• Salwa Sameer Fadhil Department of Clinical Reproductive Physiology, High Institute of Infertility Diagnosis & ART Al-Nahrain University
  • Mohammad Oda Selman Department of Clinical Reproductive Physiology, High Institute of Infertility Diagnosis & ART Al-Nahrain University
  • Manal Taha Al-Obaidi Department of Clinical Reproductive Physiology, High Institute of Infertility Diagnosis & ART Al-Nahrain University




Embryo Transfer, Failed IVF Trials, Implantation Failure, Infertility, Embryo Glue, ICSI, IVF


Purpose: One of the reasons for failed implantation after transferring good quality embryos in an intracytoplasmic sperm injection cycle is the failure of creation a viscid layer between the embryo and the endometrium. Many modifications have been made in embryo transfer medium to improve implantation and increase pregnancy rates such as adding albumin as a source of energy and adding hyaluronic acid in high concentrations such as in Embryo Glue medium: a human embryo transfer medium. To investigate whether the use of Embryo Glue had any effect on clinical pregnancy rates in intracytoplasmic sperm injection-fresh embryo transfer cycles.

Methods: A prospective study included one hundred and twenty-eight infertile Iraqi women who were selected and subjected to a stimulation protocol in an intracytoplasmic sperm injection-fresh embryo transfer cycle. All patients were considered to be eligible for embryo transfer (no visible causes could prevent implantation) and only good quality embryos were transferred to them. Those women were divided randomly into two groups according to type of embryo transfer medium: group A: Embryo Glue medium. group B: Conventional medium. Then group A was subdivided according to age into:  AI (34 women with age < 35 years and represented 50.7%) AII (33 women with age ≥ 35 years and represented 49.3%) While group B was subdivided into:  BI (41women with age < 35 years and represented 67.3%)  BII (20 women with age ≥ 35 years and represented 32.7%).

Results: Although there was no significant difference between all groups in causes of infertility, the pregnancy rate was significantly higher in subgroup AII (18 pregnant from 33 women) while only 5 patients became pregnant from 20 patients in subgroup BII.  In all women no more than four good quality embryos were transferred, and when total number of transferred embryos was significantly more in group B than group A (P=0.013), the significant increase in pregnancy rates was only observed in subgroup AII (P=0.048). Even though a highly significant difference in number of repeated implantation failure was in group A than group B (P=0.027), the pregnancy rates were significantly higher in group A (P=0.038).

Conclusion: This study concluded that using Embryo Glue has a beneficial effect on old women and increase pregnancy rates, also it has a positive effect on pregnancy rates in repeated implantation failure and increases pregnancy rates even if the women is old.


Download data is not yet available.


Nargund G, Chian RC, Campbell S. A successful pregnancy following ‘double rescue’ egg retrieval in a woman with Natural cycle IVF. Facts Views Vis Obgyn. 2014; 6(2): Pp96–98.

Timeva T, Shterev A, Kyurkchiev S. Recurrent implantation failure: the role of the en-dometrium. J Reprod Infertil. 2014;15(4):Pp173–183.

Folk RS. Implantation of the human embryo. In: Wu B (editor). Advances in Embryo Transfer. 1st edition. Croatia: INTECH; 2016. Pp193-204.

Simon, A, Laufer N. Assessment and treatment of repeated implantation failure (RIF). J Assist Reprod Genet. 2012; 29(11):Pp1227–1239.

Merchant R, Gandhi G, Allahbadia GN. In vitro fertilization/ intracytoplasmic sperm injection for male infertility. Indian J Urol. 2011;27(1):Pp121–132.

Abu-Hassan D, Al-Hasani S. The use of ICSI in all cases of in‐vitro conception. Hum Reprod. 2003;18(4):Pp893-895.‏

Chronopoulou E, Harper JC. IVF culture media: past, present and future. Hum Reprod Update. 2015;21(1):Pp39–55.

Park, D, Kim Y, Kim H, Kim K, Lee YS, Choe J, Hahn JH, Lee H, Jeon J, Choi C, and others. Hyaluronic acid promotes angiogenesis by inducing RHAMM-TGFβ receptor interac-tion via CD44-PKCδ. Mol Cells. 2012;33(6):Pp563–574.

Aplin JD, Kimber SJ. Trophoblast-uterine interactions at implantation. Reprod Biol Endocrinol. 2004;2:P48.

Mojarrad M, Hassanzadeh-Nazarabadi M, Tafazoli1 N. Polymorphism of genes and im-plantation failure. Int J Mol Cell Med. 2013;2(1): Pp1–8.

Urman B, Yakin K, Ata B, Isiklar A, Balaban B. Effect of hyaluronan-enriched transfer medium on implantation and pregnancy rates after day 3 and day 5 embryo transfers: a pro-spective randomized study. Fertil Steril. 2008;90(3):Pp604-612.

O’Flynn N. Assessment and treatment for people with fertility problems: NICE guide-line. Br J Gen Pract. 2014;64(618):Pp50–51.

Galliano D, Bellver J, Díaz-García C, Simón C, Pellicer A. ART and uterine pathology: how relevant is the maternal side for implantation?. Hum Reprod Update. 2015;21(1):Pp13-38.

Mahajan N. Endometrial receptivity array: Clinical application. J Hum Reprod Sci. 2015;8(3):Pp121–129.

Swift BE, Liu KE. The effect of age, ethnicity, and level of education on fertility awareness and duration of infertility. J Obstet Gynaecol Can. 2014;36(11):Pp990-996.

Weissman A. Blastocyst culture and transfer: lessons from an unselected, difficult IVF population. RBM Online. 2008;17(2):Pp220-228.

Ly KD, Aziz N, Safi J, Agarwal A. Evidence-based management of infertile couples with repeated implantation failure following IVF. Curr Womens Health Rev. 2010;6(3):Pp200-218.

Singh M, Chaudhry P, Asselin E. Bridging endometrial receptivity and implantation: network of hormones, cytokines, and growth factors. J Endocrinol. 2011;210(1):Pp5-14.

Fancsovits P, Lehner A, Murber A, Kaszas Z, Rigo J, Urbancsek J. Effect of hyalu-ronan-enriched embryo transfer medium on IVF outcome: a prospective randomized clinical trial. Arch Gynecol Obstet. 2015;291:Pp1173–1179.

Singh N, Gupta M, Kriplani A, Vanamail P. Role of Embryo Glue as a transfer medium in the outcome of fresh non-donor in-vitro fertilization cycles. J Hum Reprod Sci. 2015;8(4):Pp214–217.

Mahani IM, Davar R. Hyaluronic acid versus albumin in human embryo transfer medium. East Mediterr Health J. 2007;13(4):Pp876-880.

Friedler S, Schachter M, Strassburger D, Esther K, Ron ER, Raziel A. A randomized clinical trial comparing recombinant hyaluronan/recombinant albumin versus human tubal fluid for cleavage stage embryo transfer in patients with multiple IVF-embryo transfer failure. Hum Reprod. 2007;22(9):Pp2444-2448.

Martin S, Soto-Suazo M, Zorn TM. Distribution of versican and hyaluronan in the mouse uterus during decidualization. Braz J Med Biol Res. 2003;36(8):Pp1067-1071.

Babayan A, Neuer A, Dieterle S, Bongiovanni AM, Witkin SS. Hyaluronan in follicular fluid and embryo implantation following in vitro fertilization and embryo transfer. J Assist Reprod Genet. 2008;25(9-10):Pp473–476.

Litwiniuk M, Krejner A, Grzela T. Hyaluronic acid in inflammation and tissue regen-eration. J Wound. 2016;28(3):Pp78-88.

Isık S, Taşkapılıoğlu M Ö, Atalay FO, Dogan S. Effects of cross-linked high-molecular-weight hyaluronic acid on epidural fibrosis: experimental study. J Neurosurg Spine. 2015;22(1):Pp94-100.

Richmond JR, Deshpande N, Lyall H, Yates RW, Fleming R. Follicular diameters in conception cycles with and without multiple pregnancy after stimulated ovulation induction. Hum Reprod. 2005;20(3):756-760.

Simon A1, Safran A, Revel A, Aizenman E, Reubinoff B, Porat-Katz A et al. Hyaluron-ic acid can successfully replace albumin as the sole macromolecule in a human embryo transfer medium. Fertil Steril. 2003;79(6):Pp1434-1438.

Mansour R. The Middle East IVF registry for the year 2000. Middle East Fertil Soc J. 2004;9(3):Pp181-185.

Inhorn MC, Gürtin ZB. Infertility and assisted reproduction in the Muslim Middle East: social, religious, and resource considerations. FVV IN ObGyn. 2012;Pp24-29.

Daar AS, Meral Z. Infertility and social suffering: the case of ART in developing coun-tries. In: Vayena E, Rowe PJ, Griffin ROWE PD (editors). Current practices and controver-sies in assisted reproduction. Switzerland:WHO;2002.Pp5-11.

Abduljabbar HS, Amin R. Assisted reproductive technology in Saudi Arabia. Saudi Med J. 2009;30(4):Pp461-464.

Chun S, Seo JE, Rim YJ,2 Joo JH, Lee YC, Koo YH. Efficacy of hyaluronan-rich trans-fer medium on implantation and pregnancy rates in fresh and frozen-thawed blastocyst trans-fers in Korean women with previous implantation failure. Obstet Gynecol Sci. 2016;59(3):Pp201–207.

Loutradi KE, Prassas I, Bili E, Sanopoulou T, Bontis I, Tarlatzis BC. Evaluation of a transfer medium containing high concentration of hyaluronan in human in vitro fertilization. Fertil Steril. 2007;87(1):Pp48-52.

Korosec S, Virant-Klun I, Tomazevic T, Zech NH, Meden-Vrtovec H. Single fresh and frozen-thawed blastocyst transfer using hyaluronan-rich transfer medium. Reprod Biomed Online. 2007;15(6):Pp701-707.

Valojerdi MR, Karimian L, Yazdi PE, Gilani MA, Madani T, Baghestani AR. Efficacy of a human embryo transfer medium: a prospective, randomized clinical trial study. J Assist Reprod Genet. 2006;23(5):Pp207-212.

Sifer C, Mour P, Tranchant S, Visentin E, Hafhouf E, Sermondade N, Martin-Pont B, Benzacken B, Lévy R. Is there an interest in the addition of hyaluronan to human embryo cul-ture in IVF/ICSI attempts?. Gynecol Obstet Fertil. 2009;37(11-12):Pp884-889.




How to Cite

Fadhil, S., Selman, M., & Al-Obaidi, M. (2021). EMBRYO GLUE AND CLINICAL PREGNANCY RATES IN ICSI EMBRYO TRANSFER CYCLES: A PROSPECTIVE STUDY. Journal of Health, Medicine and Nursing, 7(4), 1 – 12. https://doi.org/10.47604/jhmn.1429