{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:41:52Z","timestamp":1760060512003,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T00:00:00Z","timestamp":1756598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Tainan Municipal Hospital, Taiwan","award":["109-13"],"award-info":[{"award-number":["109-13"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Live birth rates in women with diminished ovarian reserve (AMH &lt; 2.0 ng\/mL) undergoing in vitro fertilization (IVF) remain under 20%. While Chinese herbal medicine (CHM) is often used to treat infertility and support IVF, its effectiveness in this group is unclear. This study assessed live birth outcomes by treatment type and patient characteristics. Materials and Methods: We retrospectively analyzed 240 infertile women with low ovarian reserve and partners with normal sperm. Of these, 63 were in the control group, 118 received CHM only, and 59 received IVF with CHM. Logistic regression and a nomogram were used to assess live birth outcomes. Results: The live birth rate was 5% in the control group, 32% in the CHM-only group, and 42% in the mixed treatment group. Univariate analysis showed that both treatment type and patient age were significantly associated with live birth outcomes. In multivariate logistic regression, CHM-only treatment was significantly associated with an increased likelihood of live birth (odds ratio [OR]: 8.98, p = 0.001), as was the mixed treatment group (OR = 18.77, p &lt; 0.001), with the control group as the reference. Women aged \u226437 had significantly higher live birth rates (OR = 3.24, p = 0.018), using those over 37 as the reference group. A predictive model was developed based on age, AMH level, and treatment type, achieving an area under the curve (AUC) of 0.756 for predicting live birth probability. Conclusions: This clinical prediction model offers guidance for couples and clinicians on pregnancy outcomes in low ovarian reserve patients treated with CHM alone or alongside IVF.<\/jats:p>","DOI":"10.3390\/medicina61091571","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T08:28:15Z","timestamp":1756715295000},"page":"1571","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Chinese Herbal Medicine on Pregnancy Outcomes in IVF Patients with Low Ovarian Reserve: A Predictive Model"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7542-5554","authenticated-orcid":false,"given":"Meng-Hsing","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu-Chiu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Traditional Chinese Medicine, Tainan Municipal Hospital, Tainan 701, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1149-8022","authenticated-orcid":false,"given":"Pei-Fang","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Statistics, National Cheng Kung University, Tainan 701, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3908-3427","authenticated-orcid":false,"given":"Liang-Miin","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Tainan Municipal Hospital, Tainan 701, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0824-9615","authenticated-orcid":false,"given":"Po-Ming","family":"Chen","sequence":"additional","affiliation":[{"name":"Research Assistant Center, Show Chwan Memorial Hospital, Changhua 500, Taiwan"},{"name":"Department of Nursing, Central Taiwan University of Science and Technology, Taichung 406, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3773-9015","authenticated-orcid":false,"given":"Chia-Jung","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2005-495X","authenticated-orcid":false,"given":"Hsing-Ju","family":"Wu","sequence":"additional","affiliation":[{"name":"Research Assistant Center, Show Chwan Memorial Hospital, Changhua 500, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6917-4875","authenticated-orcid":false,"given":"Chiung-Hung","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Traditional Chinese Medicine, Tainan Municipal Hospital, Tainan 701, Taiwan"},{"name":"School of Chinese Medicine for Post-Baccalaureate, I-Shou University, Kaohsiung 840, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1186\/s13048-023-01296-x","article-title":"Potential factors result in diminished ovarian reserve: A comprehensive review","volume":"16","author":"Zhu","year":"2023","journal-title":"J. Ovarian Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"R19","DOI":"10.1530\/REP-21-0022","article-title":"Mechanisms of ovarian aging","volume":"162","author":"Park","year":"2021","journal-title":"Reproduction"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1097\/GRF.0000000000000445","article-title":"Ovarian Reserve Testing: A Review of the Options, Their Applications, and Their Limitations","volume":"62","author":"Ulrich","year":"2019","journal-title":"Clin. Obstet. Gynecol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e057689","DOI":"10.1136\/bmjopen-2021-057689","article-title":"Effect of folic acid supplementation on diminished ovarian reserve: Study protocol of a single-centre, open-label, randomised, placebo-controlled clinical trial","volume":"12","author":"Liao","year":"2022","journal-title":"BMJ Open"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00018-020-03576-x","article-title":"New insights into anti-Mullerian hormone role in the hypothalamic-pituitary-gonadal axis and neuroendocrine development","volume":"78","author":"Silva","year":"2021","journal-title":"Cell. Mol. Life Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1007\/s13224-013-0482-3","article-title":"Anti-mullerian hormone: A new marker of ovarian function","volume":"64","author":"Dayal","year":"2014","journal-title":"J. Obstet. Gynaecol. India"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3361","DOI":"10.1210\/clinem\/dgaa513","article-title":"Anti-Mullerian Hormone and Ovarian Reserve: Update on Assessing Ovarian Function","volume":"105","author":"Moolhuijsen","year":"2020","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1002\/ibd.21872","article-title":"Ovarian reserve in young women of reproductive age with Crohn\u2019s disease","volume":"18","author":"Freour","year":"2012","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"200","DOI":"10.5217\/ir.2019.00103","article-title":"Risk Factors Associated with Impaired Ovarian Reserve in Young Women of Reproductive Age with Crohn\u2019s Disease","volume":"18","author":"Zhao","year":"2020","journal-title":"Intest. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.1007\/s10815-015-0595-y","article-title":"Diminished ovarian reserve, premature ovarian failure, poor ovarian responder\u2014A plea for universal definitions","volume":"32","author":"Cohen","year":"2015","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s40738-017-0041-1","article-title":"Fertility with early reduction of ovarian reserve: The last straw that breaks the Camel\u2019s back","volume":"3","author":"Rasool","year":"2017","journal-title":"Fertil. Res. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"597","DOI":"10.3945\/an.116.014647","article-title":"Current Evidence on Associations of Nutritional Factors with Ovarian Reserve and Timing of Menopause: A Systematic Review","volume":"8","author":"Moslehi","year":"2017","journal-title":"Adv. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.ss6909a1","article-title":"Assisted Reproductive Technology Surveillance\u2014United States, 2017","volume":"69","author":"Sunderam","year":"2020","journal-title":"MMWR Surveill. Summ."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2683","DOI":"10.1093\/humrep\/dep343","article-title":"The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009","volume":"24","author":"Adamson","year":"2009","journal-title":"Hum. Reprod."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"hoz017","DOI":"10.1093\/hropen\/hoz017","article-title":"Worldwide decline of IVF birth rates and its probable causes","volume":"2019","author":"Gleicher","year":"2019","journal-title":"Hum. Reprod. Open"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1093\/humrep\/der392","article-title":"Nomogram to predict pregnancy rate after ICSI-IVF cycle in patients with endometriosis","volume":"27","author":"Ballester","year":"2012","journal-title":"Hum. Reprod."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Zhang, Q., Wang, X., Zhang, Y., Lu, H., and Yu, Y. (2022). Nomogram prediction for the prediction of clinical pregnancy in Freeze-thawed Embryo Transfer. BMC Pregnancy Childbirth, 22.","DOI":"10.1186\/s12884-022-04958-8"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.1007\/s00404-024-07598-9","article-title":"Nomogram to predict the probability of clinical pregnancy in women with poor ovarian response undergoing in vitro fertilization\/intracytoplasmic sperm injection cycles","volume":"310","author":"Zhu","year":"2024","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1016\/j.fertnstert.2016.12.005","article-title":"Which factors are most predictive for live birth after in vitro fertilization and intracytoplasmic sperm injection (IVF\/ICSI) treatments? Analysis of 100 prospectively recorded variables in 8,400 IVF\/ICSI single-embryo transfers","volume":"107","author":"Vaegter","year":"2017","journal-title":"Fertil. Steril."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1093\/humrep\/dev268","article-title":"Predicting the chance of live birth for women undergoing IVF: A novel pretreatment counselling tool","volume":"31","author":"Dhillon","year":"2016","journal-title":"Hum. Reprod."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Kotlyar, A.M., and Seifer, D.B. (2020). Ethnicity\/Race and Age-Specific Variations of Serum AMH in Women\u2014A Review. Front. Endocrinol., 11.","DOI":"10.3389\/fendo.2020.593216"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1186\/s12967-025-06223-w","article-title":"The impact of mitochondrial dysfunction on ovarian aging","volume":"23","author":"Zhang","year":"2025","journal-title":"J. Transl. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e18246","DOI":"10.1097\/MD.0000000000018246","article-title":"Factors predicting clinical pregnancy rate of in vitro fertilization-embryo transfer (a STROBE-compliant article)","volume":"98","author":"Zhang","year":"2019","journal-title":"Medicine"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Si, M., Jiang, H., Zhao, Y., Qi, X., Li, R., Long, X., and Qiao, J. (2023). Nomogram for Predicting Live Birth after the First Fresh Embryo Transfer in Patients with PCOS Undergoing IVF\/ICSI Treatment with the GnRH-Ant Protocol. Diagnostics, 13.","DOI":"10.3390\/diagnostics13111927"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Wu, M.H., Su, P.F., Chen, K.Y., Tie, T.H., Ke, H.C., Chen, H., Su, Y.C., Ou, H.T., and Subramanian, S.K. (2018). Heart rate variability among women undergoing in vitro fertilization treatment: Its predictive ability for pregnancy. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0193899"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.3892\/etm.2016.3025","article-title":"Advancement in the treatment of diminished ovarian reserve by traditional Chinese and Western medicine","volume":"11","author":"Zhang","year":"2016","journal-title":"Exp. Ther. Med."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Jiang, M., Wang, W., Zhang, J., Wang, C., Bi, Y., Li, P., Yang, S., Li, J., Xu, Y.T., and Wang, T. (2020). Protective Effects and Possible Mechanisms of Actions of Bushen Cuyun Recipe on Diminished Ovarian Reserve Induced by Cyclophosphamide in Rats. Front. Pharmacol., 11.","DOI":"10.3389\/fphar.2020.00546"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/s13048-025-01669-4","article-title":"The role of Chinese herbal medicine in diminished ovarian reserve management","volume":"18","author":"Zhang","year":"2025","journal-title":"J. Ovarian Res."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Cao, H., Han, M., Ng, E.H., Wu, X., Flower, A., Lewith, G., Liu, J.P., and Walker, N. (2013). Can Chinese herbal medicine improve outcomes of in vitro fertilization? A systematic review and meta-analysis of randomized controlled trials. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0081650"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1016\/j.rbmo.2015.02.005","article-title":"Impact of whole systems traditional Chinese medicine on in-vitro fertilization outcomes","volume":"30","author":"Opsahl","year":"2015","journal-title":"Reprod. Biomed. Online"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1080\/14647273.2023.2266619","article-title":"Chinese herbal medicines as complementary therapy to in vitro fertilization-embryo transfer in women with infertility: Protocols and applications","volume":"26","author":"Chang","year":"2023","journal-title":"Hum. Fertil."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/9\/1571\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:36:29Z","timestamp":1760034989000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/9\/1571"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,31]]},"references-count":31,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["medicina61091571"],"URL":"https:\/\/doi.org\/10.3390\/medicina61091571","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2025,8,31]]}}}