The effect of intrauterine HCG injection on IVF outcome: a systematic review and meta-analysis

Abstract

In this systematic review and meta-analysis, the effect of intrauterine HCG infusion before embryo transfer on IVF outcomes (live birth rate, clinical pregnancy rate and spontaneous aboretion rate) was investigated. Searches were conducted on MEDLINE, EMBASE and The Cochrane Library. Randomized studies in women undergoing IVF and intracytoplasmic sperm injection comparing intrauterine HCG administration at embryo transfer compared with no intrauterine HCG were eligible for inclusion. Eight randomized controlled trials were eligible for inclusion in the meta-analysis. A total of 3087 women undergoing IVF and intracytoplasmic sperm injection cycles were enrolled (intrauterine HCG group: n = 1614; control group: n = 1473). No significant difference was found in the live birth rate (RR 1.13; 95% CI 0.84 to 1.53) and spontaneous abortion rate (RR 1.00, 95% CI 0.74 to 1.34) between women who received intrauterine HCG and those who did not receive HCG. Although this review was extensive and included randomized controlled trials, no significant heterogeneity was found, and the overall included numbers are relatively small. In conclusion the current evidence does not support the use of intrauterine HCG administration before embryo transfer. Well-designed multicentre trials are needed to provide robust evidence.

Effect of intrauterine injection of human chorionic gonadotropin before fresh embryo transfer on IVF and ICSI outcomes: a meta-analysis

“…However, after analyzing eight RCTs, Osman et al [26] concluded that the current evidence did not support the use of intrauterine hCG injection before ET. A total of 3087 women undergoing IVF/ICSI (intrauterine hCG group: n  = 1614; control group: n  = 1473) were enrolled.…”

The Role of HCG in Implantation: A Mini-Review of Molecular and Clinical Evidence

“…More importantly, this finding was independent of blastocyst quality and of HCG administration timing (either two days or immediately prior to embryo transfer). The size of that study was large enough for a second meta-analysis to be performed and published later on by Osman et al [44]. This included eight studies with 3087 participants, randomized as a study (HCG) group ( n = 1614) and a control group ( n = 1473).…”

Intrauterine infusion of human chorionic gonadotropin before embryo transfer in IVF/ET cycle: The critical review

“…Unfortunately, the administration of these biologics has not been developed based on the assessment of endometrial receptivity using specific biomarkers. 14,19 In this review, IUI-hCG will be critically evaluated by discussing the possible immune modulatory effect of hCG, analyzing the differences in experimental designs, outcomes, and limitations of previous studies, and providing future directions for this treatment. Increasing number of clinical trials to investigate the clinical efficacy of IUI-hCG before embryo transfer has been reported since 2010.…”

“…In the area of therapeutics, the main objective has been to develop clinical interventions to improve endometrial receptivity by introducing factors, including intrauterine infusion of chorionic gonadotropin (IUI-hCG), 14 granulocyte colony-stimulating factor (G-CSF), 15 peripheral blood mononuclear cells (PBMC), 16 and blood platelet, 17 in the uterus that will act directly in the cellular components of the endometrium. Unfortunately, the administration of these biologics has not been developed based on the assessment of endometrial receptivity using specific biomarkers.…”

“…However, according to the recent meta-analysis, the efficacy of this treatment remains still controversial. 14,19 In this review, IUI-hCG will be critically evaluated by discussing the possible immune modulatory effect of hCG, analyzing the differences in experimental designs, outcomes, and limitations of previous studies, and providing future directions for this treatment.…”