Effect of Intrauterine Injection of Hcg Before ET on Clinical Outcomes in IVF/ICSI Cycles
Status:
Completed
Trial end date:
2020-10-04
Target enrollment:
Participant gender:
Summary
Subfertility is the inability to conceive after 12 months of regular unprotected sexual
intercourse. Around 15% of couples suffer from subfertility. As a treatment for subfertility,
Assisted Reproductive Techniques (ART) have been a choice for subfertile couples. In Egypt in
2010, Pregnancy Rate was calculated to be 36.2%, Live Birth Rate to be 25.7%.
Implantation is the process by which the embryo adheres to the wall of the uterus.
Endometrial receptivity plays the most important role for successful implantation after
embryo quality. It is estimated that up to 70% of early pregnancy losses are due to failure
of implantation.
Despite extensive research, the embryo-maternal dialogue that orchestrates the implantation
process is still not fully understood. Much effort has been done in the last decades to
detect factors affecting Implantation and improve endometrial receptivity.
Human Chorionic Gonadotropin (hCG) is a placental glycoprotein hormone that required to
maintain pregnancy. Recent research data demonstrates that hCG is secreted very early by the
embryo before implantation to facilitate it. hCG has been proved to cause attraction of
inflammatory cells, promote angiogenesis, regulate chemical mediators at the endometrium.
These effects proceed the classical role of hCG during pregnancy and could be a directly
involved in and facilitating the implantation process.
Studies have been conducted to study the effect of injection of different concentrations of
hCG inside the uterine cavity before Embryo Transfer (ET) to improve endometrial receptivity
and outcomes of In-Vitro Fertilization (IVF) or Intra-Cytoplasmic Sperm Injection (ICSI)
cycles.
A recent systematic review was conducted on 12 studies performing intrauterine injection of
different doses of hCG before ET. Results of this study showed that there is increased
pregnancy outcome after injection of intrauterine 500 IU of hCG. The study recommended a
definitive large clinical trial with live birth as the primary outcome. There was no evidence
that miscarriage was influenced by intrauterine hCG administration, irrespective of embryo
stage at transfer or dose of intrauterine hCG.
Aim of the study:
To detect whether intrauterine injection of hCG before ET improves clinical outcomes in
IVF/ICSI cycles.