Hyaluronan enriched transfer medium – a possible alternative to freeze-all cycles in PCOS
New study evaluating the benefit of EmbryoGlue in PCOS patients
A study by Sayali Kandari, MS PhD, Cellsure Biotech And Research Centre, Mumbai, India, has evaluated the benefit of EmbryoGlue in PCOS patients. The use of EmbryoGlue for time-lapse selected sET in PCOS shows significant increase in implantation and live birth rates with lower miscarriage rates compared with conventional embryo transfer medium.
Learn more about the study below.
Background
Polycystic ovary syndrome (PCOS) is known to affect implantation rates, miscarriage rates and live birth rates in fresh embryo transfers. The freeze-all strategy has been developed to avoid ovarian hyperstimulation syndrome and reduced endometrial receptivity in these patients but the added vitrification and preparation in subsequent cycles increase cost and time associated with treatment significantly.
The Cochrane review (2014) on the use of adherence compounds shows evidence that EmbryoGlue increases implantation and pregnancy rates. The objective of this study by Kandari (2019) was to evaluate whether the use of embryo transfer medium enriched with hyaluronan (EmbryoGlue) improves outcomes like implantation rates, live birth rate and miscarriage rates in time-lapse selected fresh SET in PCOS women. This is a prospective randomized study. Sample size was calculated with for statistical power of 80% with alpha = 0.05 and beta = 0.2.
The study was presented orally at ASRM 2019.
Material and methods
Patients were allocated on the day of transfer into two groups, transfer in EmbryoGlue or in a culture medium. For the patients in the study group (n=153) the embryos (day 3 or blastocysts) were placed in EmbryoGlue before transfer and transferred in the same medium. The embryo transfers of the control group (n=168) were performed in a culture medium without hyaluronan, CSCM (Irvine Sci).
Fertilisation and culture conditions (time-lapse) were the same for all patients regardless of group. Age, infertility duration, previous IVF cycles, oocyte number and stage of transferred embryo were similar in both groups as well. SET was employed for all patients.
Results
Statistical differences: Implantation rate p<0.005, live birth rate p<0.001, miscarriage rate p<0.17).
Conclusions
“The use of EmbryoGlue for time-lapse sET in PCOS shows a significant increase in implantation rate and live birth rate with lower miscarriage rates compared with conventional embryo transfer medium. This strategy should also be explored to improve outcomes as an effectively alternative to freeze-all cycles for PCOS patients.”
REFERENCE Kandari, S. (2019). Time-lapse selected elective single embryo transfer medium in PCOS improves live birth rates compared to use of conventional transfer medium. A possible alternative to freeze-all cycles in PCOS. Fertility & Sterility, Vol 112, No 3, Supplement. ASRM abstract O-113.