The Impact of Transfer Medium on Implantation and Live Birth Rates in Frozen-Thawed Embryo Transfer Cycles

Background: Embryo Glue, a hyaluronan-enriched transfer medium, enhances implantation rates by improving uterine receptivity. Advanced maternal age negatively impacts implantation rates in assisted reproductive technology, as implantation success declines with increasing age. The current study aimed to assess whether using Embryo Glue for embryo transfer improves implantation rates and live birth outcomes in freeze-thaw cycles. Methods: This study involved patients undergoing ICSI-FET (Day 5) with conditions like POR, Advanced Maternal Age, RIF, PCOS, or Unexplained Infertility. After informed consent, Overall, 196 patients for this study were identified with the inclusion and exclusion criteria. Patients treated with FET using embryo glue as transfer medium were grouped as Test (n=104) while those treated with FET with standard transfer medium were grouped as Control group (n= 92) divided. Pregnancy was confirmed by measuring beta-human chorionic gonadotropin (beta-hCG) level after 14 days of embryo transfer. Results: The test group (embryo glue) showed significantly higher implantation (25% vs. 19.6%, p = 0.02) and live birth rates (79.8% vs. 65.21%, p = 0.03) compared to the control group, attributed to the adhesive properties of the glue. Pregnancy rates were higher (52.88% vs. 45.65%) and abortion rates lower (20.19% vs. 34.78%) in the test group, demonstrating no increased miscarriage risk. Additionally, the multiple pregnancy rate was significantly higher in the test group (27.88% vs. 18.47%, p = 0.019), supporting the role of embryo glue in improving implantation outcomes. Conclusion: Hyaluronan-enriched transfer medium (HETM), or embryo glue, is safe during ART. It considerably increases pregnancy and implantation rates. To avoid multiple pregnancies, the number of implanted embryos can be reduced. The positive outcomes shown for HETM are significantly outlined in this study, especially in females above 35 years old.