title: Chinese herbal medicine and clomiphene citrate for anovulation: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  The study objective was to investigate the efficacy of Chinese herbal medicine for improving standard infertility treatments.
  
  
  METHODS
  A search of the literature between 2000 and 2006 was done in English and Chinese using the search terms anovulation, infertility, clomiphene citrate, Chinese herbal medicine, and randomized controlled trials. A review was done of 1009 studies with selection criteria including randomized controlled trials (RCTs) of Chinese herbal medicine combined with clomiphene citrate (CC) versus a control arm using CC alone with primary endpoints of changes in basal body temperatures, ovulation rates, endometrial lining, and pregnancy outcomes.
  
  
  RESULTS
  Fourteen (14) randomized studies representing 1316 patients met inclusion criteria. Four (4) studies (n = 315) reported 14% higher likelihood of biphasic basal body temperatures (risk ratios [RR] = 1.14; 95% confidence interval [CI], 1.00, 1.29). Six (6) studies (n = 604) reported a nonsignificant 18% increase in ovulation rates (RR = 1.18; 95% CI, 0.91, 1.52). Two studies (n = 138) reported subjects 78% more likely to have endometrial lining greater than 6 mm (RR = 1.78; 95% CI, 1.22, 2.60). Thirteen (13) studies (n = 1202) reported a 50% increase in pregnancy rates (RR = 1.50; 95% CI, 1.23, 1.84).
  
  
  CONCLUSIONS
  Chinese herbal medicine may increase the effectiveness of CC therapy. However, the RCTs are of poor methodological quality and small sample size, and the results require confirmation with rigorously controlled studies.
authors.affiliation: Acupuncture Kitchen, 2339 3rd Street, San Francisco, CA 94107, USA. caylie@acupuncturekitchen.com
authors.forename: Caylie J
authors.initials: CJ
authors.lastname: See
authors.forename: Michael
authors.initials: M
authors.lastname: McCulloch
authors.forename: Collin
authors.initials: C
authors.lastname: Smikle
authors.forename: Jin
authors.initials: J
authors.lastname: Gao
mesh_terms: D000858:Anovulation / Q000188:drug therapy*; D001831:Body Temperature / Q000187:drug effects; D002996:Clomiphene / Q000494:pharmacology / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004365:Drugs, Chinese Herbal / Q000494:pharmacology / Q000627:therapeutic use*; D004717:Endometrium / Q000187:drug effects; D005260:Female; D005306:Fertilization / Q000187:drug effects; D029001:Herbal Medicine; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy*; D008516:Medicine, Chinese Traditional; D010060:Ovulation / Q000187:drug effects*; D008517:Phytotherapy; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic
chemical_list: D004365:Drugs, Chinese Herbal; D002996:Clomiphene