Ayurvedic management of secondary infertility associated with intramural subserosal fibroid and thyroid dysfunction: A case report

Introduction

Secondary infertility, defined as the inability to conceive following a previous successful conception, presents complex diagnostic and therapeutic challenges. Common etiological factors include uterine fibroids, particularly intramural subserosal fibroid types, which may distort the endometrial cavity and impair implantation, and thyroid dysfunction, which affects endocrine regulation and ovulatory cycles. Ayurvedic medicine provides a holistic and individualized approach, targeting both structural and systemic dysfunctions. This case report presents the Ayurvedic management of secondary infertility associated with intramural subserosal fibroid and subclinical hypothyroidism. Methodology: A 32-year-old female presented with secondary infertility persisting for 5 years, accompanied by scanty, irregular menstruation and a history of one spontaneous abortion. Radiological evaluation confirmed a posterior intramural-subserosal fibroid of size ~10×10×6 mm and two right lateral intramural fibroids of sizes 24×23×21 mm and 27×24×24 mm. Thyroid function tests revealed subclinical hypothyroidism with elevated TSH (8.76 µIU/mL). The condition was diagnosed as Vandhyatva associated with Granthi (fibroid) and Agnimandya (metabolic dysfunction) according to Ayurvedic principles. Management began with Deepana and Pachana to stimulate digestion and metabolism, followed by Shodhana Chikitsa involving Yoga Vasti (Asthapana Vasti with Arbudhara Kwatha and Dashamula Kwatha, and Anuvasana Vasti with Prasarini Taila and Dashamula Taila). This was succeeded by Uttara Vasti using Kashishadi Taila and Apamarga Kshara Taila. Samana Chikitsa was administered to resolve fibroid pathology and support endocrine balance. The patient was also advised on lifestyle modifications and dietary regulations consistent with Ayurvedic guidelines.