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J Ayurveda Integr Med
J Ayurveda Integr Med
Journal of Ayurveda and Integrative Medicine
0975-9476
0976-2809
Elsevier

S0975-9476(24)00080-9
10.1016/j.jaim.2024.100965
100965
Letter to the Editor
Letter to editor - Assessing the efficacy of meditation in the management of infertility
Jadhav Mahesh P. mahesh.jadhav@dpu.edu.in
⁎
Patil Priyanka D.
Department of Shalyatantra, Dr. D. Y. Patil Vidyapeeth, Pune (Deemed to be University), Dr. D. Y. Patil College of Ayurved and Research Centre, Pimpri, Pune-18, India
Dhone Pooja D.
Department of Kayachikitsa, Matoshri Asarabai Darade Ayurved College & Hospital, Bhabulagaon, Yeola, Dist. Nasik, 423401, India
⁎ Corresponding author. Department of Shalyatantra, Dr. D. Y. Patil Vidyapeeth, Pune (Deemed to be University), Dr. D. Y. Patil College of Ayurved and Research Centre, Pimpri, Pune-18, India. mahesh.jadhav@dpu.edu.in
13 6 2024
Jul-Aug 2024
13 6 2024
15 4 1009656 12 2023
3 4 2024
4 5 2024
© 2024 The Authors
2024
https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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pmcDear Editor,

The article published in Journal of Ayurved and Integrative Medicine titled “Effect of Heartfulness meditation based integrative therapy on infertility outcomes: A retrospective case series evaluation”, is indeed an interesting article. We read it with utmost interest. The insights gained from the retrospective analysis are valuable and have sparked a keen interest in exploring the topic further.

In our fast paced world, where chaos frequently takes priority and when disorders frequently triumphs, the practice of meditation has emerged as a heaven of serenity. The practice of meditation contributes towards the progressive evolution of consciousness by creating the conditions for stilling the mind at deeper and deeper levels, and opening up the inner world [1]. The meditation does have positive impact on the Physical, Emotional, Mental and Spiritual (PEMS) conditions [1].

Infertility in India is a complex challenge. A significant portion of the population experience infertility as a result of multiple circumstances, such as postponed marriages, alteration in lifestyle and environmental conditions. Both urban and rural couples struggle with the emotional, financial and medical complexities associated with infertility. Access to infertility treatment and knowledge about available options vary, further highlighting the need for a comprehensive approach to health.

According to recent scientific research, psychological therapy, particularly mind-body therapy can dramatically increase the likelihood of pregnancy for women receiving assisted reproductive technology (ART) [2]. In the complex field of reproductive health, where people deal with the complex issues of infertility, there is a need for increased consciousness and compassion in our medical discourse. By integrating with alternative science and using various tools, we can pave the way for comprehensive treatment modalities that acknowledge the complexities of fertility struggle. In improving the quality of life of women with infertility the short term MSBR (Mindfullness Based Stress Reduction) program is found to be potentially effective [9]. It is also found that yoga therapy is potentially effective in improving the anxiety scores of woman who are suffering from infertility [10].

When it comes to dealing with the emotional ups and downs that come with infertility, meditation appears to be a helpful tool for individuals navigating the complex journey of infertility. Heartfulness meditation reduced intraoperative anxiety levels after just one session [3]. As we explore avenues for support in this sensitive journey, acknowledging the role of meditation becomes imperative for fostering holistic well being. Most people consider infertility to be a private matter, but public health viewpoints and expertise can significantly advance our understanding of the condition and help in the creation of sensible public policies for access to care, prevention, and regulation of emerging technologies [4].

I am writing to shed light on conducting a prospective study as a follow-up to the retrospective study recently published in Journal of Ayurved and Integrative Medicine specifically referring to the article titled “Effect of Heartfulness meditation based integrative therapy on infertility outcomes: A retrospective case series evaluation”. The insights gained from the retrospective analysis have sparked a keen interest in exploring the topic further through a prospective lens

The retrospective study has provided valuable insights into the findings such asa) Conception - 24 out of 54 participants conceived of which 18 couples conceived naturally suggesting that majority of conception occurred naturally

b) Engagement outcome - The rate of engagement was 64% participants over the period of two years which suggest the motivation and acceptance of treatment amongst participants [5].

However a prospective study would allow for a more robust exploration of causality, potential interventions and a deeper understanding of the factors influencing the observed outcome. Correct interpretation of study data requires a full understanding of the advantages and disadvantages of the various designs. An essential method for researching uncommon diseases, their symptoms, and their consequences is a retrospective study. The results of these investigations may serve as the foundation for future research plans.

Due to their design, retrospective studies do have certain drawbacks. Some data is unavoidably lacking since they rely on the review of charts that were not intended to gather data for research. Selection and recall biases also impact the outcomes, and it is frequently impossible to determine the causes of patient treatment disparities and missed follow-ups, which might result in bias [6]. To overcome these limitations the following measures can be undertaken such as prospective data collection, inclusion of control group, by ensuring thorough documentation and by utilizing appropriate statistical methods.

With prospective study we can delve into the exact mechanism of meditation for relieving stress and thereby helping in normalizing the hormonal imbalance. We can investigate and quantify the potential therapeutic impact of meditation as an adjunctive management strategy for individuals having infertility. We can also investigate the possible outcomes using different meditation techniques alone or with combination with yoga and lifestyle modification.

The inclusion criteria would be couples those are actively seeking fertility treatment and are diagnosed with primary and secondary infertility. The couples with pre existing medical or psychiatric illness that may interfere with meditation practice would be excluded from study.

Participants can be randomized into two groups. Trial group would be seeking guided meditation and mindfulness techniques. Control group receiving standard fertility treatment without meditation.

Independent variables such as the specific meditation technique, adherence to the practice of meditation, engagement of participants, frequency and duration of meditation sessions, diet and exercise can be included. Dependant variables such as pregnancy rates, hormonal levels, time to conception, successful conceptions can be included for the study design.

The collected data can be assessed by applying various techniques such as1. Changes in stress level can be measured by standardized scales like perceived stress scale [7].

2. Improvement in mental health can be assessed by validated questionnaires [8].

3. By doing regular fertility assessments and hormonal profiles

4. Pre and post interventional surveys on stress and mental health

5. By applying proper statistical tool we can compare the conception rates in trial and control groups and also we can do analysis to assess differences in stress and mental health outcomes.

Thus we can provide valuable insights into the potential role of meditation as an adjunctive therapeutic tool in the management of infertility, contributing to a more comprehensive understanding of holistic approaches to fertility care. This prospective approach will not only complement the existing retrospective data but also contribute to a more comprehensive understanding of effects of meditation in infertility cases.

Declaration of competing interest

The authors declare that there is no conflict of interest in this study.

Acknowledgement

I would like to acknowledge Dr. D. Y. Patil College of Ayurved and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune - 18 for providing guidance resource at every step of manuscript writing.

Peer review under responsibility of Transdisciplinary University, Bangalore.
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References

1 Hegde Rajeshwari Hegde and Dr. Mohandas. “Effect of Heartfulness meditation on Human consciousness.” SANSKAI: Sanskrit from Dharmic to Artificial Intelligence March 17, 2023 http://sanskrit-ai.com/threads/effect-of-heartfulness-meditation-on-human-consciousness.14332/
2 Hajela Supriya Prasad Sudha Kumaran Aswathy Kumar Yogesh Stress and infertility: a review International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2016 940 943 10.18203/2320-1770.ijrcog20160846
3 Gurram Prashanthi Narayanan Vivek Chandran Saravanan Ramakrishnan Karthik Subramanian Abinaya Kalakumari Anudarsh Padmakumar Effect of Heartfulness meditation on anxiety and perceived Pain in patients undergoing impacted third molar surgery J Oral Maxillofac Surg 79 10 2021 2060.e1 2060.e7 10.1016/j.joms.2021.04.027
4 Fidler A.T. Maternal and child health. Infertility: from a personal to a public health problem Publ Health Rep 114 6 , 1999 494 511 10.1093/phr/114.6.494
5 Deshpande Snehal Patel Kamlesh D. Parulkar Tejal Mahabalesh Kalpana Madhusudhan Poornima Madhusudhan Divya K. Jayaram Thimmapuram Effect of heartfulness meditation based integrative therapy on infertility outcomes: a retrospective case series evaluation J Ayurveda Integr Med 14 6 2023 100793 10.1016/j.jaim.2023.100793
6 Talari Keerthi Goyal Mohit Retrospective studies – utility and caveats J Roy Coll Phys Edinb 50 4 2020 398 402 10.4997/jrcpe.2020.409
7 Lee Eun-Hyun Review of the psychometric evidence of the perceived stress scale Asian Nurs Res 6 4 2012 121 127 10.1016/j.anr.2012.08.004
8 Coulombe Simon Radziszewski Stephanie Trépanier Sarah-Geneviève Provencher Hélène Roberge Pasquale Hudon Catherine Meunier Sophie Provencher Martin D. Houle Janie Mental health self-management questionnaire: development and psychometric properties J Affect Disord 181 August 2015 41 49 10.1016/j.jad.2015.04.007 25917292
9 Hosseini Masoumeh Sadat Mousavi Parvaneh Hekmat Khadijeh Haghighyzadeh Mohammad Hossein Johari Fard Reza Jafari Razieh Mohammad Effects of a short-term mindfulness-based stress reduction program on the quality of life of women with infertility: a randomized controlled clinical trial Compl Ther Med 50 2020 102403 10.1016/j.ctim.2020.102403
10 Desai Geetha Dumbala Sowjanya Bhargav Hemant Satyanarayana Veena Arasappa Rashmi Varambally Shivarama Bangalore GangadharN. Effect of yoga on psychological distress among women receiving treatment for infertility Int J Yoga 13 2 2020 115 10.4103/ijoy.ijoy_34_19 32669765
