PURUSH VANDHYATVA (MALE INFERTILITY): A CRITICAL INTEGRATIVE REVIEW OF AYURVEDIC CONCEPTUAL FRAMEWORKS AND CONTEMPORARY BIOMEDICAL EVIDENCE

Abstract

Background: Male infertility, recognised in classical Ayurvedic texts as Purush Vandhyatva, constitutes a global reproductive health burden contributing to approximately 20–50% of infertility cases worldwide. Despite remarkable advances in andrology and assisted reproductive technologies (ART), aetiological complexity continues to challenge clinicians. Ayurvedic scholars systematically catalogued semen disorders, pathogenic mechanisms, and therapeutic principles millennia before the advent of modern spermatology, creating a parallel conceptual architecture that warrants rigorous academic re-examination.

Objective: This article critically reviews the Ayurvedic conceptualisation of Purush Vandhyatva in the Charaka Samhita and Sushruta Samhita alongside contemporary biomedical evidence, exploring congruences, divergences, and areas of untapped research potential.

Methods: A systematic narrative review was conducted using classical Ayurvedic primary texts (Charaka Samhita, Sushruta Samhita, Ashtanga Hridayam) and peer-reviewed biomedical literature published between 2013 and 2024, sourced from PubMed, Scopus, and Google Scholar using MeSH-aligned search terms related to male infertility, semen parameters, oxidative stress, and Ayurvedic andrological concepts.

Results: Classical Ayurvedic texts describe eight types of Shukra Dushti (semen abnormalities), a multifactorial aetiological framework encompassing nutritional, lifestyle, psychosexual, traumatic, and hereditary causes, and a Dosha-based pathogenesis model (Samprapti) that corresponds structurally to modern semen parameter categories including oligospermia, asthenospermia, and azoospermia. Hereditary disorders described as Pitruja Sahaj Vikarani demonstrate conceptual alignment with Y-linked genetic disorders.

Conclusion: Purush Vandhyatva represents a holistically conceived clinical entity in Ayurveda that overlaps substantially with contemporary andrological classifications. Validated integrative research protocols are urgently needed to translate classical therapeutic principles into evidence-based clinical applications. The study identifies significant research gaps including the absence of randomised controlled trials on classical Vajikarana formulations for specific semen parameter deficits.