Introduction: Phloroglucinol may be able to improve embryo transfer outcomes. We aimed to systematically evaluate the effects of phloroglucinol on embryo transfer outcomes. Methods: The databases searched were PubMed, Ovid MEDLINE, Web of Science, Wanfang, CQVIP, China National Knowledge Infrastructure, and ClinicalTrials.gov. The last search was on February 7, 2023. The included studies were written in English or Chinese. Randomized controlled trials and cohort studies aiming to assess the effect of phloroglucinol on embryo transfer outcomes were included. The studies reported at least one of the primary outcomes (biochemical pregnancy rate, clinical pregnancy rate, and live birth rate). The odds ratio (OR) and 95% confidence interval (CI) were calculated. A random-effects or fixed model was used where applicable to estimate the results. Results: Seventeen articles reporting 5,953 cycles were included. Biochemical pregnancy rate (OR = 1.58, 95% CI = 1.20–2.08, I2 = 71%), clinical pregnancy rate (OR = 1.69, 95% CI = 1.35–2.10, I2 = 64%), and live birth rate (OR = 1.45, 95% CI = 1.23–1.71, I2 = 36%) were improved by phloroglucinol. Less miscarriage (OR = 0.46, 95% CI = 0.35–0.60, I2 = 0%), less ectopic pregnancy (OR = 0.45, 95% CI = 0.28–0.72, I2 = 0%), higher implantation rate (OR = 1.45, 95% CI = 1.24–1.71, I2 = 62%) but more multiple pregnancy rate (OR = 1.48, 95% CI = 1.13–1.94, I2 = 0%) were induced by phloroglucinol. Endometrial peristaltic waves were improved by phloroglucinol (OR = 22.87, 95% CI = 5.52–94.74, I2 = 72%). Conclusion: Phloroglucinol may improve the outcomes of embryo transfer, including biochemical pregnancy, clinical pregnancy, and live birth rates. Further studies are warranted.

1.
Ruiz-Alonso
M
,
Valbuena
D
,
Gomez
C
,
Cuzzi
J
,
Simon
C
.
Endometrial receptivity analysis (ERA): data versus opinions
.
Hum Reprod Open
.
2021
;
2021
(
2
):
hoab011
.
2.
Lessey
BA
,
Young
SL
.
What exactly is endometrial receptivity
.
Fertil Steril
.
2019
;
111
(
4
):
611
7
.
3.
Zhang
CH
,
Chen
C
,
Wang
JR
,
Wang
Y
,
Wen
SX
,
Cao
YP
, et al
.
An endometrial receptivity scoring system basing on the endometrial thickness, volume, echo, peristalsis, and blood flow evaluated by ultrasonography
.
Front Endocrinol
.
2022
;
13
:
907874
.
4.
Pinto
V
,
Matteo
M
,
Tinelli
R
,
Mitola
PC
,
De Ziegler
D
,
Cicinelli
E
.
Altered uterine contractility in women with chronic endometritis
.
Fertil Steril
.
2015
;
103
(
4
):
1049
52
.
5.
Chung
CH
,
Wong
AW
,
Chan
CP
,
Saravelos
SH
,
Kong
GW
,
Cheung
LP
, et al
.
The changing pattern of uterine contractions before and after fresh embryo transfer and its relation to clinical outcome
.
Reprod Biomed Online
.
2017
;
34
(
3
):
240
7
.
6.
Zhu
L
,
Che
HS
,
Xiao
L
,
Li
YP
.
Uterine peristalsis before embryo transfer affects the chance of clinical pregnancy in fresh and frozen-thawed embryo transfer cycles
.
Hum Reprod
.
2014
;
29
(
6
):
1238
43
.
7.
Zhu
L
,
Xiao
L
,
Che
HS
,
Li
YP
,
Liao
JT
.
Uterine peristalsis exerts control over fluid migration after mock embryo transfer
.
Hum Reprod
.
2014
;
29
(
2
):
279
85
.
8.
Kuijsters
NPM
,
Methorst
WG
,
Kortenhorst
MSQ
,
Rabotti
C
,
Mischi
M
,
Schoot
BC
.
Uterine peristalsis and fertility: current knowledge and future perspectives: a review and meta-analysis
.
Reprod Biomed Online
.
2017
;
35
(
1
):
50
71
.
9.
Buddhabunyakan
N
,
Sothornwit
J
,
Seejorn
K
,
Buppasiri
P
,
Salang
L
.
Effects of atosiban on uterine peristalsis following frozen embryo transfer: a randomized controlled trial
.
Eur J Obstet Gynecol Reprod Biol
.
2021
;
265
:
96
101
.
10.
Dreyer Holt
M
,
Warzecha
AK
,
Bulow
NS
,
Skouby
SO
,
Englund
ALM
,
Birch Petersen
K
, et al
.
Does adjuvant letrozole reduce uterine peristalsis prior to fresh embryo transfer
.
Hum Reprod Open
.
2022
;
2022
(
2
):
hoac011
.
11.
Khairy
M
,
Dhillon
RK
,
Chu
J
,
Rajkhowa
M
,
Coomarasamy
A
.
The effect of peri-implantation administration of uterine relaxing agents in assisted reproduction treatment cycles: a systematic review and meta-analysis
.
Reprod Biomed Online
.
2016
;
32
(
4
):
362
76
.
12.
Clara
B
,
Paul
V
,
Denis
P
,
Stephanie
M
,
Helene
VR
,
Remy
B
.
Efficacy of phloroglucinol for the treatment of pain of gynaecologic or obstetrical origin: a systematic review of literature of randomised controlled trials
.
Eur J Clin Pharmacol
.
2020
;
76
:
1
6
.
13.
Chassany
O
,
Bonaz
B
,
Bruley DES Varannes
S
,
Bueno
L
,
Cargill
G
,
Coffin
B
, et al
.
Acute exacerbation of pain in irritable bowel syndrome: efficacy of phloroglucinol/trimethylphloroglucinol. A randomized, double-blind, placebo-controlled study
.
Aliment Pharmacol Ther
.
2007
;
25
(
9
):
1115
23
.
14.
Jung
H
,
Kim
HJ
,
Choi
ES
,
Lee
JY
,
Park
KS
,
Cho
KB
, et al
.
Effectiveness of oral phloroglucinol as a premedication for unsedated esophagogastroduodenoscopy: a prospective, double-blinded, placebo-controlled, randomized trial
.
PLoS One
.
2021
;
16
(
8
):
e0255016
.
15.
Shin
SY
,
Cha
BK
,
Kim
WS
,
Park
JY
,
Kim
JW
,
Choi
CH
.
The effect of phloroglucinol in patients with diarrhea-predominant irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial
.
J Neurogastroenterol Motil
.
2020
;
26
(
1
):
117
27
.
16.
Wu
F
,
Chen
Y
,
Zheng
C
.
Efficacy of phloroglucinol for acceleration of labour: a systematic review and meta-analysis
.
Arch Gynecol Obstet
.
2021
;
304
(
2
):
421
8
.
17.
Xu
D
,
Zhang
X
,
He
J
.
A prospective, randomized comparison of intramuscular phloroglucinol versus oral misoprostol for cervix pretreatment before diagnostic hysteroscopy
.
Int Surg
.
2015
;
100
(
7–8
):
1207
11
.
18.
Yu
J
,
Chen
L
,
Wang
X
,
Li
X
.
Efficacy and safety analysis of phloroglucinol in combination with oxytocin for the induction of labor in women with term premature rupture of membranes (PROM)
.
Comput Math Methods Med
.
2022
;
2022
:
2617075
.
19.
Xu
A
,
Li
Y
,
Zhu
L
,
Tian
T
,
Hao
J
,
Zhao
J
, et al
.
Inhibition of endometrial fundocervical wave by phloroglucinol and the outcome of in vitro fertilization
.
Reprod Biol
.
2013
;
13
(
1
):
88
91
.
20.
Ye
Y
,
Ou
Q
.
Application value of phloroglucinol in embryo transfer
.
J Guangxi Med Univ
.
2015
;
32
:
783
5
.
21.
Chen
HH
,
Hong
L
.
Clinical effect of phloroglucinol on infertile patients with endometrial negative peristaltic wave undergoing IVF/ICSI-ET
.
Chinese Journal of Family Planning & Gynecotokology
.
2017
;
Vol. 9
:
65
7
.
22.
Lei
L
,
Yang
Y
,
Wang
S
.
The impact of phloroglucinol on endometrial negative wave
.
Beijing Med J
.
2017
;
39
:
1104
6
.
23.
Li
S
,
Chen
X
,
Li
P
,
Guo
J
.
Application of phloroglucinol for frozen-thawed embryo transfer
.
Chinese Journal of Family Planning
;
2017
.
Vol. 25
. p.
173
6
.
24.
Zhang
Y
,
Li
N
,
Chi
Y
,
Qin
J
,
Tan
W
,
Cheng
J
, et al
.
Application of phloroglucinol injection in embryo transfer in patients with recurrent implantation failure
.
J Chin Physician
.
2017
;
19
:
487
90
. 94.
25.
Chi
Y
,
Qin
J
,
Huang
H
,
He
B
,
He
Z
,
Tan
W
.
Application of phloroglucinol in frozen-thawed embro transfer in artificial cycle
.
J Guangxi Med Univ
.
2019
;
36
:
998
1001
.
26.
Chi
Y
,
Qin
J
,
Huang
HY
,
Mo
WY
,
He
B
,
Huang
TS
, et al
.
Application of phloroglucinol to in vitro fertilization and embryo transfer
.
Guangxi Med J
.
2019
;
41
:
431
4
.
27.
Tu
Z
,
Gao
R
,
Wang
L
,
Duan
R
,
Zhang
H
,
Tian
X
, et al
.
Effect of phloroglucinol vs atosiban on frozen embryo transfer in subjects with repeated implantation failure
.
Chin Remedies Clin
.
2020
;
20
:
1765
7
.
28.
Huang
J
,
Liu
X
,
Zhou
Y
,
Xiao
J
,
Feng
Q
,
Li
Q
.
Effects of GnRHa and phloroglucinol on endometrial peristaltic waves for patients with repeated implantation failure in frozen-thawed embryo transfer
.
Beijing Med J
.
2021
;
43
:
679
81
.
29.
Li
SJ
,
Shang
Y
,
Yin
TL
,
Yang
J
.
Effect of phloroglucinol on pregnancy outcomes in fresh embryo transfer of IVF/ICSI
.
J Reprod Med
.
2021
;
30
:
490
5
.
30.
Li
L
,
Wu
R
,
Hong
M
.
Evaluation of the application effect of phloroglucinol in thawed embryo transfer in patients with repeated implantation failure
.
Drug Eval
.
2022
;
19
:
497
9
.
31.
Liang
J
,
Lin
B
,
Pang
Y
,
Deng
Y
.
Effect of phloroglucinol intravenous infusion on pregnancy outcome of fresh embryo transfer in patients with abnormal endometrial peristalsis
.
Heilongjiang Med J
.
2022
;
35
:
860
2
.
32.
Lin
DH
,
Liu
L
,
Zhang
ML
,
Lian
B
,
Li
SF
,
Qin
CR
.
Effect of phloroglucinol on pregnancy outcome of patients with repeated implantation failure
.
Matern Child Health Care China
.
2022
;
37
:
2417
20
.
33.
Pang
WJ
,
Feng
X
,
Wang
X
,
Wang
L
,
Sun
NX
.
Analysis of the effect of phloroglucinol on pregnancy outcomes involving frozen embryo transfers in patients with endometriosis: a retrospective case-control study
.
Front Surg
.
2022
;
9
:
994775
.
34.
Zhang
J
,
Ling
W
,
Gao
J
.
Effect of phloroglucinol with different administration regimens in artificial cycle frozen-thawed embro transfer patients
.
Chin J Hum Sex
.
2022
;
31
:
40
4
.
35.
Shang
Y
,
Li
SJ
,
Yang
J
.
Effect of phloroglucinol on pregnancy outcome in patients with frozen-thawed embryo transfer
.
Chin J Reprod Health
.
2023
;
34
:
90
3
.
36.
Arian
SE
,
Hessami
K
,
Khatibi
A
,
To
AK
,
Shamshirsaz
AA
,
Gibbons
W
.
Endometrial receptivity array before frozen embryo transfer cycles: a systematic review and meta-analysis
.
Fertil Steril
.
2023
;
119
(
2
):
229
38
.
37.
Hunt
S
,
Abdallah
KS
,
Ng
E
,
Rombauts
L
,
Vollenhoven
B
,
Mol
BW
.
Impairment of uterine contractility is associated with unexplained infertility
.
Semin Reprod Med
.
2020
;
38
(
1
):
61
73
.
38.
Fanchin
R
,
Righini
C
,
Olivennes
F
,
Taylor
S
,
de Ziegler
D
,
Frydman
R
.
Uterine contractions at the time of embryo transfer alter pregnancy rates after in-vitro fertilization
.
Hum Reprod
.
1998
;
13
(
7
):
1968
74
.
39.
Yang
W
,
Guo
H
,
Niu
J
,
Liu
J
,
Su
R
,
Bai
Y
, et al
.
Phloroglucinol inhibits oxytocin-induced contraction in rat gastric circular muscle and uterine smooth muscle
.
J Obstet Gynaecol
.
2023
;
43
(
1
):
2130208
.
40.
Zhu
L
,
Li
Y
,
Xu
A
.
Influence of controlled ovarian hyperstimulation on uterine peristalsis in infertile women
.
Hum Reprod
.
2012
;
27
:
2684
9
.
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