Hyaluronic acid–enriched transfer medium for frozen embryo transfer: a randomized, double-blind, controlled trial

Yung, S. P.; Lai, Shui Fan; Lam, MF; Lui, Ellen Man Wa; Ko, Jennifer K.Y.; Li, Raymond; Wong, Jacki Y Y; Lau, Esther Yuet Ying; Yeung, William Shu Biu; Ng, Ernest Hung Yu

doi:10.1016/j.fertnstert.2021.02.015

Cited by 9 publications

(9 citation statements)

References 19 publications

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“…This study found no significant difference in the clinical pregnancy rates between the HETM and control groups. Thus, our results are in line with previous reports, which found no significant difference in birth rates with frozen embryo transfers [ 9 ]. However, reports of significant differences in birth rates in fresh embryo transfers do exist, with no significant differences in frozen embryo transfers [ 11 , 12 ].…”

Section: Discussionsupporting

confidence: 94%

“…However, reports of significant differences in birth rates in fresh embryo transfers do exist, with no significant differences in frozen embryo transfers [ 11 , 12 ]. It is difficult to speculate on the reason for the increased birth rate in fresh embryo transfers alone, but one hypothesis is that hyaluronic acid assists in maintaining the embryonic receptivity of the endometrium, which is reduced by the high estrogen state caused by ovarian stimulation during fresh embryo transfer [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, on the other hand, some reports show no significant differences in implantation, pregnancy, or birth rates with the use of HETM [ 7 , 8 ]. In particular, recent reports have found no significant differences in birth rates with the use of HETM in frozen-thawed embryo transfers [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Hyaluronan-Enriched Transfer Medium for Low-Grade Frozen Embryo Transfer

Homma¹,

Yanaihara²,

Hatakeyama³

et al. 2023

Cureus

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Research question: This study aimed to retrospectively evaluate the efficacy of a hyaluronan-enriched transfer medium (HETM) for transfer failures and transfer of frozen embryos that have been graded as C at the time of transfer according to the Gardner classification of trophectoderm (TE). Design: This study included 365 cycles of unsuccessful frozen-thawed embryo transfers in hormone replacement cycles graded C according to the Gardner classification of TE at the time of transfer. Clinical pregnancy rates were compared using the χ 2 test, with the patients divided into two groups: one whose transfers did include HETM (HETM group) and one whose transfers did not include HETM (control group). As a subgroup analysis, patients with a TE grade of C at the time of transplantation were divided into two groups: those aged 39 years or younger and those aged 40 years or older at the time of transplantation. The clinical pregnancy rates of the groups with and without HETM were then compared. Results: No difference in the clinical pregnancy rates between the HETM and control groups was observed. Conclusions: Hyaluronic acid is believed to favor implantation by promoting adhesion between the embryo and the endometrium, and there are reports of improved implantation and pregnancy rates as a result of HETM. However, the present results suggest limited effectiveness for HETM. Further case series should be conducted, and the suitability of its use as a treatment should be investigated.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Efficacy of Hyaluronan-Enriched Transfer Medium for Low-Grade Frozen Embryo Transfer

Homma¹,

Yanaihara²,

Hatakeyama³

et al. 2023

Cureus

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“…Some of the studies were mixed fresh and frozen-thawed transfers, however three studies were performed only on frozen ET cycles (n = 713), and these studies showed no evidence of a beneficial effect. This was supported by a recent RCT including 550 frozen ET cycles, where Yung etal. (2021) found no improvement in LBR with 0.5 mg/ml HA compared to standard transfer medium.…”

Section: Resultssupporting

confidence: 56%

Good practice recommendations on add-ons in reproductive medicine

Lundin,

Bentzen,

Bozdag

et al. 2023

Human Reproduction

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STUDY QUESTION Which add-ons are safe and effective to be used in ART treatment? SUMMARY ANSWER Forty-two recommendations were formulated on the use of add-ons in the diagnosis of fertility problems, the IVF laboratory and clinical management of IVF treatment. WHAT IS KNOWN ALREADY The innovative nature of ART combined with the extremely high motivation of the patients has opened the door to the wide application of what has become known as ‘add-ons’ in reproductive medicine. These supplementary options are available to patients in addition to standard fertility procedures, typically incurring an additional cost. A diverse array of supplementary options is made available, encompassing tests, drugs, equipment, complementary or alternative therapies, laboratory procedures, and surgical interventions. These options share the common aim of stating to enhance pregnancy or live birth rates, mitigate the risk of miscarriage, or expedite the time to achieving pregnancy. STUDY DESIGN, SIZE, DURATION ESHRE aimed to develop clinically relevant and evidence-based recommendations focusing on the safety and efficacy of add-ons currently used in fertility procedures in order to improve the quality of care for patients with infertility. PARTICIPANTS/MATERIALS, SETTING, METHODS ESHRE appointed a European multidisciplinary working group consisting of practising clinicians, embryologists, and researchers who have demonstrated leadership and expertise in the care and research of infertility. Patient representatives were included in the working group. To ensure that the guidelines are evidence-based, the literature identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, recommendations were based on the professional experience and consensus of the working group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 46 independent international reviewers. A total of 272 comments were received and incorporated where relevant. MAIN RESULTS AND THE ROLE OF CHANCE The multidisciplinary working group formulated 42 recommendations in three sections; diagnosis and diagnostic tests, laboratory tests and interventions, and clinical management. LIMITATIONS, REASONS FOR CAUTION Of the 42 recommendations, none could be based on high-quality evidence and only four could be based on moderate-quality evidence, implicating that 95% of the recommendations are supported only by low-quality randomized controlled trials, observational data, professional experience, or consensus of the development group. WIDER IMPLICATIONS OF THE FINDINGS These guidelines offer valuable direction for healthcare professionals who are responsible for the care of patients undergoing ART treatment for infertility. Their purpose is to promote safe and effective ART treatment, enabling patients to make informed decisions based on realistic expectations. The guidelines aim to ensure that patients are fully informed about the various treatment options available to them and the likelihood of any additional treatment or test to improve the chance of achieving a live birth. STUDY FUNDING/COMPETING INTEREST(S) All costs relating to the development process were covered from ESHRE funds. There was no external funding of the development process or manuscript production. K.L. reports speakers fees from Merck and was part of a research study by Vitrolife (unpaid). T.E. reports consulting fees from Gynemed, speakers fees from Gynemed and is part of the scientific advisory board of Hamilton Thorne. N.P.P. reports grants from Merck Serono, Ferring Pharmaceutical, Theramex, Gedeon Richter, Organon, Roche, IBSA and Besins Healthcare, speakers fees from Merck Serono, Ferring Pharmaceutical, Theramex, Gedeon Richter, Organon, Roche, IBSA and Besins Healthcare. S.R.H. declares being managing director of Fertility Europe, a not-for-profit organization receiving financial support from ESHRE. I.S. is a scientific advisor for and has stock options from Alife Health, is co-founder of IVFvision LTD (unpaid) and received speakers’ fee from the 2023 ART Young Leader Prestige workshop in China. A.P. reports grants from Gedeon Richter, Ferring Pharmaceuticals and Merck A/S, consulting fees from Preglem, Novo Nordisk, Ferring Pharmaceuticals, Gedeon Richter, Cryos and Merck A/S, speakers fees from Gedeon Richter, Ferring Pharmaceuticals, Merck A/S, Theramex and Organon, travel fees from Gedeon Richter. The other authors disclosed no conflicts of interest. DISCLAIMER This Good Practice Recommendations (GPRs) document represents the views of ESHRE, which are the result of consensus between the relevant ESHRE stakeholders and are based on the scientific evidence available at the time of preparation. ESHRE GPRs should be used for information and educational purposes. They should not be interpreted as setting a standard of care or bedeemedinclusive of all proper methods of care, or be exclusive of other methods of care reasonably directed to obtaining the same results.Theydo not replace the need for application of clinical judgement to each individual presentation, or variations based on locality and facility type. Furthermore, ESHRE GPRs do not constitute or imply the endorsement, or favouring, of any of the included technologies by ESHRE.

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“…Most studies have failed to demonstrate the universal benefit of embryo glue hence only showed that it could be beneficial in selected groups of patients particularly patients with repeated implantation failures [60,61]. Yung et al in a randomized, double blind controlled trial involving 550 women concluded embryo glue use does not improve live birth rate following frozen embryo transfer [62]. In a review article Atkinson and Woodland concluded that the use of embryo glue may be justified for selected group of patients since there is no evidence to show any harmful effect [63].…”

Section: The Use Of Embryo Gluementioning

confidence: 99%

Embryo Transfer in In-Vitro Fertilization: Factors Affecting Successful Outcome

Onuh¹

2023

Embryology Update

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Embryo transfer is the last component of series of events in the process of in vitro fertilization treatment. Events happening at the embryo transfer stage if not well managed could jeopardize the entire process with unpleasant consequences. It is considered to be a critical determinant of clinical outcome in the entire in vitro fertilization procedure. Consequently, factors affecting its efficiency are very vital in the determination of clinical pregnancy, implantation, ongoing pregnancy and live birth rates. Some factors have been clearly seen to be beneficial to the positive outcome of in vitro fertilization, while the benefit of the other factors is still very questionable or have been dismissed. The most important of all factors are ultrasound guided embryo transfer and the use of soft flexible catheters for embryo transfer. Others are removal of cervical mucus before the transfer process, accurate placement of the embryo within the endometrial cavity and immediate ambulation after embryo transfer.

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Hyaluronic acid–enriched transfer medium for frozen embryo transfer: a randomized, double-blind, controlled trial

Cited by 9 publications

References 19 publications

Efficacy of Hyaluronan-Enriched Transfer Medium for Low-Grade Frozen Embryo Transfer

Efficacy of Hyaluronan-Enriched Transfer Medium for Low-Grade Frozen Embryo Transfer

Good practice recommendations on add-ons in reproductive medicine

Embryo Transfer in In-Vitro Fertilization: Factors Affecting Successful Outcome

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