Background: Infertility is a growing reproductive health challenge in India, with Polycystic Ovarian Disease (PCOD), unexplained infertility, and low Anti-Müllerian Hormone (AMH) representing a significant proportion of clinical cases. This clinical study was initiated to evaluate the effectiveness of a standardized Ayurveda-based fertility protocol across multiple clinics in India. Objective: To assess conception outcomes following a structured, protocol-driven Ayurvedic fertility intervention across four primary infertility cohorts. Methods: A multicenter, prospective observational study was conducted from May 2025 onwards across India, enrolling 534 women diagnosed with PCOD (delayed and regular cycles), unexplained infertility, and low AMH. Standardized treatment protocols involving Ayurvedic formulations, ovulation tracking, male fertility support, and structured follow-up framework were implemented. The study was designed for a 90-day follow-up period; however, substantial loss to follow-up beyond 60 days resulted in primary outcome analysis based on available data during the active observation period. Results: Out of 534 enrolled patients, 167 achieved conception, resulting in an overall conception rate of 31% during the observation period. Conception rates varied across cohorts: PCOD delayed (45%), PCOD regular (27%), unexplained infertility (27%), and low AMH (33%). Patient engagement declined over time, limiting complete follow-up for a proportion of participants beyond 60 days. Conclusion: A structured Ayurveda-based fertility protocol integrated with ovulation tracking and standardized follow-up demonstrated moderate conception outcomes in real-world clinical settings. However, variability in adherence, diagnostic accuracy, and patient engagement significantly influenced outcomes. Further controlled studies are required to validate efficacy and optimize protocol adherence.