Best Chinese Fertility Herbs: Dang Gui, Tu Si Zi and the Cycle Formulas I Prescribe Most

By Dr (TCM) Attilio D'Alberto | Traditional Chinese Medicine Practitioner, Wokingham

The best Chinese herbs for fertility are Dang Gui, Tu Si Zi, Gou Qi Zi, He Shou Wu and Yin Yang Huo for women, combined into cycle-phase formulas such as Si Wu Tang, Wen Jing Tang and Jia Wei Xiao Yao San; and Gou Qi Zi, Yin Yang Huo, Wu Wei Zi and Dong Chong Xia Cao for men. A meta-analysis of 40 RCTs covering 4,247 women found Chinese herbal medicine produced a 1.74-fold higher pregnancy rate than western medical treatment alone (60% vs 33% over 3–6 months) across PCOS, endometriosis, anovulation and unexplained infertility. This is the practitioner's guide to the herbs and formulas I prescribe most for fertility, what they do, the research that supports them, and how they fit alongside conventional fertility treatment and IVF.

Chinese herbal medicine has 2,000 years of documented use in fertility, and is one of the most evidence-backed natural fertility treatments available. Unlike single-target supplements, Chinese herbs work systemically — they correct the underlying TCM pattern (Kidney yin or yang deficiency, blood stasis, Liver qi stagnation, phlegm-damp) so that egg quality, ovulation, sperm production, the uterine environment, and implantation all improve together. In my Wokingham clinic I prescribe pharmaceutical-grade Sun Ten granules from Taiwan, blended individually for each patient and adjusted across the menstrual cycle. This page is the practitioner's guide to the herbs and formulas I prescribe most for fertility, what they do, and how they fit with conventional fertility treatment.

On this page

1. How Chinese herbs work for fertility
2. The evidence base
3. Key herbs for female fertility
4. Key herbs for male fertility
5. Key fertility formulas
6. Cycle-phase prescribing
7. Combining with IVF
8. Treatment timeline
9. Chinese herbs for fertility over 40
10. Safety, quality and sourcing
11. Cautions and contraindications
12. FAQs

How do Chinese herbs work for fertility?

Chinese herbs work for fertility through seven documented mechanisms: HPO-axis modulation (normalising LH and FSH and restoring ovulation), improved ovarian and uterine blood flow on Doppler, better follicular environment for egg quality, endometrial development, anti-inflammatory and immunomodulatory effects, spermatogenesis support, and HPA-axis regulation that lowers cortisol and regularises cycles.

Chinese herbs influence fertility through several documented mechanisms:

• HPO-axis modulation — normalising LH and FSH; restoring ovulation in PCOS, hypothalamic amenorrhoea and post-pill states.
• Improved ovarian and uterine blood flow — Doppler studies show reduced uterine artery resistance after combined herbal treatment.
• Better follicular environment — antioxidants, mitochondrial support, hormonal balance — improves egg quality.
• Endometrial development — blood-building and warming herbs thicken and improve receptivity of the lining.
• Anti-inflammatory and immunomodulatory effects — relevant for endometriosis, autoimmune-related infertility, and unexplained infertility.
• Spermatogenesis — yang-tonifying and antioxidant herbs improve count, motility and DNA integrity.
• Stress and HPA-axis regulation — Qi-moving formulas reduce cortisol and improve cycle regularity.

The evidence base for Chinese herbs for fertility

The Cochrane systematic review (Ried 2015) found Chinese herbal medicine doubled pregnancy rates compared with conventional Western treatment in subfertile women. PCOS-specific meta-analyses show combined acupuncture and herbal medicine outperforms metformin and clomiphene alone for ovulation rate, and male-fertility trials confirm consistent improvements in sperm count, motility and DNA integrity.

• Cochrane systematic review (Ried 2015) — Chinese herbal medicine doubled pregnancy rates compared with conventional Western treatment in subfertile women.
• PCOS-specific meta-analyses — combined acupuncture and herbal medicine outperforms metformin and clomiphene alone for ovulation rate.
• Endometriosis trials — Gui Zhi Fu Ling Wan reduces endometrioma size and CA-125 in multiple RCTs.
• Male infertility trials — herbs such as Yin Yang Huo, Wu Zi Yan Zong Wan and Lycium consistently improve sperm count, motility and DNA integrity in randomised trials.
• IVF integration trials — pre-cycle TCM herbal treatment improves egg quality, embryo development and live birth rates in selected populations.

I prescribe within the framework of pattern diagnosis, not single-herb supplementation, which is what the strongest research evidence supports.

Best Chinese herbs for female fertility

The best Chinese herbs for female fertility are Dang Gui (the women's tonic, nourishes and moves Blood), Shu Di Huang (Kidney Yin and Jing tonic for low AMH), Tu Si Zi (the most versatile fertility herb), Bai Shao (Liver Blood and dysmenorrhoea), Yin Yang Huo (Kidney Yang and cold-uterus), Gou Qi Zi (Kidney/Liver Yin and AMH support), Xu Duan + Sang Ji Sheng (recurrent pregnancy loss) and Dan Shen (uterine microcirculation).

Dang Gui (Angelica sinensis)

The most important women's tonic herb. Nourishes and moves blood, regulates menstruation, improves uterine circulation. Workhorse for blood deficiency, irregular cycles, painful periods. Found in dozens of fertility formulas.

Shu Di Huang (Prepared Rehmannia)

The principal Kidney yin and jing tonic — the cornerstone of treatment for low AMH, diminished ovarian reserve, poor egg quality and perimenopausal infertility.

Tu Si Zi (Cuscuta)

Tonifies both Kidney yang and yin, consolidates jing, supports the luteal phase. The most versatile fertility herb — used across virtually all fertility patterns. Essential herb in Wu Zi Yan Zong Wan ("five seed formula").

Bai Shao (white peony)

Nourishes Liver blood, relieves pain, softens the Liver. Key for dysmenorrhoea, blood deficiency, premenstrual tension from Liver qi stagnation.

Yin Yang Huo (epimedium)

Strongly tonifies Kidney yang. In women, useful for cold-uterus, low BBT, late ovulation and post-pill recovery.

Gou Qi Zi (goji berries)

Nourishes Kidney and Liver yin, replenishes jing. Mild, daily-use tonic; key herb in Wu Zi Yan Zong Wan; supports egg quality and AMH.

Xu Duan and Sang Ji Sheng

Both tonify Kidney and Liver, strengthen the lower back and "calm the foetus" — used together for threatened miscarriage and recurrent pregnancy loss with Kidney deficiency.

Dan Shen (salvia)

Moves blood and improves microcirculation — particularly useful for uterine artery flow, endometriosis, fibroids, and unexplained infertility with stasis features.

Yi Mu Cao (motherwort)

Moves blood and reduces uterine stasis; classical herb for menstrual regulation and reducing clotting.

Mai Ya (barley sprout)

Reduces prolactin in idiopathic hyperprolactinaemia at 60-120 g doses; useful in stress-driven hyperprolactinaemia affecting fertility.

Best Chinese herbs for male fertility

The best Chinese herbs for male fertility are Yin Yang Huo (epimedium, Kidney Yang and sperm motility), Gou Qi Zi (antioxidant for sperm count, motility and DNA), Huang Qi (sperm motility and immunological infertility), Lu Rong (severe Jing-Yang deficiency including azoospermia), the five seeds of Wu Zi Yan Zong Wan (Tu Si Zi, Wu Wei Zi, Fu Pen Zi, Che Qian Zi, Gou Qi Zi) and Dan Shen (testicular microcirculation in varicocele).

Yin Yang Huo (epimedium)

Strongly tonifies Kidney yang and improves sperm motility. RCTs confirm improvements in semen parameters and testosterone in men with Kidney yang deficiency.

Gou Qi Zi (lycium)

Antioxidant Kidney yin and jing tonic. RCT evidence for improved sperm count, motility and DNA integrity. Often combined with vitamin E for oxidative stress.

Huang Qi (astragalus)

Tonifies qi; improves sperm motility in clinical trials; useful for immunological infertility.

Lu Rong (deer antler velvet)

Strongest jing-and-yang tonic in the pharmacopoeia. Reserved for severe deficiency presentations including azoospermia with low FSH and testosterone.

Tu Si Zi, Wu Wei Zi, Fu Pen Zi, Che Qian Zi, Gou Qi Zi

The "five seeds" of Wu Zi Yan Zong Wan — the classical male fertility formula.

Dan Shen (salvia)

Moves blood; improves testicular microcirculation; useful in varicocele and idiopathic male infertility.

Suo Yang and Rou Cong Rong

Yang-tonifying herbs traditionally combined for low libido and erectile difficulty in deficiency-cold patterns.

Key Chinese herbal formulas for fertility

The key Chinese herbal formulas for fertility are Zuo Gui Wan (Kidney Yin and Jing for low AMH), You Gui Wan (Kidney Yang for cold uterus), Wu Zi Yan Zong Wan (male fertility), Ba Zhen Tang (Qi and Blood deficiency), Gui Zhi Fu Ling Wan (endometriosis and fibroids), Wen Jing Tang (cold and blood stasis in the uterus), Xiao Yao San (stress-driven cycle irregularity) and Cang Fu Dao Tan Tang (PCOS with insulin resistance).

• Zuo Gui Wan — Kidney yin and jing tonic; the cornerstone formula for low AMH, dryness, hot-type fertility patterns.
• You Gui Wan — Kidney yang and jing tonic; the cornerstone for cold-uterus, low BBT, low libido and recurrent miscarriage from Kidney yang deficiency.
• Wu Zi Yan Zong Wan — "Five seed formula"; balanced jing tonic for both partners; used widely in male fertility.
• Ba Zhen Tang — qi and blood deficiency; postnatal recovery and pre-conception preparation.
• Gui Zhi Fu Ling Wan — blood stasis with masses; endometriosis, fibroids, adenomyosis.
• Wen Jing Tang — cold and blood stasis in the uterus; thin endometrium, recurrent miscarriage, period pain with cold.
• Xiao Yao San — Liver qi stagnation with blood deficiency; stress-driven cycle irregularity, PMS.
• Cang Fu Dao Tan Tang — phlegm-damp; the workhorse for PCOS with insulin resistance and weight around the middle.
• Modified Bu Shen Tiao Jing Tang — modern Kidney-tonifying fertility formula.

Cycle-phase prescribing

The most effective fertility prescribing follows the four phases of the cycle:

• Menstrual phase (days 1-5) — blood-moving formulas to support complete shedding (Si Wu Tang, Tao Hong Si Wu Tang).
• Follicular phase (days 6-13) — Kidney yin and blood tonics for follicle development (modified Liu Wei Di Huang Wan, Si Wu Tang).
• Ovulation (days 14-16) — qi-moving and yang-warming herbs for the LH surge and follicle release (chai hu, xiang fu, yi mu cao with yin yang huo, tu si zi).
• Luteal phase (days 17-28) — Kidney yang and Spleen qi tonics for the corpus luteum (You Gui Wan, modified Bu Zhong Yi Qi Tang, Tu Si Zi-rich formulas).

Cycle-phase prescribing produces consistently better results than single-formula approaches in my clinic and in published trials.

Combining with IVF

Chinese herbs combine well with IVF when used strategically:

• Pre-cycle preparation (3 months before stimulation) — herbs to optimise egg quality and uterine receptivity. Strong blood-movers and warming herbs are useful here.
• During stimulation — most clinics ask patients to pause herbs, particularly strong blood-movers; some specialist herbalists continue gentler tonics.
• Around transfer — herbs are usually paused; acupuncture continues.
• Post-transfer / luteal support — gentle Kidney-yang formulas can support implantation; coordinate with your IVF clinic.
• Between cycles — full active herbal treatment to improve baseline and prepare for the next cycle.

Treatment timeline

• Cycles 1-2 — sleep, energy, PMS and cycle pain typically improve first.
• Cycles 2-3 — cycle length and ovulation regularity often normalise; BBT pattern improves.
• Cycles 3-6 — peak window for natural conception; AMH and follicular development show measurable change.
• Cycles 6-12 — for longer-standing cases (chronic PCOS, post-pill recovery, low AMH, recurrent miscarriage), full benefit reached.
• Male fertility — minimum 90 days because spermatogenesis takes 74 days; semen analysis re-checked at 3 and 6 months.

Chinese herbs for fertility over 40

For women trying to conceive over 40, Chinese herbal medicine focuses on preserving and replenishing Kidney Yin and Essence (Jing) — the foundational substances behind ovarian reserve, egg quality and uterine receptivity. The principal herbs are Tu Si Zi, Shu Di Huang, He Shou Wu, Gou Qi Zi and Sang Ji Sheng, combined into classical formulas: Zuo Gui Wan for strong Kidney Yin and Essence tonification (cornerstone for low AMH), Liu Wei Di Huang Wan for gentler long-term support, You Gui Wan for Kidney Yang deficiency and Er Xian Tang for combined Yin and Yang in perimenopause.

For the full over-40 protocol — including CoQ10 and DHEA dosing, mini-IVF, donor egg decision-making and realistic timelines — see the dedicated guide: How to improve fertility naturally over 40.

Safety, quality and sourcing

• Use only properly trained Chinese herbal medicine practitioners (UK: RCHM, ATCM).
• Insist on pharmaceutical-grade granules from a reputable manufacturer (I use Sun Ten Taiwan) — these are tested for heavy metals, pesticides, microbial contamination, and identity.
• Avoid cheap online "Chinese herbal" preparations of unknown origin.
• Avoid raw herbs from non-medical sources.
• Tell your doctor and fertility consultant what you are taking.
• Some herbs interact with medications — discuss with your prescriber.

Cautions and contraindications

• Pregnancy — many fertility herbs (especially blood-movers) are stopped at the first positive pregnancy test; some are continued (e.g., Xu Duan, Sang Ji Sheng) for threatened miscarriage under specialist guidance.
• Strong blood-movers — pause during heavy menstruation if flow is already heavy.
• Anticoagulants — caution with strong blood-movers (Dan Shen, Tao Ren, Hong Hua).
• Hormone-sensitive cancer history — avoid hormone-modulating herbs without specialist input.
• Acute infection — pause tonifying herbs during fever or acute viral illness.
• Children and adolescents — different prescribing principles; specialist input.
• Always tell your prescriber what you are taking.

Frequently asked questions

Do Chinese herbs really work for fertility?

Yes. Cochrane reviews and multiple meta-analyses show pregnancy rates roughly double with Chinese herbal treatment compared with conventional Western treatment in subfertile women. Effects build over 3-6 months.

Which Chinese herb is best for fertility?

There is no single "best" herb — fertility responds to pattern-tailored formulas, not single herbs. Tu Si Zi, Dang Gui, Shu Di Huang and Bai Shao appear in most female fertility formulas; Yin Yang Huo, Gou Qi Zi and Tu Si Zi are central to male fertility formulas.

Can I take Chinese herbs alongside IVF?

Yes, strategically. Best used in the 3-month preparation window, paused during active stimulation, and resumed (in adjusted form) post-transfer. Coordinate with both your fertility clinic and your herbalist.

How long until I see results?

2-3 cycles for cycle and PMS improvement, 3-6 cycles for measurable fertility outcomes, 6-12 cycles for longer-standing or more severe cases. Sperm parameters need 90+ days minimum.

Are Chinese fertility herbs safe?

Yes when prescribed by a qualified practitioner using pharmaceutical-grade granules. Always tell your doctor and fertility consultant what you are taking; some herbs interact with medications.

Should I buy Chinese herb supplements off the shelf?

No. Single-herb supplements rarely match the clinical effect of properly blended formulas, and quality varies enormously. A practitioner consultation gives much better results.

Can men take Chinese herbs for fertility?

Absolutely. Male fertility responds well to Wu Zi Yan Zong Wan-based formulas plus targeted herbs like Yin Yang Huo, Lycium, and Dan Shen. Treatment must run for at least 90 days because spermatogenesis takes 74 days.

For a personalised fertility herbal prescription, contact me or book a consultation at my Wokingham clinic.

My Fertility Guide

Related reading: Getting pregnant after 30 | B12 for fertility | Chinese herbs for fertility

← Back to blog