Effect of Chinese Herbal Medicine on Pregnancy Outcomes in IVF Patients with Low Ovarian Reserve: A Predictive Model

Background and Objectives: Live birth rates in women with diminished ovarian reserve (AMH < 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 < 0.001), with the control group as the reference. Women aged ≤37 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.