Hormone IVF add-on does not increase chances of having a baby

Intrauterine hCG, an IVF add-on treatment, is unlikely to improve the chance of pregnancy or live birth, according to a new analysis.

Human chorionic gonadotropin (hCG) is a hormone produced naturally in early pregnancy. However, fertility clinics widely offer to inject it inside the uterus prior to embryo transfer. Previous studies evaluating the effectiveness of this treatment provided inconsistent conclusions, but a new meta-analysis using a 'gold standard' approach has reached a more definite answer.

'This add-on does not improve fertility outcomes… There was no evidence of benefit in any group we analysed, including fresh or frozen transfers, different embryo stages, or different doses,' said Dr Rui Wang from the University of Sydney, Australia, who led the research published in Human Reproduction Update. 'This hormone shouldn't be routinely offered as part of IVF treatment.'

Some trials had previously shown the treatment to be effective, but Dr Wang noted that when the analysis was restricted to studies where the raw data could be reviewed and verified, 'the effect disappeared completely.'

The researchers selected seven high-quality studies from 28 international registry trials, including 2244 participants in total. By comparing pre-IVF participants who had received a placebo, no intervention or the intrauterine administration of hCG before embryo transfer, they detected no improvement in live birth rates or pregnancy rates following the treatment.

The team used an individual participant data meta-analysis to reanalyse the original data from each patient, rather than looking at the conclusion of each study.

Add-ons are extra treatments that are not part of the basic IVF protocol. They are often offered by IVF clinics to patients for additional cost, even when there is no evidence that they improve outcomes.

'Every procedure offered to patients should be backed by reliable evidence… adding procedures with no proven benefit is an unnecessary burden on people navigating an already difficult journey,' said Dr Wang.

'Many IVF add-ons look promising on paper because early studies report benefits,' he added. 'But if those studies are flawed or the data can't be verified, patients may be making decisions based on evidence that doesn't hold up.'