Effect of Hyaluronic Acid Vaginal Pessary on Endometrial Receptivity and Pregnancy Outcome through assessment of Serum and Follicular fluid Lymphatic Vessel Endothelial Hyaluronan Receptor 1 (LYVE1) in Women Undergoing ICSI

Abstract

Successful implantation needs a receptive endometrium, a functional and normal embryo at the stage of blastocyst developmental and a synchronized dialogue between embryonic tissues and maternal tissues. Local angiogenesis is an essential pre-requisite for implantation and pregnancy. This study included 63 infertile women (32 women as study group receiving hyaluronic acid and 31 control group) who were subjected to ovulation induction programs with GnRH antagonist protocols for IVF/ICSI procedures. Blood samples were taken by Vacutainer tubes and centrifuged according to the manufacturer’s instructions for the preparation of serum samples. Serum samples for LYVE1 were obtained from each patient when the basal hormonal status was determined. The second time point when the samples were obtained on the day of ova pickup, after that the G1 embryos will be transferred inside uterine cavity. Then performance of endometrial receptivity parameters or patterns evaluation and patients were followed up to do pregnancy test after 14 days after embryo transfer. At day of hCG, there was no significant difference in mean serum LYVE1 between hyaluronic acid group and reference group, respectively (p=0.824). There was no significant difference in mean follicular fluid LYVE1 between hyaluronic acid group and reference group, 0.92±0.36 pg/ml versus 0.82±0.22 pg/ml, respectively (p=0.223). Treatment with hyaluronic acid resulted in not significant increase in serum and follicular fluid LYVE1, and this increment not related to LYVE1 improvement in local blood endometrial blood flow as reflected by reduction in resistive index and pulsatility index with eventual improvement in pregnancy outcome.