Effect of Uttarbasti Combined with Ayurvedic Oral Medicines in Women with PCOS Associated Anovulation and Thin Endometrium: A Case Series

Abstract

Polycystic Ovary Syndrome (PCOS) affects 8-13% women of reproductive age and is responsible for 80% cases of anovulatory infertility. The presence of thin endometrium (<7 mm) in PCOS patients is another challenging co-existing pathology along with anovulation to achieve implantation successfully. This case series included 13 patients aged 18-35 years with Rotterdam criteriaconfirmed PCOS, Endometrial Thickness (EMT) <7 mm and anovulation. Management consisted of 3-months of oral Ayurvedic medicines and monthly Uttarbasti, followed by 3-month follow-up. Primary outcomes were ovulation, EMT ≥7 mm, and menstrual cycle regularisation. Secondary outcomes included conception rate. All 13 patients completed the treatment protocol. Promising improvements were noted in all primary outcomes from start to end point of treatment. The mean follicle grade increased from 0.00±0.00 to 2.38±1.04 (p=0.001, Wilcoxon signed-rank test), the mean EMT grade improved from 1.00±0.00 to 2.23±0.83 (p=0.004), and the mean menstrual regularity grade enhanced from 1.77±0.73 to 0.54±1.05 (p=0.005). After the end of the study 69.2% patients achieved ovulation, EMT improvement of ≥7 mm was attained by 76.9% patients, and menstrual cycles was regularised in 76.9% patients. No serious adverse events or treatment discontinuation occurred. The treatment protocol showed a satisfactory safety profile with minimal adverse effects with encouraging results in conception. This case series suggests that Uttarbasti with oral Ayurvedic medicines may improve ovulation, EMT, and menstrual cycle regularity in women with PCOS-associated anovulation and thin endometrium. Large scale randomised controlled trials are necessary to support these findings.