Effects of human chorionic gonadotropin intrauterine injection on oocyte retrieval day on assisted reproductive techniques outcomes: An RCT

Abstract

Background: Several mediators play an important role in implantation. One of these mediators is human chorionic gonadotropin (HCG).
 Objective: To evaluate the effects of HCG intrauterine injection on the day of oocyte retrieval on the result of assisted reproductive techniques (ART).
 Materials and Methods: In this randomized clinical trial study, 126 women who were referred to Afzalipour Infertility Center between December 2018 to December 2019 undergoing in vitro fertilization/intracytoplasmic sperm injection cycles were enrolled and assigned to two groups of: a case (n = 62) and a control group (n = 64). The protocols for both groups were the same; except that the case group was injected with the protocols for both groups were the same, except that the case group was injected with 1000 IU of HCG into uterine cavity following the oocyte puncture, while no medication was administered to the control group. The implantation rate, chemical pregnancy, clinical pregnancy, and abortion rates were compared between the two groups.
 Results: Positive chemical pregnancy was seen in 15 (27.3%) cases of the case group and 14 (25.5%) of the control group. No significant difference was seen in the chemical and clinical pregnancy rates between the groups. The abortion rate was higher in the control group but that was not significant.
 Conclusion: A 1000 IU of HCG intrauterine injection after oocyte retrieval does not improve implantation, chemical or clinical pregnancy rates in ART cycles. Further studies are needed to clearly understand the role of HCG intrauterine injection in the day of oocyte retrieval in ART outcomes.
 Key words: Oocyte retrieval, Chorionic gonadotropin, Pregnancy, Assisted reproductive techniques.

Value of Intrauterine Injection of HCG (Human Chorionic Gonadotropin) before Fresh Embryo Transfer on Clinical Pregnancy Rate in Women with Previous Failed One or Two ICSI (Intra Cytoplasmic Sperm Injection) Trials

“…The results of our study were consistent with those of other studies that were done on patients who had ICSI trials in a randomized control study with 126 women, 15 (27.3 percent) of the case group and 14 (25.5 percent) of the control group experienced positive chemical pregnancy after intrauterine injection of 1000 units of HCG immediately following oocyte retrieval. The clinical or chemical pregnancy rates did not differ significantly between the groups (14) .…”

Good practice recommendations on add-ons in reproductive medicine

“…Two recent RCTs evaluated intrauterine administration of hCG (dosage 1000 IU and 500 IU, respectively) immediately after OPU, rather than at ET as in the other studies. The study using the higher dosage reported no benefit with regards to LBR or any other outcome, while the trial using the lower dosage reported an increased CPR (49%) compared to saline intrauterine infusion (22.9%) ( Hosseinisadat etal. , 2021 ; Torky etal.…”

Does Intrauterine Injection of hCG Improve IVF Outcome? A Systematic Review and a Meta-Analysis

“…Fifty-four papers were assessed for eligibility. Eighteen RCTs were included in the qualitative and quantitative analysis [ 10 , 11 , 15 , 16 , 17 , 18 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 37 , 38 , 39 , 40 , 41 ]. The baseline characteristics of the studies included are reported in Table 1 .…”

“…The most recent Cochrane review includes 17 RCTs, 6 of which are conference abstracts, and concluded that women undergoing cleavage-stage transfer might benefit from intrauterine hCG [ 20 ]. Since the publication of the latter paper, another seven RCTs have been published [ 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. More recently, a comprehensive meta-analysis of different interventions, including intrauterine hCG during embryo transfer, concluded that intrauterine hCG could significantly increase the clinical pregnancy rate [ 29 ].…”