title: Effect of hyaluronan-enriched transfer medium on implantation and pregnancy rates after day 3 and day 5 embryo transfers: a prospective randomized study.
abstract: OBJECTIVE
  To analyze whether the use of a hyaluronan-enriched transfer medium (HETM) increases rates of implantation (IRs) and clinical pregnancy (CPRs), compared with the use of a conventional transfer medium after day 3 and day 5 embryo transfers.
  
  
  METHODS
  Prospective randomized controlled trial.
  
  
  METHODS
  An assisted reproduction program in a private tertiary-care hospital in Turkey.
  
  
  METHODS
  A total of 1,282 consecutive fresh embryo transfer cycles (825 day 3 and 457 day 5) were randomly allocated into two groups. In 639 women, ET was effected with HETM, and in 643, it was effected with a conventional embryo transfer medium.
  
  
  METHODS
  Embryo transfer using HETM or conventional embryo transfer medium.
  
  
  METHODS
  Clinical pregnancy rates and IRs were compared with regard to day of embryo transfer, women's age, quality of the transferred embryos, and presence of previous implantation failures.
  
  
  RESULTS
  Overall CPRs and IRs significantly increased with the use of HETM (CPR: 54.6% vs. 48.5%, odds ratio: 1.28, 95% confidence interval: 1.03-1.59; IR: 32% vs. 25%, odds ratio: 1.43, 95% confidence interval: 1.23-1.66, for HETM and control groups, respectively). The number needed to treat (NNT) for one additional pregnancy with routine use of HETM was 17. The beneficial effect was more prominent in women who were >35 years of age (NNT = 7), in women who had previous failed cycles (NNT = 7), and in women who had poor-quality embryos (NNT = 8).
  
  
  CONCLUSIONS
  The enrichment of transfer medium with hyaluronan increases CPRs and IRs, both for day 3 and day 5 embryo transfers. The beneficial effect was most evident in women who were >35 years of age, in women who had only poor-quality embryos available for transfer, and in women who had previous implantation failures.
authors.affiliation: Assisted Reproduction Unit, American Hospital of Istanbul, Istanbul, Turkey. burman@superonline.com
authors.forename: Bulent
authors.initials: B
authors.lastname: Urman
authors.forename: Kayhan
authors.initials: K
authors.lastname: Yakin
authors.forename: Baris
authors.initials: B
authors.lastname: Ata
authors.forename: Aycan
authors.initials: A
authors.lastname: Isiklar
authors.forename: Basak
authors.initials: B
authors.lastname: Balaban
mesh_terms: D000328:Adult; D010064:Embryo Implantation / Q000187:drug effects*; D004624:Embryo Transfer / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007246:Infertility / Q000453:epidemiology* / Q000628:therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
chemical_list: D006820:Hyaluronic Acid