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Meta-Analysis
. 2013 Jan 31;2013(1):CD008611.
doi: 10.1002/14651858.CD008611.pub2.

Human chorionic gonadotrophin (hCG) for preventing miscarriage

Lara C Morley  1 , Nigel Simpson, Thomas Tang
Affiliations
Meta-Analysis

Human chorionic gonadotrophin (hCG) for preventing miscarriage

Lara C Morley et al. Cochrane Database Syst Rev. .

Abstract

Background: Recurrent miscarriage (RM) is defined as the loss of three or more consecutive pregnancies. Further research is required to understand the causes of RM, which remain unknown for many couples. Human chorionic gonadotrophin (hCG) is vital for maintaining the corpus luteum, but may have additional roles during implantation which support its use as a therapeutic agent for RM.

Objectives: To determine the efficacy of hCG in preventing further miscarriage in women with a history of unexplained RM.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2012) and reference lists of retrieved studies.

Selection criteria: Randomised controlled trials investigating the efficacy of hCG versus placebo or no treatment in preventing RM. Quasi-randomised trials are included. Cluster-randomised trials and trials with a cross-over design are excluded.

Data collection and analysis: Two review authors independently assessed trials for inclusion and assessed the methodological quality of each study. Date were extracted by two review authors and checked for accuracy.

Main results: We included five studies (involving 596 women). Meta-analysis suggested a statistically significant reduction in miscarriage rate using hCG.The number of women needed to treat to prevent subsequent pregnancy loss was seven. However, when two studies of weaker methodological quality were removed, there was no longer a statistically significant benefit (risk ratio 0.74; 95% confidence interval 0.44 to 1.23). There were no documented adverse effects of using hCG.

Authors' conclusions: The evidence supporting hCG supplementation to prevent RM remains equivocal. A well-designed randomised controlled trial of adequate power and methodological quality is required to determine whether hCG is beneficial in RM.

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Conflict of interest statement

None known.

Figures

1
1
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
2
2
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Human chorionic gonadotrophin versus control, Outcome 1 1st trimester miscarriage.
1.2
1.2. Analysis
Comparison 1 Human chorionic gonadotrophin versus control, Outcome 2 Miscarriage rate excluding 2 studies.
1.3
1.3. Analysis
Comparison 1 Human chorionic gonadotrophin versus control, Outcome 3 Threatened miscarriage.
1.4
1.4. Analysis
Comparison 1 Human chorionic gonadotrophin versus control, Outcome 4 Congenital defects.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD008611

References

References to studies included in this review

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