. 2013 Dec 10;8(12):e81650. doi: 10.1371/journal.pone.0081650

Table 3. Estimate effect of Chinese herbal medicine for improving clinical outcomes of patients with In Vitro Fertilization (IVF).

Study ID	Total No. ofparticipants(embryoimplantation/pregnant)	Interventions	Odds Ratio [95% CI], M-H, Random model	p value
*1. Clinical pregnancy rate*
1.1 herbal medicine before IVF
Gao et al., 2012	42	Periodic herbal decoction, one potion per day, twicedaily for 3 months	2.62 [0.64, 10.61]
Li et al., 2012	54	Hua Yu Powder 28 g, three times daily for 2 months	1.25 [0.42, 3.78]
Li et al., 2008	20	Qu Yu Jie Du Decoction 71 g, once daily for 3 months	3.86 [0.33, 45.57]
Liu et al., 2008	82	Qu Yu Jie Du Decoction 71 g, once daily for 3 months	2.72 [1.01, 7.32]
Pooling analysis 1.1 ( I² = 0%)			2.14 [1.14, 4.02]	0.02
1.2 herbal medicine during IVF
1.2.1 herbal medicine was given after GnRHa injection
Chang et al., 2011	70	Fixed herbal decoction 150 ml, twice daily until HCG injection	2.65 [0.99, 7.11]
Gao and Du, 2012	58	Xiao Yao Powder 150 ml, twice daily until HCG injection	2.33 [0.80, 6.85]
Lei and Luo, 2011	42	Cu Pai Luan Decoction, one portion daily until HCG injection	2.57 [0.71, 9.27]
Pooling analysis 1.2.1 ( I² = 0%)			2.51 [1.34, 4.74]	0.002
1.2.2 herbal medicine was given after FSH injection
Lian et al., 2006	66	Erzhi Tiangui Granule 3 g three times daily until HCG injection	2.94 [1.03, 8.39]
Lian et al., 2008	64	Erzhi Tiangui Granule 3 g three times daily until HCG injection	2.07 [0.67, 6.42]
Sun et al., 2011	61	Erzhi Tiangui Granule 3 g three times daily until HCG injection	3.15 [1.10, 8.99]
Teng and Lian, 2009	49	Erzhi Tiangui Granule 6 g three times daily until HCG injection	2.65 [0.70, 10.07]
Teng and Lian, 2006	80	Erzhi Tiangui Granule 6 g three times daily until HCG injection	2.55 [0.99, 6.53]
Zhang et al., 2007	66	Erzhi Tiangui Granule 10 g three times daily until HCG injection	2.74 [0.93, 8.08]
Pooling analysis 1.2.2 ( I² = 0%)			2.67 [1.72, 4.15]	<0.0001
Pooling analysis 1.2 ( I² = 0%)			2.62 [1.82, 3.76]	<0.00001
1.3 herbal medicine after IVF
1.3.1 herbal medicine was given immediately after oocyte retrieval
Zhu et al., 2002	135	Zi Shen Yu Tai Pills 6 g, three times daily for 14 days	1.99 [1.00, 3.98]	0.05
1.3.2 herbal medicine was given after embryo transfer
Huang, 2012	162	An Tai Mixture 250 ml, twice daily for 14 days	2.23 [1.19, 4.18]
Li, 2009	70	Adjusted Wenshen Yangxue Antai Decoction, one portionfor twice daily for 10–14 days	3.33 [1.06, 10.53]
Pooling analysis 1.3.2 ( I² = 0%)			2.44 [1.41, 4.24]	0.001
Pooling analysis 1.3 ( I² = 45%)			2.26 [1.47, 3.47]	0.00502
1.4 herbal medicine during and after IVF
Deng et al., 2011	249	Periodic herbal decoction, one potion per day, twice daily	1.67 [1.01, 2.76]
Ge et al., 2010	207	Periodic herbal decoction, one potion per day, twice daily	1.15 [0.67, 1.99]
Li, 2008	63	Adjusted Erzhi Pills and Siwu Decoction during IVF, Wenshen Yangxue AntaiDecoction after IVF, one portion per day, twice daily	1.85 [0.65, 5.27]
Pooling analysis 1.4 ( I² = 0%)			1.45 [1.02, 2.06]	0.04
1.5 herbal medicine before, during and after IVF
Deng et al., 2011a	82	Periodic herbal decoction, one potion per day, twice daily	2.45 [1.01, 5.95]	0.05
Total meta-analysis 1 ( I² = 0%)			2.04 [1.67, 2.49]	<0.00001
*2. ongoing pregnancy rate*
2.1 herbal medicine before IVF
Liu et al., 2008	82	Qu Yu Jie Du Decoction 71 g, once daily for 3 months	2.04 [0.79, 5.25]	0.14
2.2 herbal medicine during IVF
Lian et al., 2008	64	Erzhi Tiangui Granule 3 g three times daily until HCG injection	1.34 [0.48, 3.79]
Teng and Lian, 2006	80	Erzhi Tiangui Granule 6 g three times daily until HCG injection	1.69 [0.69, 4.10]
Pooling analysis 2.2 ( I² = 0%)			1.53 [0.78, 3.01]	0.22
2.3 herbal medicine after IVF
Li, 2009	70	Adjusted Wenshen Yangxue Antai Decoction, one portion for twice daily for 10–14 days	2.97 [1.04, 8.49]	0.04
Total meta-analysis 2 ( I² = 0%)			1.91[1.17, 3.10]	0.009
*3. implantation rate*
3.1 herbal medicine during IVF
Gao and Du, 2012	58 (85)	Xiao Yao Powder 150 ml, twice daily until HCG injection	2.50 [1.03, 6.11]
Teng and Lian, 2009	49 (120)	Erzhi Tiangui Granule 6 g three times daily until HCG injection	2.40 [0.80, 7.24]
Pooling analysis 3.1 ( I² = 0%)			2.46 [1.23, 4.93]	0.01
3.2 herbal medicine after IVF
Zhu et al., 2002	135 (492)	Zi Shen Yu Tai Pills 6 g, three times daily for 14 days	1.59 [1.02, 2.48]
3.3 herbal medicine during and after IVF
Deng et al., 2011	249 (489)	Periodic herbal decoction, one potion per day, twice daily	1.51 [1.04, 2.20]
Ge et al., 2010	207 (428)	Periodic herbal decoction, one potion per day, twice daily	1.51 [1.01, 2.25]
Pooling analysis 3.3 ( I² = 0%)			1.51 [1.15, 1.99]	0.003
3.4 herbal medicine before, during and after IVF
Deng et al., 2011a	82 (225)	Periodic herbal decoction, one potion per day, twice daily	1.84 [1.03, 3.26]	0.04
Total meta-analysis 3 (I² = 0%)			1.64 [1.33, 2.01]	<0.00001
*4. adverse events*
*4.1 abortion rate (only included trials with herbal interventions post IVF)*
Huang, 2012	(81)	An Tai Mixture 250 ml, twice daily for 14 days	0.29 [0.09, 0.97]	0.04
*4.2 OHSS rate*
Chang et al., 2011	70	Fixed herbal decoction, 150 ml twice daily until HCG injection	3.09 [0.12, 78.41]
Deng et al., 2011	249	Periodic herbal decoction, one potion per day, twice daily	0.22 [0.05, 1.02]
Gao and Du, 2012	58	Xiao Yao Powder 150 ml, twice daily until HCG injection	0.30 [0.01, 7.69]
Lian et al., 2008	64	Erzhi Tiangui Granule 3 g three times daily until HCG injection	0.49 [0.08, 3.16]
Total meta-analysis 4.2 ( I² = 0%)			0.39 [0.14, 1.11]	0.08

CI: confidence interval; GnRH-a: GnRH-a gonadotropin releasing hormone agonist; FSH: follicle stimulating hormone; HCG: human chorionic gonadotrophin.