TOT Protocol Success: Bilateral Tubal Block, Low AMH, irregular cycles

Summary: This is a remarkable case of successful TOT Ayurvedic management of bilateral tubal block with inflammatory pathology, irregular cycles, and low AMH.
Through a structured treatment plan including TOT protocol-the patient achieved:

• Blocked tubes opened. (tubal patency achieved)
• Regular cycles
• Improved AMH
• Successful natural conception
• Full-term healthy delivery

This case reinforces the potential of our individualized Ayurvedic intervention (using TOT protocol) in complex infertility conditions. Read the full case study below- 

When JH first called me in April 2024, her voice carried a quiet mix of exhaustion and hope. She was just 32, living in Chennai, and working hard as a teacher-in-training. But behind her calm words was a woman who had spent the last one and a half years longing for something she deeply cherished--a child.
For months after her marriage, she and her husband tried joyfully, enthusiastically, and then anxiously… but nothing happened. Six months passed. Then more. Doctors, tests, treatments—everything became part of her routine.

She went through two cycles of hormonal injections, hoping each time that this would be the month her life changed. But both attempts failed. The natural cycles brought only disappointment. Then came the test that changed everything. She then underwent tube test (HSG) which showed- Her tubes were blocked. Both of them. She cannot forget the day she heard it. The doctor suggested immediate laparoscopy. She underwent the procedure in March 2024 and was told she had salpingitis, an infection causing the tubes to close leading to bilateral cornual block. An endometrial biopsy was sent for TB PCR, adding to her anxiety. She was then referred for an IVF procedure. 

Investigations: 
AMH (9TH March 2024): 1.41 ng/mL
Pap smear was normal.
Laparoscopy (March 2024):

• Diagnosed with salpingitis (infection of fallopian tubes)
• Bilateral cornual block noted
• Endometrial biopsy sent for HP/TB PCR

Behind all of this, JH carried another burden—her periods had never been normal. Ever since she was 14, her cycle came once every 45+ days, with barely any flow, just spotting, and pain in her hips every month. She also had a history of gastric discomfort and childhood wheezing. Years of irregularity, stress, and uncertainty had built up silently inside her.
🌿 The First Meeting
When she walked into my clinic in May, I could sense the weight she was carrying. But her eyes had something stronger than pain--determination. She asked softly,
“Doctor… will I ever be able to conceive?”
And I told her, “Let’s begin. Let’s work together. But first, we must wait for your TB PCR report.”
She waited patiently, anxiously. When it came negative, we finally began.
Based on her symptoms, her irregular periods, inflammation, and blocked tubes, I diagnosed her with Pitta-Vata yoni Vyāpada in Ayurveda.

🌿 The Healing Begins
For the first month, we focused simply on calming her disturbed Pitta and Vata. Surprisingly, after months of taking pills just to bleed, her periods came naturally.
This was our first turning point. Next, we planned TOT protocol—a cleansing therapy. She underwent the process, successfully passing 13–14 vegas, releasing years of accumulated heat and imbalance. After this step, we began medicines to reduce inflammation and open the blockages in her reproductive channels. Month after month, her cycles became regular, timely, and healthy. Even symptoms like breast tenderness slowly faded.
Her body was reopening, rebalancing. JH often said,
“Doctor, for the first time in my life… my cycle feels normal.”

✨ The Day Miracles Began
By October 2024, we both felt the time was right. She repeated her HSG test.
A few hours later, my phone rang.
Her voice was trembling—this time with joy.
“Doctor… both my tubes are open! They’re really open!”
It was one of those moments that remind a doctor why they chose this path.
In November, her AMH—earlier 1.41—rose to 2.33. Her hormones improved. Her ovulation improved. Her mind became calmer. Her body became stronger.
We began follicular monitoring and continued the treatment for natural conception.

Clinical Findings and Improvements

HSG Re-evaluation (October 2024)
Result: Bilateral tubal opening achieved
The patient reported immense relief and renewed hope.

Hormonal Profile (November 2024)

• AMH increased significantly from 1.41 → 2.33
• All other parameters normal
• Prolactin normal, TSH normal, Hb=12.2, Mildly elevated LH (9.5) compared to FSH (5.5), managed through egg-quality therapies, Rasayana and Vajikarna treatments, and continued Ayurvedic medicines

Follicular Monitoring

• Regular monitoring initiated
• Ovulation improved steadily

🌸 The Moment She Dreamed of 
In March 2025, JH called again. This time she was crying—happy tears.
“Doctor… the test is positive. I’m pregnant.”
That one sentence held months of struggle, pain, hope, prayers, and endurance.
Her pregnancy journey was smooth except for a little high BP and borderline sugar in the eighth month, which we managed. And then, finally…

👶 A New Life Arrives
She delivered a healthy baby boy.
Her dream—once blocked by fear, infection, and uncertainty—was now in her arms.
When she brought the baby to meet me, she said something I will never forget:
“Doctor… you didn’t just treat me. You gave me my motherhood back.”

🌿 JH’s Story Is Not Just a Case, It is a reminder that…
✨ Hope can return
✨ The body can heal
✨ TOT protocol can restore balance where there is imbalance
✨ And miracles do happen
This journey from bilateral tubal block and irregular cycles to natural conception and a healthy delivery stands as a testimony to the power of holistic healing, patience, and faith.
If JH’s story inspires even one woman who is struggling silently, then sharing it becomes meaningful.
Namaste 
Vaidya Vibhuti Rao
Natural Fertility Expert