Is there a natural miracle goli for fertility?

Diva West resident Rasika Sanjay Katre Patil, who was diagnosed with PCOS and hypothyroidism after having her firstborn, started taking ayurvedic supplements in 2021, to regulate her period cycles. Her daughter was born last year. Pic/Satej Shinde

Rachana and husband Vishal Gupta say that they discovered the "miraculous results" of Ayurveda almost a decade ago. Vishal, she says, was battling psoriasis - a skin disease that causes a rash with itchy and scaly patches, often on the knees, elbows and scalp. He has struggled with it since he was 20. After pumping money into medication that yielded very little result, Vishal, despite being a sceptic, tried Ayurveda. "He diligently consumed the herbal concoction and kadhas daily," Rachana remembers, "The results started showing but slowly. Eventually, his skin was back to what it used to be in his teens." That was a turning point for the Guptas.

Gynoveda co-founders Rachana Gupta and Dr Aarati Patil at their Malad West office. One of their most selling supplement is Jeehv, an Ayurvedic formula for "timely ovulation and natural pregnancy", which they launched in January last year. Over 3,000 women have reaped its benefit, they claimed. Pic/Anurag Ahire

"We began reading up on Ayurveda in greater detail and gradually adopted it as a way of life." Sometime in 2017, the couple who were both working in the corporate sector, invested in a clinic in Mumbai. "At the time, we saw a lot of young women come to us for Ayurvedic solutions for menstrual health problems." The success stories they witnessed at the centre, prompted them to launch, Gynoveda, an Ayurveda femtech company that specialises in the menstrual and reproductive health space. Gynaecologist Dr Aarati Patil came on board as co-founder. In March 2020, their website went live with seven health products. "When we learnt that women with polycystic ovary syndrome (PCOS) who had been struggling to become pregnant and had tried every treatment under the sun, were able to conceive naturally with some help from our health supplements, we decided to get into the reproductive health space as well," says Rachana. In a span of three years, their consumer base, they say, has touched 4.5 lakh women. They now have nearly 40 supplements on their inventory.

Twenty six-year-old Diva resident Rasika Sanjay Katre Patil, who has PCOS, turned to Gynoveda's ayurvedic supplements when she wanted to conceive again. Her second child was born last year. Pic/Satej Shinde

One of their bestselling products, Rachana says, is Jeehv, an Ayurvedic formula for "timely ovulation and natural pregnancy". They launched this in January last year. "It includes 17 herbs [shivlingi, shatavari, ashwagandha, punarnava, shilajit, aloe vera, haritaki, among others]... all originating from the Ayurvedic scripture Charaka Samhita," says Rachana. A bottle containing 120 tablets costs R2,000 - a fraction of what most women are willing to shell out at fertility clinics. On its website, Gynoveda has also published details of their clinical trials. The company teamed up with the European Journal of Pharmaceutical and Medical Research to administer the trials. Dr Divya CS, a PhD scholar was the principal investigator. As per the paper, a total of 127 of the 149 participants (85.23 per cent) reported achieving ovulation on time after trying the remedy, while irregular menstrual cycle normalised in 98 of the 123 women. "So far, we are aware of 3,000 babies conceived by women helped by this," claims Rachana, whose brand also runs an online women's support group, Circle of Sisterhood.

The 2019 revision of the World Population Prospects estimated that the "fertility rate [the number of children born to a woman] of Indians plunged by more than 50 per cent". The crude birth rate went down from 36.7 births per thousand population during 1975-80 to 18.9 during 2015-20. The report projects that the rate will drop to 18 by 2025-30, and even dip further to 12.1 by 2045-50. The Sample Registration System (SRS) data 2020, which was released last year, tells a similar story. According to SRS, the General Fertility Rate (GFR) - children born per 1,000 women - had declined in India by 20 per cent.

For women dealing with infertility and reproductive niggles, femtech companies like Gynoveda and their range of supplements are bringing hope. A quick search on the Internet throws up a number of new over-the-counter supplements. Wellness brand Hera, for instance, has a drink to optimise egg quality. They also claim to have tablets that enrich eggs, and multivitamins to help conceive and get the menstrual cycle in order. The TeaCurry range includes a plant-based Women Fertility Tea, comprising mentha spicata spearmint, asparagus, sarmentosa linn variety of shatavari and Himalayan nettle.

Dr Sudeshna Ray and Dr C Jyothi Budi

Mumbai-based Veera Health that focuses primarily on PCOS treatment and is helmed by sisters Shashwata and Shobhita Narain, recently introduced a "daily superpowder" comprising myo-inositol and a blend of essential nutrients and multivitamins to balance hormones. The motivation for the sisters to launch the firm was Shobhita's own tryst with PCOS. The 29-year-old was studying at an American university, when she was diagnosed with the condition that is characterised by an irregular period. PCOS, according to hopkinsmedicine.org, is a condition where the ovaries produce an abnormal amount of androgen, the male sex hormone that is usually present in all women, but in small amounts. It often leads to numerous small cysts (fluid-filled sacs) forming in the ovaries, and is one of the causes of infertility and miscarriage. "I was extremely frustrated by how long it took me to get diagnosed, and get proper medical advice. It was all very overwhelming," Shobhita recounts. "We felt there was a need to get chronic conditions like these, treated in a scientific and progressive way." The realisation led them to start digital therapeutics company Veera Health, which diagnoses and treats female health conditions, through their app. The company adopts the international evidence-based guidelines, says 33-year-old Shashwata, to provide standardised and effective treatment, with a team of medical experts, including gynaecologists, dermatologists and therapists on their roster. "Since we launched, over 100,000 women have been impacted by our services, and we are growing exponentially," shares Shashwata. The myo-inositol supplement, VeeVital PCOS Support, is their latest offering. "Myo-inositol is the hero-ingredient of our supplement; it is clinically-proven to improve insulin balance and irregular periods, and reduce excessive hair and acne caused due to PCOS. It also has D12, D3, Folate and Zinc which are usually low in women with hormonal issues," says Shashwata. The Veera Health team worked closely with doctors on their panel, including leading PCOS expert Dr Anuja Dokras, the executive director, Women's Health Center for Clinical Innovation, Penn Medicine, to work on their formulation. "We have seen a 7x growth since we launched it two-and-a-half months ago," says Shashwata. "Currently, we are looking at launching other supplements as well. Our research is ongoing and we have identified areas that we'd like to dive deep into."

Clinical nutritionist Apoorva Joshi who has been taking supplements for the last one year for PCOS, endometriosis and inflammatory conditions, says it's always advisable to opt for supplements that are backed by research

Diva-resident Rasika Sanjay Katre Patil's newborn, she says, is the miracle baby, courtesy Ayurvedic supplements. Twenty six-year-old Patil was diagnosed with PCOS and a thyroid condition in 2016, right after she delivered her baby boy. She was 21, then. "My periods had become very irregular; I'd bleed every two or three months." Hoping to have another baby, Patil consulted gynaecologists. "I changed almost four of them," she remembers. "Almost of all them put me on contraceptives to regulate my periods. It caused a lot of side-effects... I was also putting on weight and experiencing severe hair loss due to hypothyroidism."

Shashwata and Shobhita Narain (left) launched Veera Health, following the latter's difficult journey with getting diagnosed for PCOS. The digital therapeutics company recently launched a myo-inositol supplement, VeeVital PCOS Support, to improve insulin balance and regulate periods

Patil came across Gynoveda, while scrolling through her social media feed two years ago. "I spoke to my husband, but he was hesitant about my believing in a supplement sold online." Wanting to give Ayurveda a shot, Patil went through the website and browsed through the reviews, before buying herself two supplement bottles. "I began taking them in January 2021, and also attended the webinars that they conducted regularly, to understand how the dosage works," she says, adding, "My period cycles slowly started becoming regular." Patil gave birth to a baby girl late last year.

Patil isn't alone. A 36-year-old Mumbai resident, who works in the food and beverage industry, tells this writer that she started taking multivitamins, after she decided to freeze her eggs. "I always thought I had time on my side. My periods too had always been regular, until this January, when I bled for 17 days straight," she says. The Anti-Müllerian Hormone Test to check her ovarian reserve, reflected that the size of the remaining egg supply was low. "This came as a bit of a shock to me, because I never had PCOS or thyroid," she says, adding, "I wanted to give myself a chance [to become a mother]." Oocyte cryopreservation or egg preservation is a painful process. Over the course of four period cycles, she has had to take nearly 60 hormonal injections. Apart from that, her doctor, she says, has suggested Folic Acid, Vitamin B12 and D3 supplements, and a tablet comprising grape-seed extract, Omega 3 and minerals.

Dr C Jyothi Budi, medical director, Ferty9, a leading IVF chain in the south, says that usually when a woman is planning to get pregnant, doctors put her on Folic Acid, for at least three to six months. "Especially a woman who is in an advanced stage [in India, women who are 35 and above would fall in this category]," she says. Getting enough folic acid before and during pregnancy can prevent major birth defects of the baby's brain or spine, and there is literature supporting its benefits. "But when it comes to the other supplements, including multivitamins and antioxidants that are fat and water-soluble, there is still a lot of debate [within the fertility practice] about whether they should be consumed." The reason, she says, is the lack of evidence as to whether it directly improves the fertility rate. "Most of the studies only say that it ‘may' help, and the reasons why these studies are so contradictory is because every woman's body and bodily requirements are different. Someone might have a Vitamin C deficiency, while another might lack in a mineral." Dr Budi says that in India, many people abuse the use of multivitamins and antioxidants. "In some cases, it can cause Hypervitaminosis [it occurs when the storage levels of vitamins are abnormally high]... so patients should know when to stop using the medicines." It's always safe to consult a doctor before buying a supplement, she says.

Mumbai-based obstetrician and gynaecologist Dr Sudeshna Ray is the medical director of Gytree, which looks into women's preventive health in gynaecology and sexual health by providing end-to-end services online. The brand recently launched a dual plant-based protein powder, comprising golden pea, brown rice and coffee. The powder has nine essential amino acids, which help improve immunity and metabolism, and gut health. "It's true that women are more keen on taking supplements when it comes to treating conditions like irregular periods," says Ray, cautioning, "But a supplement is never a replacement for any treatment. It complements an ongoing treatment. What it does is provide the right kind of nutrition, and in the right balance." A lot of the foods available in India are not fortified, and that's why, she feels, Indian women need extra nutrition. "Supplements are a wholesome short cut [to good health], and take care of nutrition needs, making the journey towards fertility easier. I call this preventive care."

Clinical nutritionist Apoorva Joshi has PCOS and a condition called endometriosis, in which tissue similar to the lining of the uterus grows outside the uterus. "I also have some inflammatory diseases," she says, "So, I consume a lot of coloured fruits and vegetables. I also have magnesium and Vitamin D supplements [as it is co-related to gynaecological conditions]." Joshi, who follows an evidence-based approach in her own practice, advises women against taking supplements if there aren't enough studies backing its use. "Nutraceuticals [any food product with health benefits] are not put through the same, stringent trials as pharmaceuticals. So, if you have an option between these two supplements, always go for the latter," she says, adding, "Supplements help, but only in the long term. The changes [you see] are not drastic. It may take at least three months before you see an improvement in the physical [reduced acne, less fatigue for instance], clinical [blood pressure improves] and pathological [insulin values improve] aspects. If you see good results, it's working for you."

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Percentage by which the fertility rate [the number of children born to a woman] of Indians plunged, according to the 2019 World Population Prospects