Hyaluronan-enriched transfer medium improves outcome in patients with multiple embryo transfer failures
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To ascertain whether the use of hyaluronan-enriched transfer medium (HETM) improves pregnancy and implantation rates among embryo transfer patients with a history of multiple implantation failures.
Patients (n = 314) under the age of 40 and with a history of multiple unsuccessful embryo transfers were enrolled. There were three groups of patients: those undergoing fresh embryo transfer (fresh ET [n = 111]), those undergoing vitrified-warmed ET in the natural cycle (WET-N [n = 101]) and those undergoing WET in a hormone replacement cycle (WET-H [n = 102]). On the day of ET, patients were randomized to HETM (0.5 mg/ml hyaluronan) or control medium containing no hyaluronan. Only patients with good quality embryos on day 3 were included.
For all three patients groups (fresh ET, WET-N and WET-H) pregnancy rates (37.5 %, 31.4 % and 41.2 %, respectively) were significantly higher when using HETM compared with control medium (10.9 %, 10.0 % and 15.7 %, respectively; p < 0.05), and implantation rates when using HETM were also significantly higher compared with control medium (p < 0.05). Miscarriage rates were similar in both groups.
HETM significantly increased pregnancy and implantation rates among embryo transfer patients with a history of multiple unsuccessful implantations–regardless of method used to prepare the endometrium.
KeywordsHyaluronan Vitrified-warmed embryo Multiple embryo transfer failures Implantation Natural cycle Hormone replacement cycle
- 4.Afify AM, Crais S, Paulino AF. Temporal variation in the distribution if hyaluronic acid, CD44s, and CD44v6 in the human endometrium across the menstrual cycle. Mol Morphol. 2006;14:328–33.Google Scholar
- 8.Nakagawa K, Nishi Y, Sugiyama R, Jyuen H, Takahashi C, Ojiro Y, Kuribayashi Y, Sugiyama R. A programmed schedule of oocyte retrieval using mild ovarian stimulation (clomiphene citrate and recombinant follicular stimulating hormone). Reprod Med Biol. doi: 10.1007/s12522-011-0110-9.
- 11.Veeck LL. Atlas of the human oocyte and early conceptus Vol. 2, Williams & Wilkins Co; 1991.Google Scholar
- 20.Bontekoe S, Blake D, Heineman MJ, Williams EC, Johnson N. Adherence compounds in embryo transfer media for assisted reproductive technologies. Cochrane Detabase Syst Rev. 2010;(7):CD007421.Google Scholar
- 21.Friedler S, Schachter M, Strassburger D, Esther K, Ron EI-R, Raziel A. A randomized clinical trial comparing recombinant hyaluronan/recombinant albumin versus human tubal fluid for cleavage stage embryo transfer in patients with multiple IVF-embryo transfer failure. Hum Reprod. 2007;22:2444–8.PubMedCrossRefGoogle Scholar