Addressing the clinical challenge of repeated IVF–ET failure in women of advanced maternal age: Advantages of sequential phase-based traditional Chinese medicine therapy
image: Phase-based TCM intervention during the interval after failed IVF-ET: a case report
Credit: Hanzhi Zhong
Recently, Professor Shaobin Wei’s team from the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine published an article in the World Journal of Integrated Traditional and Western Medicine（WJIM）entitled “Addressing Repeated IVF–ET Failure in Women of Advanced Maternal Age: A Case Report of Sequential Phase-Based Traditional Chinese Medicine Treatment.”
Based on the first batch of typical clinical cases of traditional Chinese medicine selected by the China Association of Chinese Medicine, namely “A Case of Spontaneous Pregnancy After Repeated In Vitro Fertilization and Embryo Transfer（IVF–ET）Failure in a Woman of Advanced Maternal Age Treated with Sequential Phase-Based Therapy Through Regulation of the Liver, Spleen, and Kidney,” this article focuses on the therapeutic challenge of repeated IVF-ET failure in women of advanced maternal age. It analyzes the value and advantages of traditional Chinese medicine（TCM）intervention during the peri-IVF-ET period and the interval after failed IVF-ET and proposes recommended strategic layouts, research directions, anticipated goals and value, and suggested funding priorities around evidence system development, optimization of integrated Chinese and Western medicine treatment models, and translation of clinical practice outcomes.
Infertility is a common and difficult gynecological condition with complex etiologies and multiple influencing factors. With the increasing number of women of advanced maternal age seeking pregnancy, these patients often face reduced embryo implantation rates, clinical pregnancy rates, and live birth rates, as well as increased miscarriage rates when undergoing assisted reproductive technology. For women of advanced maternal age with complex etiologies and repeated IVF-ET failure, current therapeutic strategies remain limited in improving pregnancy outcomes.
The article reports a complex and difficult case of a 40-year-old woman with 4 years of infertility, three failed IVF-ET attempts, and two previous spontaneous miscarriages. The patient had multiple factors affecting infertility and pregnancy outcomes, including hyperinsulinemia, chronic endometritis, subclinical hypothyroidism, and a possible prethrombotic state. After a comprehensive assessment, Professor Wei Shaobin developed a phase-based sequential TCM regimen tailored to the follicular and luteal phases was initiated, and psychological support was provided to alleviate anxiety and distress, and advised the patient to attempt spontaneous pregnancy during treatment. After 4 months of TCM treatment, the patient achieved spontaneous pregnancy. She then received integrated Chinese and Western medicine treatment for pregnancy maintenance and ultimately delivered at term, with both mother and infant in good health. This case demonstrated favorable outcomes with sequential phase-based TCM treatment when conventional Western medical strategies and approaches had encountered limitations.
This article suggests that TCM may play a role in two key stages: the peri-IVF-ET period and the interval after failed IVF-ET. During the peri-IVF-ET period, TCM can participate in the pre-stimulation phase, controlled ovarian stimulation, endometrial preparation for embryo transfer, and post-embryo-transfer luteal phase support stage. By integrating biomedical diagnosis with TCM pattern differentiation and drawing on the multi-target and multi-pathway regulatory characteristics of herbal medicine, integrated TCM-biomedical treatment protocols and clinical pathways may be developed. During the interval after failed IVF-ET, sequential phase-based TCM intervention and emotional regulation may promote physical and psychological recovery, creating favorable conditions for subsequent IVF treatment or spontaneous pregnancy.
Repeated IVF-ET failure in women of advanced maternal age is a key and difficult issue in assisted reproduction. At present, the evidence base for many therapeutic approaches in this population remains relatively weak, and the appropriate patient populations for TCM intervention, the optimal timing of such interventions, and its positioning within the overall diagnostic and treatment framework still need to be further clarified. The value of this article lies in distilling a diagnostic and therapeutic approach centered on sequential phase-based TCM treatment and coordinated mind-body regulation. It clarifies the advantageous role of TCM in repeated IVF-ET failure among women of advanced maternal age, establishes a phase-based intervention model linking the peri-IVF-ET period with the interval after failed IVF-ET, and discusses evidence system development, optimization of integrated Chinese and Western medicine clinical pathways, and translation of clinical practice outcomes, thereby proposing scientific research ideas and clinical practice pathways with distinctive TCM characteristics.
Full Article Link: https://doi.org/10.70976/j.2096-0964.WJIM-2026-0002
World Journal of Integrated traditional and western Medicine (English Version) (WJIM, CN 10-1354/R, ISSN 2096-0964) is a quarterly, English-language, peer-reviewed academic journal dedicated to advancing the integration of traditional Chinese and Western medicine. Established in 2015, the journal is supervised by the China Association for Science and Technology and is solely sponsored by the China Association of Chinese Medicine. The founding Editor-in-Chief was Professor Wu Yiling, Academician of the Chinese Academy of Engineering, with Professor Lu Zhizheng, a distinguished TCM Master, serving as the Honorary Editor-in-Chief. The current Editor-in-Chief is Professor Zhang Xiaoxiao.
WJIM aims to report original theoretical research, the development and application of novel technologies and methodologies, as well as breakthroughs in clinical scientific inquiries, to promote the international exchange of Chinese medicine and integrative medicine.
WJIM welcomes manuscripts from all over the world on all aspects of traditional Chinese medicine, Chinese materia medica, and integrated traditional Chinese and Western medicine. Article types include Perspective, Review, Research Article, and Case Reports etc.
website: www.tcmjc.com/wjim/home