P-151 In women with recurrent implantation failures, can hyaluronan enriched media optimize reproductive outcomes?

Abstract

Abstract Study question To evaluate the efficacy of Hyaluronan Enriched Media (HEM) to optimize Reproductive Outcomes in women with Recurrent Implantation Failures (RIF)? Summary answer In women with RIF, HEM seems to offer beneficial and safer reproductive outcomes. What is known already HEM has shown to enhance the implantation process of an embryo in-utero. Efficacy of HEM to optimize reproductive outcomes is still not proven. Study design, size, duration This retrospective study comprises data of 430 women with two failed IVF cycles or had RIF undergoing infertility treatment between 2016 to 2021. Study group included Young women (<37yrs) with RIF who opted elective-single blastocyst transfer (eSET) with HEM (n = 228). Control group had young women with RIF and eSET without use HEM (n = 202). Only self-gamete cycles with No PGT-A screening were included in this study. Women with known uterine pathologies were excluded from the study. Participants/materials, setting, methods All women had ICSI - freeze all culture strategy. In a FET, blastocyst showing 100% survival post warming was considered transfer. In study group, embryos were incubated in pre-equilibrated HEM for 10minutes before the intended embryo transfer. In control group embryo was transferred in single step media. ET procedure done as per the clinic’s SOP. Outcomes measured: Clinical Pregnancy Rates (CPR), Implantation rates (IR), Miscarriage Rates(MR), Live Birth rates(LBR) and Neonatal outcomes. Main results and the role of chance Following were the outcomes measured in HEM group Vs Control group: CPR- 66.22% Vs 61.38% (p = 0.2938) IR – 49.56% Vs 31.68% (p = 0.0002; Significant) MR – 11.4% Vs 16.33% (p = 0.1359) LBR – 54.82% Vs 45.05% (p = 0.0418; Significant) There was no significant adverse events with neonatal outcomes between the groups and data looked comparable. Use of HEM at embryo transfer for women with RIF seemed to be a beneficial intervention. It showed significant improvement with embryo implantation and live birth. Data in this study has also looked at Neonatal outcomes. Since HEM group had no reported adverse neonatal outcomes, it not only aids in improving reproductive outcomes but also is a safe intervention and can be considered for routine clinical use for indicated cases. Limitations, reasons for caution Retrospective data with small and unequal sample size. Wider implications of the findings Efficacy of various therapies is still unknown for women who had RIF. PGT-A and ERA (invasive therapies) have been tried for such cases, but its effectiveness is still up in question. Development for newer & safer therapies to improve embryo implantation and live birth for these patients is still awaited. Trial registration number Not applicable