Primary Infertility Treated with Individualized Classical Homeopathy

Infertility, a prevalent and emotionally challenging reproductive health issue, is marked by the inability to conceive after a year of regular, unprotected intercourse. The global burden of infertility is substantial, impacting one in seven couples worldwide.

Conventional treatments, including assisted reproductive technologies and hormonal interventions, are widely employed, but they come with limitations such as invasiveness, financial burden, and variable success rates. Non-invasive and holistic approaches to address infertility are of great interest in such a scenario. This study explores the potential benefits of individualized classical homeopathy in the context of male and female infertility.

Cases Summary: We present four cases involving male and female patients experiencing infertility. Each case underwent individualized classical homeopathic treatment tailored to their specific symptoms and medical histories. The progress was systematically recorded with regular follow-ups. The attributability to homeopathic intervention was assessed through the MONARCH causality assessment score.

Outcome: The cases conceived after individualized classical homeopathic treatment. Sperm quality improved in male patients, while female patients achieved menstrual regularity and favourable hormonal profiles. The positive outcomes suggest a potential role for classical homeopathy in addressing infertility for both men and women, emphasizing the need for further scientific investigation into its efficacy in reproductive health.

Keywords: Infertility, Primary infertility, female infertility, male infertility, asthenozoospermia, oligozoospermia, progesterone deficiency, homeopathy, case report.

Introduction:

Infertility is commonly defined as the inability to conceive after one year of regular unprotected sexual intercourse which may be reduced to six months for women aged 35 and older due to the natural decline in fertility with age.^1,2 Global infertility estimates suggest that approximately 15% of couples have trouble conceiving.^1,3

The prevalence varies across populations and is influenced by age, geographical location, and socio-economic conditions.⁴ Infertility may be primary or secondary . Primary infertility meaning a couple has never achieved a pregnancy, while secondary refers to the inability to conceive following a previous successful pregnancy.⁵

Infertility can stem from various factors, both male and female.⁴ Female causes may include ovulatory disorders, tubal abnormalities, uterine factors, and endometriosis.⁶ Male causes often involve issues with sperm production, function, or obstruction.³ In some cases, infertility may result from a combination of male and female factors and are listed in Table 1.

Table 1: Identifiable causes for female and male infertility.

Female infertility:	Male infertility:
Ovulatory disorders – 25%Endometriosis – 15% Pelvic adhesions – 12% Tubal blockage – 11% Other tubal/uterine abnormalities – 11% Hyperprolactinemia – 7%	Varicocoele-37% Idiopathic causes-25% Semen disorders- 10% Hypogonadism – 10% Testicular failure- 9% Obstructive causes- 6% Undescended testes -8%

Age is a significant risk factor for both men and women, as fertility declines with advancing age. Smoking, excessive alcohol consumption, obesity, and exposure to environmental toxins are other identified risk factors.^4,2 The pathogenesis of infertility involves the intricate interplay of physiological, genetic, epigenetic, and environmental factors.

In females, disruption in the menstrual cycle, hormonal imbalances, and structural abnormalities can impede fertility.^3,6 In males, issues with sperm production, motility, or morphology can contribute to infertility.³ Investigating the underlying pathophysiology is crucial for targeted interventions..¹

For females, diagnostic procedures may include assessing ovulatory function, fallopian tube patency, and uterine health.⁷ In males, semen analysis is a key diagnostic tool to evaluate sperm quantity and quality. Treatment modalities include lifestyle modifications, hormonal therapies, surgical interventions, and assisted reproductive technologies.⁷

Advanced reproductive technologies, such as in vitro fertilization (IVF), genetic testing and infertility cell therapies, may be employed to identify and address specific causes.⁸ Counselling and psychological support are integral components of acknowledging the emotional impact of infertility on individuals and couples.⁹

Although recent advances look promising, they use generalised approach without addressing the root cause. Therefore, classical homeopathy emerges as an alternative, offering an individualized strategy. In this case series, we present four individuals who achieved fertility through classical homeopathic interventions.

Case reports:

Case 1:

A 30-year-old woman presented primary infertility despite three years of unprotected sexual intercourse. She was diagnosed with progesterone deficiency at twenty years of age for which she took hormonal therapy. Since childhood, the patient has been shy and emotionally sensitive.

The patient lost her mother in an accident when she was 9 years old and her father remarried subsequently. This event affected her deeply, causing emotional distress. Her father passed away one year ago, leading to the onset of depression in her.

Past medical history:

The patient had no major illnesses, except for nocturnal enuresis at the age of nine which lasted for two years after her mother’s death.

Menstrual history:

• The patient achieved menarche at 12, displaying regular menstrual pattern for the first five years. Later, menses became irregular occurring every three months once.
• At the age of 20, she started using contraceptive drugs (Medroxyprogesterone, Duphaston, Diane), resulting in weight gain (78 Kg in February 2006, 85 Kg in June 2006, and 95 Kg after her father’s death in 2007).

Diagnosis: Primary infertility with progesterone deficiency. (ICD 10 :N 97.9)¹⁰

Homeopathic consultation and prescription:

The symptoms considered for prescription were her grief (+++) after her parents’ demise. She used to weep very easily (++) and often sighed (++). She had sensation of lump in her throat (++). After a thorough case-taking, Ignatia 1M one dose was prescribed on 19/03/2007 based on the essence of the case. (figure 1)

Figure 1: Repertorial result on 19/03/2007 (Vithoulkas compass)

The follow up is listed in table 2.

Table 2: follow up of case 1.

DATE	SYMPTOMS	ANALYSIS	PRESCRIPTION
23/06/2008	Patient was doing better emotionally after previous remedy. Grief from her father’s death was better. no conception yet Her menstrual cycles are still irregular (++). Her last menstrual period was on 06/06/2008 after 4 months of amenorrhea (+++). She is still a timid person (++), cries very easily (++) and feels better from consolation (++) Her face turns red when she hears any exciting news. (++) Patient does not like to consume pork (++) and fat (+++)	Previous layer of grief is better, and patient is presenting with new symptoms pointing to a clear remedy pattern (figure 2) hence we must treat the case.	Pulsatilla nigricans 200CH once a day for 3 days.
27/06/2008	Patient conceived within 3 weeks after the remedy. Generally, patient is doing good.	We must wait as the remedy is still acting.	Nil
12/08/2008	Pregnancy confirmed and 7 weeks according to ultrasonography.	Case is doing better. But may benefit from a remedy as progesterone is low	Progesterone (Lutheinium) 5CH daily for 3 months.
20/03/2009	The patient gave birth to a healthy baby girl.	The case is doing better	Nil

 

Figure 2: Repertorial result on 23/06/2008 (Vithoulkas compass)

Outcome:

Patient conceived within 3 weeks of taking the remedy and gave birth to a healthy baby girl.

 Case 2:

A 33-year-old woman sought homeopathic consultation due to bilateral calf erythema nodosum (figure 3), that had been persisting since 2016. The condition was managed with corticotherapy (Prednisone 10 mg/day) and Colchicine 1.5 mg/day.

However, in October 2021, the eruption became worse, and the patient stopped using corticosteroids. The condition aggravated by May 2022. Concurrently, the patient was diagnosed with infertility despite three years of unprotected intercourse. Her husband was also diagnosed with asthenozoospermia during the same period.

Figure 3: erythema nodosum before treatment

Past medical history:

Tonsillitis leading to tonsillectomy at 3 years age, adenoidectomy at 10 years age, chickenpox in 2017, gastritis since 2019, and surgical intervention for a left ovarian cyst in 2020. Additionally, she reported frequent respiratory infections in the last year (laryngitis and pharyngitis) and contracted COVID in November 2021 post-Johnson & Johnson vaccination.

The patient had been married since 2019, with no successful pregnancies despite stopping contraceptives for three years. She had used contraceptive drugs for four years before marriage.

Menstrual history:

At the age of 14, she attained menarche, and her menstrual cycle were regular with a 26-day cycle. She reported experiencing abdominal pain for 1-2 days before menses. She also passed dark clots.

Diagnosis: Primary infertility  (ICD 10 : N97.9)¹⁰ , Erythema nodosum (ICD 10 : L52)¹¹

Homeopathic consultation and prescription:

The symptoms available for prescription at the time of consultation were: eruptions on calves (++), lump sensation in the throat (+++). Patient felt guilty (++) that she could not visit her grandfather before his demise, and she used to get angry for trivial matters. She was afraid of spiders (+). She craved sweets (++), salt (+) and had aversion to fats (+). She slept on abdomen (+). The remedy was chosen based on totality of symptoms (figure 4). The patient was given Lachesis 30 CH, twice per day, for one month from 02/06/2022.

The follow up is listed in table 3.

Figure 4: Reportorial result on 02/06/2022 (Vithoulkas compass)

Table 3: follow up of case 2.

DATE	SYMPTOMS	ANALYSIS	PRESCRIPTION
08/07/2022	Skin eruptions subsided by 80%. Anxiety and guilty feelings persist. Generally better. No pregnancy yet.	The remedy is correct, and the case needs continuous stimulation.	Lachesis 32 CH twice a day for one month
08/09/2022	Skin eruptions almost disappeared. Generally better. No pregnancy yet. Patient has increased desire to conceive.	The remedy is correct, and the case needs continuous stimulation.	Lachesis 34 CH twice a day for one month.
20/10/2022	Patient had an episode of urinary tract infection.       (positive for Klebsiella) She also developed new skin eruptions but very mild compared to earlier. Last menstrual period was on 14/10/2022. No pregnancy yet. New symptoms- Desire -salt (+++) Dwelling on past occurrences (++) Irritability < morning waking on (++) She cannot pass urine if her husband is around at her home (++)	Case has clear symptoms pointing to a new remedy. (figure 5) We must treat the case.	Natrum muraticum 200CH three dose given at twelve hours interval each.
24/11/2022	Patient conceived with confirmation of pregnancy test. Her skin complaints improved drastically. (Figure 6) She gave birth to a baby girl on 04/07/2023. Emotionally better.	The case is doing better. We must wait until any new symptoms appear.	Nil
01/12/2023	Patient was doing better except for coryza on and off.	The case is doing better. We must wait until any new symptoms appear.	Nil

 

Figure 5: Repertorial result as on 20/10/2022 (Vithoulkas compass)

Figure 6: erythema nodosum during and after treatment.

Outcome:

Patient conceived after five months of homeopathic treatment and gave birth to a baby girl. Her skin achieved clearance along with overall wellbeing.

 Case 3:

The partner of the woman in the case above, a 30-year-old man, presented with a diagnosis of infertility, specifically asthenozoospermia. Despite treatment with Profertil between January and April 2022, there was no improvement, and subsequent semen analysis results on 08/04/2022 revealed oligospermia and persistent asthenozoospermia. (figure 7) At this point, he sought homeopathic help.

Figure 7: before and after report of semen analysis for case 3.

Past medical history:

The patient had a history of chickenpox, recurrent tonsillitis treated with antibiotics, a right radius fracture, panaritium of the second finger of the right hand, and cryptorchidism, which was initially managed with hormonal therapy for three months, followed by surgery at 2 years of age. Additionally, he experienced epidemic parotiditis with orchitis at 10 years of age.

Diagnosis: Primary infertility with asthenozoospermia and oligospermia (ICD 10 : N46.1)¹²

Homeopathic consultation and prescription:

The patient displayed a timid disposition (++) and sought consolation (++) when feeling sad. As a child, he had a history of a retracted right testicle (++) and experienced orchitis from mumps during childhood (+++). Patient had warts on fingers (++). He desired to eat spicy food (++) and had an aversion to fats (+++).

His comfortable sleep position was on back (+) and he used to uncover his feet during sleep (++). The cause for his infertility was cryptorchidism during childhood and it gave rise to a totality of symptoms (figure 8). Pulsatilla 200 CH, two doses at 12 hours intervals each and then Pulsatilla 1M, one dose, after another 12 hours was given on 29/07/2022. Pulsatilla is a well-known remedy for infertility arising from the history of undescended testis.

The follow up of the case is listed in table 4.

Figure 8: Repertorial result on 29/07/2022 (Vithoulkas compass)

Table 4: follow up of case 3.

DATE	SYMPTOMS	ANALYSIS	PRESCRIPTION
20/10/2022	The patient is generally and emotionally better. No new symptoms.	We must wait until any new symptoms appear.	Nil
24/11/2022	The sperm analysis test appeared normal. (figure 7) On 24/11/2022, his wife conceived, and she delivered a baby girl on 04/07/2023	Case is doing better. We must wait until any new symptoms appear.	Nil.
01/12/2023	Unfortunately, patient did not repeat the sperm analysis test. However, he was doing much better and did not have symptoms.	The case is doing better. We must wait until any new symptoms appear.	Nil

 

Outcome:

The couple conceived within 5 months of treatment and gave birth to a healthy baby girl.

 Case 4:

A 36-year-old male patient sought homeopathic treatment for infertility characterized by hyperspermia (7 ml, normal <5.5 ml) and asthenozoospermia (32.5 mil/ml with only 4.2 mil/ml functional cells, normal >7 mil/ml), along with a low percentage of normal morphology (12.5%, normal >15%).

Patient also suffered from dyspeptic ulcer with Helicobacter pylori infection and was treated with Metronidazole, Amoxicillin, and proton pump inhibitors four months ago. He still had gastric symptoms which appeared seasonally.

Past medical history:

Childhood illnesses included chickenpox, measles, and recurrent pharyngitis and tonsillitis which were treated with antibiotics.

Diagnosis: Primary infertility with asthenozoospermia. (ICD 10: N46.9) ¹³

Homeopathic consultation and prescription:

The symptoms available for prescription were the onset of gastric symptoms in the spring and autumn, knife-like pains in the stomach associated with nausea, worse in the morning at 11am -12 pm (++). He also had diarrhea after consuming fruits and milk (++). He was a very critical person (+++).

He loved sweets (++) and did not like sour (++). While sleeping he would uncover his feet and he could not tolerate warm weather (+++). Based on totality of symptoms (figure 9), Sulphur 200 CH one dose daily for three days was prescribed on 01/04/2010.

The follow up of the case is listed in table 5.

Figure 9: Repertorial result on 01/04/2010 (Vithoulkas compass)

Table 5: follow up of case 4.

DATE	SYMPTOMS	ANALYSIS	PRESCRIPTION
28/08/2010	There was a moderate improvement in the semen analysis. The test revealed hyperspermia with asthenozoospermia – 26 mil/ml, mobility at 1 hour was only 5% (normal >50%). The gastric complaints completely disappeared. Patient improved emotionally and generally. He developed few new symptoms: Swelling of ankles (+) Desire for unripe fruits (++) Desire for ice cubes (++) Hawking tendency of throat (++)	Case has clear symptoms pointing to a new remedy. (figure 10) We must treat the case.	Medorrhinum 200CH one dose for three days.
10/09/2010	Swelling of ankles got better. Gastric symptoms improved drastically. Patient did not repeat the semen analysis, however, one month after the remedy the wife became pregnant, and gave birth to a healthy baby boy on 17/06/2011.	Case is doing better. We must wait until any symptoms appear.	Nil

Figure 10:

 

Repertorial result on 28/08/2010 (Vithoulkas compass)

Outcome:

Although the semen analysis did not show drastic changes, the couple conceived, and his partner gave birth to a healthy baby boy on 17/06/2011.

Discussion:

Infertility is a significant global health concern affecting millions of couples, leading to emotional distress, and impacting overall well-being.¹ Infertility, whether experienced by the male or female partner, profoundly affects couples on both emotional and psychological levels. ⁹.

Conventional assisted reproductive technologies (ART), such as in vitro fertilization (IVF) and intrauterine insemination (IUI), are commonly employed to overcome fertility challenges.⁶ While new technologies have undoubtedly revolutionized the field of reproductive medicine, they come with their share of drawbacks.

Invasive procedures and the use of powerful hormonal interventions may lead to side effects, multiple pregnancies, and psychological stress.^7,9 The financial burden of repeated treatments can be overwhelming for many couples. Classical homeopathy emerges as a promising alternative, offering a holistic and individualized approach to treating infertility in both men and women.

Moreover, there is growing awareness of the importance of addressing the root causes of infertility rather than merely treating symptoms. ⁸ This approach goes beyond addressing the physical symptoms and considers the emotional and mental aspects that may contribute to infertility.^14,15

In the above-presented case series, comprising two females and two males, including a couple, classical homeopathy not only addressed infertility but also positively impacted overall health and well-being. Notably, treating couples may enhance the likelihood of conception.¹⁶ In cases 1 and 2, emotional factors played a significant role in the onset of infertility.

With the application of classical homeopathy, there was a remarkable improvement, leading to conception within a short period of 3 weeks and 5 months, respectively. In case 3, where fertility supplements like “profertil” proved ineffective, there was a rapid improvement suggesting the beneficial role of homeopathy.

Despite the presence of asthenozoospermia and hyperspermia in case 4, the couple successfully conceived within a very short span of time after undergoing homeopathic treatment. Previous studies also have shown positive outcomes highlighting the efficacy of homeopathy, potentially averting the need for use of assisted reproductive technologies in infertility cases.^18,19,20

The Modified Naranjo Criteria for Homeopathy (MONARCH) causality assessment provided a score of 10/13(case 1), 9/13 (case 2), 11/13 (case 3) and 8/13 (case 4) suggesting a likely causal relationship to the treatment (Table 6).²¹

Table 6: Modified Naranjo Criteria for Homeopathy (MONARCH) – for causality assessment

Criteria	Y	N	Not sure/NA	Score in case 1	Score in case 2	Score in case 3	Score in case 4
1. Was there an improvement in the main symptom or condition for which the homeopathic medicine was prescribed?	2	-1	0	2	2	2	2
2. Did the clinical improvement occur within a plausible time frame relative to the drug intake?	1	-2	0	1	1	1	1
3. Was there an initial aggravation of symptoms?	1	0	0	0	0	0	0
4. Did the effect encompass more than the main symptom or condition, i.e., were other symptoms ultimately improved or changed?	1	0	0	1	1	1	1
5. Did overall well-being improve?	1	0	0	1	1	1	1
6 (A) Direction of cure: did some symptoms improve in the opposite order of the development of symptoms of the disease?	1	0	0	1	1	1	1
6 (B) Direction of cure: did at least two of the following aspects apply to the order of improvement of symptoms:  from organs of more importance to those of less importance, from deeper to more superficial aspects of the individual, from the top downwards	1	0	0	1	1	1	1
7. Did “old symptoms” (defined as non-seasonal and non-cyclical symptoms that were previously thought to have resolved) reappear temporarily during the course of improvement?	1	0	0	0	0	0	0
8. Are there alternate causes (other than the medicine) that with a high probability could have caused the improvement? (consider known course of disease, other forms of treatment, and other clinically relevant interventions) (voice therapy in this case)	-3	1	0	1	1	1	1
9. Was the health improvement confirmed by any objective evidence?	2	0	0	0	0	2	0
10. Did repeat dosing, if conducted, create similar clinical improvement?	1	0	0	1	0	1	0
Total				10	9	11	8

Conclusion:

Classical homeopathy emerges as a viable alternative in the realm of infertility, offering a holistic, individualized, and patient-centric approach. The global burden of infertility, coupled with the drawbacks of invasive/expensive technologies stresses the need for complementary therapies that address the root causes of fertility challenges.

As the evidence supporting the effectiveness of classical homeopathy in infertility grows, it presents an encouraging option for couples seeking alternative and holistic approaches to achieve parenthood. Further research and exploration of classical homeopathy in infertility will contribute to a more comprehensive understanding of its role in cases of infertility.

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