Changsha Central Hospital, 410004, Changsha, China.
Reproductive Medicine Center, Xiangya Hospital of Central South University, 410008, Changsha, China.
Eur J Obstet Gynecol Reprod Biol. 2019 Dec;243:133-138. doi: 10.1016/j.ejogrb.2019.10.039. Epub 2019 Oct 28.
To investigate whether intrauterine perfusion of hCG before embryo transfer (ET) is effective in women experienced two or more implantation failures.
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).
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).
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.
研究胚胎移植（ET）前宫腔内注射 hCG 是否对经历过两次或两次以上着床失败的妇女有效。
系统评价和荟萃分析。在本次荟萃分析中，检索了 Pubmed、EMBASE 和 The Cochrane Library 中的试验，比较了在体外受精（IVF）、胞浆内精子注射（ICSI）或冷冻胚胎移植（FET）前宫腔内注射 hCG 与不注射 hCG 对接受 IVF、ICSI 或 FET 的妇女的疗效。主要结局是临床妊娠率（CPR）和活产率（LBR）。
6 项试验共纳入 1432 名妇女，符合定量分析条件。hCG 组的 CPR（包括 6 项试验共 1432 名妇女）和 LBR（包括 3 项试验共 870 名妇女）均显著高于对照组，CPR 为 41.8% vs. 31.2%（RR 1.30，95%CI 1.14～1.50，P<.001），LBR 为 27.8% vs. 18.0%（RR 1.52，95%CI 1.18～1.96，P=.001）。
宫腔内注射 hCG 可有效提高经历过两次或两次以上着床失败的妇女的临床妊娠率和活产率，为复发性着床失败（RIF）提供了一种潜在的治疗干预方法。尽管前景广阔，但需要更多来自多中心、随机对照试验的证据来证实本次荟萃分析的结论。
