International journal of reproductive biomedicine · 2025
Impact of intrauterine infusion of human chorionic gonadotropin and hyaluronic acid enriched medium on pregnancy outcomes in frozen-thawed cycles with recurrent implantation failure: An RCT.
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Peivandi Sepideh, Jafarifard Pegah, Zamaniyan Marzieh, Yazdani-Charati Jamshid
Аннотация
BACKGROUND: Recurrent implantation failure in assisted reproductive technology is a major challenge. Intrauterine human chorionic gonadotropin (hCG) infusion and hyaluronic acid enriched embryo transfer media have shown individual effects, but their combined effect in these cases undergoing frozen-thawed embryo transfer is unknown.
OBJECTIVE: This study aims to investigate the effect of combined therapy on pregnancy outcomes.
MATERIALS AND METHODS: This is a single-blind, randomized controlled trial on 158 participants. The cases were randomly assigned to either the intervention group (pretransfer intrauterine hCG infusion and embryo loaded with hyaluronic acid-enriched embryo transfer medium at the time of transfer) or the control group (standard embryo transfer medium). The outcomes were chemical and clinical pregnancy rates, implantation, abortion, and ongoing pregnancy rates.
RESULTS: A total of 158 participants were enrolled in this study in 2 equal groups. The intervention did not significantly improve the overall pregnancy rate compared to control (24% vs. 33.7%, p = 0.30). The results showed that, by controlling variables, the chance of clinical pregnancy in the intervention group was 12% lower than in the control group, although the difference was not statistically significant (p = 0.879). With each increase in the number of embryos, the chance of a pregnancy would be 2.26 times higher. Also, the chance of pregnancy in the morula stage was 68% lower than in the cleavage stage (p < 0.05).
CONCLUSION: The combined approach of intrauterine hCG infusion and the hyaluronan-enriched embryo transfer medium did not significantly improve the overall pregnancy rate but had a significant effect on specific cases using the embryo at the cleavage stage for transfer and cases that received more than one embryo for transfer.
OBJECTIVE: This study aims to investigate the effect of combined therapy on pregnancy outcomes.
MATERIALS AND METHODS: This is a single-blind, randomized controlled trial on 158 participants. The cases were randomly assigned to either the intervention group (pretransfer intrauterine hCG infusion and embryo loaded with hyaluronic acid-enriched embryo transfer medium at the time of transfer) or the control group (standard embryo transfer medium). The outcomes were chemical and clinical pregnancy rates, implantation, abortion, and ongoing pregnancy rates.
RESULTS: A total of 158 participants were enrolled in this study in 2 equal groups. The intervention did not significantly improve the overall pregnancy rate compared to control (24% vs. 33.7%, p = 0.30). The results showed that, by controlling variables, the chance of clinical pregnancy in the intervention group was 12% lower than in the control group, although the difference was not statistically significant (p = 0.879). With each increase in the number of embryos, the chance of a pregnancy would be 2.26 times higher. Also, the chance of pregnancy in the morula stage was 68% lower than in the cleavage stage (p < 0.05).
CONCLUSION: The combined approach of intrauterine hCG infusion and the hyaluronan-enriched embryo transfer medium did not significantly improve the overall pregnancy rate but had a significant effect on specific cases using the embryo at the cleavage stage for transfer and cases that received more than one embryo for transfer.