Effect of intrauterine perfusion of human chorionic gonadotropin before embryo transfer after two or more implantation failures: A systematic review and meta-analysis. (December 2019)

• Record Type: Journal Article
• Authors: Xie, Hebin; Zeng, Hong; He, Dongmei; Liu, Nenghui
• Is Part Of: European journal of obstetrics, gynecology, and reproductive biology. Volume 243(2019)
• Page Start: 133
• Page End: 138
• Publication Date: 2019-12
• Subjects: 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; Human chorionic gonadotropin -- Intrauterine perfusion -- IVF -- ICSI -- FET; Obstetrics -- Periodicals; Gynecology -- Periodicals; Reproductive health -- Periodicals; Gynecology -- Periodicals; Obstetrics -- Periodicals; Reproduction -- Periodicals; Obstétrique -- Périodiques; Gynécologie -- Périodiques; Reproduction -- Périodiques; Verloskunde; Gynaecologie; Voortplanting (biologie); Gynecology; Obstetrics; Reproduction; Electronic journals; Periodicals; Electronic journals; 618.05
• DOI: 10.1016/j.ejogrb.2019.10.039
• Languages: English
• ISSNs: 0301-2115

Abstract

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.