Horiuchi Yoriko, Yanaihara Atsushi, Hatakeyama Shota, Taga Yukino, Kondou Tetsurou, Kuramoto Goro, Ohgi Shirei
Obstetrics and Gynecology, Yanaihara Women's Clinic, Kamakura, JPN.
Obstetrics and Gynecology, Showa University Koto Toyosu Hospital, Tokyo, JPN.
Cureus. 2023 May 19;15(5):e39210. doi: 10.7759/cureus.39210. eCollection 2023 May.
This study aimed to retrospectively evaluate the efficacy of a hyaluronan-enriched transfer medium (HETM) for transfer failures and transfer of frozen embryos that have been graded as C at the time of transfer according to the Gardner classification of trophectoderm (TE).
This study included 365 cycles of unsuccessful frozen-thawed embryo transfers in hormone replacement cycles graded C according to the Gardner classification of TE at the time of transfer. Clinical pregnancy rates were compared using the χ test, with the patients divided into two groups: one whose transfers did include HETM (HETM group) and one whose transfers did not include HETM (control group). As a subgroup analysis, patients with a TE grade of C at the time of transplantation were divided into two groups: those aged 39 years or younger and those aged 40 years or older at the time of transplantation. The clinical pregnancy rates of the groups with and without HETM were then compared.
No difference in the clinical pregnancy rates between the HETM and control groups was observed.
Hyaluronic acid is believed to favor implantation by promoting adhesion between the embryo and the endometrium, and there are reports of improved implantation and pregnancy rates as a result of HETM. However, the present results suggest limited effectiveness for HETM. Further case series should be conducted, and the suitability of its use as a treatment should be investigated.
本研究旨在回顾性评估富含透明质酸的移植培养基(HETM)对移植失败以及对根据滋养外胚层(TE)的加德纳分类在移植时被评为C级的冷冻胚胎移植的疗效。
本研究纳入了365个在激素替代周期中冻融胚胎移植未成功的周期,这些胚胎根据移植时TE的加德纳分类被评为C级。使用χ检验比较临床妊娠率,将患者分为两组:一组移植中使用了HETM(HETM组),另一组移植中未使用HETM(对照组)。作为亚组分析,将移植时TE分级为C级的患者分为两组:移植时年龄在39岁及以下的患者和移植时年龄在40岁及以上的患者。然后比较使用和未使用HETM的两组的临床妊娠率。
未观察到HETM组和对照组之间临床妊娠率的差异。
透明质酸被认为通过促进胚胎与子宫内膜之间的黏附而有利于着床,并且有报道称HETM可提高着床率和妊娠率。然而,目前的结果表明HETM的有效性有限。应进行更多病例系列研究,并调查其作为一种治疗方法的适用性。