Revifert

of these are reduced no. of Spermatozoa (Oligozoospermia), reduced sperm motility (Asthenozoospermia), reduced sperm vitality (Necrozoospermia), abnormal sperm morphology (Teratozoospermia) or any combination of these.

Some common causes of male infertility

1. Abnormal sperm production or function-Sperm abnormalities may be caused by inflammation of the testicles, swollen veins in the scrotum and abnormally developed testicles.
2. Ejaculation problems-Premature ejaculation, retrograde ejaculation (when the semen is forced back into the bladder), erectile dysfunction.
3. Hormone imbalances– Infertility can result from disorders of the testicles themselves or an abnormality affecting other hormonal systems including the hypothalamus, pituitary, thyroid and adrenal glands. Low testosterone (male hypogonadism) and other hormonal problems have a number of possible underlying causes.
4. Certain medications- Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), certain antifungal medications, some ulcer drugs and certain other medications can impair sperm production and decrease male fertility.
5. Other issues- Anatomical abnormalities such as having a urethral opening beneath the penis(hypospadias), psychological and relationship problems, any injury or infection in reproductive organ, bad lifestyle,overexposure to certain things like heat, chemicals and alcohol etc.

COMMON INFERTILITY ISSUES

Male infertility usually manifests as issues with the sperm or with the process of ejaculation. These issues can take many forms, but the most common problems seen by fertility specialists include:

Azoospermia: This condition is defined as the complete absence of sperm in the semen. It may be that the body is not producing any sperm, but more often it is a result of a blockage or obstruction in the ejaculatory ducts or vas deferens. This can prevent any sperm from leaving the testicles and reaching the ejaculate.

Oligospermia:Oligospermia means that there are very few sperm cells in the ejaculate or “low sperm count”. This could be caused by low sperm production or by a partial ejaculatory ducts or vas deferens obstruction.

Congenital absence of the vas deferens: In some cases, the tubes which transport sperm to the penis in the event of ejaculation do not develop before birth.  A patient who has this condition may actually be producing viable sperm in the testes. However, without a way to travel to the ejaculate, pregnancy becomes impossible.

Ejaculatory duct obstruction (EDO) is a blockage in a man’s ejaculatory ducts may be caused by an injury or infection, or it may be a congenital issue which has been present since birth.

Varicocele: Some men develop enlarged varicose veins in the scrotum. This can affect the reproductive function in several ways, any of which may impact sperm production, quality, and transport.

Poor sperm motility (Asthenozoospermia) or morphology (Teratozoospermia): Sometimes a man is producing a good quantity of sperm, but there are issues with how the sperm are shaped (morphology) or how they move (motility). These problems can mean that the sperm has a hard time reaching or penetrating the egg.

Previous vasectomy: This is a straightforward cause of infertility, where a man who underwent a vasectomy (surgical procedure for male sterilization) at an earlier point in his life now wishes to conceive.

Premature ejaculation: If a man consistently ejaculates before vaginal penetration (which can be caused by prostate health issues, mental health issues, and certain medications) the chances of a sperm meeting an egg are very low.

Erectile dysfunction: Consistent trouble achieving or maintaining an erection (often due to medical issues) can make conceiving naturally extremely difficult or even impossible.

Male infertility according to ayurveda

In Ayurveda sperm is called as Shukra which considered as one of the Dhatu and is assigned with the function of bestowing the progeny.

Causes of male infertility according to Ayurveda: Vitiation of Tridoshas; impaired agni; impaired production of Dhatu (Rasa to Shukra) all these factors impair the shukradhatu. Ayurveda explains sukradushti (seminal abnormalities)&Klaibya (sexual dysfunction), main reason for the male infertility.Intake of ruksha, tikta, kashya, atilavana, amla and ushnaahar and anxiety, sadness or old age are some other causes of Shukradushti.

Mainly Vatadosha along with Pitta undergo vitiation and the normal qualities and quantity of the Shukradhatuis deranged. As a result of the vitiation of Vata and Pitta doshas the channels which carry Shukra (Shukravahastrotas) under goes Dushti, which in capacitates one normal individual from conceiving his life partner, ending in infertility.

Qualities of semen according to Ayurveda:

• Spatikabha (Shukra is crystalline translucent in color)
• Drava(It is in liquid state)
• Ghana (After ejaculation, semen is coagulated)
• Snigdha(Shukra is lustrous)
• Madhur(Shukra is sweet in taste)
• Madhugandhi(Smells like chest nut flowers, honey)
• Picchila(Viscous)
• Avidahi(There is no burning sensation during ejaculation)

In Ayurvedic pharmacology,Rasayana(rejuvenators)and vajikarana/ Vrishya(aphrodisiac) herbs aids nourishment andstimulate the sexual tissues.

Vajikaran therapy helps to revitalize all seven dhatus and restores equilibrium and health. It minimizes the shukra defects and ensures a healthy progeny. Rasayanadrugs replenish the vital fluids of our body. The rasayana therapy enhance the qualities of rasa, enriches it with nutrients so one can attain longevity, memory, intelligence, youthfulness, optimum development of physique and sense organs.

Composition

Each capsule contains

Aqueous extract derived from: Ashwagandha 325mg, Varahikand 325mg, Giloy 275mg, Kapikacchu 250mg, ShwetaMusali 250mg, Shtawari 250mg, Shalmali 250mg, Vidarikand 96mg, Gokhru 96mg, Amlaki 48mg

Powders of: Kokilaksha 96mg, ShilajeetShudha 48mg, BhallatakaShudha 24mg, Jaiphala 24mg, Poorana Chandra Rasa 24mg, PravalPishti 20mg, VangaBhasma 16mg, Sounth 8mg, Pippali 8mg

Features of Herbs

Ashwagandha (Withaniasomnifera)

Ashwagandhais widely utilized in Ayurveda as a rasayana (or rejuvenating) tonic that restores strength from within.Owing to it stress relieving, relaxing effect on the body and mind,as well as fortifying of all the dhatus, it is considered as the best herb to target many of the contributing factors that are associated with reduced sexual energy. Its root extract is used to treat sexual weakness, erectile dysfunction, and performance anxiety in men. According to some studies:

• Withaniasomnifera root powder when administered to normozoospermic infertile man for 3 months showed a significant reduction in stress, improved antioxidants, and enhanced semen volume.
• The aqueous extract of this herb has been shown to improve spermatogenesis, owing to elevated interstitial cell stimulating hormone and testosterone-mimicking effects together with induction of nitric oxide synthase.

Varahikand (Dioscoreabulbifera)

Varahikand possesses profound therapeuticalpotency attributed with Vrushya (Aphrodisiac), Balya (strength promoting), Rasayana(Rejuvinative) karmas.

 Kapikacchu (MucunaPruriens)

• In a study, pruriens has been shown to efficiently recover the spermatogenic loss which was induced in male rats by ethinylestradiol administration. The major constituent of M. pruriens, L-DOPA, largely contributes to its pro-spermatogenic properties.
• The seed extract of M. pruriens showed marked improvement in sexual potency and behavior, libido, sperm parameters, and endocrine levels.
• In a clinical study, pruriens seeds increased sperm concentration and motility in all the infertile groups, the levels of lipids, antioxidant vitamins and corrected fructose were recovered after a decrease in lipid peroxides after treatment. ^{BioMed Research Internatinal. Vol 2014, 19 pages.}

 

Shatavari (Asparagus racemosus)

Shatavari can serve as a powerful male tonic. With a bittersweet taste, this herb renders cooling and purifying effect to the liver and blood, and targets pitta at its main site in the small intestine. Its cooling properties balance the heating herbs which are used to improve sperm count. Thus, Shatavari prevents depletion of sperm caused by burning via excess pitta.

General fatigue,low sexual energy, anger, stress, irritability, inflammation, hyperacidity,urogenital infections, burning sensations etc. are the conditions when this herb can be used as drug in standardized dose.

Pippali (Piper longum)

Pippali is a rejuvenating herb with a stimulating action. Its oily nature prevents it from drying making it suitable for vata and its pleasant post digestive effect makes it more calming to pitta than other hot spices and herbs.

Shilajit

Shilajit is immensely important Ayurvedic herb which, increases virility and sexual stamina via removing excesskapha, while maintaining the normal genital tone. In kapha related reproductive imbalances, it is used in combination with Ashwagandha.

In a study the aphrodisiac and spermatogenic potential of the aqueous extract of Shilajitwas evaluated in rats and it is concluded that Shilajit can be useful in the treatment of certain forms of sexual inadequacies, such as premature ejaculation and oligospermia.

 Gokhru (Tribulusterrestris)

It is regarded as an aphrodisiac since ancient times. Administration of T. terrestris to animals showed to improve plasma testosterone level and induced spermatogenesis.It increases sexual behavior evident through increase in mount frequency and intromission frequency, reduction in mount latency, intromission latency, and penile erection index as well as increase in prostate weight and intracavernosal pressure.

ShwetaMusli (Asparagus adscendens)

The aqueous extract of dried roots of this herb enhanced sexual arousal, strength, and libido as well as sperm count in Wistar male rats. Extract of this herb showed anabolic and spermatogenic effect in treated male rats.

Sounth (Zingiberofficinale)

In a study, Administration of ginger for 22 consecutive days significantlyincreased Sperm motility and viability in both experimental groups as compared with the control group. The lumen in experimental groups the seminiferous tubules showed a significant increase in the luminal spermatozoa.^{Journal of Advances in Biology, Volume 8 Number 2, 1607-1611.}

Shalmali (Bombaxceiba)

Bombaxceibais used traditionally in Indian subcontinent as sexual stimulant.In an animal study, treatment withB. ceiba extract had a pronounced effect on sexual behaviour. A significant increase in mount, intromission and ejaculation frequency was observed in case of B. ceiba treated animals (P < 0.05).Mount latency time that is an indicator of physical exhaustion during a sexual act was reduced by 38% in B. ceiba treated and 34% in testosterone-treated group as compared to control group. Intromission (IL) and PEL time was reduced by 34% in B. ceibatreated group whereas only 17% reduction was observed in testosterone-treated group. Reduced IL and PEL have been correlated with invigoration of endocrine system thereby, resulting in enhanced sexual performance and motivation.^{Andrologia 2012, 44, 474–478}

Amlaki (Emblicaofficinalis)

Amalaki is one of the greatest rejuvenators and a powerful natural antioxidant. It also helps to boost the immune system.Amla pacifies all the three doshas – vata, pitta andkapha – it has a wide range of corrective and curative effects on the human body.

Alaboratory study indicates that E. officinalia plays acore role to reduce the Chlorpyrifos (Fertilizer) toxicity in male reproductive aspect. When the subjects were treated with E. officinalisGarten in conjugation with Chlorpyrifos, the parameters like body weight, male reproductive organ weight, sperm count, sperm morphology, ACP, ALP, total protein, uric acid and serum testosterone exhibited recovery and when treated with E. officinalisGarten alone, these parameters were near to the control group that highlights the scavenging property of E. officinalis.^{SpringerPlus2013, 2:541}

Kokilaksha (Asteracanthalongifolia)

In a study, the effect of seeds of A.longifolia on the sexual behaviour of male albino rats was evaluated. The extract of seeds of A. longifolia was administered to groups of rats for a period of 28 days. The ethanolic extract exhibited pronounced anabolic effects in treated animals. Increased spermatogenesis due to treatment with extracts was also witnessed in transverse section. A significant increase in the sperm count as well as fructose levels of seminal vesicles was noted.^{Natural Product Research. Vol. 25, No. 15, September 2011, 1423–1431}

Giloy (Tinosporacordifolia)

In Ayurveda, Giloy has been used since long for its Rasayana properties to increase the vigor and immunity. Pharmacological properties of T. cordifolia are Deepana (ability to facilitate metabolism) and TridoshaShamaka (helps to maintain body humors).

1. cordifolia is known as an adaptogen, as it increases the resistance of the body to physical, chemical, and biological stress and builds energy and general vitality. In many preclinical and clinical studies, T. cordifolia has shown following properties, such as anti-stress, immunostimulatory, anti-inflammatory, antihyperlipidemic and antioxidant

Vidarikand (Puerariatuberosa)

The tuberous roots of this plant are used in Indian traditional medicine (Ayurveda) in general debility, spermatorrhoea and burning sensation.It strengthens body and boosts immunity.It rejuvenates the male reproductive system and increases both quality and quantity of semen by increasing its count and mobility. It reduces vatapitta and normalizes kapha, which increases shukradhatu. This shukradhatuhelps in increasing hard erections, libido and sexual energy.

BhallatakaShudha (Semecarpusanacardium):

In an experimentalstudy, the sexual improving effect of Bhallataka on normal male rat was conducted. The extract of bhallatak was administrated to male mice and they were found to stimulate the mounting behaviour of mice, and also significantly increase their mating performance. The extract of bhallatakaenhanced the sexual behaviour of the male mice.^{Int. Res. J. Pharm. 2013, 4(4)}

Jaiphala (Myristicafragrans):

In an experimental study, the extract of Jaiphalashowed significant increase in aphrodisiac properties in mice such as increase in mating frequency, libido and potency. The extract was also observed to be devoid of any adverse effects and acute toxicity. It has also been used in Unani medicine for the treatment of sexual disorders.^{BMC Complementary and Alternative Medicine 2005, 5:16}

Purnachandra Rasa:

Purnachandra Rasais an Ayurvedic formulation containingherbo mineral compounds. In a study, Spermatogenic activity of Purnachandra Rasa was evaluated experimentally on albino rats. Purnachandra Rasa produced significant increase in weight of reproductive organs as compared to Normal group, Negative group & Standard group. The sperm counts in Cauda epididymis were significantly increased in Test Groups. It is concluded that administration of Purnachandra Rasa suggested increasedSpermatogenic activity.^{PIJAR.July-August-17,volume 1,Issue-6. 102-112}

PravalPishti:

The continuous usage of pravalpishti helps in improving the functions of the immune system properly.It strengthens the male reproductive system, useful in spermatorrhoea and sexual function. PravalPisthi is highly beneficial for reducing this type of fatigue and tiredness. It also reduces body ache and general weakness that occurs after infection.

VangaBhasma:

In a study, the efficacy of VangaBhasma as Vrishya on the basis of seminal parameters, sexual dysfunction, and quality of sexual life was evaluated. The study was conducted on 30 male subjects. Statistically significant improvement was observed on total sperm count and semen volume. Highly significant improvement was observed on abnormal sperm forms and sperm motility. In terms of subjective parameters also, highly significant improvementwas observed in sexual desire, rigidity, ejaculation, erection and orgasm. The study revealed that VangaBhasma can be used as a Vrishya drug.^{PiyushChaudhary et al / Int. J.}

Justification and Rationale of the Combination

Male infertility refers to a male’s inability to cause pregnancy in a fertile female which is commonly due to abnormality and poor quality of the semen. According to Ayurveda, Mainly Vatadosha along with Pitta undergo vitiation and the normal qualities and quantity of the Shukradhatuis deranged. As a result of the vitiation of Vata and Pitta doshas the channels which carry Shukra (Shukravahastrotas) under goes Dushti.

Revifert is the Ayurvedic formulation prepared by the combination of Rasayan and Vajikaran herbs that helps in the management of male sexual health by improving the semen quality by balancing vitiated doshas (Body Humours).

• The natural ingredients of Revifertpossess tonic and aphrodisiac properties which are beneficial in treating impotency due to seminal debilities.
• Vangabhasma, Purnachandra rasa, Kokilaksha and Sonth in Revifert works as Spermatogenic that increases Sperm count, sperm motility, viability and sperm quality.
• Ashwagandha, Varahikand, and Shilajit restore vigor, vitality and improve sexual performance.
• Revifert stimulates, rejuvenates and nourishes the male reproductive tissues for production of healthy progeny.