Comparative Evaluation and Therapeutic Protocols for Oligospermia (Kshina Shukra): An Integrative Review of Ayurvedic and Biomedical Perspectives

Abstract

Background: Male factor infertility accounts for approximately 40%–50% of childlessness worldwide, with oligospermia (low sperm concentration) standing out as a primary etiology. While contemporary medicine relies heavily on hormonal therapy, surgical interventions, and Assisted Reproductive Technology (ART)⁴, long-term pharmacological management is limited by cost, variable success rates, and side effects. Ayurveda conceptualizes oligospermia as Kshina Shukra or Shukra Kshaya, emphasizing holistic restoration through Vajikarana Tantra (andrology/ virilification therapy), Shodhana (bio-purification), and phytotherapy. Objective: To conduct a comprehensive literature review comparing the etiology, pathogenesis, diagnostic markers, and management strategies of oligospermia in contemporary biomedicine and classical Ayurveda. Methods: This narrative review draws upon classical Ayurvedic text and contemporary biomedical literature concerning male infertility, semen parameters and selected vajikarana medicinal interventions. The search strategy, eligibility criteria, and limitations of the available evidence should be reported transparently. Results: Biomedical mechanisms (oxidative stress, endocrine disruption, varicocele) align structurally with Ayurvedic etiology (Vata-Pitta Dushti, Srotorodha, Agnimandya). Classical Vajikarana herbs (Withania somnifera, Mucuna pruriens, Asparagus racemosus) demonstrate antioxidant, gonadotropic, and anti-inflammatory activities that modulate the hypothalamic-pituitary-gonadal (HPG) axis.

Conclusion: Integrating Ayurvedic protocols (Shodhana followed by Vajikarana) with modern diagnostic tools offers an effective, non-invasive framework for managing oligospermia.