Chinese herbal medicine for subfertile women with polycystic ovarian syndrome

Zhou K, Zhang J, Xu L, Lim CED · Cochrane Database of Systematic Reviews · 2021 June 04

Objective

To assess the efficacy and safety of Chinese herbal medicine (CHM) for subfertile women with polycystic ovarian syndrome (PCOS).

Conclusions

There is insufficient evidence to support the use of CHM for subfertile women with PCOS. No data are available on live birth. We are uncertain of the effect of CHM on pregnancy rates for there is no consistent evidence to indicate that CHM influences fertility outcomes. However, we find that the addition of CHM to clomiphene may improve pregnancy rates, but there is very limited, low certainty evidence for this outcome. Furthermore, there is insufficient evidence on adverse effects to indicate whether CHM is safe. In the future, well‐designed, carefully conducted RCTs are needed, with a particular focus on the live birth rate and other safety indexes.

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Insights

The addition of CHM to clomiphene may improve pregnancy rates.

The study aimed to assess the effectiveness and safety of Chinese herbal medicine (CHM) for subfertile women with polycystic ovarian syndrome (PCOS). They conducted a comprehensive search across databases and trials registries, ultimately including eight randomized controlled trials with 609 participants. The trials compared various interventions, such as CHM versus clomiphene, CHM plus clomiphene versus clomiphene alone, CHM plus other treatments versus those treatments alone. The evidence quality was generally very low, and the primary outcome of live birth rate was not reported. While some comparisons suggested potential benefits, such as the addition of CHM to clomiphene leading to higher pregnancy rates, the overall uncertainty and lack of consistent evidence hindered conclusive findings. The study underscores the need for well-designed trials focusing on live birth rates and safety indicators in assessing the use of CHM for subfertile women with PCOS.