Hyaluronan-enriched transfer medium improves outcome in patients with multiple embryo transfer failures

  • Koji Nakagawa
  • Chie Takahashi
  • Yayoi Nishi
  • Hiroyasu Jyuen
  • Rie Sugiyama
  • Yasushi Kuribayashi
  • Rikikazu Sugiyama
Technological Innovations



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.


Hyaluronan Vitrified-warmed embryo Multiple embryo transfer failures Implantation Natural cycle Hormone replacement cycle 


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Koji Nakagawa
    • 1
  • Chie Takahashi
    • 1
  • Yayoi Nishi
    • 1
  • Hiroyasu Jyuen
    • 1
  • Rie Sugiyama
    • 1
  • Yasushi Kuribayashi
    • 1
  • Rikikazu Sugiyama
    • 1
  1. 1.Division of Reproductive MedicineSugiyama ClinicSetagayaJapan

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