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Nakagawa K, Horikawa T, Orita Y, Yamashiro E, Watanabe H, Shirai A, Ogata S, Kataoka H, Kuroda K, Takamizawa S, Sugiyama R. Hyaluronan-enriched transfer medium ( HETM) can improve the implantation rate in morphologically poor euploid blastocyst transfer. Arch Gynecol Obstet 2023; 308:611-619. [PMID: 37256356 PMCID: PMC10293447 DOI: 10.1007/s00404-023-07083-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/04/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE Hyaluronan-enriched transfer medium (HETM) could improve the clinical pregnancy rate (CPR) for patients with repeated implantation failures (RIF). In contrast, there have been seldom reports addressing the potentially beneficial effects of HETM for morphologically poor blastocysts (MPBLs). Our study aimed to evaluate whether the use of HETM would improve the CPR for the patients who were transferred with euploid MPBLs. METHODS Patients who underwent single euploid blastocyst transfer between July 2020 and June 2022 were enrolled. We included only those blastocysts confirmed as euploid by PGT-A, and those blastocysts were transferred after thawing. The natural ovulatory cycle or hormone replacement cycle (HRC) protocol were used for endometrial preparation for frozen embryo transfer (FET). A total of 1,168 FET cycles were performed in the study period, including 954 cycles of morphologically good blastocysts (≥ 4BB in Gardner's classification), and 85 cycles of MPBLs, of which 47 were transferred using HETM in FET (the HETM group), and the remaining 38 were transferred with the medium without hyaluronan (the control group). We compared the CPR between these two groups. RESULTS The characteristics of patients were similar between the HETM and control groups. The CPR in the HETM group was significantly higher than the control group (47.4% and 21.5%, respectively, p = 0.019). The multiple logistic regression analysis found that the use of HETM was a predictive factor of positive pregnancy outcomes (OR = 5.08, 95% CI = 1.62-16.0, p = 0.019). CONCLUSION Our data suggests that HETM used in the euploid blastocyst transfer can improve the clinical pregnancy rates of morphologically poor blastocysts.
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Affiliation(s)
- Koji Nakagawa
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, 1-19-6, Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan.
| | - Takashi Horikawa
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, 1-19-6, Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Yuji Orita
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, 1-19-6, Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
- Takeuchi Ladies Clinic, Aira City, Kagoshima, Japan
| | - Emi Yamashiro
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, 1-19-6, Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Hideaki Watanabe
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, 1-19-6, Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Asako Shirai
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, 1-19-6, Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | | | - Hisayo Kataoka
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, 1-19-6, Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Keiji Kuroda
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, 1-19-6, Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Satoru Takamizawa
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, 1-19-6, Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Rikikazu Sugiyama
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, 1-19-6, Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
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