To observe the clinical effect of Erzhi Tiangui Recipe (ETR), a traditional Chinese recipe for strengthening Shen and nourishing Tiangui, in improving the ovarian reactivity in elderly sterile women.Sixty-six elderly sterile women receiving in vitro fertilization pre-embryo transfer (IVF-ET) were randomly divided into two groups: the ETR group treated with ETR plus follicle stimulating hormone (FSH) and the control group treated with FSH alone, 33 cases in each group. Changes of symptoms and the relative parameters were observed, including the dosage of FSH used, the serum hormone levels at different periods, endometrium thickness and arteriopalmus of uterus and ovary on the day of HCG injection, follicle number, follicular oocyte number, mature follicular oocyte rate and fertilization rate, prime embryo rate, and pregnancy rate. Moreover, the correlation of the symptom score of colpoxerosis (CR2) and serum estradiol (E2) level was analyzed after treatment (on the HCG injection day).Symptoms of Shen qi-yin deficiency were improved significantly in the ETR group, with the improvement better than that in the control group (P < 0.05). The total and daily FSH dosage in the ETR group were lower than those in the control group, showing significant difference between the two groups (P < 0.05). The effects were better in the ETR group than those in the control group in increasing serum E2 and endometrium thickness on the HCG injection day, and also in elevating the follicular oocyte number, the mature oocytes rate, the fertilization rate, and the prime embryo rate (all P < 0.05). CR2 analysis showed low negative correlation in both groups (r = -0.369 in the ETR group and r = -0.425 in the control group), suggesting E2 could be one of the factors but not the only factor for influencing colpoxerosis. And the score of colpoxerosis was lower in the ETR group after treatment than that in the control group (t = 2.422, P < 0.05).ETR combined with FSH can obviously reduce the dosage of FSH used, improve ovarian reactivity and pregnancy rate, and improve the quality of oocytes, the mechanism is possibly related with its effects in improving ovarian reactivity elevating blood estrodiol and regulating the hypothalamus-pituitary-ovary axis (HPOA).