Impact of whole-systems traditional Chinese medicine therapy on in vitro fertilization and embryo transfer outcomes: A retrospective cohort study

Whole-systems traditional Chinese medicine (WS-TCM) therapy has been widely used as a multi-dimensional intervention for in vitro fertilization and embryo transfer (IVF-ET) during clinical practice in China. This study aimed to assess the impact of WS-TCM on IVF-ET outcomes. This retrospective cohort study was conducted on 2733 patients at a tertiary-referral academic university hospital from January 2018 to June 2021. We compared the outcomes of WS-TCM therapies, including acupuncture, moxibustion, Chinese herbs, as well as dietary and lifestyle recommendations (WS-TCM group) with conventional IVF-ET care alone (Non-WS-TCM group) during fresh IVF (n = 1048) and frozen-thawed embryo transfer (FET) cycles (n = 1685). The live birth rate (LBR) per ET was the primary endpoint. Propensity score (PS) matching and multivariable logistic regression analyses were performed to adjust for potential confounders. The LBR per ET was comparable between the WS-TCM and Non-WS-TCM groups (39.9% versus 38.0%, P = 0.604) in fresh IVF cycles after PS matching, while significant differences in cumulative LBR (60.5% versus 52.7%, P = 0.045) were detected. Meanwhile, for patients that underwent FET cycles, significant differences in LBR were detected between the WS-TCM and Non-WS-TCM groups (42.7% versus 35.3%, p = 0.019, after PS matching). These findings were validated by multivariate logistic regression analysis (adjusted odds ratio [aOR] 1.28, 95% confidence interval [CI] 1.01–1.63, p = 0.044). Our findings suggest that WS-TCM therapy may improve the LBRs and cumulative LBRs of subfertile women undergoing IVF-ET. Nonetheless, more comprehensive, rigorous, large-scale prospective comparative studies are needed to verify these findings.