A Randomized Controlled Trial of Intrauterine Infusion of Human Chorionic Gonadotropin Prior to Embryo Transfer in Patients with Multiple IVF Failures

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 313–324

DOI: 10.46882/2026/IJOG/000503

Original Research Article

Title: A Randomized Controlled Trial of Intrauterine Infusion of Human Chorionic Gonadotropin Prior to Embryo Transfer in Patients with Multiple IVF Failures

Names of Authors: Ibrahim K. Sanusi¹, Chioma J. Nwachukwu¹

Authors’ Affiliations:
¹ Department of Obstetrics and Gynecology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

Abstract:
Impaired cross-talk between the blastocyst and maternal endometrium contributes significantly to recurrent implantation failure. This double-blind, randomized controlled trial evaluated whether an intrauterine infusion of human chorionic gonadotropin (hCG) immediately before embryo transfer influences implantation and clinical pregnancy rates in women with at least three prior failed in vitro fertilization (IVF) cycles. Two hundred subfertile women scheduled for fresh or frozen cleavage-stage embryo transfer were randomized to either the intervention group (n = 100) or the control group (n = 100). The intervention cohort received an intrauterine infusion of 500 IU of recombinant hCG diluted in 0.1 mL of culture medium 3 minutes prior to embryo transfer. The control group received an infusion of 0.1 mL of culture medium alone. The primary outcome was the clinical pregnancy rate confirmed via transvaginal ultrasound at 7 weeks. The clinical pregnancy rate was significantly higher in the intrauterine hCG group compared to the control group (39.0% vs. 24.0%; Odds Ratio [OR] = 2.03; 95% CI, 1.10 to 3.74; p = 0.023). Implantation rates were also significantly improved in the hCG-treated cohort (22.5% vs. 13.4%, p = 0.011). No cases of pelvic infection or hypersensitivity reactions were observed in either group. Intrauterine infusion of 500 IU of human chorionic gonadotropin shortly before embryo transfer represents a safe, inexpensive, and efficient strategy to enhance endometrial receptivity and pregnancy rates in patients with recurrent implantation failures.

Keywords: In Vitro Fertilization; Recurrent Implantation Failure; Human Chorionic Gonadotropin; Intrauterine Infusion; Clinical Pregnancy Rate; Endometrial Receptivity.

Manuscript Timeline: Received: May 14, 2026; Revised: July 04, 2026; Accepted: July 28, 2026; Published: August 06, 2026.

Citation: Sanusi IK, Nwachukwu CJ. A Randomized Controlled Trial of Intrauterine Infusion of Human Chorionic Gonadotropin Prior to Embryo Transfer in Patients with Multiple IVF Failures. International Journal of Obstetrics and Gynecology. 2026; 14(8): 313–324.

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