The effect of hyaluronic acid-enriched transfer medium on the implantation rate in frozen-thawed embryo transfer cycles

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Abstract

Background: The treatment strategy for patients with a history of multiple failures in in vitro fertilization cycles remains a subject of active research. Embryo transfer in cryocycles is known to be more successful than “fresh” embryo transfer, when ovarian stimulation, follicle puncture, fertilization, and embryo culture were performed but the overall efficiency of in vitro fertilization cycles decreases with maternal age and transfer of poor quality embryos. One of the key factors influencing the failure of high quality embryo implantation is the deficiency of the adhesive matrix, which ensures the interaction between the embryo and the endometrium. The implementation of protocols that include the use of hyaluronic acid-enriched transfer media in the process of embryo transfer is a promising direction for improving implantation outcomes. Special attention of researchers is paid to determining the indications for the use of this technique.

Aim: The aim of this study was to evaluate the effect of hyaluronic acid-enriched transfer media on the pregnancy rate in cryocycles.

Materials and methods: This retrospective cohort comparative study, included 609 women who underwent controlled ovarian stimulation and frozen-thawed embryo transfer.

Results: The main outcomes of frozen-thawed embryo transfer cycles were analyzed, taking into account the quality of the transferred embryos and the use of hyaluronic acid-enriched transfer media. The latter was not shown to be associated with an increase in biochemical and clinical pregnancy rates in women under 35 years of age with a history of repeated implantation failures or after transfer of poor quality embryos. However, in patients over 40 years of age with poor quality embryos, the use of hyaluronic acid-enriched transfer media was effective, since it increased the clinical pregnancy rate. As expected, our data showed an increase in the clinical pregnancy rate in women with high quality embryos on the day of transfer, regardless of the patient’s age. At the same time, in patients with a thin (thickness less than 7 mm) endometrium or a history of miscarriage, the use of hyaluronic acid-enriched transfer media was also associated with an increase in the clinical pregnancy rate and live birth during embryo transfer in cryocycles.

Conclusions: The data obtained have shown that the use of hyaluronic acid-enriched transfer media in cryocycles may be recommended for women over 40 years of age, regardless of the quality of the transferred embryos, as well as for women of any reproductive age with a thin endometrium and a history of miscarriage when transferring good quality embryos.

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About the authors

Elena A. Lesik

The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott

Author for correspondence.
Email: lesike@yandex.ru
ORCID iD: 0000-0003-1611-6318
SPIN-code: 6102-4690

Cand. Sci. (Biology)

Russian Federation, Saint Petersburg

Evgenia M. Komarova

The Research Institute of Obstetrics, Gynecology and Reproductology named after D. O. Ott

Email: evgmkomarova@gmail.com
ORCID iD: 0000-0002-9988-9879
SPIN-code: 1056-7821

Cand. Sci. (Biology)

Russian Federation, Saint Petersburg

Mariia A. Ishchuk

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: mashamazilina@gmail.com
ORCID iD: 0000-0002-4443-4287
SPIN-code: 1237-6373
Russian Federation, Saint Petersburg

Ksenia V. Ob’edkova

The Research Institute of Obstetrics, Gynecology and Reproductology named after D. O. Ott

Email: obedkova_ks@mail.ru
ORCID iD: 0000-0002-2056-7907
SPIN-code: 2709-2890

MD, Cand. Sci. (Medicine)

Russian Federation, Saint Petersburg

Yanina M. Sagurova

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: yanina.sagurova96@mail.ru
ORCID iD: 0000-0003-4947-8171
SPIN-code: 8908-7033
Russian Federation, Saint Petersburg

Galina Kh. Safarian

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: galasaf07@gmail.com
ORCID iD: 0000-0001-5988-323X
SPIN-code: 7096-3838

MD, Cand. Sci. (Medicine)

Russian Federation, Saint Petersburg

Manizha R. Makhmadalieva

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: 2563737@mail.ru
ORCID iD: 0000-0002-9578-8931
SPIN-code: 1523-0196

MD

Russian Federation, Saint Petersburg

Yuliya P. Milyutina

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: milyutina1010@mail.ru
ORCID iD: 0000-0003-1951-8312

Cand. Sci. (Biology)

Russian Federation, Saint Petersburg

Alexander M. Gzgzyan

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: agzgzyan@mail.ru
ORCID iD: 0000-0003-3917-9493
SPIN-code: 6412-4801

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg

Natalia I. Tapilskaya

The Research Institute of Obstetrics, Gynecology and Reproductology named after D. O. Ott

Email: tapnatalia@yandex.ru
ORCID iD: 0000-0001-5309-0087
SPIN-code: 3605-0413

Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg

Olesya N. Bespalova

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: shiggerra@mail.ru
ORCID iD: 0000-0002-6542-5953
SPIN-code: 4732-8089
Scopus Author ID: D-3880-2018

MD, Dr. Sci. (Medicine)

Russian Federation, Saint Petersburg

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Supplementary files

Supplementary Files
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1. JATS XML
2. Figure. Schematic representation of recommendations for the use of hyaluronic acid-enriched transfer media (HA) depending on the woman’s age and the quality of the embryo (day 5 of development, 120–122 hours post fertilization)

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия Эл № 77 - 6389
от 15.07.2002 г.