‘Infertility’ is a word that no married couple ever wants to hear. It carries with it a sense of gloom and fear and also is attached to the social stigma. With changing times the angle with which the problem is visualized has changed. Being childless can be a cause of marital discord as well as personal unhappiness and ill health.
Infertility means the inability to conceive despite regular unprotected sexual intercourse for more than one year. The main causes of female infertility are advanced age, hormonal imbalance, tubal, uterine, or endometrial-related conditions. In men, infertility is seen to occur due to poor sperm quantity and/or quality and as well as erectile dysfunction. Apart from this, stress and other psychosomatic factors are also responsible.
In Ayurveda, Gandharva or infertility is not classified or explained as an independent disease. It is a complication of many other conditions when they are not treated. Hence there is no reference to an independent nidana-causative factor for this disease. In Ayurveda, it’s explained that there are four factors essential for conception. They are rutu, kshetra, Ambu, and beeja.
‘Rutu’ implies the season and time-rutukala, of conception. The age of the couple and the reproductive cycle has to be considered. In “Hemanta rutu” Bala-strength, Agni-digestive fire is at its peak. So, this time is the best season for conception as all the dhatus-tissue will be healthy structural and functional integrity.
‘Kshetra’ means ‘place’. But in this context, it means uterus/ womb. It is explained that the yoni or garbhashaya should be ‘avyapanna’ meaning healthy, undiseased. A healthy body also means a healthy womb that is devoid of congenital defects, acquired defects, systemic or local diseases. Thus kshetra is the second chief factor for conception.
‘Ambu’ is ‘rasa’, the nutrient liquid product from the diet which nourishes the rest of the tissues. Here, it represents the nutritional elements responsible for the growth of the foetus. It depends on the diet of the mother. Hence, the diet should not be unbalanced, deficient, or unhealthy.