33 %) were literate and 34 patients (56.67%) were illiterate.
Socio-Economic status
24 patients (40%) belonged to middle class, 18 patients (30.0%) to upper class and 18 patients (30.0%) to Low economic status.
Investigations
Routine Blood, Urine and Stool examinations were done in all 60 patients. ESR, VDRL. Endometrial Biopsy were also done in all the Patients. Hystero-salpingogram could be done only in 38 cases (63.33 %). Mantoux test was done in 38 cases (63.33%). Basal Body Temperature Chart could be maintained in 55 patients (91.67%).
The husband’s semen analysis was done in all the 60 cases and one of the criteria for inclusion in the trial was the normal malefactor.
Pathological Factors Observed
Anovulation with DUB (including neuropathic hemorrhagic) was seen in 22 cases (36.66 %), chronic PID was diagnosed in 9 cases (15·00 %). Trichomonas Vaginalis infection and Candidiasis were found in 13 cases (21.67%)
Appropriate adjuvant treatment was given wherever necessary.
Aloes Compound Treatment in the Trial Group. (N: 30)
Aloes Compound, 2 tabs. two times a day was given from the day menstruation stopped till the 15th day, counting from the first day of menstruation, This was repeated for every cycle till the period was missed and pregnancy was suspected when Aloes Compound was stopped The couple was advised not to misscoitus during Aloes Compound treatment and atleast for a week after that.
Results of Conception
15 cases (50%) conceived with Aloes Compound treatment. whereas in the hormonal group, only 5 cases (16.67%) conceived. Comparing the results of the Hormonal Group & Aloes Compound
Group statistically by Chi Test, it was found that the beneficial action of Aloes Compound for successful conception was highly significant: P <0.01 (Table II)
Duration of Treatment For Conception in the Aloes Compound Group and the Hormonal Group.
Out of 15 cases conceived in the Aloes Compound Group, 11 cases (73.3%) conceived between 3-6 months of treatment. Out of 5 cases conceived in the Hormonal Group, 3 cases (60.0%) conceived within 3-6 months, out of which one was twin delivery (Table IV).
Discussion
There were three abortions in each group and statistically not significant. There was one twin delivery in the Hormonal Group, whereas there was no twin delivery in the Aloes Compound Group.
Toxic or Side Effects
There were no toxic or side effects with the use of Aloes Compound, either to the mother or to the child.
Conclusions
In the Aloes Compound group, the conception rate was 50.0%, whereas, in the Hormonal Group, it was only ‘ 16.67.
In our country where sophisticated methods of investigations of the hormonal status are not easily available or are beyond the reach of the common man, Aloes Compound, a hormonal drug, is useful the management of female infertility, irrespective of the hormonal status.
There is no danger of multiple births as seen with ovulatory stimulating agents and hormones. There are no side or adverse effects on the newborn child, whose mothers are treated with Aloes Compound.
The Medicine & Surgery
Acknow ledgement
The authors are deeply indebted to Dr. P.C. Swain, M.S., Chief District Medical Officer & Superintendent of District Headquarters Hospital, Phulbani, for allowing them to conduct this trial and for the use of hospital records for this study.
The authors thank Mr. P. G. Shukla and Dr. R.V.S. Rao of Alarsin, Bombay 400 023, for their kind cooperation.
References
- Mrs, Agrawal, S. (1979): A Controlled trial of Aloes com pound in cases of Sterility and menstrual irregularity: First Asian Congress of Induced Abortion and Voluntary Steri lisation, 4-9 Mar. 79, Bombay.
- Balsara. R.R. (1966): Sterility associated with irregular and scanty Menstruation (use of Aloes Compound an adjuvant) : The Ind. Pract. 19:1- 123-5, Jan. 66.
- Gupta, K. (1972) : Aloes Compound (A Herbal Drug) in Functional Sterility: XVI All India Obst. & Gynec. Congress, 10-12 Mar. 72, New Delhi.
- Jhaveri, L., Mrs.Ila S.Mody, Mrs. Munim, J.K. & Miss Das (1972): Clinical evaluation in infertility associated with irregular menstrual cycles treated with an Indigenous preparation: XVI All India Obst. Gynec. Congress, 10-12 Mar. 72, New Delhi.
- Mukherjee, & Mukherjee, M. (1972): A trial of Aloes Compound (an indigenous drug in cases of Sterility associated with menstrual Irregularity: XVI All India Obst. & Gynec. Congress, 10-12 Mar. 72, New Delhi .
- Rajasekharan, , Vijaya, R., Celia Dorothy white & Uma Rani S. (1975) : Trial with indi genous drug Aloes Compound in Infertility : The Antiseptic, Vol. 72, No.9, Sept, 75.
- Ramani Sivaraman, Sujaya Kumari Dhathri & Usha Kanna (1976) : Aloes Compound in Sterility: The Antiseptic, Vol. 73, 7, July 76.
- Sangamnerkar, V. (1971) : Aloes Compound in Sterility (A review of 797 cases) : XXI All India Obst. & Gynec. Congress, 27-29 Dec. 77, Cuttack & The Antiseptic, 76:1, 22-27, Jan. 79.