Repeated implantation failure (RIF) belongs to the category of buyun (infertility) in Traditional Chinese Medicine (TCM). Sufficient and unobstructed essence-blood is the basis for embryo accommodation and development. Adequate essence-blood is the material foundation for nurturing embryos and maintaining the uterine environment, while smooth essence-blood circulation is crucial for normal embryo implantation and development. This article posits that the root cause of low endometrial receptivity (ER) in RIF is essence-blood insufficiency, and essence-blood stagnation is a key pathological mechanism. Consequently, the fundamental treatment strategy is to replenish and regulate essence-blood, with the Bushen Zixue Formula (Kidney-Tonifying and Blood-Nourishing Formula), an original prescription as the main remedy. In clinical practice, modifications are made flexibly according to the assisted reproductive cycle, menstrual cycle, and symptoms. This article elaborates on the differentiation and treatment of RIF patients with low ER based on the essence-blood theory, by combining with clinical case studies.

repeated implantation failure;endometrial receptivity;infertility;essence-blood theory;treatment based on syndrome differentiation