Chinese medicine could double the chances of childless couples conceiving (?)

It is perfectly reasonable to believe that in the course of a very old civilization, herbal discoveries may have been made and passed on which have a genuine therapeutic benefit. After all, to this day a large part of the pharmacopeia is of herbal origin. And there are many places where Chinese herbalists enjoy considerable acceptance. Where I grew up (Innisfail), if you were sick, you went to the doctor. But if you were REALLY sick you went to the Chinese herbalist.

And I myself seem to have had some benefit from it. When I got glandular fever many years ago and the doctors told me that there was nothing they could do for it, my course of action was clear. I promptly went to a Chinese herbalist, took his preparations and was better within a week!

Anecdotes prove nothing of course but I mention that one to show that I was disposed to accept the findings below. I am afraid, however that I have to offer the old Scottish verdict of "Not Proven".

Meta-analyses are very hard to critique unless you either know the relevant literature very well or re-do the whole meta-analysis yourself. And if you do know well the literature that is analysed you can get a considerable shock at how badly such an analysis can be done -- even analyses reported in the most prestigious journals. I comment on one such analysis in my own research field here. The problem is particularly bad where there is a barrow to be pushed and "complementary" medicine is of course a very large barrow indeed.

My suspicions are aroused by the very large discrepancy reported between the effects of Chinese and Western medicine. It is a characteristic of quackery to claim exaggerated benefits and it seems to me that the endless search for new molecules carried out by drug companies would long ago have gone through anything as effective as that with a fine-toothed comb.

So in the end it gets back to what was meta-analysed. It seems to me that the people most likely to have done the sort of study described below would be enthusiasts for alternative therapies and we all know how large the effect of experimenter expectations can be. Just one good double-blind study from someone skeptical of Chinese medicine would be more persuasive.

I include the journal Abstract below

Couples with fertility problems are twice as likely to get pregnant using traditional Chinese medicine as western drugs, say researchers. They found a two-fold improvement in pregnancy rates over just four months of treatment from practitioners of traditional Chinese medicine.

At least six million Britons have consulted a Western or traditional Chinese herbal practitioner in the last two years, according to Ipsos Mori research. Previous research suggests acupuncture may help some childless couples to conceive.

The latest study from researchers at Adelaide University, Australia, reviewed eight clinical trials, 13 other studies and case reports comparing the efficacy of traditional Chinese medicine (TCM) with western drugs or IVF treatment.

The review funded by the Australian government included 1,851 women with infertility problems, says a report in the journal Complementary Therapies in Medicine.

Review of the clinical trials alone found a 3.5 rise in pregnancies over a four-month period among women using TCM compared with western medicine.

Other data covering 616 women within the review showed 50 per cent of women having TCM got pregnant compared with 30 per cent of those receiving IVF treatment.

The overall analysis concluded there was a two-fold increase in the likelihood of getting pregnant in a four-month period for women using TCM compared with orthodox approaches.

The study’s authors said ‘Our meta-analysis suggests traditional Chinese herbal medicine to be more effective in the treatment of female infertility - achieving on average a 60 per cent pregnancy rate over four months compared with 30 per cent achieved with standard western drug treatment.’

The study said the difference appeared to be due to the careful analysis of the menstrual cycle – the period when it is possible for a woman to conceive – by TCM practitioners.

It said ‘Assessment of the quality of the menstrual cycle integral to TCM diagnosis appears to be fundamental to the successful treatment of female infertility.’

Dr Karin Ried (correct) of the university’s school of population health and clinical practice, who led the study, said infertility affects one in six couples and even after investigations 20 per cent of infertility remains ‘unexplained’.

She said TCM recognises many more ‘menstrual disturbances’ than conventional medicine, is far less expensive than IVF treatment and less stressful.

Efficacy of Traditional Chinese Herbal Medicine in the management of female infertility: A systematic review

By Karin Ried & Keren Stuart

To assess the effect of Traditional Chinese Herbal Medicine (CHM) in the management of female infertility and on pregnancy rates compared with Western Medical (WM) treatment.

We searched the Medline and Cochrane databases and Google Scholar until February 2010 for abstracts in English of studies investigating infertility, menstrual health and Traditional Chinese Medicine (TCM). We undertook meta-analyses of (non-)randomised controlled trials (RCTs) or cohort studies, and compared clinical pregnancy rates achieved with CHM versus WM drug treatment or in vitro fertilisation (IVF). In addition, we collated common TCM pattern diagnosis in infertility in relation to the quality of the menstrual cycle and associated symptoms.

Eight RCTs, 13 cohort studies, 3 case series and 6 case studies involving 1851 women with infertility were included in the systematic review. Meta-analysis of RCTs suggested a 3.5 greater likelihood of achieving a pregnancy with CHM therapy over a 4-month period compared with WM drug therapy alone (odds ratio = 3.5, 95% CI: 2.3, 5.2, p < 0.0001, n = 1005). Mean (SD) pregnancy rates were 60 ± 12.5% for CHM compared with 32 ± 10% using WM drug therapy. Meta-analysis of selected cohort studies (n = 616 women) suggested a mean clinical pregnancy rate of 50% using CHM compared with IVF (30%) (p < 0.0001).

Our review suggests that management of female infertility with Chinese Herbal Medicine can improve pregnancy rates 2-fold within a 4 month period compared with Western Medical fertility drug therapy or IVF. Assessment of the quality of the menstrual cycle, integral to TCM diagnosis, appears to be fundamental to successful treatment of female infertility.


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