TN govt plans to start Siddha fertility clinic, doctors question efficacy

The recent announcement by Tamil Nadu Health Minister Ma Subramanian to establish a Siddha fertility clinic at the Government Siddha Hospital in Chennai has sparked criticism from medical experts.

The health minister cited ancient Siddha medicine textbooks as a potential solution to infertility, but obstetricians and gynaecologists argue that this approach lacks scientific backing. On the contrary, Siddha practitioners say they have seen successful cases of infertility treatment through Siddha treatments in the state.

Little scientific evidence

Siddha, being a traditional system of medicine, has cultural and historical significance, but the lack of scientific evidence raises questions about its efficacy.

Specific Siddha treatments such as Arootha Chooranam and Anda Odu Parpam, which are traditionally popular for the treatment of infertility, have little scientific evidence supporting their effectiveness.

Doctors also say that infertility is a complex issue requiring evidence-based medicine and advanced technology. Medical experts are concerned that promoting Siddha medicine without rigorous research may undermine progress in treating infertility.

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No clinical trial data in study

There is some preliminary evidence suggesting that Siddha medicine may improve certain infertility parameters, particularly in male infertility cases like oligospermia, but the data is far from conclusive.

A 2017 review on Evidence-Based Siddha Therapeutics in Treating Female Infertility suggests that Siddha principles, using herbal and herbo-mineral formulations, have been traditionally applied to address female infertility (termed “Pen Maladu” or “Karparogam”). However, the study lacked detailed clinical trial data and relied on traditional knowledge and anecdotal success.

Siddha treatments, such as churnas, kashayas, legiyams, and higher-order medicines like chendoorams and parpams, are claimed to support follicle maturation and egg quality. Besides the traditional texts and practitioner experiences, no scientific evidence can be highlighted.

Probiotics and antioxidants

“Probiotics and antioxidants play a small role in promoting fertility and those components are found in certain Siddha medicines. However, the standalone effectiveness of these treatments is not known,” said Dr Meena Suresh, former director of the Institute of Obstetrics and Gynaecology.

“But at the same time, we cannot ignore that some of these treatments can be supported by modern medicine as well, and the impact can be due to the combination of medicines,” she added.

She added that modern medicine has evidence-based treatment methods and there is an average percentage of efficiency and success rate that a particular treatment has. However, the impact, side effects, and effectiveness of these Siddha treatments that are claimed to treat or cure infertility are not certain or supported by data.”

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No standard protocol

Another 2018 pilot study titled Siddha Medicine for Male Infertility investigated the efficacy of Dhathu Bushti Chooranam for low sperm count in 10 male patients.

The study said that after 90 days of treatment, semen analysis showed improvements in sperm count and motility, but the study lacked a control group and the sample size was too small to derive any substantial conclusions.

With no standard protocol for Siddha formulations and treatments, these studies often fail to reach a common conclusion, and many rely on traditional claims rather than empirical data.

No comprehensive studies

Gynaecologists say that modern infertility treatments such as IVF, IUI, and others have well-documented success rates, whereas Siddha’s evidence remains preliminary. A gynaecologist, based in Chennai, said there are no comprehensive studies to prove the effectiveness of Siddha treatments in treating infertility.

“Infertility is a huge problem with many components. Modern medicine has a lot to discover in infertility. It is a complex problem to address; it has a multi factorial causality and it involves two people. Hence, treating a couple with infertility is difficult,” he added.

“With advancements in medicine and technology, we have been having more and more success in treating infertile couples. But saying centuries old textbooks have answers to infertility without scientific evidence is not right. It belittles the struggles of infertile couples and the advances made by science,” the doctor asserted.

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The Siddha point of view

Medicos question the scientific evidence for Siddha medicine curing infertility, even as fertility clinics are being run by Siddha practitioners claiming good outcomes. With limited research that consists of small-scale studies, case reports, and observational data, the move to establish Siddha fertility clinic needs more evaluation of the effectiveness of such treatments and scientific data before it is implemented.

Siddha practitioners argue that their treatments enhance outcomes in the case of infertility. They claim several lifestyle factors, including lack of proper nutrition, are responsible for infertility and these are what they target to cure it.

“The ingredients of Siddha medicines include nutritional supplements that are required to improve fertility. Modern medicine practitioners also advise the same, as do dieticians. Siddha medicines can be combined with modern treatments, potentially to improve overall reproductive health. However, there is a lack of clinical evidence, and now we are working on documenting all the treatments that are being taken up in Siddha,” said Dr K Elavarasan, Siddha consultant at Southern Railways Headquarters Hospital.

No specific protocol

Admitting that there is a lack of scientific evidence on the effectiveness and success rate of Siddha treatments for infertility, Siddha practitioners say they are now following the case data and even adopting integrated practices of modern medicine and allopathy.

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“Several processes are involved in curing infertility, which starts with detoxification of the couple. We look at the cause of infertility and treat them accordingly and it is being done in combination with modern medicine,” added Dr Elavarasan, explaining that “there is no specific protocol for the treatment of infertility for men and women in Siddha medicine and it is customised to the health concerns of the individual patient”.

“The National Institute of Siddha has a special outpatient clinic for infertility. We have seen a good success rate and we have cases who come to us after the repeated failure of IVF and others,” he added.