Traditional Chinese Medicine in the Treatment of Infertility: A Comprehensive Review

Infertility, defined as the failure to conceive after 1 year of regular unprotected intercourse, is increasingly prevalent and affecting younger populations. Traditional Chinese medicine (TCM) offers significant therapeutic potential for infertility, with its holistic approach and emphasis on syndrome differentiation minimizing the drawbacks of conventional hormone-based treatments. This review aims to summarize the regulatory mechanisms of infertility and evaluate the therapeutic effects of TCM, including single herbs and herbal formulas, along with their underlying mechanisms. Evidence suggests that TCM may contribute to the regulation of reproductive function through modulation of the hypothalamic-pituitary-ovarian axis, improvement of the local reproductive microenvironment and immune regulation. At the molecular level, studies have reported that bioactive components of certain TCM herbs interact with hormone receptors, cytokines' signalling pathways and antioxidant enzymes, thereby potentially influencing ovarian reserve, follicular development, endometrial repair and immune tolerance. This review highlights the theoretical basis for TCM in treating infertility and suggests that further mechanistic and clinical studies are essential to promote its clinical application and offer new, improved options for patients.