When a patient returns to PFC for her embryo transfer procedure, a consultation with the physician and the embryologist will result in a careful decision regarding which embryos to select for transfer. This is a crucial part of an IVF cycle since patients typically transfer between one and four of the available embryos, and it is important to choose the embryos with the greatest potential for implantation. After this decision has been made, the embryos are placed in culture medium and loaded into a fine silicone (plastic) catheter. A Physician then passes the catheter through the patients cervix and into the uterus. The small drop of culture medium containing the embryos is gently expelled and the empty catheter is withdrawn. Traditionally, the medium that is used for embryo transfer has been similar or identical to the solution used for growing the embryos. However, the introduction of EmbryoGlue is purported to bring about a dramatic increase in the rate at which embryos implant after transfer. In clinical trials, implantation rates per embryo increased by 34% and overall pregnancy rates increased by 21% when EmbryoGlue was tested against a more traditional transfer medium.* Traditionally, the medium that is used for embryo transfer has been similar or identical to the solution used for growing the embryos. However, the introduction of EmbryoGlue is purported to bring about a dramatic increase in the rate at which embryos implant after transfer. In clinical trials, implantation rates per embryo increased by 34% and overall pregnancy rates increased by 21% when EmbryoGlue was tested against a more traditional transfer medium.* There are several reported benefits to the use of EmbryoGlue. The key component is an enzyme called hyaluronan, which has been shown to increase rates of implantation and fetal development, first in a mouse model, and now in humans. Hyaluronan is naturally found in fluid from follicles, the fallopian tubes and the uterus, so it is claimed to provide a more natural environment for the embryos. Hyaluronan production in the uterus is at its highest at the time of embryo implantation, and the enzyme promotes cell to cell contact between the embryo and the uterus. It also dilates the uterine blood vessels, increasing blood supply to the uterus. Lastly, hyaluronan is a viscous sticky solution that more closely resembles the natural secretions of the uterus. Much media attention has surrounded the launch of this product by its manufacturer Vitrolife (www.vitrolife.com), a company headquartered in Sweden and with a subsidiary in Denver, Colorado. Since patients actively read scientific literature and follow IVF developments on line, and since the FDA has approved this product, there has been much demand for EmbryoGlue. However the study mentioned above is only the first of many that will likely be published on the use of EmbryoGlue. It is important to point out that all studies to date have been performed by researchers affiliated with, and financially supported by the manufacturer. Widespread use of the product will generate more independent studies and help confirm or deny these initial results. For now, EmbryoGlue is one of the most exciting developments that we, at Pacific Fertility Center, have seen in a few years. Were cautiously optimistic that it will live up to its reputation since the researchers that developed the product are highly regarded in the scientific community, and the first clinical trial was a well constructed experiment. Nevertheless, in the absence of large scale and independent clinical trials, PFC is not incorporating this product into our standard treatment protocol. While EmbryoGlue is FDA approved for use with human embryos, and we are therefore confident that it does not harm embryos in any way, PFC needs more data on the efficacy of the product before we recommend its use for all patients. Watch this space for regular updates and results from our own patients that choose to have embryos transferred in EmbryoGlue. *Schoolcraft, W., and others, Fertility and Sterility Vol. 76, (2002).
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