 LECTURE ON INFERTILITY BY DR LIYAKAT NAMOLE, MD, NASHIK

Compiled by Dr Priyanka Lokare

I will be talking about female infertility here. Most of the times, the patients we get in infertility are female
patients. Male infertility is a bit difficult topic. Of course, nowadays you get lot of male infertility patients
also who will be coming forward and there are reasons. Nowadays, you will get more of feminine type of
males. So male infertility is also becoming commonly faced problem now.

Talking about female infertility, there are many reasons and there are many ways by which females are
adopting to this infertility. As I always tell you must try to find out why the person is fallen sick and why he
is being sick. There are two things. You fall sick, you attract a disease and you become ill and second is
you remain to be that. We fall sick and we come out like we suffer from viral diseases like cold. We have
ice cream and we get cold but in the matter of 2-3 days naturally we come out of that without remaining to
be in that disease for long but here you become infertile and then you remain infertile. This is something
very important that we must understand. In every case, if you try and find out this reason then finding out
the symptoms and set of rubrics and reaching to the remedy and then differentiating those remedies
become fairly easy task.

So now let's begin with the reasons why female becomes infertile.

The first very common reason I have found is PCOD. Second is, if you say uterus per say, we start from
ovaries; first is ovum, the most important factor which makes somebody pregnant.

Now let's start with the problems of ovum. What happens in PCOD is the ovum production is there but the
ovum doesn't rupture and egg becomes large and gets converted into cyst and those cysts remain in the
ovaries, that is, simply polycystic ovarian disease.

Second is the blockage in the fallopian tubes.

Third is the uterine cavity so the problem with endometrium. Sometimes the endometrium doesn't grow
which is supposed to nurture the fetus in the womb, it doesn't remain to be nurturable.

Fourth is endometriosis. Endometrium becomes huge so much so that it comes out and it stays in the
vaginal canal also. Endometrium grows out of proportion.

Fourth is again going back to ovaries, there is no production of ovum.

First is production of ovum but no rupture, second is no production of ovum. These are the common
reasons for infertility.

If you come out of uterus, there are systemic reasons why the person becomes infertile. One is thyroid
which is one of the major factors. Very rare entity is tuberculosis of the uterus. Aishwarya Rai is one of the
famous patients of that. There are reasons why the tuberculosis of fallopian tubes occurs.

Now let's begin with PCOS. Again hirsutism is another concomitant which is many times seen with
hypothyroidism and also in PCOS. I spot out hirsutism very easily. Just while looking at the patient you
tend to see thick eyebrows or eyebrows which meet in the center but females go to the beauty parlour
and they cut their eyebrows to get them in the shape. So here we have to see whether they have done
the eyebrows in beauty parlour. Then there is excess hair, there are many heroines who have very short
forehead, that is also one of the indicators that have more hair that means they are prone for hirsutism or
they are mild hirsutes.

Now coming to PCOD i.e. polycystic Ovarian Disease or nowadays called as PCOS i.e. Polycystic
Ovarian Syndrome. Now what is PCOS ?

The ovum is not rupturing. The function of ovary is to produce ovum so that the lady is fertile. Fertility is
utility. Female is like a soil or land on which the seed is going to be sown. The seed is the sperm by the
husband. So now the lady is not allowing the ovum to rupture, that means she is producing it, she is
showing that I am fertile but I am not allowing sperm to enter into my ovum and not going to make them
unite to get a new life. So, here, the lady is denying her womanhood, her femalehood. That means she is
denying to be a soil. It is j

[08/07, 10:35 AM] +91 99758 46407: ust like you throw the seeds in the soil and only few seeds will
germinate and they will grow and remaining will not. So just same here, sperms are coming and going,
not allowing to be mated, only meeting and not mating. So here now we have to think for what reasons
the lady is not allowing or is denying to be a woman.

PCOS is there even in young girls who are not married so here they are not in relation. Here the problem
is with the male figure in the family, may be father or brother or males in the society. They don't like, they
feel they are not being worthy of being my man or my male. So here in childhood or young unmarried
girls the reason for PCOD is problem with the father, brother or society. So here I directly ask is there any
clash or problem with your father or brother. I ask who all there in your family and they take a pause when
they are talking about their father or brother etc . Many time girls don't attach their father's name to their
name, many times when you ask what is your name and for eg. they say Simran Kaur; no father's name
or surname or sometimes they say only surname and no father's name then we get a clue and then we
ask. So here if there is problem with brother, there can be jealousy between the children or they feel the
parents are pampering the son more than me. So here feeling comes in their mind “I wish I was not a girl
or I wish I was a male” and they start growing mustache. Suppose this girl is little more courageous then
you will see these girls get hirsutism. Here they deny to be a woman. If you say by birth if anybody has
hirsutism then the problem happened during pregnancy. When the mother was pregnant and such
thoughts came in her mind that it is bad to be a female or she should be a male then such problems arise.
If there is problem with the sibling, the brother; then there can be rubrics like injustice cannot support
because the child feels that the brother is given more importance. It happens in Indian society that the
girls are not given importance and only the son is given more importance or the girls are not given
freedom and sons are given freedom. So then they feel that it is an injustice to them. Here the rubrics like
envy and injustice cannot support will come. If the girl starts wearing clothes like man and still hating the
man like, I have seen many ladies who have hair cut like man, they wear pant and shirt like man. Not that
they are wrong but those who stay like that and still they hate men then the rubric envy with hatred
comes. Ammon carb is the leading remedy in that. Secondly, if there is a problem with father, there is a
rubric Ailments from being neglected by father, the rubric is absent father syndrome actually, the cross
reference is ailments from being neglected by father, or if the mother doesn't standby then the rubric,
ailments from being neglected by mother comes. If the girl has a problem with her husband, then rubric
like aversion to husband or anger towards husband will come. So you have to think that way or if there is
one more problem then the lady suffers from PCOS like the lady wants to work.

I will share a case where a lady wants to work and the day she got engaged, she started getting
menstrual problem and she went to gynaecologist because mother got concerned that she is getting
married in 6 months and now she is having problem and in future she may get problem in conception. So
they went to gynaecologist and she was diagnosed as PCOD. Then she came to me after marriage for
infertility then I asked that since when you have problem, then she said it started before my marriage so I
asked since when. I asked when you got engaged and came to know that problem started after
engagement. So what does it mean? I asked her did you get marry according to your wish, she said yes.
So I asked according to your wish or parent's wish. So she said parents said and I also felt the proposal
was good. So I asked what you do. Do you work? She said, I was working. So I asked now what you are
doing? She told me now also I work but my job is not permanent, someti

[08/07, 10:36 AM] +91 99758 46407: me I have job and sometimes I don't. So I got the clue that this girl
wanted to work. Her family said after you get pregnant you will have to take a break for 2-3 years so then
I asked how will you manage if you conceive now and she said I will have to leave my job and take 2-3
your break. She was sad while talking about this. So I asked how much you love to work, she said I like to
work a lot. I don't like to sit at home, I want to work. So the body was doing this, body listened to what
mind was saying so I took this as manipulation because the lady is manipulating. Here I took rubrics like
ambition increased and manipulation. Then I asked the girl, how do you travel to work? She said my
husband comes to drop me and pick me up on a bike. So I said wow! After 2 years of marriage also your
husband comes to pick up and drop you by bike. I said it's fantastic to go with your partner on bike. In
Mumbai people dream to go for a ride with their partners, you can hug your partner and sit. So the
husband is romantic but this lady is not allowing by PCOD. Her job is her priority. Then I asked you go
with him on a bike so it's fun and she said no, I sleep on bike. It was very strange that you go with your
husband on bike and you sleep. So then I thought they must be sleeping late at night and must be having
active night life so I asked about their sexual life but she replied I sleep early. So their sexual life is also
not active and she sleeps during the day also. So, for her, sleep is very important. She said if I don't get
proper sleep then I am not able to work efficiently. Then I took the rubric, Sleep; need of sleep - great. So
taking all those rubrics Staphysagria came as a remedy and I gave her Staphysagria 6 three doses; daily
one dose for three days and she is having a child now with the grace of God. So this I took as
manipulation.

One more patient is there where actually problem was at the maternal side. I asked who all are there at
home and she replied mummy, papa etc. So I asked I am asking about your in laws house and she said
there only and she was married only for one and half year. She had PCOD before marriage and after
marriage her PCOD got cured. You will get to see so many cases where PCOD gets cured after marriage,
menstrual problem gets better after marriage, so here they are fond of in-laws place than their maternal
place. So here we take ailments from being neglected by mother or Delusion mother is dead that means
she killed her 'mayka' after her marriage and second is she didn’t get affection from mother. Rubric is
delusion his mother is dead. I gave this patient Nat Mur considering other symptoms. So we have to think
in this perspective. These are few cases of PCOD and other cases where females feel that they wanted
to be male and not female, there we take envy and they deny to be woman.

Now coming to the blockage, blockage is total block means I will not let go ahead. In these cases I have
seen that they are abused in childhood and that is the reason that they have blocked their fallopian
tubes.

Like I told you one of the precursors in tubal blockage is tuberculosis. TB again is self denial where they
deny themselves and tubal blockage starts. The reason for tuberculosis in metaphysics in self denial
where pt has denied her self and moving ahead. So she has denied her femalehood.

Now let’s move on to some of the reasons for endometriosis. Now here the female is wanting the child so
desperately that she is over nurturing the ovum or she is wanting to over nurture the fetus that is why she
has produced so much endometrium that it is actually coming out so this is outpouring. So such type of
patients we can think of rubrics like ‘Maternal instinct; exaggerated’ or ‘cares full of others about’ because
they are overly caring and overly nurturing. I have many cases of infertility because of endometriosis but I
am just trying to give you a gist of what sort of rubrics you can think of.

Now moving to the next reasons which is the IPR, the interpersonal relationship or we can say the why of
the patient as to

[08/07, 10:36 AM] +91 99758 46407: what is exactly getting affected in case of the female because she is
infertile like I ask this question to the patient what exactly is getting affected because you don’t have child
or I ask why do you want a child. I have very interesting cases about this. When I ask his question many
are reluctant. So you have to ask this again and again in different different ways like what will happen if
you have a child? how it will change your life ? what part of life get affected if you have a child ? what are
you going to do with the child ? or what changes the child will bring in your life ? Now few people say,
there is no meaning to life if you don’t have a child. Life is incomplete so here they feel that the life is
short of something like everything is there but you don’t have a child so here if people say that I have
everything car, bungalow, my husband is settled, I am settled but I don’t have a child so this can be
simply delusion poor. They have ample of other things and short of something like you say, you are poor
in English. My math is very good but I am poor in English means you are short of something and if the
tone is of sadness then we can think of sadness, silent grief or simply if it is taken very deep or female is
very deeply hurt because of this then you can think of rubrics like wretched or pathetic or anguish, such
rubrics you can think of.

Now coming back to IPR or some female say when I look at somebody else’s child then I feel very bad.
This can be simply envy because they are envious of others. Now I have a case where I ask why do you
want a child and she said I have a daughter but I want son so I said what changes the son will bring in
your life ? She said nothing but after probing for 2-3 times she said my younger brother-in-law got married
and now she is scared that if they have a son, the position of the patient will not remain to be the eldest
co-sister in the family and she will not remain to be ‘jethani’ in the next generation and her husband’s
position will not remain to be the same. So, here I took rubrics fear to lose her lucrative position because
here the question was of position, ambition increased competitive, and social position concerned about
and I gave her Staphysagria and to the husband I gave Sulphur because his concern was also same but
he was such a hypocrite like about your own real younger brother you have jealousy, you are envious of
him, so such hypocrisy and such position desire for, avarice and so many things. Of course, they got
male child but see the burning desire in both. In husband you just think about the hypocrisy part and in
wife it was the position part or the lucrative job part because she was getting the advantages of being the
‘jethani’ in the family like she was getting served and many things. She responded well to Staph 6. I have
one more lady who was very not very fair and of wheatish complexion and husband was very handsome.
It was a love marriage. This girl belongs to lower class and husband belongs to upper class and she was
accepted in the laws place but when I asked about her family, again probing deeply, I came to know that
her elder sister was yet to be married and I gave her Nat Mur. Here, the girl got very good husband but in
spite of having well settled and handsome husband and again getting chance to marry upper class why
she was denying to be a mother was because her elder sister was not married. Now see if this girl gets
pregnant and goes back to her maternal place what people are going to say. People will say “Oh my God!
What a selfish girl! Elder sister is not married and this girl was in so much hurry to get married. So this will
affect her dignity so this is indignation pregnant while. This literally also you can take. So here we have to
think what makes the lady indignant while she is pregnant. This lady got child with Nat Mur. Another case
is where the girl actually stopped going to social functions because she was not getting pregnant. It was
only 3 yrs for her marriage but still. She belongs to farmer’s community and in their community m

[08/07, 10:36 AM] +91 99758 46407: ost of the girls get pregnant immediately after they get married, they
go to the honeymoon and in a month or two you hear that the girl is pregnant so here its 3 years and she
was literally telling me that I am so fed up that I don’t want child for myself but I want for people now
because they are so much bothered for me having a child. Everywhere I go I hear people talking about
this. So she is avoiding them. So I took the rubric company aversion to, avoid sight of people and second
is Talk, talking others of, about her affects her. This is there in complete repertory. On these two rubrics I
gave her remedy. Now very similar rubric to this and very similar situation to this is people do not allow
me to live. Wherever I go I feel, my ear starts aching by listening to people’s comments. Every time
people will ask when you will get a child. So this is like a noise and the lady felt like people are making
noise. So there is a rubric, Noise people are making and the remedy is Puls very similar to the previous
case. So what you have to think about is the concern of the patient or why of the patient. In another case,
this lady’s case I had taken on the phone from Gujrat and the lady had one miscarriage. The child could
not live in the womb. Now what made this lady not nurturing? In endomtriosis, we saw they over nurture
and here what was making it not to nurture the child in the womb ? Two cases I will share. One this lady
from Gujrat, very educated girl, her husband is CA and this girl is also well educated. She takes care of
 the business in the family. She also wanted to be CA and she also wanted very affluent work profile but
she could not peruse her ambition and that made her infertile. So rubric I took was Ambition deceived and
second she stopped nurturing and this sort of selfishness I have found in Nux Vom. So ailments from
ambitions deceived and then this not nurturing the child, I gave her Nux Vom 6. She has a child now. One
more patient where she stopped nurturing is because the lady said, my husband is not having a proper
job and they don’t have own house and the child needs money immediately the moment it is there in the
womb. You have to start with the treatment and so many things. From day one you have to give
medicines and so many things and after that even if I have to put child in simple school that costs around
25-30 k, leave aside international school and all. So the lady’s main concern was the money part and
what she is going to feed the child. So fear of starvation, delusion poor, fear of poverty all this will come
here. In the beginning this lady had abortion in 7th month, then she aborted in 5th month and then the
abortion was in the second month itself. So it was not that the lady was not fertile, she was but she was
not nurturing the child. Slowly slowly her decision became firm. Initially she was in doubt whether to have
a child or not. If we try and analyze, she was in doubt whether to give birth to the child or not. So she
aborted in the 7th month automatically, then 5th month and then in the 2nd month itself. So her decision
was firm of not to have a child. This is Sepia. Most of the times, we see Sepia who has many children,
when they get married without thinking at early age. But here if the Sepia is getting married little late or
she is little intellectual type, in such cases, you can think of Sepia or this sort of rubrics

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