Introduction

In Ayurveda the genetic disorders are explained as Beej Dushtijanya Vikara. Beej, Beejbhaga, Beejbhaga Avayava are identified as certain fundamental entities, which are responsible for reproduction. This is highly evolved concept of genetics which fortunately simulates with the contemporary concept of genetics dealt by Acharya Charak in Sharir Sthan 1. For a healthy progeny, Ayurveda felt the importance of Six Procreative Factors (Shad Garbhakara Bhavas) such as Matrija (maternal), Pitrija (paternal), Atmaja (Soul), Rasaja (Nutritional), Satmyaja (Wholesomeness), and Sattvaja (Psych / Mind). These Shad Garbhakara Bhavas are must for healthy progeny. Healthy parents, practice of a wholesome regimen, and a healthy mind (Psychological status of parents) play an important role in achieving a healthy offsprings i.e., Apatya and Santan means further progenies by Acharya Charak. Thus, structuring a healthy family, society, and nation. Each procreative factor is assigned with a certain organogenesis / functional / psychological phenomenon, to develop in the forthcoming Santati, during its intrauterine life. A lag on the part of any of these Garbhakar Bhavas will lead to physical, functional or psychological defects, which can be contributed by the respective factor.

Hence there are many basic principles of Ayurveda which are applicable in current time. One important concept mentioned in classical text is Atulya Gotriya Adhyaya.

In this classical text Acharya mentioned the risk factors of Sagotra Vivah, importance of Rutu Kshetra, Ambu and Beeja, Paricharya for parents before conception, Garbha Vikruti, risk factors and solutions regarding genetic disorders according to ancient era. But in this modern era all these concepts are principally accepted and even followed for healthy progeny.

Materials and Methods

1. Atulya Gotriya Adhyaya from Charak Samhita
2. Consanguineous marriages and risk factors
3. Risk of Hemophilia in Consanguineous Marriages

Review of Literature

Atulya Gotriya Adhyay.

2. Ashtanga Hridayam: Sutrasthana, Chapter 3, Verse 14-16.
3. Manu Smriti: Chapter 3, Verse 5-7.

Sexual intercourse within the same clan causes Adharma, thus contraindicated in Dharmashastra. [Chakrapani on Cha. Sa. Sharira Sthana 2/3] Hence Atulyagotra implies non-consanguineous cohabitation.

In modern context Sagotra Vivah means Consanguine marriage. Consanguine marriage is marriage between individuals who are closely related. In a clinical sense, marriage between two family members who are second cousins or closer qualifies as consanguineous marriage. This is based on the gene copies their offspring may receive.^[1,2]

Multiple studies done and have established consanguinity as a high cause for congenital defects and abnormalities. A risk of autosomal recessive disorders increases in offspring coming from consanguineous marriages due to the increased similar or alike recessive genes from cognate parents. Inbreeding is associated with decreased cognitive abilities in children.^[3]

Younger ages of marriage are commonly seen in consanguineous marriages, which may account for the increase in fertility seen in these unions. Chances of postnatal mortality are higher in offspring. The highest chance of death due to the risk of autosomal recessive genes. This is also the cause of health complications as children born from consanguinity enter adulthood.^[4]

The primary medical concern with consanguineous marriages is the high risk of genetic disorders. When closely related individuals reproduce, there is a higher probability that both parents carry the same genetic mutations. This situation increases the risk of recessive genetic disorders in their children. Recessive disorders, such as hemophilia, thalassemia, etc., occur only if a child inherits two copies of the mutant gene, one from each parent.^[5]

In consanguineous unions, the chances of both parents carrying the same recessive gene are significantly higher compared to non-consanguineous marriages. As a result, the incidence of autosomal recessive disorders is more frequent in populations where consanguinity is commonly practiced.^[6]

such as in some Middle Eastern and South Asian communities, where the prevalence of hemophilia may be higher.

Increased risk of severe hemophilia: Consanguineous marriage/Sagotra Vivah may increase the risk of severe hemophilia, as the likelihood of inheriting two copies of the mutated gene (one from each parent) is higher.

Genetic Counseling and Testing

Importance of genetic counseling: Couples who are considering consanguineous marriage should undergo genetic counseling to understand their risk of having a child with hemophilia.

Hence in classical text of Ayurveda acharya mentioned it as Vivah should be Atulya Gotra means not in close relation or blood stream or with siblings or cousins.

Genetic testing: Genetic testing can identify carriers of hemophilia and help couples make informed decisions about their reproductive options.

It's essential to note that consanguineous marriage is not the sole cause of hemophilia, and many cases of hemophilia occur in families without a history of consanguineous marriage due to sudden genetic mutations i.e. called as sporadichemophilia.

References