Highlights

  • Chinese herbal medicine may improve pregnancy rates 2-fold in female infertility.
  • This updated meta-analysis includes 40 RCTs and more than 4000 women.
  • Chinese herbal medicine may improve ovulation rates and overall menstrual health.
  • Herbal formulae are based on the individual’s TCM pattern diagnosis.
  • Herbal formulae are to be dispensed by an experienced TCM practitioner for safety.

Summary

Objectives

To assess the effect of Traditional Chinese herbal medicine (CHM) in the management of female infertility and on pregnancy rates compared with Western medical (WM) treatment and update previous meta-analyses.

Methods

We searched the Medline and Cochrane databases until December 2013 for randomized controlled trials and meta-analyses investigating Chinese herbal medicine therapy for female infertility and compared clinical pregnancy rates achieved with CHM versus WM drug treatment.

Results

Forty RCTs involving 4247 women with infertility were included in our systematic review. Meta-analysis suggested a 1.74 higher probability of achieving a pregnancy with CHM therapy than with WM therapy alone (risk ratio 1.74, 95%CI: 1.56–1.94; p < 0.0001; odds ratio 3.14; 95%CI: 2.72–3.62; p  < 0.0001) in women with infertility. Trials included women with PCOS, endometriosis, anovulation, fallopian tube blockage, or unexplained infertility. Mean pregnancy rates in the CHM group were 60% compared with 33% in the WM group.

Conclusions

Our review suggests that management of female infertility with Chinese herbal medicine can improve pregnancy rates 2-fold within a 3–6 month period compared with Western medical fertility drug therapy. In addition, fertility indicators such as ovulation rates, cervical mucus score, biphasic basal body temperature, and appropriate thickness of the endometrial lining were positively influenced by CHM therapy, indicating an ameliorating physiological effect conducive for a viable pregnancy.