P-139 Comparison of clinical outcomes between two hyaluronan-rich transfer medium
Authors: Lee J , Shim S , Kim M J , Kim H Y , Park S Y , Park I H , Sun H G , Kim J W , Yun K Y 
Published: June 2023

Abstract

Study question
Is there any difference in effect on clinical outcomes after single vitrified-warmed blastocyst transfer on day 5 using two hyaluronan-rich transfer medium?

Summary answer
There was no significant difference in rates of clinical pregnancy, implantation and miscarriage between two hyaluronan-rich transfer medium.

What is known already
Hyaluronan is one of the glycosaminoglycan that is naturally present in female reproductive organs and promotes the endometrial stroma and preimplantation embryo adhesion through CD44 glycoprotein receptors. Several studies demonstrated that use of hyaluronan-enriched transfer medium in women receiving either cleavage-stage or blastocyst-stage embryo improved clinical outcomes compared to the standard medium. However, studies on clinical outcomes according to two transfer medium containing different concentrations of hyaluronan are still insufficient.

Study design, size, duration
A retrospective study of 1047 vitrified-warmed blastocyst transfer cycles with normal responders (aged 23-35 years) was conducted from September 2018 to November 2022. All cycles with single vitrified-warmed blastocyst transfer on day 5 were evaluated. Only first IVF attempts cycles were included. All women had undergone a GnRH antagonist protocol. Cycles were divided into two groups: Group A (n = 511, EmbryoGlue®, Vitrolife) and Group B (n = 536, UTMTM, Origio).

Participants/materials, setting, methods
All blastocyst were graded using Gardner and Schoolcraft’s criteria. The vitrified-warmed blastocysts were equilibrated for an average of 47 minutes in two transfers medium until transfer. All blasotcyst were then loaded into an embryo transfer catheter (COOK® medical). The rates of clinical pregnancy, implantation and miscarriage were compared between the two groups. Statistical analyses were conducted using Chi-square test and Independent t-test using SPSS.

Main results and the role of chance
There were no significant differences in mean female age (31.6 ± 2.5 vs. 31.8 ± 2.3, P = 0.432), mean endometrial thickness (10.4 ± 1.4 vs. 10.3 ± 1.3, P = 0.478), mean oocytes retrieved (20.8 ± 6.8 vs. 20.5 ± 6.9, P = 0.470) and number of transferred good-quality blastocyst stage rate (≥BB grade, 74.8% vs. 72.6%, P = 0.423) between the two groups. We also observed similar rates of biochemical pregnancy (79.5% vs. 78.0%, P = 0.562), clinical pregnancy (71.4% vs. 69.2%, P = 0.434), implantation (72.4% vs. 70.3%, P = 0.459), ongoing pregnancy (67.5% vs. 66.2%, P = 0.659), miscarriage (5.5% vs. 4.3%, P = 0.463) and multiple pregnancy (1.4% vs. 1.6%, P = 0.782) in Group A and B, respectively.

Limitations, reasons for caution
This study is limited by its retrospective nature in single-center and absence of live birth information. We investigated only single vitrified-warmed blastocyst on day 5 to have data reliability. Therefore, further studies are needed to evaluate our data with vitrified-warmed blastocyst transfer on day 6 or day 7.

Wider implications of the findings
The present data showed that clinical outcomes were similar between two transfer medium containing different concentrations of hyaluronan. Our findings could have significant clinical implication for selection of the appropriate commercial embryo transfer medium according to IVF laboratory conditions.

Trial registration number
not applicable