The role of Chinese herbal medicine in diminished ovarian reserve management.

Diminished Ovarian Reserve (DOR) is characterized by a reduction in the number of available follicles in the ovaries, leading to hormonal imbalances, decreased ovarian reserve, and reduced fertility. Clinically, it presents with elevated follicle-stimulating hormone (FSH) levels, decreased anti-Müllerian hormone (AMH) levels, and a lower antral follicle count (AFC). In recent years, Traditional Chinese Medicine (TCM) has gained recognition for its multi-target, holistic regulation in treating DOR, offering broad therapeutic effects with minimal side effects. This review aims to summarize the mechanisms and clinical efficacy of Chinese herbal medicine (CHM) formulas and active compounds in the treatment of DOR, providing theoretical support for their clinical application and future research. A systematic literature search was conducted from June 2019 to June 2024, and 12 clinical studies along with 38 basic research papers were selected. The findings suggest that CHM formulas primarily act by counteracting oxidative stress, regulating immune defense, modulating sex hormone secretion via the hypothalamic-pituitary-ovarian axis, and inhibiting excessive apoptosis of ovarian granulosa cells. This review highlights the therapeutic potential of TCM for improving ovarian function, regulating endocrine balance, and alleviating DOR symptoms, offering valuable insights for clinical practice and research.