P-236 Impact of Hyaluronan-enriched embryo transfer medium on the ICSI cycles outcomes
Authors: Baccouri M , Debbabi L , Chtourou S , Braham M , Bouyahia M , Turki F , Brahmi I , Ben Mefteh M , Fadhlaoui A , Zhioua F , Chakroun N , Kacem Berjeb K 
Published: June 2022

Abstract

Study question
Does the use of hyaluronan-enriched embryo transfer medium improve the ICSI cycles outcomes?

Summary answer
The pregnancy rate was significantly higher when a hyaluronan-enriched embryo transfer medium was used compared to standard medium.

What is known already
Hyaluronan (HA) is a naturally existing macromolecule in the uterine fluid that seems to increase embryo adhesion.
In fact, the human embryo and uterine endometrium express a receptor for HA in the implantation window, and it is conceivable that HA is involved in the initial phases of blastocyst attachment to the endometrium. Multiple studies demonstrated that the use of HA-enriched transfer medium in women receiving either cleavage-stage embryos or blastocyst improved the outcome of IVF cycle such as the implantation rate and life birth rate compared to the standard transfer medium. However, the effectiveness of this ET medium is controversial.

Study design, size, duration
A descriptive, prospective and randomized study was enrolled in the ART center at Aziza Othmana Hospital in Tunis recruiting patients between January 2021 and June 2021. One hundred and thirty three ICSI cycles with fresh embryo transfer (FET) were included. The embryo transfer medium was either a hyaluronan-enriched one (EmbryoGlue®, Vitrolife) or a standard one (G-2®, Vitrolife).

Participants/materials, setting, methods
ICSI cycles with FET were divided into two groups according to the ET medium. The latter’s choice was made according to the transfer’s day. Two groups were constituted: Group1 including embryo transfers with EmbryoGlue(N = 67) and Group2 including those with G2(N = 66). The pregnancy, the implantation, the miscarriage and the live birth rates were compared between the two groups. The statistical analysis was performed by Chi-square and U tests using SPSS and p &lt; 0.05 was considered as significant.

Main results and the role of chance
Among the 133 transfer cycles included, 67 were performed with EmbryoGlue medium and 66 with G2 medium. The mean female’s age was 35.14 ±4.628 years. Both groups were comparable according to the epidemiologic characteristics (age, ovarian reserve, infertility etiology) and according to the number of embryos transferred. The pregnancy rate was significantly higher when using HA-enriched transfer medium compared with standard medium (31% vs 23%, p = 0.04). However, no statistical differences between Group 1 and Group 2 were found concerning the implantation rate (18.65% vs 15.65 %, p = 0.634), the miscarriage rate (28.57% vs 40%; p = 0.804) and the life birth rate (22.38 % vs 13.64 %, p = 0.189).

Limitations, reasons for caution
The results did not consider the embryo stage transferred (cleavage stage or in blastocyst stage). All transfer cycles were included without taking into account of the transfer cycle rank and the medical history of patients.

Wider implications of the findings
The hyaluronan-enriched embryo transfer medium seems to improve the pregnancy rate and should be used especially for patients with a miscarriage history.

Trial registration number
Not Applicable