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

Area of Science:

• Reproductive Medicine
• Embryology
• Infertility Treatment

Background:

• Recurrent implantation failure (RIF) is a significant challenge in assisted reproductive technology (ART).
• Optimizing the uterine environment during embryo transfer is crucial for successful pregnancy.
• Hyaluronan is a key component of the extracellular matrix, potentially influencing embryo-uterine interactions.

Purpose of the Study:

• To evaluate the efficacy of hyaluronan-enriched transfer medium (HETM) in improving pregnancy and implantation rates.
• To determine if HETM benefits patients with a history of multiple implantation failures.
• To assess HETM's impact irrespective of the endometrial preparation method.

Main Methods:

• A randomized controlled trial involving 314 patients under 40 with a history of RIF.
• Patients were assigned to fresh embryo transfer (ET), vitrified-warmed ET in a natural cycle (WET-N), or vitrified-warmed ET in a hormone replacement cycle (WET-H).
• Participants were randomized to receive either HETM (0.5 mg/ml hyaluronan) or a control medium during ET; only good-quality day 3 embryos were included.

Main Results:

• HETM significantly increased pregnancy rates across all groups (fresh ET, WET-N, WET-H) compared to control medium (p < 0.05).
• Implantation rates were also significantly higher with HETM compared to the control group (p < 0.05).
• No significant difference in miscarriage rates was observed between HETM and control groups.

Conclusions:

• HETM significantly enhances both pregnancy and implantation rates in patients undergoing embryo transfer.
• The benefits of HETM are evident in patients with a history of multiple implantation failures.
• The positive effect of HETM on implantation success is independent of the endometrial preparation protocol used.