Does enriched growth medium improve IVF outcomes?

This review looked at adding hyaluronic acid (HA) to the medium used to grow embryos during in vitro fertilization (IVF). It found that using HA may increase IVF birth rates.

The infertility treatment IVF involves fertilizing an egg and allowing it to grow it for several days in the laboratory. The embryos are sustained in a medium which includes sugars, proteins, and other nutrients. One or more embryos are then transferred to the uterus. However, the embryo often does not successfully implant in the uterus.

The medium used to grow embryos affects their development. Some IVF clinics add enriching molecules to the IVF medium, such as HA, to improve implantation rates. HA is naturally found in the uterus and is involved in connections within living tissue. It is not clear whether the addition of HA can improve embryo implantation or pregnancy rates from IVF.

This review included 26 studies with 6704 couples undergoing IVF. They were randomly assigned to the high HA group (0.5mg/mL) or to a comparison group with no HA or low concentrations of HA (0.125mg/mL).

Compared to the group using low or no HA, the high HA group had a 21% higher chance of a live birth. Seven studies looked at miscarriage rates. Most of the studies did not find that HA had an effect on miscarriage. However, one study focused on women who had polycystic ovarian syndrome (PCOS). For these women, high HA reduced miscarriage.

This review found that including HA in culture media improves IVF birth rates. It may also reduce miscarriage for women with PCOS.

There were differences between the studies which makes combining their results more uncertain.