Abstract
BACKGROUND: Recurrent implantation failure is one of the most important problems in the assisted reproduction technologies, such as women who want frozen-thawed embryo transfers. Improvements in embryo culture and transfer techniques notwithstanding, success rates for both implantation and clinical pregnancy remain suboptimal for many patients, especially those with repeated implantation failure. In improving the conditions of embryo transfer, therefore, this has become one of the central focuses of fertility research in trying to enhance the chances of successful implantation. OBJECTIVES: The objective of this study is to evaluate whether hyaluronic acid-enhanced transfer medium improves implantation and clinical pregnancy rates (CPR) in frozen-thawed embryo transfer cycles as compared to standard transfer medium, taking into account the effects of patient demographics, exposure duration, and ovarian stimulation protocols on outcomes. EXPECTED RESULT: Women with repeated implantation failure are anticipated to have greater rates of implantation, clinical pregnancy, and live birth when using HETM as opposed to the control group using standard transfer media. Additionally, optimal exposure durations of HETM (60 and 120 min) are anticipated to further improve outcomes. Secondary outcomes, including early pregnancy loss, multiple birth rates, and adverse pregnancy outcomes, will also be assessed. CONCLUSION: In conclusion Hyaluronic Acid-Enriched Transfer Medium (HETM) has the potential to enhance implantation rates in assisted reproduction, findings of various studies are inconsistent. Its efficacy can be influenced by patient features and treatment protocols. More studies are required to define the most favorable conditions for the application of HETM, particularly in women with recurrent implantation failure, to optimize its advantage in frozen-thawed embryo transfers.