Archives of Gynecology and Obstetrics

, Volume 299, Issue 1, pp 267–275 | Cite as

Increased implantation rate after intrauterine infusion of a small volume of human chorionic gonadotropin at the time of embryo transfer: a randomized, double-blind controlled study

  • Pitak Laokirkkiat
  • Isarin ThanaboonyawatEmail author
  • Savinee Boonsuk
  • Somsin Petyim
  • Japarath Prechapanich
  • Roungsin Choavaratana
Gynecologic Endocrinology and Reproductive Medicine



Intrauterine human chorionic gonadotropin (hCG) infusion at the time of embryo transfer (ET) has resulted in controversial results. We evaluated the effects of intrauterine infusion of a small volume of hCG at the time of ET in fresh and frozen–thawed cycles.


Infertile women scheduled for ET with either fresh or frozen–thawed cycles were enrolled and randomized into two groups (n = 100 each): an hCG group, who received 500 IU of hCG in 10 µL culture medium infused into the uterine cavity using a soft catheter 4 min before ET; and a control group, who received 10 µL of culture medium alone by the same technique. The primary outcome was the implantation rate. The secondary outcomes were clinical pregnancy and live birth rate.


Two hundred infertile women aged 18–43 years, undergoing fresh or frozen–thawed ET were enrolled, regardless of any previous transfer cycles. The implantation rate was significantly higher in the hCG group compared with the control group (28.8% vs. 18.2%, p = 0.030). The clinical pregnancy rates were similar in both groups (42% vs. 30%, p = 0.077). The live birth rates were also similar (29% and 23% in the hCG and control group, respectively).


Intrauterine infusion of a small volume of hCG at the time of ET can significantly improve the implantation rate, while the clinical pregnancy rate may only be improved in younger patients (aged < 40 years). This technique may thus be of benefit to patients undergoing clinical infertility treatment.


Intrauterine hCG Implantation rate Clinical pregnancy rate Live birth rate Embryo transfer 



This study was supported by Siriraj Grant for Research Development (Grant no. R015931011), Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand. We thank James Cummins, PhD, from Edanz Group ( for editing a draft of this manuscript.

Author contributions

PL: project development, and manuscript editing. IT: data collection and analysis, manuscript writing and editing. SB: project development, data collection, data analysis, and manuscript writing. SP: manuscript editing. JP: manuscript editing. RC: manuscript editing.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Hospital Institutional Review Board, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Infertility and Reproductive Biology Unit, Department of Obstetrics and GynecologyFaculty of Medicine Siriraj Hospital, Mahidol UniversityBangkokThailand

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