At one point we had a post that indicated the difficulties of applying scientific research and Chinese medicine. At the National Center for Biotechology Information (NCBI), they have a division entitled PubMed which is comprised of over 21 million citations for biomedical literature from MEDLINE, life science journals, and online books. PubMed citations and abstracts include the fields of biomedicine and health, covering portions of the life sciences, behavioral sciences, chemical sciences, and bioengineering. PubMed also provides access to additional relevant web sites and links to research on the other NCBI molecular biology resources.
Here is a summary of some of the research on the efficacy of Chinese Medicine on female infertility. This article is merely a summary of some of the current research. It is by no means covers all of the research regarding female infertility and Chinese Medicine, nor does it ensure that proper methodology was used. The articles are categorized by treatment efficacy with herbal medicine, acupuncture and finally with Chinese Medicine in general.
Research on Treatment Efficacy: Herbal Medicine
Efficacy of Traditional Chinese Herbal Medicine in the Management of Female Infertility: a systemic review. 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.
Regulation and control of wenshen yangxue granule combined with clomifene citrate on INH-ACT-FS system in patients with follicular maldevelopment infertility. Wen Shen Yang Xue Gan combined with Clomifene Citrate could improve Chinese medicine syndrome, regulate the expressions of FM patients’ ovary local factors INHB, ACTA and FS, improve the condition of ovary functions, and control the follicle development.
Chinese herbal medicine and clomiphene citrate for anovulation: a meta-analysis of randomized controlled trials. 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 research studies.
Chinese herbal medicine for subfertile women with polycystic ovarian syndrome. There is limited evidence that the addition of CHM to clomiphene is associated with improved clinical pregnancy outcomes and no other evidence of any other effect. The methodology of RCTs was not adequately reported by primary research studies.
Exploration into rules of combined Chinese and Western medical treatment on immune infertility. It was discovered that the combined use of Chinese and Western medicines has its superiority.
Effects of Bu Shen Zhu Yun recipe on protein expressions of estrogen receptor, progesterone receptor and integrlin alpha5 and beta3 in endometrium of rats at the implantation stage. BZR can raise the receptivity of rats’ endometrium through down-regulating the expressions of ER, PR and increasing the protein expression of integrin alpha5 and beta3 in endometrium and thus to enhance the pregnant rate.
Progress of integrative Chinese and Western medicine in treating polycystic ovarian syndrome caused infertility. It can be seen from these materials that using traditional Chinese medicine (TCM) recipes formulated by Shen-replenishing herbs or acupuncture to reinforce Gan-Shen, regulate Chong-Ren Channels in treating PCOS, stable clinical efficacy could be obtained, with less adverse reaction, though the effect initiated somewhat late. Whereas, when Shen-replenishing recipe and acupuncture are combined with hormone or ovulation promoting drugs of Western medicine, the above-mentioned shortcomings would be overcome. So, this combined therapy is frequently used in clinical practice.
Clinical study on effect of Erzhi Tiangui Granule in improving the quality of oocytes and leukemia inhibitory factor in follicular fluid of women undergoing in vitro fertilization and embryo transfer. ETG can distinctively increase the amount of oocyte, elevate the quality of embryo and raise the successful rate of IVF-ET. The mechanism maybe correlated to the increase of LIF level in FF and the activating of microenvironment for its full expression.
Clinical observation on anovulatory infertility of blood and essence asthenia type treated by Lin’erlai Prescription. LEL has good effect in treating anovulatory infertility of BEAS type.
Effect of Chinese herbal medicine in the natural cycle of frozen embryo transfer. Chinese herbal medicine could enhance the clinical pregnancy rate and implantation rate in the natural cycle of FET to certain extent.
Clinical observation on effect of zhenqi zhuanyin decoction combined with intrauterine insemination in treating spleen-kidney deficiency type patients of sterility with positive anti-sperm antibody. Combined therapy of ZQZYD and IUAI shows a better effect in treating infertility with positive AsAb than that by ZQXYD or IUI alone.
Pregnancy in premature ovarian failure after therapy using Chinese herbal medicine. The modified formula of Zuo-gui-wan was prescribed again and the patient conceived 1 month after taking Zuo-gui-wan. Thus, we suggested that Chinese herbal medicine restored ovarian function effectively and promptly, and offers another option for treating infertility in patients with POF.
Therapeutic effect of Chinese herbal medicines for nourishing blood and reinforcing shen in treating patients with anovulatory sterility of shen-deficiency type and its influence on the hemodynamics in ovarian and uterine arteries. NYD has the effects of ovulation promotion and holistic regulation of reproductive system.
Clinical observation on effect of Chinese herbs in adjusting hypoestrogenemia status by clomiphene to promote ovulation. YHCD can ameliorate hypoestrinemia induced by clomiphene and increase the pregnant rate in patients.
Clinical observation on treatment of 2,062 cases of immune infertility with integration of traditional Chinese medicine and western medicine. 2,062 positive cases were periodically treated with the Chinese drug Xiaokangwan plus dexamethasone, vitamin E and vitamin C for 2 periods as a course of treatment. At the end of a treatment course, the rate for the antibodies to turn negative reached over 85% and the average pregnant rate reached 36.66%. The treatment of immune infertility with the integrated approach can reduce or eliminate the influence of antibodies in the serum of patients on various links of pregnancy, thus reaching the goal of curing infertility.
Effects of combined therapy of salpingostomy and Bushen Huoxue drugs on fallopian tube obstructive infertility. The combined therapy of salpingostomy and TCM drugs for invigorating Shen and promoting blood circulation is an effective therapy for fallopian tube obstructive infertility, it has the effect of enhancing follicular development and increasing thickness of endometrium, and could elevate the pregnancy rate in patients.
Effect of Tripterigium wilfordii Hook. f. on the fertility of rats. Non-toxic dose of GTW can cause infertility in male rats, the mechanism of which may involve and interference in the function of the epididymal and/or testicular spermatozoa; in female rats, the dose regimens employed do not have significant anti-implantation or early-pregnancy termination effect.
Effects of a Chinese herbal medicine, keishi-bukuryo-gan, on the gonadal system of rats. The results obtained in the present study indicate that TJ-25 may act as a LH-RH antagonist and/or as a weak anti-estrogen.
Treatment with hachimijiogan, a non-ergot Chinese herbal medicine, in two hyperprolactinemic infertile women. Two hyperprolactinemic infertile women, one with and one without a pituitary adenoma, who were resistant to bromocriptine treatment, were treated orally with Hachimijiogan, a Chinese herbal medicine. This treatment reduced the serum prolactin level, resulting in a normal ovulatory cycle and pregnancy, without side effects.
Hachimijiogan treatment is effective in the management of infertile women with hyperprolactinemia or bromocriptine-resistant hyperprolactinemia. These results indicate that Hachimijiogan is a new safe treatment for hyperprolactinemic women.
Suppression of spontaneous development of uterine adenomyosis by a Chinese herbal medicine, keishi-bukuryo-gan, in mice. The present mouse data support the view in humans that the oral administration of KBG is a useful tool for the treatment of uterine adenomyosis.
Guyin decoction in the treatment of immuno-sterility and its effect on humoral immunity. The decoction had significant effect on serum IgA and IgG.
Clinical observation on effect of yangjing decoction in promoting follicular growth. YJD could improve follicular development and blood supply of ovary and uterus.
Study on mechanism of bushen yugong granule in treating uterine dysgenesia. BSYGG has an estrogen-like activity, it could increase the endometrial content of ER, enhance the effect of estrogen on uterus and promote the uterine development, so as to elevate the fertilization rate.
Effect of bushen huoxue decoction on in vitro fertilization and early embryonic development in mice. BSHX could raise the fertilization rate and promote the early embryonic development.
Research – Treatment Efficacy: Acupuncture
Changes in serum cortisol and prolactin associated with acupuncture during controlled ovarian hyperstimulation in women undergoing in vitro fertilization-embryo transfer treatment. ORT levels in Ac group were significantly higher on IVF medication days 7, 8, 9, 11, 12, and 13 compared with controls. PRL levels in the Ac group were significantly higher on IVF medication days 5, 6, 7, and 8 compared with controls.
Acupuncture on the Day of Embryo Transfer: a randomized controlled trial of 635 patients. These results suggest that acupuncture administered in relation to embryo transfer has no effect on the outcome of IVF and ICSI.
Clinical efficacy of macrophage-activating Chinese mixed herbs (MACH) in improvement of embryo qualities in women with long-term infertility of unknown etiology. Administration of MACH resulted in improved embryo quality in the difficult cases. The present study demonstrates a new benefit of this herbal blend in women with refractory infertility of unknown etiology.
Effect of electroacupuncture on oocyte quality and pregnancy for patients with PCOS undergoing in vitro fertilization and embryo transfervitro fertilization and embryo transfer. Electroacupuncture plays an active role in the pregnant outcomes of PCOS patients undergoing IVF-ET and it can relieve the symptoms of kidney deficiency in terms of TCM and improve clinical pregnant rate. The results are relevant with the overall adjustment of organic endocrinal system and the local micro-environment of ovary and the improvement of oocyte quality through the up-regulation of SCF level in mechanism.
Acupuncture for infertility: is it an effective therapy? Most of the existing studies suggest a positive effect of acupuncture in infertility treatment. Firstly, acupuncture may improve ovulation by modulating the central and peripheral nervous systems, the neuroendocrine and endocrine systems, the ovarian blood flow, and metabolism. Secondly, acupuncture can improve the outcome of IVF-ET, and the mechanisms may be related to the increased uterine blood flow, inhibited uterine motility, and the anesis of depression, anxiety and stress. Its effect on modulating immune function also suggests helpfulness in improving the outcome of IVF-ET. Finally, the studies suggest that acupuncture plays a positive role in male infertility, the mechanism of which is not yet clear.
Influences of acupuncture on infertility of rats with polycystic ovarian syndrome. Acupuncture can conspicuously downregulate the expressions of serum levels of T and E2, improve the development of ovaries and uterus, promote ovulation, enhance endometrial receptivity, and advance blastocyte implantation.
Building resilience: a preliminary exploration of women’s perceptions of the use of acupuncture as an adjunct to In Vitro Fertilisation. This preliminary exploration, whilst confined to a small sample of women, confirms that acupuncture is indeed perceived by infertile women to have an impact to their health. All findings outlined here are reported cautiously because they are limited by the size of the sample. They suggest that further studies of acupuncture as an adjunct to IVF should systematically explore the issues of wellbeing, anxiety, personal and social resilience and women’s identity in relation to sexuality and reproduction.
In vitro fertilization and acupuncture: clinical efficacy and mechanistic basis. Limited but supportive evidence from clinical trials and case series suggests that acupuncture may improve the success rate of IVF and the quality of life of patients undergoing IVF and that it is a safe adjunct therapy. However, this conclusion should be interpreted with caution because most studies reviewed had design limitations, and the acupuncture interventions employed often were not consistent with traditional Chinese medical principles.
Clinical observation on acupuncture for treatment of infertility of ovulatory disturbance. Acup-moxibustion and Clomiphene have a same ovulating effect, and the pregnancy rate is higher and the abortion rate is lower for the patient of acup-moxibustion treatment than that for oral administration of Clomiphene.
Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. Current preliminary evidence suggests that acupuncture given with embryo transfer improves rates of pregnancy and live birth among women undergoing in vitro fertilisation.
Acupuncture and assisted conception. Acupuncture performed on the day of ET shows a beneficial effect on the live birth rate; however, with the present evidence this could be attributed to placebo effect and the small number of women included in the trials. Acupuncture should not be offered during the luteal phase in routine clinical practice until further evidence is available from sufficiently powered RCTs.
Controlled study on acupuncture for treatment of endocrine dysfunctional infertility. Acupuncture can cure endocrine dysfunctional infertility.
Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study. Luteal-phase acupuncture has a positive effect on the outcome of IVF/ICSI.
Clinical studies on the mechanism for acupuncture stimulation of ovulation. Results showed that acupuncture may adjust endocrine function of the generative and physiologic axis of women, thus stimulating ovulation. The results of this research will provide some scientific basis for treating and further studying this disorder.
Study on relationship between ovulation inducing effect of drug-acupuncture and endometrial contents of estradiol receptor and progesterone receptor. The replenishing Kidney drugs combined with acupuncture treatment could result a good effect in treating infertility due to anovulation, especially on those with high endometrial PR content.
Research on Chinese Medicine Treatment in General
Acupuncture and Herbal Medicine in In Vitro Fertilisation: a review of the evidence for clinical practice. The results provided no evidence of benefit in the use of acupuncture during assisted conception.
Traditional Chinese Medicine: Women’s Experiences in the Treatment of Infertility. Women appreciated the noninvasive diagnostic techniques TCM practitioners used to identify ‘imbalances’ causing infertility, learnt how to assess fertility indicators, and valued the focused personal care provided. All noticed improved menstrual cycles. Women wished for integration of holistic therapies in infertility management.
Delivery of a full-term pregnancy after TCM treatment in a previously infertile patient diagnosed with polycystic ovary syndrome. The clinical case report presented here describes the course of TCM treatment that resulted in a successful pregnancy in a previously infertile woman who had been diagnosed with polycystic ovary syndrome (PCOS). It also illustrates the importance of the need for collaborative efforts between TCM and Western medical practitioners.
A survey comparing TCM diagnosis, health status and medical diagnosis in women undergoing assisted reproduction. Associations between TCM and reproductive health diagnoses were demonstrated. Emotional health and wellbeing is an important aspect of patient care that needs to be addressed in clinical practice and research studies, as the findings suggest that this aspect of their health is often poorer during assisted reproductive technology.
Low inter-rater reliability in traditional Chinese medicine for female infertility. The low agreement on diagnoses indicates that acupuncturists follow individual pattern differentiation processes. The selection of acupuncture points seem to be closely related to the choice of TCM pattern diagnoses. The results indicate that the poor reliability in the diagnoses and thus treatment received by a patient will vary individually, which in turn is a challenge for clinical trials of acupuncture.
A comparison of the effectiveness between Western medicine and Chinese medicine outpatient consultations in primary care. Both TCM and WM consultations were associated with significant improvement in HRQOL in over 90% of patients. There was no singificant difference between the effectiveness of TCM and WM consultations. The results support the role of TCM as an alternative primary care service in Hong Kong.
Patient satisfaction with primary care: a comparison between conventional care and traditional Chinese medicine. Physicians who supply TCM in addition to COM are able to satisfy the needs of their patients more completely than solely COM-practicing physicians. Explanations for this difference include less frequent side effects in TCM, better TCM physician-patient interaction with longer duration of consultation, and different treatment expectations of patients seeking TCM.
Traditional Chinese medicine and infertility. The growing popularity of traditional Chinese medicine used alone or in combination with Western medicine highlights the need to examine the pros and cons of both Western and traditional Chinese medicine approaches. Integrating the principle and knowledge from well characterized approaches and quality control of both traditional Chinese medicine and Western medical approaches should become a trend in existing clinical practice and serve as a better methodology for treating infertility.
Application of traditional Chinese medicine in the treatment of infertility. This review focuses on the application of TCM for infertility patients, and provides a critical reflection on the efficacy and safety of selected Chinese herbal formulas. It has been claimed that some formulas produce high clinical pregnancy rates with few or no side effects, as well as improving the general well-being of patients.
Use of traditional Chinese medicine among pregnant women in Taiwan. Traditional Chinese medicine, with the exception of acupuncture, is popular among pregnant women in Taiwan. In addition to its efficacy, the safety of TCM during pregnancy requires future investigation.
Female infertility from the perspective of Chinese medicine. Determining the most effective therapy is the most important point of clinical studies.
Exploration on the relationship between positive antisperm antibody and nitric oxide level of infertile patients and on integrative Chinese and Western medicine treatment. AsAb positive and NO level abnormal may interfere mutually, to intervent the reproductive process. ICWM therapy could effectively regulate auto-immunity and endocrine function, and make the infertile patients obtain satisfactory efficacy.
TCM treatment of luteal phase defect–an analysis of 60 cases. After the treatment, the hyperthermal phase score of basal body temperature (BBT) was markedly increased (P less than 0.05), the hyperthermal phase 7-8 days after ovulation improved (P less than 0.001), the transitional period of BBT remarkably shortened, and the pregnancy rate in 32 uncomplicated cases of luteal phase defect was 56%. The close relationship between luteal phase defect and the kidney deficiency syndrome in TCM was discussed. The key points of the treatment included coordination of yin and yang, regulation of qi and blood, and combination of tonification with reduction.
Clinical observation on the effects of combined traditional Chinese and Western medicine therapy for excessive suppressive syndrome. This combined therapy was found to be significantly superior in therapeutic effect to administration of Western drugs alone or administration of Chinese drugs supplemented by progesterone. Resultant pregnancy rate was 57.4%.
Complementary therapy and infertility: an Icelandic perspective. Hormonal imbalance in both sexes may be treated with Chinese herbal mixtures such as Hachimijiogan, herbs such as Vitex agnus-castus, or a blend of essential oils designed to treat amenorrhoea or scanty/irregular periods.
Women’s reproductive health network. This article describes the health network in China that provides medical services, maternal and child health care, and family planning (FP).
Clinical study on treatment of oviduct obstruction by integrative traditional Chinese and Western medicine. TCM-WM treatment is a good and practical method in treating oviduct obstruction.
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Caroline Prodoehl, D.Ac.