ABSTRACT
Assessing the role of human chorionic gonadotropin (hCG) in recurrent pregnancy loss (RPL) remains a challenge. This chapter examines the possibilities and limitations of the therapeutic use of hCG in women with RPL in light of the physiological actions of hCG as well as the available clinical evidence concerning its utilization in early pregnancy. Despite the research advances on the mechanisms leading to RPL, nearly 50% of all RPLs are considered “unexplained”. The actions of hCG in fetoplacental tissues are paracrine and autocrine in nature. Its actions on target tissues such as the corpus luteum, and various non-gonadal tissues are endocrine in nature. In the 1990s there were some reports that hCG upregulates endometrial VEGF secretion, enhancing the growth of new blood vessels toward the developing conceptus, and later vascular remodeling of the spiral arteries to uteroplacental arteries. Many studies have been performed to investigate the effect of hCG for luteal support in women undergoing assisted reproductive technologies.
