Efficacy of Traditional Chinese Herbal Medicine in the management of female infertility: a systematic review.
OBJECTIVE
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.


METHODS
We searched the Medline and Cochrane databases and Google Scholar until February 2010 for abstracts in English of studies investigating infertility, menstrual health and Traditional Chinese Medicine (TCM). We undertook meta-analyses of (non-)randomised controlled trials (RCTs) or cohort studies, and compared clinical pregnancy rates achieved with CHM versus WM drug treatment or in vitro fertilisation (IVF). In addition, we collated common TCM pattern diagnosis in infertility in relation to the quality of the menstrual cycle and associated symptoms.


RESULTS
Eight RCTs, 13 cohort studies, 3 case series and 6 case studies involving 1851 women with infertility were included in the systematic review. Meta-analysis of RCTs suggested a 3.5 greater likelihood of achieving a pregnancy with CHM therapy over a 4-month period compared with WM drug therapy alone (odds ratio=3.5, 95% CI: 2.3, 5.2, p<0.0001, n=1005). Mean (SD) pregnancy rates were 60±12.5% for CHM compared with 32±10% using WM drug therapy. Meta-analysis of selected cohort studies (n=616 women) suggested a mean clinical pregnancy rate of 50% using CHM compared with IVF (30%) (p<0.0001).


CONCLUSIONS
Our review suggests that management of female infertility with Chinese Herbal Medicine can improve pregnancy rates 2-fold within a 4 month period compared with Western Medical fertility drug therapy or IVF. Assessment of the quality of the menstrual cycle, integral to TCM diagnosis, appears to be fundamental to successful treatment of female infertility.
Discipline of General Practice, School of Population Health & Clinical Practice, The University of Adelaide, South Australia. Karin.ried@adelaide.edu.au
Karin
K
Ried
Keren
K
Stuart
D005260:Female; D005299:Fertility Agents / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy*; D008516:Medicine, Chinese Traditional; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use; D011247:Pregnancy; D018873:Pregnancy Rate; D055553:Prescription Drugs
D005299:Fertility Agents; D010936:Plant Extracts; D055553:Prescription Drugs