Effects of the Zishen Yutai Pill Compared With Placebo on Live Births Among Women in a Fresh Embryo Transfer Cycle: A Randomized Controlled Trial.

Obstet Gynecol

Center for Reproductive Medicine, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, the Reproductive Medicine Centre, Yuhuangding Hospital of Yantai, Affiliated Hospital of Qingdao University, Yantai, the Reproductive Medicine Centre, Shenzhen Armed Police Hospital, Shenzhen, the Assisted Reproduction Center, Maternal and Child Health Care Hospital of Shanxi Province, Xi'An, the Reproductive Medicine Centre, Shenzhen Zhongshan Urology Hospital, Shenzhen, the Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, the Reproductive Medicine Centre, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, the Reproductive Medicine Centre, Women's Hospital, Affiliated to Zhejiang University School of Medicine, Hangzhou, the Reproductive Medicine Centre, The Guangxi Zhuang Autonomous Region Health and Family Planning Commission Reproductive Center, Nanning, the Reproductive Medicine Centre, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning, the Reproductive Medicine Centre, Guangdong Women and Children Hospital, Guangzhou, the Reproductive Medicine Centre, Shanghai Ji Ai Genetics and IVF Institute, Shanghai, the Reproductive Medicine Centre, Liuzhou Maternal and Child Health Care Hospital, Liuzhou, the Reproductive Medical Center, the 2nd Affiliated Hospital of Zhengzhou University, Zhengzhou, the Reproductive Medicine Center, Obstetrics and Gynecology Department of Shengjing Hospital Affiliated to China Medical University, Shenyang, the Reproductive Medicine Centre, First Affiliated Hospital of Hainan Medical College, Haikou, the Reproductive Medicine Centre, Dongguan Kanghua Hospital, Dongguan, the Reproductive Medicine Centre, Peking University Third Hospital, Beijing, the Reproductive Medicine Centre, Dongguan GuangJi Hospital, Dongguan, the Department of Reproductive Genetics, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, the Reproductive Medicine Centre, The Third People's Hospital of Dongguan, Dongguan, China; and the Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut.

Published: February 2022

Objective: To assess the efficacy of the Zishen Yutai Pill compared with placebo on live birth rates among women after fresh embryo transfer cycles.

Methods: We conducted a double-blind, multicenter, placebo-controlled, randomized trial to investigate whether administration of the Zishen Yutai Pill would improve pregnancy outcomes among women undergoing fresh embryo transfer after in vitro fertilization or intracytoplasmic sperm injection. The primary outcome was live birth rate. Secondary outcomes were rates of implantation, biochemical pregnancy, clinical pregnancy, pregnancy loss, cycle cancellation, and maternal, fetal, and neonatal complications. A total sample size of 2,265 women (1:1 in two groups) was used to detect a live birth rate difference between the Zishen Yutai Pill and placebo. Participants were enrolled and randomized to receive 5 g of the Zishen Yutai Pill or placebo orally, three times per day during the study.

Results: Recruitment was completed between April 2014 and June 2017, with 2,580 patients screened. Two thousand two hundred sixty-five patients were randomized: 1,131 to the Zishen Yutai Pill and 1,134 to placebo. Characteristics were similar between groups. In intention-to-treat analysis, the rates of live birth in the Zishen Yutai Pill (ZYP) group and placebo group were 26.8% and 23.0% (rate ratio [RR], 1.16; 95% CI 1.01-1.34; P=.038), respectively. The implantation rates were 36.8% and 32.6% in the ZYP and placebo groups, respectively (RR 1.13; 95% CI 1.01-1.25; P=.027). The biochemical pregnancy rate for the ZYP group was 35.5% compared with 31.1% in the placebo group (RR 1.14; 95% CI 1.02-1.28; P=.026). The rates of clinical pregnancy in the ZYP and placebo groups were 31.2% compared with 27.3%, respectively (RR 1.14; 95% CI 1.00-1.30; P=.043). There were no significant between-group differences in the rates of pregnancy loss, maternal, or neonatal complications (all P>.05).

Conclusion: The Zishen Yutai Pill increased the rate of live birth after fresh embryo transfer compared with placebo.

Clinical Trial Registration: Chictr.org.cn, Chictr-TRC-14004494.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8759541PMC
http://dx.doi.org/10.1097/AOG.0000000000004658DOI Listing

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Article Synopsis
  • The study investigated the effects of Zishen Yutai Pill (ZYP) on live birth rates in infertile women undergoing frozen embryo transfer (FET) cycles after showing benefits in fresh cycles.
  • Conducted at 11 centers in China, 880 eligible participants were randomly assigned to receive either ZYP or a placebo, focusing on various pregnancy outcomes.
  • While the overall increase in live birth rates with ZYP compared to placebo was not statistically significant, specific subgroups, including women with a history of miscarriage and those of advanced maternal age, showed promising results.
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Objective: To investigate whether using Zishen Yutai Pills (ZYP) following embryo transfer would affect the live birth rate in frozen-thawed embryo transfer (FET) cycles.

Methods: A retrospective analysis was performed on 15044 FET cycles in the Reproductive Medicine Center of The Affiliated Chenggong Hospital of Xiamen University from January 2013 to December 2020. Patients who used Zishen Yutai Pills were defined as Zishen Yutai Pills Group (ZYP, n=2735), while patients who did not use them were defined as Non- Zishen Yutai Pills Group (Non-ZYP, n=12309).

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In this study, we analyzed the clinical efficacy of Zishen Yutai pills (ZSYTP) combined with metformin hydrochloride on infertile women diagnosed with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization and embryo transfer (IVF-ET). Patients were assigned into 3 groups: the ZSYTP group (n = 50), the metformin group (n = 50), and the combination group (ZSYTP combined with metformin hydrochloride, n = 50), based on their respective and the indicated treatments before undergoing IVF-ET. Then, their glucose metabolism indices, sex hormone indices, traditional Chinese medicine (TCM) syndrome scores, and outcomes of IVF-ET were compared.

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Ethnopharmacological Relevance: Zishen Yutai pills (ZYP), a traditional Chinese patent medicine, was listed in China in 1981. It is composed of 15 traditional Chinese medicines and has the effects of regulating menstruation, helping pregnancy, and preventing abortion. In clinical practice, it is effective in preventing habitual and threatened miscarriages, and continuing to explore its mechanism of action is very meaningful research.

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Zishen Yutai pills restore fertility in premature ovarian failure through regulating arachidonic acid metabolism and the ATK pathway.

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April 2024

Department of Obstetrics and Gynaecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. Electronic address:

Ethnopharmacological Relevance: The Zishen Yutai pills (ZYP), a Chinese medicinal formulation derived from the Qing Dynasty prescription "Shou Tai pills", have been documented to exhibit beneficial effects in clinical observations treating premature ovarian failure (POF). However, the anti-POF effects and its comprehensive systemic mechanism have not yet been clarified.

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