دورية أكاديمية
أعرض في EDS

Intrauterine administration of human chorionic gonadotropin does not improve pregnancy and life birth rates independently of blastocyst quality: a randomised prospective study.

التفاصيل البيبلوغرافية
العنوان: Intrauterine administration of human chorionic gonadotropin does not improve pregnancy and life birth rates independently of blastocyst quality: a randomised prospective study.
المؤلفون: Wirleitner B; IVF Centers Prof. Zech, Römerstrasse 2, 6900, Bregenz, Austria. b.wirleitner@ivf.at., Schuff M; IVF Centers Prof. Zech, Römerstrasse 2, 6900, Bregenz, Austria. m.schuff@ivf.at., Vanderzwalmen P; IVF Centers Prof. Zech, Römerstrasse 2, 6900, Bregenz, Austria. pierrevdz@hotmail.com.; Centre Hospitalier Inter Régional Edith Cavell (CHIREC), Braine-l'Alleud, Bruxelles, Belgium. pierrevdz@hotmail.com., Stecher A; IVF Centers Prof. Zech, Römerstrasse 2, 6900, Bregenz, Austria. a.stecher@ivf.at., Okhowat J; IVF Centers Prof. Zech, Römerstrasse 2, 6900, Bregenz, Austria. j.okhowat@ivf.at., Hradecký L; IVF Centers Prof. Zech, B. Smetany 2, 30100, Pilsen, Czech Republic. l.hradecky@ivf-institut.cz., Kohoutek T; IVF Centers Prof. Zech, B. Smetany 2, 30100, Pilsen, Czech Republic. t.kohoutek@ivf-institut.cz., Králícková M; Department of Histology and Embryology, Charles University in Prague - Faculty of Medicine in Pilsen, Karlovarská 48, 30166, Pilsen, Czech Republic. Milena.Kralickova@lfp.cuni.cz., Spitzer D; IVF Centers Prof. Zech, Innsbrucker Bundesstr. 35, 5020, Salzburg, Austria. d.spitzer@salzburg.ivf.at., Zech NH; IVF Centers Prof. Zech, Römerstrasse 2, 6900, Bregenz, Austria. n.zech@ivf.at.
المصدر: Reproductive biology and endocrinology : RB&E [Reprod Biol Endocrinol] 2015 Jul 04; Vol. 13, pp. 70. Date of Electronic Publication: 2015 Jul 04.
نوع المنشور: Journal Article; Randomized Controlled Trial
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101153627 Publication Model: Electronic Cited Medium: Internet ISSN: 1477-7827 (Electronic) Linking ISSN: 14777827 NLM ISO Abbreviation: Reprod Biol Endocrinol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, 2003-
مواضيع طبية MeSH: Pregnancy Rate*, Blastocyst/*drug effects , Chorionic Gonadotropin/*therapeutic use , Embryo Transfer/*methods, Adult ; Birth Rate ; Chorionic Gonadotropin/pharmacology ; Female ; Humans ; Live Birth ; Pregnancy ; Prospective Studies ; Treatment Outcome ; Young Adult
مستخلص: Background: Successful embryo implantation depends on a well-timed maternal-embryonic crosstalk. Human chorionic gonadotropin (hCG) secreted by the embryo is known to play a key role in this process and to trigger a complex signal transduction cascade allowing the apposition, attachment, and invasion of the embryo into the decidualized uterus. Production of hCG was reported to be dependent on blastocyst quality and several articles suggested that intrauterine hCG injection increases pregnancy and implantation rates in IVF patients. However, no study has as yet analysed birth rates as final outcome. Our objective was to determine whether clinical outcome after blastocyst transfer can be improved by intrauterine injection of hCG and whether this is dependent on blastocyst quality.
Methods: A prospective randomised study was conducted in two settings. In cohort A, hCG application was performed two days before blastocyst transfer. In cohort B, the administration of hCG occurred just prior to embryo transfer on day 5. For both cohorts, patients were randomised to either intrauterine hCG application or to the control group that received culture medium. Clinical outcome was analysed according to blastocyst quality of transferred embryos.
Results: The outcome of 182 IVF-cycles (cohort A) and 1004 IVF-cycles (cohort B) was analysed. All patients received a fresh autologous blastocyst transfer on day five. Primary outcomes were pregnancy rates (PR), clinical pregnancy rates (cPR), miscarriage rates (MR), and live birth rates (LBR). No improvement of clinical outcome after intrauterine hCG administration on day 3 (cohort A) or day 5 (cohort B) was found, independently of blastocyst quality transferred. The final outcome in cohort A: LBR after transfer of top blastocysts was 50.0 % with hCG and 53.3 % in the control group. With non-top blastocysts, LBR of 17.1 % (hCG) and 18.2 % (control) were observed (n.s.). In cohort B, LBR with top blastocysts was 53.3 % (hCG) and 48.4 % (control), with non-top blastocysts it came to 28.7 % (hCG) and 35.0 % (control). The differences between the groups were statistically not significant. Furthermore, we investigated a possible benefit of hCG administration in correlation with female age. In both age groups (<38 years and ≥ 38 years) we found similar LBR after treatment with hCG vs. medium. A LBR of 47.1 % vs. 48.7 % was obtained in the younger group and 26.6 % vs. 30.8 % in the older group.
Conclusions: In contrast to previous studies indicating a substantial benefit from intrauterine hCG application in cleavage stage embryo transfers, in our study we could not find any evidence for improvement of clinical outcome in blastocyst transfer cycles, neither with top nor with non-top quality morphology.
References: Hum Reprod. 2011 Dec;26(12):3289-96. (PMID: 21972253)
Hum Reprod. 1988 Oct;3(7):909-14. (PMID: 2460490)
Hum Reprod. 1993 Dec;8(12):2119-27. (PMID: 8150914)
Reprod Sci. 2014 Oct;21(10):1274-80. (PMID: 24520082)
Fertil Steril. 2007 Jul;88(1):244-6. (PMID: 17292362)
Iran J Reprod Med. 2014 Jan;12(1):1-6. (PMID: 24799855)
Sci Rep. 2014;4:3894. (PMID: 24503642)
Reprod Sci. 2013 Sep;20(9):1038-45. (PMID: 23439616)
Fertil Steril. 2011 Dec;96(6):1370-1374.e1. (PMID: 22047664)
Reprod Biomed Online. 2007 Apr;14(4):538-40. (PMID: 17425841)
J Assist Reprod Genet. 2013 Mar;30(3):377-82. (PMID: 23274513)
Biol Reprod. 1999 Apr;60(4):887-92. (PMID: 10084962)
Hum Reprod. 1993 Sep;8(9):1463-8. (PMID: 8253937)
Fertil Steril. 2010 Feb;93(2):351-4. (PMID: 19342020)
PLoS One. 2010;5(4):e10287. (PMID: 20422017)
Fertil Steril. 2000 Jun;73(6):1155-8. (PMID: 10856474)
Reprod Biol Endocrinol. 2010;8:102. (PMID: 20735820)
Am J Bioeth. 2008 Jul;8(7):12-9. (PMID: 18759175)
Reprod Biol Endocrinol. 2013;11:116. (PMID: 24345207)
Reprod Biomed Online. 2013 Oct;27(4):353-61. (PMID: 23953585)
Semin Reprod Med. 2001;19(1):37-47. (PMID: 11394202)
Hum Reprod. 2011 May;26(5):1153-62. (PMID: 21345913)
J Assist Reprod Genet. 2013 Dec;30(12):1577-81. (PMID: 24114628)
J Assist Reprod Genet. 2012 Feb;29(2):131-5. (PMID: 22116647)
Nan Fang Yi Ke Da Xue Xue Bao. 2014 Jun;34(7):1039-41, 1047. (PMID: 25057080)
Biol Reprod. 2014 Oct;91(4):98. (PMID: 25187529)
J Reprod Immunol. 2010 May;85(1):93-8. (PMID: 20227765)
Hum Reprod. 2011 Oct;26(10):2636-41. (PMID: 21784735)
Hum Reprod. 2013 Aug;28(8):2215-27. (PMID: 23696542)
PLoS One. 2013;8(5):e64829. (PMID: 23717664)
Reprod Biol Endocrinol. 2014;12:9. (PMID: 24476536)
Fertil Steril. 2014 Dec;102(6):1591-5.e2. (PMID: 25234040)
Int J Fertil Steril. 2012 Oct;6(3):175-8. (PMID: 24520435)
Mol Cell Endocrinol. 2007 Apr 15;269(1-2):85-92. (PMID: 17367920)
Reprod Biomed Online. 2008 Nov;17(5):617-27. (PMID: 18983745)
Fertil Steril. 2008 Oct;90(4 Suppl):1390-5. (PMID: 18291374)
المشرفين على المادة: 0 (Chorionic Gonadotropin)
تواريخ الأحداث: Date Created: 20150705 Date Completed: 20160323 Latest Revision: 20181113
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC4491277
DOI: 10.1186/s12958-015-0069-1
PMID: 26141379
قاعدة البيانات: MEDLINE
الوصف
تدمد:1477-7827
DOI:10.1186/s12958-015-0069-1