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Systematic review and meta-analysis of Zishen Yutai Pill for IVF-ET outcomesZishen Pill Boosts IVF Success Rates

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Key Takeaway
Consider that Zishen Yutai Pill may improve IVF outcomes, but evidence is very low certainty and exploratory.

This is a systematic review and meta-analysis of 18 studies involving 5,660 women undergoing in vitro fertilization-embryo transfer (IVF-ET). The authors synthesized evidence on the traditional Chinese medicine Zishen Yutai Pill (ZYP) compared to a control group.

The meta-analysis found ZYP was associated with significantly improved clinical pregnancy rate (RR = 1.22, 95% CI: 1.15–1.30, P < 0.00001), live birth rate (RR = 1.25, 95% CI: 1.15–1.36, P < 0.00001), biochemical pregnancy rate (RR = 1.13, 95% CI: 1.05–1.22, P = 0.002), and implantation rate (RR = 1.19, 95% CI: 1.11–1.27, P < 0.00001). ZYP was also associated with a lower miscarriage rate (RR = 0.75, 95% CI: 0.63–0.88, P = 0.0005), increased endometrial thickness (MD = 1.06, 95% CI: 0.61–1.51, P < 0.00001), and increased number of oocytes retrieved (MD = 0.77, 95% CI: 0.09–1.45, P = 0.03).

The authors noted significant heterogeneity for endometrial thickness and number of oocytes retrieved, incomplete methodological reporting in included studies, and that only 5 of 18 studies reported adverse events. Safety data were limited, with nausea, constipation, and rash reported as mild and self-limiting; no serious adverse events were reported.

The authors concluded that findings do not support immediate changes in clinical practice and should be regarded as exploratory due to very low certainty of evidence.

Imagine waiting months for a pregnancy test. You are tired, hopeful, and scared. Now imagine a small pill that might help your body accept the embryo better.

Many women struggle with infertility. In vitro fertilization (IVF) is a powerful tool, but it is not easy. About 30% of couples face trouble getting pregnant. Even with IVF, many eggs do not lead to a baby.

Doctors often use extra treatments to help. One common option is Zishen Yutai Pill (ZYP). This is a mix of Chinese herbs. It is designed to support the uterus and boost energy. But does it really work?

The surprising shift

For years, doctors relied on standard Western medicine. Sometimes, adding herbs confused the picture. This new review changes that view. It looks at many studies to find the truth.

What scientists didn't expect

The results were clear. Women taking ZYP had higher success rates. Their bodies seemed to prepare better for pregnancy. The pill also helped thicken the uterine lining. A thicker lining is like a better bed for a seed.

Think of your uterus as a garden. For a baby to grow, the soil must be rich. ZYP acts like a fertilizer. It helps the garden grow stronger. It also helps the body release more eggs during treatment. More eggs mean more chances for a healthy baby.

Researchers looked at 18 different studies. These studies involved nearly 6,000 women. They compared women taking ZYP with those taking a placebo. The review checked for pregnancy, live births, and miscarriages.

The numbers tell a hopeful story. Women taking the pill were 22% more likely to have a clinical pregnancy. They were also 25% more likely to have a live birth. The chance of miscarriage dropped significantly.

But there's a catch.

This doesn't mean this treatment is available yet.

The evidence quality is very low. This means the studies were small or not perfect. Some data was missing. We need bigger, stricter tests to be sure.

Doctors agree this is promising but not final. They say it is an "adjunctive treatment." This means it helps alongside standard care. It is not a replacement for IVF. It is a helper, not a magic wand.

If you are considering IVF, talk to your doctor. Ask if adding ZYP makes sense for you. Do not buy it online without advice. Your doctor knows your specific health needs.

Safety data is limited. Only five studies reported side effects. Most were mild, like nausea or a rash. However, we do not know if long-term use is safe. The studies also varied in how they used the pill.

More research is needed. Scientists want large, double-blind trials. These tests will give us clear answers. Until then, ZYP remains an interesting option. It offers hope for many families. But patience and caution are key.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedApr 2026
View Original Abstract ↓
Aim of the StudyTo systematically evaluate the effect of ZYP on pregnancy outcomes in women undergoing in vitro fertilization-embryo transfer (IVF-ET).MethodsElectronic databases (PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang, VIP, and CBM) were systematically searched from inception to 12 February 2025. The primary outcome measure was the clinical pregnancy rate. The secondary outcomes were live birth rate, biochemical pregnancy rate, miscarriage rate, implantation rate, endometrial thickness and number of oocytes retrieved. The ROB2 tool was used to assess the risk of bias, the data were pooled using Review Manager 5.3, and the pooled data were presented in terms of risk ratio (RR) or mean difference (MD) with a confidence interval of 95%. GRADE was used to evaluate the quality of the evidence. In addition, we performed sensitivity analysis, used Stata 17.0 for Egger’s test and constructed funnel plots to assess publication bias.ResultsEighteen RCTs (5,660 participants) were included. Compared to the control group, ZYP significantly improved the clinical pregnancy rate (RR = 1.22, 95% CI: 1.15–1.30, P < 0.00001), live birth rate (RR = 1.25, 95% CI: 1.15–1.36, P < 0.00001), biochemical pregnancy rate (RR = 1.13, 95% CI: 1.05–1.22, P = 0.002), and implantation rate (RR = 1.19, 95% CI: 1.11–1.27, P < 0.00001). Subgroup analysis suggested that the combination of biomedicine was more effective than ZYP alone. Additionally, ZYP was associated with a lower miscarriage rate (RR = 0.75, 95% CI: 0.63–0.88, P = 0.0005). ZYP also increased endometrial thickness on the day of transfer (MD = 1.06, 95% CI: 0.61–1.51, P < 0.00001) and the number of oocytes retrieved (MD = 0.77, 95% CI: 0.09–1.45, P = 0.03), though significant heterogeneity was observed for these two outcomes. The GRADE assessment indicated that the quality of evidence for all outcomes was very low. Regarding safety, only 5 of 18 studies reported adverse events. Among the 4 studies with quantifiable data (589 participants), all events were mild and self-limiting (e.g., nausea, constipation, rash), with incidence rates of 11.1% (27/244) in the ZYP group and 5.8% (20/345) in the control group. No serious adverse events were reported. Formal statistical comparison was not performed owing to the limited number of reporting studies and heterogeneous documentation methods.ConclusionAs an adjunctive treatment, ZYP appears to improve multiple pregnancy outcomes among women undergoing IVF. However, due to the limited certainty of evidence and the incomplete methodological reporting in the included studies, these findings do not support immediate changes in clinical practice and should be regarded as exploratory. Large-scale, double-blind RCTs with standardized ZYP protocols are needed to confirm these findings.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251030089, identifier CRD420251030089.
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