Ayurvedic Approaches to Fertility and Infertility: Evidence & Public Health Implications

Introduction

Infertility is both a pressing public health issue and a profoundly personal experience. Beyond the medical diagnoses and potential treatment outcomes, it affects self-esteem, identity, relationships, and the fundamental hopes many people hold for building a family. Around 17.5% of the adult population, which is roughly 1 in 6 women worldwide, experience infertility (World Health Organization, 2023). Infertility carries significant mental health implications, with studies showing higher rates of depression, emotional distress, and anxiety as a result of constant stress among women battling infertility (Lakatos et al., 2017). Modern advances in reproductive medicine, including in vitro fertilization (IVF), surrogacy, and adoption, have created new possibilities for individuals and families facing infertility. These technologies represent extraordinary scientific progress, yet they remain financially inaccessible for many families. While biomedical interventions dominate mainstream infertility care, they are not the only pathways being explored, particularly in response to barriers related to cost, access, and long-term sustainability. The American Society for Reproductive Medicine identified that fewer than a quarter of infertile couples have sufficient access to infertility care. In the United States, the average cost of an IVF cycle is $12,400, with some studies estimating it to be approximately $20,000-$25,000 with very limited insurance coverage. Because patients often require multiple cycles to achieve a successful pregnancy, with estimates commonly ranging from two to three cycles on average, total costs can quickly escalate. Additionally, cost per live birth can exceed $60,000, making this an immense financial burden (Peipert et al., 2022). Alongside modern interventions, there is growing interest in traditional and complementary approaches. Among them is Ayurvedic medicine, one of the oldest medical systems. These ancient practices and emerging scientific studies truly offer a unique perspective on preserving and enhancing fertility for so many individuals across the world.

This review asks: how does existing literature describe Ayurvedic approaches to infertility, and what potential public health insights or implications do these practices offer? It first examines Ayurvedic herbal, procedural, and lifestyle practices related to fertility, then discusses gaps in research and implications for public health policy.

Background

According to Chauhan, Semwal, Mishra, and Semwal (2015), Ayurveda is a traditional Indian medicinal system that approaches health in a holistic way, considering all forms of physical, psychological, philosophical, ethical, and spiritual health and the way they intersect. Within this system, Ayurveda emphasizes the body’s inherent ability to heal itself by maintaining balance and using herbal treatments. This work is described as a “science of life” where Ayus = life and Veda = knowledge. Although it is one of the oldest medical systems, there remains a lack of sufficient scientific testing and evidence to support many of its claims. Research methodology remains limited due to challenges in standardization, funding priorities, and the evaluation of holistic and individualized treatment systems within conventional biomedical research frameworks; however, continued methodological development is essential to the advancement and acceptance of Ayurveda. Through a public health lens, an interest in this medicine has grown in response to the systemic challenges within conventional medicine such as “increased side effects in synthetic drugs, lack of curative treatment for several chronic diseases, high cost of new drugs, microbial resistance, and emerging diseases” (Chauhan, Semwal, Mishra, & Semwal, 2015). These gaps in accessibility, affordability, and long-term sustainability open the door for other integrative approaches such as Ayurveda to be explored in public health strategies.

Methods

This paper is a narrative literature review designed to explore how existing literature describes Ayurvedic approaches to infertility, and what potential public health insights or implications these practices offer. Relevant sources were gathered from PubMed, World Journal of Pharmaceutical and Medical Research, International Journal of Ayurveda and Pharma Research. The selected articles, published within the last 2–12 years, place Ayurveda and fertility at the center of their analysis. Selected works included both medical reviews and public health analyses to capture biomedical and broader cultural perspectives. This paper considers a spectrum of Ayurvedic practices, herbal, procedural, and lifestyle, to illustrate how diverse methods contribute to a holistic understanding of fertility care. The goal of this review is to identify patterns across existing research and begin establishing a consensus understanding of how Ayurvedic practices contribute to fertility care and what public health insights can be drawn.

Findings / Results

Herbal: Shatavari (Asparagus racemosus)

Shatavari (Asparagus racemosus) is one of Ayurveda's leaders in medicinal herbs catered for the protection and support of women’s fertility. It has been traditionally used to balance pitta and vata, two of the three doshas, or biological energies. Each dosha is a combination of different elements and physiological tendencies that must be in balance to maintain good health. Pitta and vata are associated with metabolism, heat production, and circulation, so balancing these are crucial for the reproductive system (Hankey, 2010). Furthermore, it has been said to have positive effects on the improvement of menstrual irregularities, pregnancy, post-partum, lactation, and menopause symptoms; however, extensive clinical trials are still needed. Shatavari contains a range of active phytochemicals, such as steroidal saponins (Shatavarins), which have phytoestrogenic properties that mimic the activity of estrogen. It may help improve hormonal imbalances, polycystic ovarian syndrome (PCOS), follicular growth, egg quality, and fertility as well.

Chronic stress is known to interfere with female reproductive health and damage ovarian function. However, shatavari has an ability to reduce this oxidative stress, restore balance, and increase antioxidant levels in the body. Further research is still needed to understand exactly how it acts at the ovarian and cellular level to support women’s reproductive health (Pandey et al., 2018). Shatavari is commonly administered in accessible forms such as powdered root, capsules, tablets, or liquid extracts and is broadly available through Ayurvedic practitioners, pharmacies, and mainstream retail and online marketplaces, without requiring clinical facilities or specialized medical delivery systems. From a public health standpoint, Shatavari has a culturally familiar and low-cost approach to managing reproductive issues, particularly in places where access to hormonal or assisted reproductive therapies are not possible.

Procedural: Virechana (Therapeutic Purgation) - Panchakarma Detox Therapy

Infertility is a complex condition with many possible causes; whether in men or women, it requires a comprehensive approach to understand the different factors at play. In Ayurveda, the challenge of conception (vandhyatva) is often explained in terms of blocked pathways: “obstruction of channels” (shrotas) or the aggravation of doshas. Ayurvedic procedures are designed with this logic in mind, to clear out what is stagnant, heavy, or obstructive, and to create space for new growth, vitality, and ultimately life. Within this framework, Virechana, a therapeutic purgation or detoxification therapy, is one of the methods used to restore balance and potentially enhance fertility, particularly noted in studies of male infertility. For example, Varsakiya et al. (2019) conducted a clinical study on the efficacy of Virechana (therapeutic purgation) followed by Go-Ghrita (cow ghee) in men with Ksheena Shukra (oligozoospermia, or low sperm count). While this study was specific to Go-Ghrita (cow’s ghee), it is worth noting that ghee itself is not a recent therapeutic discovery but a deeply traditional Indian food. For thousands of years, families have made ghee at home as a staple fat in everyday cooking and in ritual use, before it was even formalized in Ayurvedic texts. What Ayurveda did was elevate ghee into medicine. Go-Ghrita is ghee prepared specifically from cow’s milk since it is regarded as both rejuvenative and beneficial for reproductive health. This study showed significant improvements in seminal parameters, including sperm count and motility. This suggested that Virechana therapies in combination with dietary additions may enhance male reproductive health, showing an 80.92% increase in total sperm count, and 41.78% increase in sperm motility for the treatment group (Varsakiya, Goyal, Thakar, Donga, & Kathad, 2019). While this evidence is specific to male infertility, case-based clinical reports have also documented the use of Virechana in women with anovulation-related infertility, including spontaneous conception following treatment (Raturi et al., 2020). From a public health lens, these kinds of treatments are comparatively low-cost, rely on widely available ingredients such as ghee, and are embedded in cultural practices that could make them more acceptable and accessible to patients than more costly biomedical infertility treatments such as in-vitro fertilization.

Lifestyle: Pathya (Dietary Regulation)

In Ayurvedic practice, dietary regulation, or Pathya, is viewed as central to fertility and the natural processes of conception and pregnancy. Much like public health’s emphasis on prevention alongside treatment, Ayurveda positions diet as a primary form of prevention, comparable to modern nutrition guidelines. This does not suggest that Ayurvedic-based diets alone can prevent infertility; rather, they are understood as supportive strategies that may help reduce modifiable risk factors and promote overall reproductive health. Echoing these same concerns, Ayurveda links ultra-processed foods to chronic disease. At the same time, it highlights specific dietary practices, including the consumption of rice, ghee, milk, honey, and sesame, as essential for sustaining resilience and promoting reproductive health. Unlike the standardized, “one-size-fits-all” model often seen in public health nutrition, Pathya emphasizes personalization. Its scope extends beyond lists of what to eat, extending to food combinations, portion sizes, methods of preparation, the emotional effects of meals, the nature of the individual consuming them, and the broader environmental context in which eating takes place. Pathya is further described as restoring balance by softening the shrotasa (channels of circulation) and helping aggravated doshas. In the context of reproductive health, this holistic logic presents diet not only as daily sustenance but also as a preventive intervention to maintain good circulation, and nourish reproductive tissues (Sidar & Baghel, 2022).

There has been other research done outside of Ayurveda that also supports the idea that traditional foods may enhance fertility. For example, sesame seeds, which have been used in traditional and modern nutrition, have antioxidant properties, which could be effective in improving semen quality. In one clinical trial, twenty-five infertile men took sesame for three months with sperm quantity, movement, and shape measured before and after treatment. They found significant improvement in count and motility (Khani et al., 2013). In contrast to male fertility, which is commonly assessed using measurable parameters such as sperm count and motility, female fertility is more complex and is typically evaluated through a combination of indicators, including ovulatory function, menstrual regularity, hormonal profiles, ovarian reserve markers, and clinical pregnancy outcomes. This suggests that sesame supplementation may be a safe and effective method for male infertility. This approach truly shows the early understanding of connections between diet, metabolism, and reproductive health that modern public health professionals now see in nutrition and chronic disease prevention. Integrating personalized diets could help make nutrition programs more culturally relevant and sustainable.

Discussion

While scientific evidence remains limited, the existing literature shows important opportunities for culturally grounded, accessible approaches to reproductive health. Ayurveda’s herbal approaches can make fertility care more equitable by providing low-cost options in settings where fertility treatments are expensive or unavailable. The limited clinical trials in this area highlight a research gap rather than irrelevance. Rathi et.al (2024) analyzed multiple studies on Ayurvedic interventions for infertility and found that there were generally positive outcomes; however, there were still variations in study design, sample size, and outcome measures. This shows that there are still methodological challenges that make it hard to draw conclusions, but they highlight that there is indeed a growing interest in Ayurveda as a complementary approach, as opposed to a replacement of biomedical treatments. The current evidence base is insufficient to fully answer this review’s initial question. More comprehensive studies are needed to determine effectiveness.

Traditional Ayurvedic medicine values holistic, preventative, and personalized approaches, and emphasizes strong connections between the mind, body, and environment. From a public health standpoint, Ayurveda's focus on nutrition, stress management, and balance may help address key determinants of reproductive health. Within health systems, therapies from Ayurveda have the strong potential to complement modern biomedical care and be an important part of communities and struggling families that have limited resources. Ayurveda’s lifestyle approaches, like dietary regulation or Pathya, have a strong overlap with public health’s identification of nutrition as a prevention strategy. Ayurveda is able to lower barriers to care compared to expensive fertility technologies and newer treatments. As well, traditional approaches may help to reduce stigma within reproductive health, and increase patient trust. Cultural humility training for reproductive health teams and partnerships with community health workers to reduce stigma is crucial. This is especially relevant in communities where infertility is shaped by cultural or religious beliefs that can place a great emotional burden on women, reinforcing feelings of inadequacy or failure to meet societal expectations of motherhood, and where access to medical care may also be limited. Lack of interest and evidence may make this hard to implement on a large scale, but collaboration between systems could be feasible and beneficial. There needs to be standardized research frameworks for these interventions, including interdisciplinary research between biomedical, cultural, and public health methods. Ethical implications should also be carefully considered to prevent misuse or oversimplification of traditional approaches. These considerations include avoiding the replacement of evidence-based medical care, ensuring informed consent, preventing cultural appropriation or commercialization of traditional practices, and protecting patients from false or exaggerated fertility claims. There must also be collaboration, and communication between public health workers, healthcare providers, and Ayurvedic practitioners to create models of care that responsibly integrate traditional knowledge with modern scientific practice.

Conclusion

Ayurveda is a multifaceted, traditional Indian system that understands fertility in ways that align with public health’s goals of equity, prevention, and truly holistic well-being. Continued research must be done in this area to explore how these traditional practices can complement modern reproductive medicine. Incorporating Ayurvedic principles that prioritize balance, accessibility, and cultural relevance into modern reproductive health systems may help expand access to care for more women and families worldwide. Interdisciplinary research that brings together diverse perspectives, guided by inclusivity, ethical consideration, and evidence-based collaboration has the potential to create impactful reproductive health solutions.

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