Management of Couple Infertility with Aloes Compound*
In Females, and
Fortege* In Males in a Rural Area
By
L. R. Das,
MABS., Fh. D., LAMS.,
At Padhan Pali, P. O. Patkulanda, Dist. Sambalpur, Orissa
A
family with a large number of children is an economic problem' facing the
over-populated underdeveloped countries while the absence of a child in the
family is a social problem as the parents feel distressed for not having a
child, irrespective of their social status, whether rich, middle-class or poor.
In the urban population facilities for investigations with sophisticated
methods are fairly available. The vast majority of Indian population (80%) is
rural. While only 20% of those living in towns and cities enjoy better medical
facilities favorably comparable to Western standards, 80% forming the rural
population do not have access to these facilities. A medical practitioner practicing
in the rural area has to manage things to the best ofhis abilities.
Review of
Literature on Aloes Compound
Balsara
(1), Jhaveri (2), Mukherjee (3) and Agrawal (4) have reported successful
results with Aloes Compound in Sterility associated with menstrual disorders.
Gupta (5), Rajasekharan (6), Sivaraman (7), Shah (8, 9), Sangamnerkar (10).
Panda (11,12) and Khosla (13) reported good results with Aloes Compound in the
management of Primary and Secondary Sterility and the Conception Rates given in
all these studies were good. These studies encouraged the author to select
Aloes Compound for the present study.
Review of
Literature on Fortege in Male Infertility
Gupta
(14), Shelat (15), Bhalerao (16, 17),Jagadisan(18) and Pande (19) tried Fortege
in cases of oligospermia and cases of uncomplicated Male Infertility and reported
good Conception Rates in their spouses.
The author wishes to say that he and his
wife were a case of Couple Infertility and formed a part of this study.
Aloes
Compound (Alarsin)
Each tablet of Aloes Compound contains in
mg.
Aloes
(Aloes indica) :
70 mg.
Hira
Bol (Balsamodendronmyrrha) : 70 mg.
Kamboji
(Breynia patens) : 30
mg.
Manjishta
(Rubiacordifolia) : 35
mg.
Harmal
(Pegum'rn Harmala) : 35
mg.
Kasis
(Ferrisulphas) :
30 mg.
Jeevanti
(Leptadenia reticulata) : 30
mg.
Aloes
was investigated by Satyavali et a!. It was found to improve menstrual
functions and conception rate was 85% among infertile women.
Aloes
corrects menstrual disorders and regulates the flow and rhythm of monthly
periods; causes timely ovulatory cycles. It has no disadvantages of hormonal
drugs.
Fortege (Alarsin)
Each
tablet of Fortege contains in mg:
Kamboji
(Breynia patens) : 56mg.
Kauncha Beej (Mucuna pruriens) : 30mg.
Suddha Kachura (Detoxicated Strychnos
nuxvomia): 30mg.
Samudra sosh Beej (Argyria speciosa) : 15mg.
Vardhara Beej (Rourea santaloides-
seeds) : 15mg.
Laving (Carvophyllus aromalicus) : 7.5mg.
Vardhara Mool (Rourea santaloides-
root) : 15 mg.
Asan (Withania somnifera) : 15mg.
Pipar (Piper longum) : 7.5 mg.
Vacha (Acorus calamus) : 7.5 mg.
Mari (Piper nigrum) : 7.5
mg
Sunth (Zingiber officinalis) : 7 5 mg.
Chitri kabab (Cubeb officinalis) : 7.5 mg.
Alcaiakara(Anacyclus
P>rethrum) : 7 .5 mg.
Sukhedver (SatftalUm album) ; 7.5 mg,
Jaiphal (Myristicafragrans) : 4.5 mg.
Javanthn (Myristica fragrans-ariilus)
:
3.0 mg
Jeevanati (Leptadeinareiiculaia) : 56.5 mg
Fortegc tones up neuro-glandular, neuro-muscular,
gcnito-urinary and gastro-intestinal systems. Relieves fatigue. Improves sex
performance, Keeps one fresh, alert, active and vigorous.
Materials & Methods
This study was done during 1980-84 at my
ownvillage and purely in rural conditions. This is a study
Of 40 cases of Infertility treated with
Aloes Compound in females and Fortege in males. Femaleinfertility was diagnosed
by menstrual history andclinical examination. Eleven among them had
already
taken hormonal treatment without success.One woman had Mantra Chikitsa without
benefit.
The rest of the women had tried many herbs
as homeremedies for their infertility which gave no results. In all cases of
Female Infertility, the male was also investigated without exception. The only
test done and the criterion for Male Infertility was the semen analysis. From
these, three classifications were made: Female Infertility; Male Infertility
and Couple Infertility where both the partners were infertile.
Dysmenorrhoea, hypermenorrhoea and Scanty menses were the common causes for
Female Infertility. One case had gonococcal infection and was treated with
antibiotics before treatment for infertility. It was couple infertility
(Primary) and so the male partner was also similarly treated for gonococcal
infection. One male patient had syphilis. His wife was also examined and both
were treated with antibiotics for the same, before treatment for infertility
(Secondary) was started.
Semen analysis was done before starting
Fortege treatment and later once a month, and the last one being after four
months of treatment.
Female Infertility was treated with Aloes
Compound and MaleInfertility was
treated with Fortege. Females weretreated till conception and males weretreated for four months. In Female
Infertility only the woman was treated and the husband was not given any
treatment. In Male Infertility, only the man was treated and no drug was given
to his wife. In Couple Infertility, both the husband and wife were treated
accordingly. Treatment was stopped immediately as pregnancy was suspected. The
maximum period of observation was 10 months.
All the deliveries were done under our
care except one.
AGE
GROUPS: Females
Majority of cases, 31 (77.5%) females were
in the Age Groups of 20-30 years. (Table
l)
TABLE
— l ; Age Groups ; Females. N = 40
|
Age Group |
No. of cases |
% |
|
20-25 Yrs. |
16 |
40.0% |
|
26-30 Yrs. 31-35 Yrs. |
15 |
37.5% 10.0% |
|
4 |
||
|
36-40 Yrs. |
3 |
7-5% |
|
41-45 -Yrs. |
1 |
2.5% |
|
45-50 Yrs. |
1 |
2.5% |
|
Total |
40 |
100.0% |
|
AGE GROUPS |
Males |
|
|
Majority of cases, 33 (32.5%) moles |
were in the |
|
|
Age Groups of 21 |
-35 years. (Table 11) |
|
|
TABLE - II : |
Age Groups : Males. N = 40 |
|
|
Age Group |
No. of cases |
% /l> |
|
21-25 Yrs. |
: 7 |
17.5% |
|
26-30 Yrs. |
: 13 |
72.5% |
|
31-35 .Yrs. |
: 13 |
32.5% |
|
36-40 Yrjs. |
: 3 |
7.5% |
|
41-45 Yrs. |
: 2 |
5 0% |
|
46-50 Yrs. |
: 1 |
2.5% |
|
51-55 Yrs. |
: 1 |
2.5% |
|
Total |
: 40 |
100.0% |
Majority of couples,- 32 (80%)
had married life of 6-15 years. (Table 111)
TABLE - III :
Duration of married life. N=40
Duration in Years No. of cases %
|
3-5 |
Yrs. |
2 |
5-0% |
|
6-10 |
Yrs. |
18 |
45.0% |
|
11-15 |
Yrs. |
14 |
35
0% |
|
16-20 |
Yrs. |
3 |
7-5% |
|
21-25 |
Yrs. |
1 |
2-5% |
|
26-30 |
yrs. |
2 |
5.0% |
|
Total |
40 |
100.0% |
|
Female,
Male & Couple Infertility
There
were 8 cases (20%) of Female Infertion 10 cases (25%) of Male Infertility and
22 cases (55%) of Couple Infertility where both the partners had to be treated
for infertility. (Table IV)
|
TABLE - 1V : Female, Male &
Couple Infertility |
N — 40 |
|
|
|
Infertility |
No.
of cases |
% /o |
|
|
Female
Infertility |
:
8 |
20.0% |
|
|
Male
Infertility |
:
10 |
25.0% |
|
|
Couple
Infertility |
:
22 |
55.0% |
|
|
Total |
:
40 |
100.0% |
|
|
|
|
||
|
There
were 16 cases (40%) of Primary Sterility |
|||
|
and
24 cases (60%) |
of
Secondary Sterility |
|
|
|
Sterility |
Primary |
% |
Secondary |
% |
Total |
% |
|
Wife |
5 |
12.5% |
3 |
7.5% |
8 |
20.0% |
|
Husband |
2 |
5.0% |
8 |
20.0% |
10 |
25.0% |
|
Couple |
9 |
22.5% |
13 |
32.5% |
22 |
55.0% |
|
|
16 |
40% |
24 |
60% |
40 |
100% |
The
husband did not come for examination and only wife came with the complaint of
infertility. The author insisted on the semen analysis of all the husbands
without exception. Only 8 men had sperm count of over 60 mlns./ml. In about one
third of the patients, namely 15 (37.5%), sperm count was less than 20
mlns./ml. Sperm Motility in the majority of cases was less than 40%. (Table VI)
TABLE- VI :
Sperm
Count before starting treatment. N = 40
Sperm
Count No of Cases %
|
5-10 mln/ml |
5 |
12.5% |
|
11-20 mln/ml |
10 |
25.0% |
|
21-40 mln/ml |
6 |
15.0% |
|
41-60 mln/ml |
11 |
27.5% |
|
Over 60 mln/ml |
8 |
20.0% |
|
Total |
40 |
100.0% |
Treatment
in Female Infertility with Aloes Compound
In
Female Infertility, Aloes Compound 2 tabs, three times a day was continuously
given till pregnancy was suspected when the drug was immediately discontinued.
The maximum period was 9 months. As a precaution against any abortion or
miscarriage Leptaden (Alarsin) was given throughout pregnancy in a dose of 1 or
2 tabs two, or three times a day.If no conception took place within 9 months or
treatment, the case was deemed a failure.
Treatment in Male Infertility
WithFortege
In
Male Infertility, Fortege 2 tabs, three timesa day was given continuously for
four month-. Semen analysis was done once a month. If semen picture did not
improve within 4 months of Fortege treatment the case was deemed a failure.
In a
few cases where non-specific urinary tract infection was suspected, Bangshil
(Alarsin), 1 tab,three times a day was also given with Fortege.
Results
of Treatment
Conception Rate
Out
of 40 women 38 women (95%) conceived and only 2 women (5%) did not conceive. (Table
VII)
TABLE-VII : Results of Aloes Compound
treatment in Females &Fortege in Males. N = 40
Conception %
|
Conceived |
: |
38 |
95.0% |
|
Not
conceived |
: |
2 |
5.0% |
|
Total |
1 |
40 |
100.0% |
Duration of
Treatment For Conception
In 10 women
(26.3%) conception took place within 4 months; 21 women (55.3%) conceived between
5th and 7th months and 7 women (18.4%) conceived between 8th and 10th months of
observation. The maximum period of treatment was 9 months, and the observation
period for conception was one month more. (Table
VIII)
TABLE VIII : Conceived in so many months with Aloes
Compound in Females and Fortege in Males, No :38
|
Conceived In |
No of Cases |
% |
|
4th Month |
10 |
26.3% |
|
5th-7th months |
21 |
55.3% |
|
8th to 10th month |
7 |
18.4% |
|
|
38 |
100.0% |
Conception Rates in Female Infertility, Male
Infertility & Couple Infertility:
Among 8 cases of
Female Infertility, 7 cases (87.5%) conceived and only 1 woman (12.5%) did not
conceive. Among 10 cases of male infertility, all the wives conceived (100%).
Among 22 cases of Couple Infertility 21 women (95.5%) conceived and only 1
woman (4.5%) did not conceive. On the whole 38 women (95%) conceived and only
two women (5%) did not conceive. Out of these 2 women who did not conceive ,
one was a case of Female Infertility and other was the case of Couple
Infertility. (TABLE IX)
Table –
IX : Conception rates of Female Infertility, Male Infertility & Couple
Infertility, N= 40
|
Infertility |
No of cases |
Conceived |
% |
Not Conceived |
% |
4-7-10 months |
|
Female Infertility |
8 |
7 |
87.5% |
1 |
12.5% |
(1+4+2) |
|
Male Infertility |
10 |
10 |
100.0% |
0 |
- |
(1+8+1) |
|
Couple Infertility |
22 |
21 |
95.5% |
1 |
4.5% |
(8+9+4) |
|
|
40 |
38 |
95.0% |
2 |
5.0% |
(10+21+7) |
Case No 8
Married since 15 years. Infertile Couple After treatment with child.
Discussion:
Out
of 38 conceptions, 3 were delivered by caesarean, 5 were delivered by help of Forceps
and 30 were normal deliveries. Out if these normal deliveries, there were 3
still-Births.
The weights of children born ranged from 1.500 kg to 2.500 kg and the mean baby
weight was 2.100 kg.
Conclusion and Summary
In
the management of Female Infertility, Male infertility and Couple Infertility
in purely Kura! Area and Rural conditions, Aloes Compound in Females and
Fortege in Males, are found to be of immense benefit where sophisticated
investigations are unavailable. Female Infertility was diagnosed clinically and
Male infertility was diagnosed only by one test, that is Semen Analysis.
Case No 38
Married since 15 years Infertile Couple After treatment with child.
Overall conception rate was 95% that is 38 cases of infertility, primary
or secondary, conceived out of the total 40 cases.
No toxic or side effects were observed in the use of these drugs in
parents or in their offspring.
Acknowledgement
I am
thankful to Mr. P.G Shukla of Alarsin Marketing Pvt. Ltd. Bombay 400 023.
References
Aloes Compound in Female
Infertility, Sub-Fertility, Primary or Secondary.
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FORTEGE
In Male Infertility, Functional Impotence, Oligospermia :
14. Gupta, L.N. (1975) : “Role of Fortege in Oligospermia’’ : Current
Medical Practice, 19:6, p. 272-73, June 1975.
15. Shelat, R.K.; Majumdar, Muktiben; Banderia, Bhartiben A Basu, K.N.
(1977) : “Usefulness of Fortege in Oligospermia A in Low Motility of Sperms (A
Controlled Trial)” : First AsianCongress of Fertility A Sterility, Bombay,
19-23, Feb. 1977.
16. Bhalerao, Mohan N. &Bhalerao, Savitha M. (1979) : “An
Ayurvedic drug Fortege in the treatment of Oligospermia” : 19th Mah, State Med.
Conf , Bombay, 2-4 Nov. 1979.
17. Bhalerao, Mohan N,;Bhalerao, Savitha M. &Daithankar, S.G. (1979)
: “Fortege in Male Infertility - A Controlled trial" : 23rd All India
Obst&Gynec. Congress, Bangalore, 29-31, Dec. 1979; Current Medical
Practice, 24:3, p. 95-99, March 1980.
18. Jagadisan, D.; Satyanarayan, A.M.; Sivaji & Vijayan (1981) :
“Fortege in Male Infertility due to Oligospermia (Trial with a non-hormonal Ayurvedic
drug in Infertile Couples)” : Antiseptic, 78:12, p.678, Dec, 1981.
19. Panda, B.C.; Behera, Manojkumar; Pradhan, Sachidananda; Maharana,
Indrajit (1982) ‘Management of Male Infertility with Fortege- an Ayurvedic Drug
(A Double Blind Crossover Study)” : XXVI All India Obst. &Gynec. Congress,
Pune (Mah.), 29-31, Dec. 1982.