Background: Intrauterine injection of human chorionic gonadotropin (hCG) at embryo transfer (ET) has been shown to improve the outcome of assisted reproductive techniques. The aim of this study was to confirm previous findings. Methods: In this randomized controlled trial, 483 infertile women who were candidates for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) for the first time were randomly assigned to receive an intrauterine injection of 500 IU hCG or placebo (tissue culture media) before ET. The main outcome measures were implantation and clinical pregnancy rates. Results: Both the hCG-treated group (n = 240) and control group (n = 243) were similar at baseline in terms of demographic and obstetrical characteristics.There were significant differences between the two groups regarding the implantation rate (23.6 vs. 12.2%, p < 0.001), pregnancy rate (54.6 vs. 35.8%, p < 0.001), clinical pregnancy rate (50 vs. 32.1%, p < 0.001), ongoing pregnancy rate (15.3 vs. 9.2%, p < 0.001) and live delivery rate (14.3 vs. 8.4%, p < 0.001). The rate of fertilization and abortion rates were not statistically different. Conclusion: Intrauterine injection of hCG before ET improves implantation and pregnancy rates and may be considered an adjuvant in IVF/ICSI.

No abstract

Background/Aims: To assess uterine cavity with office hysteroscopy in order to diagnose and treat pathologies in patients who have started their first intracytoplasmic sperm injection (ICSI) cycles and evaluate its impact on pregnancy rate. Methods: A number of 220 infertile women scheduled for ICSI participated in this prospective randomized study. They were randomly divided into 2 equal groups. Group I (intervention) underwent office hysteroscopy before starting assisted reproductive techniques (ART) cycle. Group II (control) started ART cycles without office hysteroscopy. All women had normal transvaginal ultrasonography and hysterosalpingography. The detected intrauterine abnormalities were treated during hysteroscopy. Four weeks after embryo transfer, ultrasonography was done for detecting clinical pregnancy. Results: Abnormal findings were seen in hysteroscopy in 22.7% of the intervention group. The pregnancy rate in the intervention group (48.20%) was significantly higher than that in the control group (38.60%; p = 0.004). Conclusion: Routine office hysteroscopy before ICSI cycles provides direct evaluation of uterine cavity. Also, pregnancy rate improves after correction of endometrial cavity abnormalities.