Abstract Infertility is a major global public health concern. Although in vitro fertilization and embryo transfer (IVF-ET) offers reproductive hope for some patients, overall success rates remain limited, and repeated failure continues to pose a substantial clinical challenge. Recent studies suggest that traditional Chinese medicine (TCM) may provide clinical benefits when integrated into IVF-ET treatment and during the interval after unsuccessful cycles. This case report describes a 40-year-old woman of advanced maternal age with repeated IVF-ET failure. She had a history of one spontaneous pregnancy loss. Evaluation revealed bilateral tubal patency. After 3 years of infertility, she underwent assisted reproduction at a reproductive center in Sichuan. Hyperinsulinemia was identified and treated with oral metformin before IVF-ET. Two consecutive IVF-ET cycles failed to achieve implantation. Hysteroscopy subsequently confirmed chronic endometritis, which was then treated. A third IVF-ET cycle resulted in pregnancy, but early pregnancy loss was diagnosed at 7 weeks of gestation, and uterine evacuation was performed. Because of her strong desire to conceive, she sought TCM treatment at the hospital of Chengdu University of TCM before attempting another IVF-ET cycle. After a comprehensive assessment, 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. Attempts at natural conception were also encouraged during treatment. After 4 months of TCM therapy, she conceived spontaneously. TCM treatment was continued to support the pregnancy, and she ultimately achieved a successful delivery. This case highlights phase-based sequential TCM treatment combined with mind-body intervention as a distinctive management strategy. In women of advanced maternal age with infertility and prior IVF-ET failure, particularly in the context of limited biomedical treatment options, this approach may offer a new possibility for natural conception and provide a potentially effective TCM-based pathway for intervention. Graphical abstract Highlights: Traditional Chinese medicine (TCM) offers a distinctive stage-based strategy for repeated IVF-ET failure in advanced maternal age. Phase-based sequential intervention with mind-body regulation highlights the holistic strengths of TCM. TCM provides a complementary and alternative option when further IVF-ET is constrained. In Brief: This case highlights the distinctive value of TCM in repeated in vitro fertilization and embryo transfer (IVF-ET) failure in a woman of advanced maternal age. Phase-based sequential intervention with mind-body regulation was applied during the interval after failed IVF-ET, simultaneously supporting pre-IVF conditioning and creating an opportunity for spontaneous conception, with important clinical and research value.
Zhong et al. (Wed,) studied this question.
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