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CTRI Number  CTRI/2024/06/068484 [Registered on: 06/06/2024] Trial Registered Prospectively
Last Modified On: 20/04/2024
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Ayurveda 
Study Design  Randomized, Parallel Group Trial 
Public Title of Study   Ayurvedic Management of Reduced Sperm Count 
Scientific Title of Study   A Randomized Controlled Comparative Clinical Study to Evaluate the Efficacy of Guduchyadi Churna over Gokshuradi Churna in Ksheena Shukra (Oligoasthenozoospermia) 
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  DR SHOAIB AHMED F 
Designation  ASSISTANT PROFESSOR 
Affiliation  Atreya Ayurvedic Medical College Hospital & Research Centre 
Address  BLDEA’S AVS Ayurveda Mahavidyalaya, Hospital and Research centre, Vijayapura
Atreya Ayurvedic Medical College Hospital & Research Centre Kakkali Road , Kodigehalli Post, Doddaballapura-561203 Bangalore , Karnataka (India)
Bangalore Rural
KARNATAKA
586109
India 
Phone  9980445265  
Fax    
Email  shoaibahmedf16@gmail.com  
 
Details of Contact Person
Scientific Query
 
Name  Dr Sanjay Kadlimatti 
Designation  Professor and Principal 
Affiliation  LDEA’S AVS Ayurveda Mahavidyalaya, Hospital and Research centre, Vijayapura 
Address  Professor and Principal Department of Kaya Chikitsa BLDEA’S AVS Ayurveda Mahavidyalaya, Hospital and Research centre, Vijayapura
OPD no 07 and 10, Department of Kaya Chikitsa BLDEA’S AVS Ayurveda Mahavidyalaya, Hospital and Research centre, Vijayapura
Bijapur
KARNATAKA
586109
India 
Phone  8970744656  
Fax    
Email  ayursanjay@gmail.com  
 
Details of Contact Person
Public Query
 
Name  Dr.Shoaib Ahmed F 
Designation  Assistant Professor 
Affiliation  Atreya Ayurvedic Medical College Hospital and Research Centre 
Address  Atreya Ayurvedic Medical College Hospital and Research Centre Department of Kaya Chikitsa OPD no 01 Kodigehalli, Doddaballapura
Atreya Ayurvedic Medical College Hospital and Research Centre Department of Kaya Chikitsa OPD no 01 Kodigehalli, Doddaballapura
Bangalore Rural
KARNATAKA
561203
India 
Phone  9980445264  
Fax    
Email  shoaibahmedf16@gmail.com  
 
Source of Monetary or Material Support  
Raw Drugs from Rasa Shastra and Bhaishajya Kalpana, Department of BLDEAs AVS Ayurveda Mahavidyalaya, Patients attending BLDEAs Ayurveda Hospital OPD 
 
Primary Sponsor  
Name  DR SHOAIB AHMED F 
Address  BLDEA’S AVS Ayurveda Mahavidyalaya, Hospital and Research centre, Vijayapura 
Type of Sponsor  Other [Self] 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
DR SHOAIB AHMED F  BLDEA’S AVS Ayurveda Mahavidyalaya, Hospital  Department of Kaya Chikitsa OPD no 07 and 10
Bijapur
KARNATAKA 
9980445264

shoaibahmedf16@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
BLDEA’S AVS Ayurveda Mahavidyalaya, Hospital and Research centre, Vijayapura  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: N468||Other male infertility,  
 
Intervention / Comparator Agent  
snoIntervention/ComparatorTypeDrug-TypeProcedure NameDetails
1Comparator ArmDrugClassical(1) Medicine Name: Gokshuradi Choorna, Reference: Chakradatta Vrishyadhikara 67/09, Route: Oral, Dosage Form: Churna/ Powder, Dose: 6(g), Frequency: bd, Bhaishajya Kal: Adhobhakta, Duration: 60 Days, anupAna/sahapAna: Yes(details: Jala), Additional Information: -
2Intervention ArmDrugClassical(1) Medicine Name: Guduchyadi Choorna, Reference: Harita Samhita 27/14-15, Route: Oral, Dosage Form: Churna/ Powder, Dose: 6(g), Frequency: bd, Bhaishajya Kal: Adhobhakta, Duration: 60 Days, anupAna/sahapAna: Yes(details: Jala), Additional Information: -
Intervention  Internal Administration  The trial group will be given with “Guduchyadi Churna” 6 gm, twice a day with milk, morning and night in empty stomach. The duration of the treatment will be 60 days.  
Comparator Agent  Internal Medication  The Control group will be given with “Gokshuradi Churna” 6 gm, twice a day with milk, morning and night in empty stomach. The duration of the treatment will be 60 days.  
 
Inclusion Criteria  
Age From  21.00 Year(s)
Age To  45.00 Year(s)
Gender  Male 
Details  1. Male Subjects of age ranging from 21 to 45 years.
2. Subjects diagnosed as Ksheena Shukra on Cardinal symptoms like Dourbalya, Sadana, Mukhashosha, Maithuna Ashakti, Medra Vedana etc.
3. Subjects with oligoasthenozoospermia, i.e. sperm count / concentration less than 15 million / milliliter with Total sperm motility 40% and sperm progressive motility 32%.
 
 
ExclusionCriteria 
Details  1. Known cases of genetic abnormalities and congenital Oligoasthenozoospermia.
2. Subjects associated with systemic disorders like Diabetes, Hypertension, TB and HIV.
3. Subjects having Sexually transmitted diseases.
4. Post traumatic Oligoasthenozoospermia.
5. Subjects diagnosed as Azoospermia, Teratoazoospemia.
6. Subjects with the conditions where surgical interventions needed will be excluded.
 
 
Method of Generating Random Sequence   Permuted block randomization, variable 
Method of Concealment   On-site computer system 
Blinding/Masking   Open Label 
Primary Outcome  
Outcome  TimePoints 
To compare the efficacy of Gokshuradi churna and Guduchyadi churna in Ksheena shukra (Oligoasthenozoospermia).  92 Days 
 
Secondary Outcome  
Outcome  TimePoints 
Tp assess the efficacy of Gokshuradi churna and Guduchyadi churna in Ksheena shukra (Oligoasthenozoospermia).  92 days 
 
Target Sample Size   Total Sample Size="120"
Sample Size from India="120" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   Phase 1/ Phase 2 
Date of First Enrollment (India)   01/12/2024 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="1"
Months="8"
Days="0" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - YES
  1. What data in particular will be shared?
    Response (Others) -  NIL

  2. What additional supporting information will be shared?
    Response -  Study Protocol
    Response -  Statistical Analysis Plan
    Response - Informed Consent Form
    Response - Clinical Study Report
    Response (Others) -  NIL
  3. Who will be able to view these files?
    Response (Others) -  NIL

  4. For what types of analyses will this data be available?
    Response (Others) -  NIL

  5. By what mechanism will data be made available?
    Response (Others) -  NIL

  6. For how long will this data be available start date provided 16-07-2027 and end date provided 16-06-2030?
    Response (Others) -  NIL

  7. Any URL or additional information regarding plan/policy for sharing IPD? 
    Additional Information - NIL
Brief Summary  

Ayurveda entitled as a “Divine science” due to its origin as well as its unimaginable potency in curing the diseases and protecting the health of a healthy person, physically and mentally. In Ayurvedic classics, Acharyas mentioned about four Purushaarthaas i.e. Dharma, Artha, Kaama and Moksha. Kaama, the desire is also related with sexual gratification, which is one of the happiness in the life and to create a healthy progeny. The essential factors of conception are Ritu (reproductive age and ovulation period), Kshetra (female reproductive tract), Ambu (nutritional factors) and Beeja (sperm and ovum) 1. Any malfunction of these factors may lead to infertility. Acharya Charaka compares the man who is incapable of procreation as shadow less, single branched, foul smelling tree devoid of fruits that has no purpose or plays no role in the world2.

 The ambition or aim of a person is that to propagate his legacy through his progeny. Infertility makes the man incapable for this. Ayurvedic classics have mentioned that the function of Shukra Dhaatu is reproduction3. There are eight types of Shukradusti according to classics4. A person having Shukradusti is unable to fulfil his Chaturvidha Purushaartha. Ksheena Shukra is one type of Shukradusti. It is Vata Pittaja Vyadhi, manifested as a result of Shukravaha Srotodusti and prevalence will be in Madhyama Vayas, being a disease from Apaana Vata province, in which decreased quality and quantity of Shukra Dhaatu is observed, which incapacitates him from conceiving his life partner, ending in Infertility.

Infertility is defined as a failure to conceive within one or more years of unprotected coitus5. Oligoasthenozoospermia is one among the prime factor in the male infertility and it is defined as a subnormal concentration of spermatozoa in the penile ejaculate with decreased sperm motility6. According to WHO guidelines on semen analysis, Oligoasthenozoospermia is the condition where the sperm concentration is less than 15 millions/milliliter7 with 40% of total sperm motility and 32% progressively motile sperm in the ejaculate. The condition Oligoasthenozoospermia can be well matched with Ksheena Shukra in Ayurveda.

Shukra Dhaatu is quantitatively and qualitatively vitiates in Ksheena Shukra and in Oligoasthenozoospermia there is quantitative reduction of sperms. According to Acharya Charaka, Ksheena Shukra and Shukra Kshaya are one and the same whereas according to Acharya Sushrutha and Acharya Vaagbhata, it is one among the Shukra Dushti in which Vata and Pitta are Vitiated8. Ativyavaaya, Ati Ruksha-Laghu-Ushna Aahaaras, Chinta, Shoka etc are considered as the Nidaanas9,10,11,12 and Dourbalya, Mukhasosha, Paandutwa, Sadana, Shrama, Maithuna ashakti etc, are the Lakshanaas of Ksheena Shukra13,14.

Infertility is global problem in the field of reproductive health. It is considered as a social stigma in India which ultimately affects the psychological harmony of the family, disturbed sexual and social life. ‘The incidence of infertility varies in different regions nearly 8-12% of couples worldwide. Of all infertility cases, approximately 40-50% is due to ‘male factor’ infertility and as many as 2% of all men will exhibit suboptimal sperm parameters. It may be one or a combination of low sperm concentration, poor sperm motility or abnormal morphology.15

As the sperm count decreases, there is corresponding decrease in likelihood of conception. Modern medical science has reached to its peak in MART (Medically Assisted Reproductive Technology), artificial insemination, invitro-fertilization, and intra-cytoplasmic sperm injection. These are considered as advanced technologies, but not accepted widely in India where poverty is rampant. So it is unable to provide service to all class of people in society, also it is not successful in even if infertile couple, they try again and again i.e. low success rate is the main fact. Ayurveda, the holistic medicine describes potent drugs and efficient therapeutic procedures to face the problem of infertility. Vajikarana, the eighth branch of Ayurveda mainly deals with the drugs and therapeutics which are aphrodisiacs in nature. It provides progeny to infertile couple, potency to the impotent, at the same time excellence of progeny with suitable therapeutic measures.Although a number of research studies have been carried out, by keeping prevalence of the disease in view, to find an effective and safe formulation for the management of Ksheena Shukra (Oligoasthenozoospermia), this research work has been undertaken, which is entitled as “A Randomized Controlled Comparative Clinical Study to evaluate the efficacy of Guduchyadi Churna over Gokshuradi Churna in Ksheena Shukra (Oligoasthenozoospermia).

The inspiration behind to take an herbal formulation “Gokshuradi Churna”16 mentioned in Chakradatta, Vrishyaadhikara (67th Chapter) for the clinical study is based on the hypothesis that its ingredients Gokshura, Ikshuraka (Kokilaaksha), Shataavari, Vaanari (Kapikachu), Naagabala and Atibala having Vrishya property,  and “ Guduchyadi Churna”17 mentioned in Harita samhita, 27th Chapter, Vajikarana adhyaya  ingredients Guduchi, Sathavari, swayangupta, Bala , Shalmali , Musali Mula  it may be useful for combating the Ksheena Shukra. The Anupana is Goksheera (cow’s milk) which is considered as Sadyovrishya and this Anupaana may be enhancing the properties of the drugs in the formula ‘Gokshuraadi Churna’ & ‘Guduchyadhi Churna’ along with its own action.

 
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