Quenby, S., & Farquharson, R. G. (1994). Human chorionic gonadotropin supplementation in recurring pregnancy loss: a controlled trial. Fertility and Sterility, 62(4), 708-710. https://doi.org/10.1016/s0015-0282(16)56992-1
Quenby S, Farquharson RG. Human chorionic gonadotropin supplementation in recurring pregnancy loss: a controlled trial. Fertil Steril. 1994;62(4):708-710. doi:10.1016/s0015-0282(16)56992-1
Quenby, Siobhan, and Roy G. Farquharson. "Human chorionic gonadotropin supplementation in recurring pregnancy loss: a controlled trial." Fertility and Sterility, vol. 62, no. 4, 1994, pp. 708-710.
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hCG raised live births in recurrent miscarriage with long cycles
A trial of 81 women with unexplained recurrent miscarriage found women with long, irregular cycles had more live births with hCG than with placebo. Among them, more than 8 out of 10 given hCG had a live birth, against 4 out of 10 on placebo. Women with regular cycles did equally well on either: more than 8 out of 10.
Study at a glance, randomized, double-blind trial of 81 women: hCG raised live births in recurrent miscarriage with long cycles. Source: Quenby S et al., 1994, PMID 7646609.
Key Findings
Among women with regular cycles (29 in each group), the live birth rate was 86% with hCG and 86% with placebo.
Among women with long cycles (oligomenorrhea), 11 of 13 given hCG had a live birth, against 4 of 10 given placebo (40%).
A two-tailed Fisher's exact test gave a P value of 0.039 for the comparison in women with oligomenorrhea.
In all, 15 pregnancies were unsuccessful: 2 ectopic pregnancies, 12 first-trimester miscarriages and 1 second-trimester miscarriage. The trial recorded no third-trimester intrauterine deaths.
Interpretation
This randomized, double-blind trial followed 81 women with unexplained recurrent miscarriage at a miscarriage clinic in Liverpool. The authors defined long cycles as longer than 35 days. Every woman in the trial also received review and reassurance scans every 2 weeks between 6 and 14 weeks of pregnancy. The authors note that how hCG works is not established. The findings support larger studies of hCG in women with long, irregular cycles.
RRM Context
The trial sorted women by cycle pattern before comparing treatments. Restorative reproductive medicine works the same way: it evaluates each woman first and reads her cycle as a clinical clue. The authors think long cycles may point to a weak corpus luteum in early pregnancy.
Our editorial summary of this paper, not the article's abstract.
Abstract
Objectives
To investigate the efficacy of hCG in the management of recurrent early pregnancy loss.
Design
A prospective, randomized, controlled trial.
Setting
Miscarriage Clinic, Women's Hospital, Liverpool, United Kingdom.
Subjects
Eighty-one women attending the miscarriage clinic with idiopathic recurrent pregnancy loss were randomized to receive hCG supplementation or placebo in early pregnancy.
Main Outcome Measures
The success rate or live birth rate.
Results
In women with regular menstrual cycles it was found that hCG had no beneficial effect, the pregnancy success rate being 86% in both groups. However, women with oligomenorrhea had a pregnancy success rate of 40% in the placebo group but a statistically significant improvement to 86% if hCG was given.
Conclusions
Human chorionic gonadotropin can be recommended for idiopathic recurrent pregnancy loss in women with oligomenorrhea.
