Efficacy and Safety of Traditional Chinese Medicine in the Treatment of Immune Infertility Based on the Theory of “Kidney Deficiency and Blood Stasis”: A Systematic Review and Meta-Analysis

Abstract

Objective. This study aims to evaluate the efficacy and safety of traditional Chinese medicine (TCM) therapy of tonifying kidney and activating blood circulation (TKABC) based on the theory of “kidney deficiency and blood stasis” for the treatment of immune infertility. Methods. Six electronic databases, including the Cochrane Library, PubMed, EMBASE, the China National Knowledge Infrastructure, Wanfang Data, and VIP information database, were searched from inception to January 2021 to identify eligible studies of randomized controlled trials (RCTs). The primary outcome measurements were the total effective rate and pregnancy rate, and the secondary outcome measurements included the negative conversion rate of serum antibodies and the incidence of adverse effects. The quantitative synthesis was performed using the Review Manager 5.3 software. The chi-square statistic and I2 statistic were employed to investigate statistical heterogeneity. The fixed-effects model was used for a low heterogeneity (I2 < 50%), and the random-effects model was applied if heterogeneity was moderate (50% < I2 < 75%). Funnel plots were used to evaluate potential reporting bias when more than ten eligible studies were included. Results. Thirteen RCTs involving 1298 patients with immune infertility of kidney deficiency and blood stasis were included. Compared with conventional group, TCM TKABC therapy showed a significant improvement on the total effective rate (RR: 1.38; 95% CI: 1.30,1.47; and I2 = 0%), pregnancy rate (RR: 2.04; 95% CI: 1.73, 2.40; and I2 = 30%), negative conversion rates of AsAb (RR: 1.42; 95% CI: 1.12,1.79; and I2 = 62%), AEmAb rates (RR: 1.21; 95% CI: 1.04,1.41; and I2 = 0%), and AhCGAb with less adverse effects (RR: 0.24; 95% CI: 1.73, 2.40; and I2 = 55%). However, the negative conversion rate of AoAb and ACAb showed no significant statistical difference. Conclusions. Our review suggests that TCM TKABC therapy based on the theory of kidney deficiency and blood stasis appears to be an effective and safe approach for patients with immune infertility. However, the methodological quality of included RCTs was unsatisfactory, and it is necessary to verify its effectiveness with more well-designed and high-quality multicenter RCTs.

The Application of Complementary and Alternative Medicine in Polycystic Ovary Syndrome Infertility

“…erefore, most of the TCMs for PCOS infertility are kidney-tonifying, supplemented by qi-expelling, phlegm-resolving, bloodactivating, and stasis-resolving therapies, with good clinical results. erefore, the majority of scholars have carried out a large number of in vitro and in vivo experiments on TCM, studies have shown that TCM by regulating sex hormone levels, improves IR and promotes follicle development [19][20][21][22]. We have listed some RCTs in Table 2.…”

Comprehensive analysis of immune-related genes associated with the microenvironment of patients with unexplained infertility

“…Inadequate functional competence or insufficient Treg numbers are related to infertility ( 10 ). Bai et al reported that the presence of such antibodies as antiendometrium (AEmAb), antisperm (AsAb), antiovary (AoAb), and antitrophoblast (ATB) may affect the fertilization process, resulting in infertility ( 11 ). Brazdova et al showed that lower expression of Foxp3, failure of lymphocyte chemotaxis and adherence, and diminished CD4 + CD25 + Treg population seemed to be precursors of infertility ( 12 ).…”

Effect of Chinese patent medicine Kunling Pill on endometrial receptivity: A clinical trial, network pharmacology, and animal-based study

“…Traditional Chinese medicine (TCM) prescriptions have been widely accepted, and research has focused on their applications and mechanisms for treating infertility and gynecopathy in recent years in China (13)(14)(15). Kunling Pill (KLP), a Chinese patent medicine, is available to treat women with infertility and recurrent spontaneous abortion.…”