Integrative System Evaluation For The Treatment Of Female Infertility

Objectives:This review aims to assess the effectiveness and safety of female infertility by Traditional Chinese Medicine(TCM) combing with west medicine.Methods:We searched for studies according to the search strategy of female infertility.The following datebases were serched:the CNKI China full-text datebase, Chinese biological medicine datebase(CBM),Chinese VIP datebase,MEDLINE and EMBASE online in 1979 to 2007,and 7 medical journals and documentaries manually in December of 2006 to December of 2007 was serehed by manual method. Clinical randomized or quarsi-randomized controlled trials for female infertility published by the integrative method were selected.Then to evaluate the quality of the included documents,and valid data was extracted from the included trials.Finally the author used Revman 4.2.10 software to give the statistical analysis and systemic review to the included sterility due to obstruction of the ovary duct,the ovulatory disorder,immunology disorder.Results:1412 documents were found during the primary search,among which 30 articles were included for their RCT or quarsi-RCT methodology despite of their poor methodology quality.13 articles were for sterility due to the obstructed ovarian duct, among which 10 were used to evaluate sterility due to the ovulatory disorder,7 articles were used to evaluate immunology sterility,All of the 30 documents showed positive results.The grave untoward reaction was not reported in all the studys. Meta analysis shows that:(1) sterility due to the obstructed ovulatory duct:compared to the regular western method and that combining Chinese decoctions,the latter shows better effect in recanalization of vas deferens(OR=5.93,95%confidential interval [3.06,9.22],P＜0.00001),and higher pregnancy rate(OR=5.51,95%confidential interval[1.93,15.72],P=0.001).The herbal decoction taken orally and by enema combing the regular western method,compared to the separate western method,the recanalization of vas defere effect is better(OR=4.24,95% confedential interval[2.44,7.35],P＜0.00001).(2) sterility due to ovulatory disorder:Chinese herb combining clomifene is better than the clomifene solely(OR=2.08,95%confidential interval[1.37,3.16],P =0.0006).(3) immunology sterility:Chinese herbs combining prednisone,condoms is better in pregnancy rate(OR=5.24,95%confedential interval[1.12,24.67],P= 0.04) serum negative change of the antibody(OR=14.42,95%confidential interval[5.22,39.82],P＜0.00001) than the sole prednisone and condemn.The Chinese herbs combining hexadecadrol,condoms is better in pregnancy rate (OR=2.78,95%confedential interval[1.90,4.08],P＜0.00001) than the sole hexadecadrol and condoms.Conclusions:The systematic review shows that the effectiveness of female infertility due to obstruction of the ovary duct,the ovulatory disorder,immunology disorder by Traditional Chinese Medicine(TCM) combing with west medicine was assured.There is no suftieient evidence for the grave untoward reaction.Further randomized and multicentric double-blind controlled trials are needed and the systematic review is not suitable to assess the effectiveness and safety of female infertility by Traditional Chinese Medicine(TCM) combing with west medicine at this time.