Santibañez Alvaro, García Jorge, Pashkova Olga, Colín Omar, Castellanos Guillermo, Sánchez Ana P, De la Jara Julio F
Procrea, Reproductive Centre, 1st floor 670 Ejercito Nacional Avenue, Polanco Reforma, 11550 Mexico City, Mexico.
Reprod Biol Endocrinol. 2014 Jan 29;12:9. doi: 10.1186/1477-7827-12-9.
The implantation process after embryo transfer depends on the embryo quality and endometrial receptivity. It is estimated that fifty to seventy-five per cent of pregnancies are lost due to a failure of implantation. There is evidence that there is an early secretion of human chorionic gonadotrophin before embryo implantation, and this secretion has been linked to an important function in angiogenesis and the inflammatory response that promotes the implantation process. Our objective was to determine the effects of intrauterine injection of human chorionic gonadotropin (hCG) before the embryo transfer in an in vitro fertilisation cycle.
A prospective randomised study was conducted in Reproductive Medicine Centre PROCREA in Mexico City. Infertile patients who had a medical indication for in vitro fertilisation were studied. Two groups were included (n 210); the intervention group received an intrauterine injection of 500 IU of hCG before the embryo transfer (n 101). The control group (n 109) did not receive hCG. Comparisons were performed using a chi-square test.
The clinical pregnancy rate (CPR) was our principal outcome. The implantation rate was a secondary outcome. The implantation rate was significantly higher in the hCG group compared to the control group (52.4% vs 35.7%, p 0.014). The clinical pregnancy rate was also significantly higher (50.4 vs 33.0%, p 0.010). No adverse effects were observed.
The intrauterine injection of hCG before embryo transfer showed a significant increase in the clinical pregnancy rate. More clinical trials are needed to reproduce these results on this promising intervention. The live birth rate must be included in subsequent studies.
胚胎移植后的着床过程取决于胚胎质量和子宫内膜容受性。据估计，50%至75%的妊娠因着床失败而流失。有证据表明，在胚胎着床前就有早期人绒毛膜促性腺激素分泌，且这种分泌与血管生成及促进着床过程的炎症反应中的一项重要功能有关。我们的目的是确定在体外受精周期中胚胎移植前宫腔内注射人绒毛膜促性腺激素（hCG）的效果。
在墨西哥城的生殖医学中心PROCREA进行了一项前瞻性随机研究。对有体外受精医学指征的不孕患者进行了研究。纳入两组（n = 210）；干预组在胚胎移植前接受500 IU hCG的宫腔内注射（n = 101）。对照组（n = 109）未接受hCG。使用卡方检验进行比较。
临床妊娠率（CPR）是我们的主要结局。着床率是次要结局。与对照组相比，hCG组的着床率显著更高（52.4%对35.7%，p = 0.014）。临床妊娠率也显著更高（50.4对33.0%，p = 0.010）。未观察到不良反应。
胚胎移植前宫腔内注射hCG显示临床妊娠率显著提高。需要更多的临床试验来重现这项有前景的干预措施的这些结果。后续研究必须纳入活产率。
