Using propensity score matching to evaluate the effect of complementary medicine on clinical and embryologic outcomes of in vitro fertilization

Objective: To evaluate associations between using complementary medical therapies (CMTs) and embryologic and clinical outcomes of in vitro fertilization (IVF). Methods: The present prospective questionnaire-based cohort study enrolled women aged 18–44 years undergoing their first, second, or third IVF cycle using their own oocytes at a large IVF clinic in Israel between February 1, 2013, and July 31, 2015. Clinical and embryologic data were obtained from patient records and patients completed a self-administered questionnaire that included details of any CMTs used to treat infertility. Propensity score matching was used and the proportion of top-quality embryos was compared between CMT users and non-users. Results: The study enrolled 400 participants and 134 (33.5%) reported using CMT to treat infertility. In an unmatched analysis, reduced endometrium thickness was observed among CMT users (P=0.020); differences were not observed for embryologic or other clinical parameters. Following propensity score matching, reduced endometrial thickness (P=0.046), and a lower proportion (P=0.046) and number (P=0.040) of top-quality embryos were observed among CMT users in comparison with patients who did not use CMTs. Conclusions: Using CMTs was associated with inferior clinical and embryologic outcomes; using CMTs during IVF treatment could contribute to adverse outcomes.