Hyaluronan-enriched transfer media in PGT-A cycles: a stratified cohort analysis

Can hyaluronan-enriched transfer medium (HETM) improve reproductive outcomes in frozen single euploid blastocyst transfers after preimplantation genetic testing for aneuploidy (PGT-A)?

Retrospective analysis of 445 patients (549 cycles), who had PGT-A embryo transfers that used HETM (EmbryoGlue) versus standard medium. Subgroup analyses were conducted based on blastocyst morphology, maternal age and previous implantation failure.

No significant differences were found between HETM and control groups in the main reproductive outcomes, including positive HCG rates (72.27% versus 70.23%, P = 0.648), clinical pregancy rates per positive BHCG (80.23% versus 84.11%, P = 0.440), live birth rates (66.28% versus 72.85%, P = 0.237), and miscarriage rates (13.95% and 11.26%, P = 0.404). Subgroup analyses by blastocyst cohort quality, maternal age and previous implantation failure showed no statistically significant benefit of HETM. On transfers of poor morphology (C-grade) blastocysts, HETM was associated with a significantly higher HCG-positive rate (79.17% for HETM versus 52.94% for the control group, P = 0.021), but this did not translate into improved clinical pregnancy (52.63% HETM versus 68.89% control group; P = 0.231) or live birth rates (47.37% HETM versus 62.22% control group; P = 0.284).

HETM did not provide a significant advantage in reproductive outcomes after single euploid blastocyst transfer. Its limited benefit in specific subgroups, such as poor morphology embryos, warrants cautious use and further research.