title: Hyaluronan-enriched transfer medium improves outcome in patients with multiple embryo transfer failures.
abstract: OBJECTIVE
  To ascertain whether the use of hyaluronan-enriched transfer medium (HETM) improves pregnancy and implantation rates among embryo transfer patients with a history of multiple implantation failures.
  
  
  METHODS
  Patients (n = 314) under the age of 40 and with a history of multiple unsuccessful embryo transfers were enrolled. There were three groups of patients: those undergoing fresh embryo transfer (fresh ET [n = 111]), those undergoing vitrified-warmed ET in the natural cycle (WET-N [n = 101]) and those undergoing WET in a hormone replacement cycle (WET-H [n = 102]). On the day of ET, patients were randomized to HETM (0.5 mg/ml hyaluronan) or control medium containing no hyaluronan. Only patients with good quality embryos on day 3 were included.
  
  
  RESULTS
  For all three patients groups (fresh ET, WET-N and WET-H) pregnancy rates (37.5 %, 31.4 % and 41.2 %, respectively) were significantly higher when using HETM compared with control medium (10.9 %, 10.0 % and 15.7 %, respectively; p < 0.05), and implantation rates when using HETM were also significantly higher compared with control medium (p < 0.05). Miscarriage rates were similar in both groups.
  
  
  CONCLUSIONS
  HETM significantly increased pregnancy and implantation rates among embryo transfer patients with a history of multiple unsuccessful implantations-regardless of method used to prepare the endometrium.
authors.affiliation: Division of Reproductive Medicine, Sugiyama Clinic, 1-53-1, Ohara, Setagaya, Tokyo, 156-0041, Japan. nakagawa-jiko@spice.ocn.ne.jp
authors.forename: Koji
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Chie
authors.initials: C
authors.lastname: Takahashi
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Nishi
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Jyuen
authors.forename: Rie
authors.initials: R
authors.lastname: Sugiyama
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kuribayashi
authors.forename: Rikikazu
authors.initials: R
authors.lastname: Sugiyama
mesh_terms: D000328:Adult; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D006820:Hyaluronic Acid / Q000494:pharmacology*; D011247:Pregnancy; D018873:Pregnancy Rate
chemical_list: D006820:Hyaluronic Acid