The purpose of this study was to assess whether intrauterine administration of peripheral blood mononuclear cells (PBMCs) activated by human chorionic gonadotropin (hCG) could improve the pregnancy and live birth rates in women with repeated implantation failure (RIF), and whether the parameters of co-culture of hCG and PBMCs would affect the clinical outcomes. Six databases (PubMed, Ovid, Medline, NCBI, Cqvip and Wanfang) were searched up to October 2020 by two independent reviewers. Seven studies were included according to specific inclusion and exclusion criteria. A meta-analysis showed that the pregnancy and live birth rates were significantly increased in the case group compared with the control group (odds ratio [OR]: 3.43, 95 % confidence interval [CI]: 1.78–6.61; P = 0.0002 and OR: 2.79, 95 % CI: 1.09–7.15; P = 0.03), especially when hCG was cultured with PBMCs for 48 h or PBMCs administration was performed two or three days before embryo transfer (ET). Neither the dosage of the hCG co-cultured with PBMCs nor the mean concentration of the administered PBMCs appeared to influence the therapeutic efficiency. In conclusion, intrauterine administration of PBMCs co-cultured with hCG for 48 h, conducted two or three days before ET, could be an effective therapy for women experiencing RIF. Due to the limitations of sample size and quality of the included studies, further high-quality studies with large sample sizes are warranted to optimize the parameters of hCG and PBMC co-culture to help more RIF patients benefit from this therapy.

本研究的目的是评估宫内注射由人绒毛膜促性腺激素 (hCG) 激活的外周血单核细胞 (PBMC) 是否可以提高反复着床失败 (RIF) 妇女的妊娠率和活产率，以及hCG 和 PBMC 的共培养会影响临床结果。截至 2020 年 10 月，两名独立审查员检索了六个数据库（PubMed、Ovid、Medline、NCBI、Cqvip 和 Wanfang）。根据特定的纳入和排除标准纳入了 7 项研究。荟萃分析显示，与对照组相比，病例组的妊娠率和活产率显着增加（优势比 [OR]：3.43，95% 置信区间 [CI]：1.78-6.61；P = 0.0002 和 OR：2.79，95% CI：1.09–7.15；P  = 0.03)，尤其是当 hCG 与 PBMC 一起培养 48 小时或在胚胎移植 (ET) 前两三天进行 PBMC 给药时。与 PBMC 共培养的 hCG 的剂量和所施用的 PBMC 的平均浓度似乎都不会影响治疗效率。总之，在 ET 前两到三天进行与 hCG 共培养 48 小时的 PBMC 的宫内给药，可能是治疗 RIF 女性的有效疗法。由于纳入研究的样本量和质量的限制，需要进一步进行大样本的高质量研究来优化 hCG 和 PBMC 共培养的参数，以帮助更多的 RIF 患者受益于该疗法。