Akbari Asbagh Firoozeh, Ghasemzadeh Fatemeh, Ebrahimi Mahbod, Davari-Tanha Fatemeh, Feizabad Elham, Akbari Asbagh Parvin, Hosseini Quchani Samaneh
Department of Infertility, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Caspian J Intern Med. 2023 Spring;14(2):185-191. doi: 10.22088/cjim.14.2.185.
Assisted reproductive therapy (ART) has been developed remarkably in these decades; however, the rate of unsuccessful embryo implantation especially in the frozen-thawed embryo transfer (FET) cycles remains high and is reported up to 70%. The current study was designed to compare the effect of intramuscular injection of hCG on endometrium preparation and embryo implantation, in women undergoing FET compared to the control group.
This clinical trial was done on 140 infertile women that underwent FET. The study sample was randomly allocated to the intervention group (two 5000 unit ampoules of hCG were injected intramuscularly before the first dose of progesterone administration) and the control group (without hCG injection). In both groups, 4 days after progesterone administration, the cleavage stage embryos were transferred. The study outcomes were biochemical pregnancy, clinical pregnancy and abortion rate.
The average age of intervention and control group was 32.65±6.05 and 33.11±5.36 years, respectively. The basic information between two study groups did not differ significantly. The chemical (30% vs. 17.1%, P=0.073, relative risk (RR)=0.57) and clinical (28.6% vs. 14.3%, P=0.039, RR=0.50) pregnancy rates were higher in the intervention group compared to the control group; these higher ratios were only significant in clinical pregnancy rate. Abortion rate was not significantly (P=0.620) different between the intervention and control groups (4.3% vs. 1.4%, respectively).
This study showed that intramuscular injection of 10000 IU hCG before the endometrial secretory transformation phase in cleavage-stage embryo, improves IVF cycle outcomes.
近几十年来辅助生殖技术（ART）有了显著发展；然而，胚胎着床失败率仍然很高，尤其是在冻融胚胎移植（FET）周期中，据报道高达70%。本研究旨在比较与对照组相比，接受FET的女性肌肉注射hCG对子宫内膜准备和胚胎着床的影响。
本临床试验对140例接受FET的不孕女性进行。研究样本被随机分为干预组（在首次给予黄体酮前肌肉注射两支5000单位的hCG）和对照组（不注射hCG）。两组在给予黄体酮4天后移植卵裂期胚胎。研究结果为生化妊娠、临床妊娠和流产率。
干预组和对照组的平均年龄分别为32.65±6.05岁和33.11±5.36岁。两个研究组之间的基本信息没有显著差异。干预组的化学妊娠率（30%对17.1%，P=0.073，相对风险（RR）=0.57）和临床妊娠率（28.6%对14.3%，P=0.039，RR=0.50）高于对照组；这些较高的比率仅在临床妊娠率方面具有显著性。干预组和对照组之间的流产率没有显著差异（P=0.620）（分别为4.3%和1.4%）。
本研究表明，在卵裂期胚胎子宫内膜分泌转化期前肌肉注射10000IU hCG可改善体外受精周期结局。
