Application and effect of intrauterine injection of human chorionic gonadotropin in frozen-thawed embryo transfer cycle for endometriosis patients

doi:10.12092/j.issn.1009-2501.2018.11.015

Abstract

Abstract:

AIM: To investigate the effect of intrauterine injection of human chorionic gonadotropin (hCG) upon pregnancy outcomes following frozen-thawed embryo transfer (FET) for endometriosis (EMs) patients. METHODS: We retrospectively collected 228 FET cycles of EMs patients, and divided them into intrauterine injection group (50 cycles) and control group (178 cycles). Age, infertile duration, body mass index, hormone profile, endometrial thickness, embryo quality, clinical pregnancy rate and live birth rate were compared, the related factors affecting live birth were further analyzed. RESULTS: No significant difference was detected when baseline character, hormone change, endometrial thickness and embryo quality were compared between two groups, while live birth rate was found statistically higher and miscarriage rate was remarkably lower in intrauterine injection group. Age and intrauterine injection of hCG were two independent factors affecting live birth in EMs following FET. CONCLUSION: Intrauterine injection of hCG prior to FET can improve the live birth rate and reduce the miscarriage rate for EMs patients.

Key words: endometriosis, frozen-thawed embryo transfer, intrauterine injection, human chorionic gonadotropin

CLC Number:

XU Zhihui, ZHOU Jiechun, CHEN Huinan, WANG Anlan. Application and effect of intrauterine injection of human chorionic gonadotropin in frozen-thawed embryo transfer cycle for endometriosis patients[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2018, 23(11): 1287-1291.

References

［1］Meuleman C, Vandenabeele B, Fieuws S, et al. High prevalence of endometriosis in infertile women with normal ovulation and normospermic partners［J］.Fertil Steril, 2009,92 (1):68-74.
［2］林芸, 周灿权, 庄广伦, 等. 子宫内膜异位症影响体外受精-胚胎移植结局的初步探讨［J］.中国实用妇科与产科杂志, 2004,20 (12):729-731.
［3］吴泽璇, 张清学. 子宫内膜异位症和子宫腺肌病患者降调节促排卵方案的选择［J］.生殖医学杂志, 2017,26 (11):1083-1087.
［4］Lessey BA. Implantation defects in infertile women with endometriosis［J］.Ann N Y Acad Sci, 2002,955:265-280.
［5］林荭, 冷金花. 子宫内膜异位症孕激素抵抗的发生机制及临床意义［J］.现代妇产科进展, 2013,22 (11):915-917.
［6］Pei T, Liu C, Liu T, et al. miR-194-3p represses the progesterone receptor and decidualization in eutopic endometrium from women with endometriosis［J］.Endocrinology, 2018,159(7):2554-2562.
［7］Tsampalas M, Gridelet V, Berndt S, et al. Human chorionic gonadotropin: a hormone with immunological and angiogenic properties［J］.J Reprod Immunol, 2010,85 (1):93-98.
［8］Mansour R,Tawab N,Kamal O,et al.Intrauterine injection of human chorionic gonadotropin before embryo transfer significantly improves the implantation and pregnancy rates in in vitro fertilization/intracytoplasmic sperm injection: a prospective randomized study［J］.Fertil Steril,2011,96 (6):1370-1374 e1371.
［9］金聪聪, 王佩玉, 林佳, 等. 经皮雌二醇凝胶与口服戊酸雌二醇片在冻融胚胎移植中的临床应用疗效比较［J］.中国临床药理学与治疗学, 2017,22 (10):1162-1166.
［10］王佩玉, 赵军招, 金聪聪, 等. 芬吗通和补佳乐在冻融胚胎移植周期中的应用比较［J］.温州医科大学学报, 2015,45 (1):36-39.
［11］郑屹, 张欢, 林佳, 等. 两侧卵巢获卵数差异率与体外受精-胚胎移植结局的关系［J］.生殖医学杂志, 2015,24 (1):26-31.
［12］Gardner DK, Lane M, Stevens J, et al. Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer［J］.Fertil Steril, 2000,73 (6):1155-1158.
［13］孟绿荷, 赵军招, 林金菊, 等. 拮抗剂在不孕症患者微刺激周期中的应用与效果［J］.中华全科医学, 2013,11 (11):1680-1682.
［14］Barnhart K, Dunsmoor-Su R, Coutifaris C. Effect of endometriosis on in vitro fertilization［J］.Fertil Steril, 2002,77 (6):1148-1155.
［15］Gonzalez-Comadran M, Schwarze JE, Zegers-Hochschild F, et al. The impact of endometriosis on the outcome of Assisted Reproductive Technology［J］.Reprod Biol Endocrinol, 2017,15 (1):8.
［16］Jurisicova A, Antenos M, Kapasi K, et al. Variability in the expression of trophectodermal markers beta-human chorionic gonadotrophin, human leukocyte antigen-G and pregnancy specific beta-1 glycoprotein by the human blastocyst［J］.Hum Reprod, 1999,14 (7):1852-1858.
［17］Bourdiec A, Bedard D, Rao CV, et al. Human chorionic gonadotropin regulates endothelial cell responsiveness to interleukin 1 and amplifies the cytokine-mediated effect on cell proliferation, migration and the release of angiogenic factors［J］.Am J Reprod Immunol, 2013,70 (2):127-138.
［18］Shiotani M, Matsumoto Y, Okamoto E, et al. Is human chorionic gonadotropin supplementation beneficial for frozen and thawed embryo transfer in estrogen/progesterone replacement cycles?: A randomized clinical trial［J］.Reprod Med Biol, 2017,16 (2):166-169.
［19］Huang P,Wei L,Li X.A study of intrauterine infusion of human chorionic gonadotropin (hCG) before frozen-thawed embryo transfer after two or more implantation failures［J］.Gynecol Endocrinol,2017,33(1):67-69.
［20］Roux P,Perrin J,Mancini J,et al.Factors associated with a poor prognosis for the IVF-ICSI live birth rate in women with rAFS stage III and IV endometriosis［J］.J Assist Reprod Genet,2017,34 (7):921-928.
［21］Senapati S, Sammel MD, Morse C, et al. Impact of endometriosis on in vitro fertilization outcomes: an evaluation of the Society for Assisted Reproductive Technologies Database［J］.Fertil Steril, 2016,106 (1):164-171.
［22］Harb HM, Gallos ID, Chu J, et al. The effect of endometriosis on in vitro fertilisation outcome: a systematic review and meta-analysis［J］.BJOG, 2013,120 (11):1308-1320.
［23］Cole LA. hCG, the wonder of today's science［J］.Reprod Biol Endocrinol, 2012,10:24.

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