Human chorionic gonadotrophin for recurrent miscarriage: Cochrane systematic review

Abstract

Assessed as up to date: 1995/07/17

Background

There may be an association between recurrent miscarriage and abnormal hormone function in the follicular phase. Human chorionic gonadotrophin may play a role in preventing miscarriages.

Objectives

The objective of this review was to assess the effects of human chorionic gonadotrophin administration during early pregnancy on the risk of miscarriage in women with a history of recurrent miscarriage.

Search strategy

The Cochrane Pregnancy and Childbirth Group trials register was searched. Date of last search: 9 January 1998.

Selection criteria

Randomised trials of human chorionic gonadotrophin compared with placebo or no treatment in women who have had two or more miscarriages.

Data collection and analysis

Eligibility and trial quality were assessed by one reviewer.

Main results

Four trials involving 180 women were included. The trials were of variable quality. Human chorionic gonadotrophin was associated with a reduced risk of miscarriage for women with a history of recurrent miscarriage (odds ratio 0.26, 95% confidence interval 0.14 to 0.52). This result should be interpreted cautiously because the apparent effect is greatly influenced by the two methodologically weaker studies.

Authors' conclusions

There is not enough evidence to evaluate the use of human chorionic gonadotrophin during pregnancy in order to prevent miscarriage in women with a history of unexplained recurrent spontaneous miscarriage.

Author(s)

Scott James R, Pattison Neil

Summary

Human chorionic gonadotrophin for recurrent miscarriage

To be prepared.

Reviewer's Conclusions

Implications for practice

There is insufficient evidence concerning the effects of HCG, when used during pregnancy in order to prevent miscarriage in women with a history of unexplained recurrent spontaneous miscarriage, to support its use in clinical practice.

Implications for research

Whilst there is unconvincing and incomplete evidence about the effect of HCG on the risk of miscarriage when given to women with recurrent miscarriage in general, there are promising data that HCG could be effective in reducing the risk of miscarriage in women with oligomenorrhoea. This evidence needs to be supported by independent large randomised controlled trials.

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