Investigating the Optimal Time for Intrauterine Human Chorionic Gonadotropin Infusion in Order to Improve IVF Outcome: A Systematic Review and Meta-Analysis

In Vivo. 2019 Nov-Dec;33(6):1737-1749. doi: 10.21873/invivo.11664.

Abstract

Background/aim: Studies on the impact of intrauterine human Chorionic Gonadotropin (hCG) administration in order to improve the In Vitro Fertilization (IVF) outcome have yielded conflicting results. The aim of the present systematic review and meta-analysis is to investigate whether timing of intrauterine hCG administration prior to embryo transfer affects its efficiency.

Materials and methods: A systematic search of the literature on Pubmed/Medline, Embase and Cochrane databases was performed. Only Randomized Control Trials were included in this meta-analysis.

Results: Live birth rates were not improved following hCG administration (RR=1.13, 95%CI=0.88-1.46, p=0.34) in the pooled results. Combined live birth and ongoing pregnancy rates were borderline statistically significant following hCG administration (RR=1.27, 95%CI=1.00-1.62, p=0.05). Following subgroup analysis regarding live birth and ongoing pregnancy rates, only the 5-12 minutes prior to the embryo transfer group reported a statistically significant improvement.

Conclusion: Intrauterine infusion of hCG within an IVF-Intracytoplasmic Sperm Injection (ICSI) cycle improves outcome only when administered 5-12 min prior to embryo transfer.

Keywords: Human chorionic gonadotropin; in vitro fertilization; live birth; meta-analysis; review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Animals
  • Chorionic Gonadotropin / administration & dosage*
  • Embryo Transfer / methods
  • Female
  • Fertilization in Vitro / methods
  • Humans
  • Infertility, Female / drug therapy*
  • Live Birth
  • Pregnancy
  • Pregnancy Rate

Substances

  • Chorionic Gonadotropin