Whole systems traditional Chinese medicine utilization among women undergoing frozen embryo transfers at an academic fertility center.

OBJECTIVE: To investigate sociodemographic and clinical variables associated with Whole Systems Traditional Chinese Medicine (WS-TCM) utilization alongside frozen embryo transfers (FETs) after in vitro fertilization. DESIGN: We conducted a retrospective review of all autologous FETs performed within an academic medical center's fertility clinic between January 2019 and March 2024. One FET cycle per patient was randomly selected for analysis. After conducting bivariate analyses, a logistic regression model was employed to examine independent associations with WS-TCM utilization. SUBJECTS: Women aged 21-42 who underwent an FET after in vitro fertilization. FETs involving donor egg embryos, gestational carriers, and those with missing live birth outcome data were excluded. EXPOSURE: Attending ≥1 WS-TCM appointment between 120 days pre- and 12 days post-FET. Whole Systems Traditional Chinese Medicine treatment modalities included individualized acupuncture, nutritional and lifestyle modifications, and focused dietary supplements. MAIN OUTCOME MEASURES: Sociodemographic and clinical variables associated with WS-TCM utilization. RESULTS: Of 799 women studied, 162 (20.3%) utilized WS-TCM, receiving a median of 5.5 treatments between 120 days pre- and 12 days post-FET. Whole Systems Traditional Chinese Medicine users resided in neighborhoods with higher median income ($83,025 vs. $75,602). Previous medical histories of women incorporating WS-TCM included higher rates of migraine/headache (21.6% vs. 13.3%), musculoskeletal pain (37.0% vs. 27.5%), recurrent pregnancy loss (RPL; 25.9% vs. 12.9%), pain associated with genital organs (21.0% vs. 14.1%), and undergoing more assisted reproductive technology cycles. Higher neighborhood median income (adjusted odds ratio and 95% confidence interval: 1.36 [1.13, 1.64]), recurrent pregnancy loss (2.15 [1.33, 3.47]), and undergoing ≥3 vs. 0-1 assisted reproductive technology cycles (1.78 [1.02, 3.06]) were independently associated with higher odds of WS-TCM engagement, whereas higher body mass index (0.79 [0.64, 0.97]), undergoing preimplantation genetic testing (0.61 [0.39, 0.94]), and having a history of salpingitis/oophoritis/pelvic inflammatory disease (0.59 [0.37, 0.92]) or high-risk pregnancy supervision (0.53 [0.30, 0.93]) were associated with lower odds. CONCLUSION: Within this cohort, multiple pain- and reproductive health-related diagnoses were more prevalent among individuals utilizing WS-TCM. Findings inform factors that may influence clinicians' and patients' decisions to refer or pursue WS-TCM (e.g., migraine, musculoskeletal pain, RPL) and covariates that should be accounted for in future observational studies of WS-TCM's effectiveness.