Ayurvedic approach in managing Primary Infertility associated with Endometrioma - A Case Report

Endometriomas, commonly known as chocolate cysts, are a manifestation of endometriosis that can impact fertility. This case highlights the role of Ayurvedic management in conjunction with modern diagnostics for a successful pregnancy outcome. A 26-year-old woman with a history of 3 years of infertility presented with regular menstruation but was experiencing moderate dysmenorrhea (VAS-5) without clot passage. Her obstetric and contraceptive history was nil, and no dyspareunia was noted. Previous assisted reproductive techniques (IUI and IVF in 2021) had been unsuccessful. Imaging revealed a retroverted, normal-sized uterus and bilateral bulky ovaries with adherent chocolate cysts (36×28 mm on the right and 20×18 mm on the left). Hormonal evaluations were within normal limits (CA-125: 28.5 U/mL; Prolactin: 11.42 ng/mL). Her surgical history included prior chocolate cyst removal in 2020.The patient underwent Ayurvedic Shodhana and Shamana therapy aimed at reducing cyst size and improving reproductive health. Clinical follow-up showed reduction in cyst size and significant relief in menstrual pain. She conceived naturally in October 2022, and subsequent antenatal evaluations revealed normal fetal development. A healthy female baby was delivered in August 2023. Timely diagnosis and multidisciplinary management of endometriomas can result in successful pregnancy outcomes, even in infertile patients with a history of assisted reproductive failure.