Berberine as adjuvant therapy for treating reduced fertility potential in women with polycystic ovary syndrome: A meta-analysis of randomized controlled trials

Objective: To evaluate the effect of berberine as adjuvant therapy for the treatment of reduced fertility potential in women with polycystic ovary syndrome (PCOS) through a meta-analysis. Methods: We comprehensively searched CNKI, SinoMed, Wanfang, Cochrane Library, PubMed, Embase databases to identify randomized controlled trials (RCTs) evaluating the effect of berberine as adjuvant therapy for treating reduced fertility potential in women with PCOS. Results: A total of 10 RCTs involving 713 patients were included. Berberine in combination with Western medicine significantly improved endometrial thickness (weight mean difference [WMD] 1.62 mm; 95 % confidence interval [CI] 1.39-1.85), ovulation rate (risk ratio [RR] 1.41; 95 % CI 1.26-1.60), and clinical pregnancy rate (RR 1.96; 95 % CI 1.59-2.41) compared to Western medicine alone. Moreover, berberine as adjuvant therapy also significantly reduced the blood levels of luteinizing hormone (WMD -2.07 U/L; 95 % CI -2.62 to -1.51) and total testosterone (standard mean difference -0.70; 95 % CI -1.02 to -0.39) but not the level of folliclestimulating hormone level (WMD -0.23 IU/L; 95 % CI -0.52 to 0.06). Conclusions: Berberine may serve as an adjuvant therapy to enhance ovulation and increase clinical pregnancy rates in women with PCOS. The potential advantages of berberine may be linked to improvements in endometrial thickness, total testosterone, and luteinizing hormone level. However, further clinical trials are needed to confirm these findings and establish definitive conclusions.