Abstract
Objective
To investigate whether intrauterine perfusion of hCG before embryo transfer (ET) is
effective in women experienced two or more implantation failures.
Study design
Systematic review and meta-analysis. In the current meta-analysis, Pubmed, EMBASE
and The Cochrane Library were searched for trials which compared the efficacy of intrauterine
perfusion of hCG with no perfusion of hCG in women undergoing in vitro fertilization
(IVF), intracytoplasmic sperm injection (ICSI), or frozen embryo transfer (FET) before
ET. The primary outcomes are the clinical pregnancy rate (CPR) and live birth rate
(LBR).
Results
Six trials consisted of 1432 women were eligible for quantitative analysis. CPR (including
6 trials consisted of 1432 women) and LBR (including 3 trials consisted of 870 women)
were significantly improved in the hCG group compared to the control group, with a
CPR of 41.8 % vs. 31.2 % (RR 1.30, 95 % CI 1.14∼1.50, P < .001), an LBR of 27.8 % vs. 18.0 % (RR 1.52, 95 % CI 1.18∼1.96, P = .001).
Conclusion
Intrauterine perfusion of hCG is effective in improving clinical pregnancy rate and
live birth rate in women who experienced two or more implantation failures, which
might provide a potential therapeutical intervention for recurrent implantation failure
(RIF). Although promising, further evidence from multicenter, randomized controlled
trials are needed to confirm the conclusion from the current meta-analysis.
Abbreviations:
HCG (human chorionic gonadotropin), IVF (in vitro fertilization), ICSI (intracytoplasmic sperm injection), FET (frozen embryo transfer), ET (embryo transfer), CPR (clinical pregnancy rate), LBR (live birth rate), RR (risk ratio), CI (confidence index), RIF (recurrent implantation failure), ART (assisted reproductive technology)Keywords
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Article Info
Publication History
Published online: October 28, 2019
Accepted:
October 23,
2019
Received in revised form:
October 21,
2019
Received:
July 22,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
