Usha Khosia

Management of Primary and Secondary Sterility with

                 (i) Aloes Compound (ii) D & C-Aloes Compou nd and

{iii) D & C-Aloes Compou nd with Inj. Placentrex


Mrs. Usha Khosla ,

MBBS., MAGS. (USA), Obstetrican & Gynacologist, and

K. Khosla,

MD ., MCCP. (USA), Khosla Clinic & Nursing Home, Phagwara  144 401, Dist, Kapurthala,  Punjab


A Montly Medical and Surgical Journal

Sayajiganj , BARODA – 390005 – INDIA


Childless couples lead their lives in anguish. A child in their home is more important to them than any amount of wealth. Childlessness is a tragic human problem  all over the world  The solution to  this problem is limited to those cases where organic defects are the causative  factors which   can be  corrected.
Infertility becomes a baffling problem when the woman  does not conceive even   though investigations show no organic defects and her husband  is normal without any sperm defects or deficiency. lt is said that about  10% of t he  couples all over the world face the problem of infertitity.

The  object of this  study  was to see  whether   Aloes Com pound an Ayurvedi c products, is useful  in the management  of Primary & Secondary sterility. Aloes was in  regular use in Allopathy  till some years ago  when it was a B.P.  drug.   Now  hormonal treat ment  is in vogue.

Treating cases of Primary & Secondary sterility becomes all the more difficult in a rural area where sophisticated techniques are not available or are beyond the reach of the  majoritv of the  local  community.  Our object was to get the best conception results  within the limited  facilities and resources    available   to  suit  the  local  community.  Having found  good results in  cases  of primary  and secondary sterility in our clinical practice with Aloes Compound, we decided to undertake a regular  study of the drug,

  Each tablet of Aloes Compound contains :
Aloes Indica 70mg
Hira Bol (Balsamo- dendron Myrrha) 70mg
Kamboji (Breynia patens) 30mg
Manjishta (Rubia cordifolia) 35mg
Hurmal (Pegunum harmala) 35mg
Kasis (Ferri sulphas) 30mg
Jeevanti (Leptadenia reticulata) 30mg

The actions of Aloes Compound are given as follows  :

Stimulates   ovulatory   menstrual cycles, regulates   menstrual   periods where   they   are   not normal, useful in scanty, irregular  periods, improves fertility   index   in   cases  of Primary and Secondary Sterility; there are no hazards   or   multiple   births as seen with  clomiphene etc. ; Checks obesity. Materials & Methods 140 cases consisting 110 cases of Primary Sterility and 30 cases of Secondary Sterility are included  in  this study. These exclude cases t hat could not be followed  up regularly. We do not   have facilities   for endometrial biopsy,  histopathology,   patency  tests for   Fallopian  tubes,  etc, The male partner  was    examined   and semen analysis was done. Cases of azoospermia and moderate to severe oligospermia were  excluded  from the  study.  Cases  of  mild oligospermia and  those  with  sperm  defects like lesser  percentage  of motile  sperms were included in the study. Testicular biopsy could  not be done for want of facilities.

Cases of  Sterility were divided into three Groups :

Group I received Aloes  Compound only; Group II had D & C and then were  given  Aloes  Compound, and Group Ill had D & C and were given Aloes Compound and Placentrex lnj. In all the Groups, treatment was  stopped, when pregnancy was suspected. Placentrex Inj. was given every alternate day or twice a week to a maximum of 15 Iuj. Though most of our patients belonged to  low income group, in cases of Group II and III, D &  C  was  done  and  Group  III received Placentrex lnj. also as these patients  were very much anxious to become pregnant  soon · and  were prepared  for extra cost. In Group I (Aloes Compound),  the trial period was   12  months  or till pregnancy if earlier. In Group II & Ill, the total trial period was 15 months or till concept ion if earlier, as they had received Aloes Compound for the first three months without success. However, the assessment of results are made on the basis of 12 month period commencing from D and C in Group II and D & C and Placentrex Inj. in cases of Group  III. The number of cases in each group was as follows : Group 1 : 56 cases; Group II :28 cases: Group III-: 56 cases.

Fortege  was  given to male partners to correct sperm defects, if any, and  to tone up sexual, nervous and  muscular  systems  for  better  sex performance.  Fortege was continued in male partner, as long as the female partner  received  Aloes Compound.

Aloes Compound was immediately stopped when pregnancy was suspected.  The results as to conception rates   were  divided   into   two  categories : those  who conceived within six months of therapy and those conceived  between  7-12 months of therapy. Those who did not  conceive within  12 months of therapy, were considered a failure.

Secondary Sterility

18 cases (60%) of Secondary Sterility .were  in the age grou p of 20-30 years and 12 cases (40%) were in the age group of  31-42 years. (Table I)

Menstrual History

Out  of the total of 140 cases, 100 cases (71. 4%) had  menstrual disorders  and  only  40 cases (28.6%) had regular  menstruation. 50 cases (35.7%) had oligomenorrhoea with periods extending  beyond  35 days. 20 cases (14.3%) had dysmenorrhoea, and   30  cases (21 .4%) had irregular and  or scanty  menstrution.(Table  II)

Distribution  of Cases Among I, II & Ill Groups

Among the total of 140 of sterility 56 women of Group I were treated for 12 months, or till pregnancy if earlier, with Aloes Compound only. 28 women of Group II received Aloes  Compound  for  the first three months without  success and then D & C was done and were continued  with Aloes Com pound for 12  more  months   or· till pregnancy, if   earlier.            6 women of Group III, received   Aloes  Compound .for first three   months  without  response and then   D &  C  was  done.  and  were continued  wi t h Aloes Compou nd for 12 more mon ths. or t ill pregnancy, if earlier.    In       addition, group III  patients received Placentrex  lnj. every alternate  day  or twice a week for a maxi mum   of   15  Inj. after D &  C. In   all   cases  treatment was  stopped immediately pregnancy was suspected. All cases of secondary  Sterility were given  only  Aloes  Compound treatment . (Table  III)

Duration of Marriage

Duration of marriage in cases of sterility ranged from 3-20 years, though there was only one case with married life of 20 years,  and this was of primary Sterilit y.

Dosage Schedule of A loes Compound

Aloes  Compound  was  given 1 tab.two times a day, for two weeks from  the  first day of menstruation, and then 1 tab.  three times a day in the  third  week and the full dose of 2   tab.  two  times  a day during the  , fourth week. Patients were advised not to take Aloes Compound on an empty stomach and preferably to take after meals. By this schedule, no side effects were observed, as in my experience some patients may have griping and nausea if full dose is given from the start and in a few cases there may be diarrhoea also. Aloes Compound was stopped two days prior to the expected period and  started again  from the 1st day of  the  period. If no period occurs Aloes   Compound was stopped altogether  as  pregnancy  was suspected and   the  patient   was  keptunder observation   and  all care was taken to sustain the pregnancy. However,  in  cases  of dysmeorrhoea   and  oligomenorrhoea,   they were advised to take Aloes Compound continuously ( including during menstruation ) till these complaints were corrected, when they were advised to stop Aloes Compound 2 days before the expected period.

Aloes Compound was completely stopped when once a period was missed & pregnancy was suspected.

Fortege For Male Partners

Fortege (Alarsin) was given, two tablets, two times a day continuously to male partners, for 12 months (the trial period), or till his wife became pregnant, if earlier. This was to improve the quality and quantity of semen & for better sex performance.

Results : Conception Rates, Primary & Secondary Sterility

Among   the total of 140 cases of all the  three   Groups,  100 women (71. 4%)  conceived  within the trial period   and  40 women (28.6%) did not  conceive.  Among  110 cases of  Primary Sterility, 80 women (72.7%) conceived  and  30 women ( 27.3% )  did not conceive and were considered   as a failure  in  this trial. Among 30 cases of  Secondary Sterility, 20 cases (66.7%)   conceived   10  and   cases (33.3%)  did  not conceive and were considered as a failure. (Table IV)


Conception Rates : Groups  I, II, Ill. Among  56  cases  of  sterility of Group I ( Aloes  Compound   only ), 40  cases  ( 71.4%) conceived and 16 cases  ( 28.6% ) did  not  conceive. Among  28 cases of Group II (D & C and on Aloes Compound ). 20 cases (71.4%)conceived and  8  cases (28.6%) did not conceive. Among 56 cases of Group III (D & C, Placentrex lnj. Aloes Compound) 40 cases (71.4%)  conceived  and 16 cases (28.6) did not conceive.


Conception Rates Within 6 Months And Between 7-12 Months: In group I (Aloes Compound) 40 cases conceived. Among these 30 cases (75%) conceived. Within 6 months  of  treatment   and  10 cases ( 25% ) conceived between 7-12 months of  treatment.  In  Group   II  (D & C and Aloes Comp.), 20 cases conceived. Among these  10 cases  (50%) conceived in six   months   and  10  cases  (50%) conceived between 6-12 months In Group III (D & C, Placentrex lnj.. Aloes Com.), 40 cases conceived Among these 10 cases (25%) conceived in  6  months  and  30  cases (75%) conceived between 7-12 months Overall,  50  cases  (50%)  conceived within  first  6  months and 50 cases conceived        between 7-12   months. (Table VI)

Discussion A patient of Primary Sterility aged 40 years and married for 20 years conceived within a year’s treatment with Aloes Compound only. She delivered a healthy female child by Caesarian. Majority of patients of Sterility (71.4%) had menstrual disorders. This appears to be the main contributing factor to sterility. There were 30 cases  with irregular scanty menstruation. More than half of these patients had so much irregularity that they used to bleed only about thrice a year that too just spotting. Some of these  conceived. These persons profoundly  expressed their gratefulness to me because  they had lost hopes of conceiving.  In my opinion, the mode of action  of Aloes Com pound  is that  it  increases  fertility   index   by correcting menstrual  disorders where present. We are getting encouraging results with Aloes Compound in the management of Primary and Secondary sterility. This is all the more important, as we lack facilities for investigations like endometrial biopsy, tubal patency tests, testicular biopsy etc. Even with these limitations and shortcomings, we are glad that we are getting good results  wi th  Aloes Compound. In a developing country like ours and with backward rural areas which constitute 80% of the population, Aloes compound gives hope for infertile women.

Conclusions and Summary

140 cases of Sterility, comprising 1t O cases of Primary Sterility and 30 cases of Secondary Sterility were treated with Aloes Compou nd alone (Group I), D & C and Aloes Com· pou nd (Group II) and D & C, Aloes compound with Placentrcx lnj (Gr· oup lll).  The  trial  period  was 12 months. The study was done  during 1979-80. Those who did not conceive with in the trial  period  were  considered a failure. Treatment   was stopped immediately pregnancy was suspected. Among the total of 140  cases too cases (71.4%) conceived and 40 cases (28.6%)  did not conceive. Among 110 cases of  Primary   Sterility, 80 cases (72.7%) conceived and 30 cases (27.3%) did  not   conceive.    Among  30  cases   of  Secondary Sterility,  20 cases (66.7% ) conceived  and  10 cases (33.3%) did  not  conceive. 50 cases (50%) conceived within 6 months of treatment  and 50 cases (50%)conceived between 7-12 months. The conception   rates  in  Group I, Group II and Group III were all   the same, namely   71.4%   This shows that  in  many  moffusil  places like Phagwara, where facilities for endometrial biopsy tubal Patency tests, semen analysis and other investigations are generally  not  available, the sterile women and Fortege for their husbands  gives a high concepton rate (71.4%)Aloes Compound and Fortege are found to be safe drugs without any side effects.


The authors thank M/s. Ala rsin Pharmaceuticals for their coopera­ tion, References 1 Mrs.   Agrawal,    R.   S. (1979}-A Controlled  trial  of  Aloes  Compo­ und  in cases of Sterility   and   mens• trual  irregularity   : Frist  Asian  Con­ gress of induced  Abortion  & Volun­ tary  Sterilisation,  Bombay,   4-9  Ma rch, 1979.

Mrs. Balsara Roshan R. (1966)­ Sterility associated with irregular . and scanty menstruation ( use of Aloes (Compound  as an  adju· vant) The Indian Pract. 19;1, 123- 25, Jna. 1966.

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Jhaveri C. L., Mrs, Mody  Ila  S., Mrs.  Munim,  J. K. and  Miss  Das (1972) – Clinical   evaluation   in Infertility  associated  with  irregu· 1ar menstrual cycles  treated with . an   indigenous     preparation-XVI All India  Obst.  and Gynec. Con­ gress, New Delhi, 10-12,  March 1972.

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 The Medicine & Surgery  : July  1981