***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To investigate the efficacy of hyaluronan-enriched transfer media in cleavage-stage frozen embryo transfer cycles . DESIGN Two commercially available transfer media were prospect ively compared in an observational study . SETTING Hospital-based in vitro fertilization clinic . PATIENT(S ) Patients ( n = 425 ) undergoing frozen-thawed embryo transfer ( FET ) . The embryos transferred were included in either a study group ( high hyaluronic acid [ HA ] , n = 199 ) or a control group ( low HA , n = 226 ) . INTERVENTION(S ) Delivery rate per FET ; positive hCG rate , biochemical pregnancy rate , clinical pregnancy rate , implantation rate , and clinical abortion rate were secondary outcomes . RESULT ( S ) The use of HA in the transfer media significantly increased the positive hCG rate ( 37.2 % vs. 25.2 % ) and implantation rate ( 23.1 % vs. 15.8 % ) without increasing the delivery rate ( 21.6 % vs. 21.2 % ) . More subjects in the study group with a positive hCG test experienced biochemical pregnancy ( 28.4 % vs. 8.9 % ) . CONCLUSION ( S ) Addition of HA to transfer media seems to favor attachment of early embryos in FETs without increasing the delivery rate Purpose To ascertain whether the use of hyaluronan-enriched transfer medium ( HETM ) improves pregnancy and implantation rates among embryo transfer patients with a history of multiple implantation failures . Methods Patients ( n = 314 ) under the age of 40 and with a history of multiple unsuccessful embryo transfers were enrolled . There were three groups of patients : those undergoing fresh embryo transfer ( fresh ET [ n = 111 ] ) , those undergoing  vitrified-warmed ET in the natural cycle ( WET-N [ n = 101 ] ) and those undergoing WET in a hormone replacement cycle ( WET-H [ n = 102 ] ) . On the day of ET , patients were r and omized to HETM ( 0.5 mg/ml hyaluronan ) or control medium containing no hyaluronan .  Only patients with good quality embryos on day 3 were included . Results For all three patients groups ( fresh ET , WET-N and WET-H ) pregnancy rates ( 37.5 % , 31.4 % and 41.2 % , respectively ) were significantly higher when using HETM compared with control medium ( 10.9 % , 10.0 % and 15.7 % , respectively ; p < 0.05 ) , and implantation rates when using HETM were also significantly higher compared with control medium ( p < 0.05 ) . Miscarriage rates were similar in both groups . Conclusion HETM significantly increased pregnancy and implantation rates among embryo transfer patients with a history of multiple unsuccessful implantations – regardless of method used to prepare the endometrium Purpose : The aim of this prospect i ve , r and omized trial was to evaluate the efficacy of Embryo-Glue ® as a human embryo transfer medium in IVF/ICSI cycles . Method : A total of 815 nonselected patients undergoing IVF/ICSI treatment between September 2003 and February 2004 were r and omly allocated into the test ( 417 patients ) and the control ( 398 patients ) groups . In both groups , embryos were cultured in G-1 ™ ver 3 , supplemented with 10 % recombinant human albumin . On the day of embryo transfer ( day 3 ) , the best or good quality embryos were selected for intrauterine transfer . In the test group , the selected embryos were treated with EmbryoGlue ® prior to the transfer , whereas in the control group they were transferred without any treatment . Results : The patients ’ characteristics such as age and the number of ART cycles and also the number of patients in each indication of infertility and the number of embryos selected for transfer were all similar between the two groups . In the test group , the clinical pregnancy rate in the tubal factors and the implantation rate in the tubal factors and recurrent implantation failures increased significantly compared with those in the control group . In the test group , life birth and the triplet delivery rates increased significantly compared with those in the control group . Conclusion : EmbryoGlue ® is a useful embryo transfer medium , and at least in some infertile patients it can improve clinical implantation and ongoing pregnancy rates OBJECTIVE To analyze whether the use of a hyaluronan-enriched transfer medium ( HETM ) increases rates of implantation ( IRs ) and clinical pregnancy ( CPRs ) , compared with the use of a conventional transfer medium after day 3 and day 5 embryo transfers . DESIGN Prospect i ve r and omized controlled trial . SETTING An assisted reproduction program in a private tertiary-care hospital in Turkey . PATIENT(S ) A total of 1,282 consecutive fresh embryo transfer cycles ( 825 day 3 and 457 day 5 ) were r and omly allocated into two groups . In 639 women , ET was effected with HETM , and in 643 , it was effected with a conventional embryo transfer medium . INTERVENTION(S ) Embryo transfer using HETM or conventional embryo transfer medium . MAIN OUTCOME MEASURE(S ) Clinical pregnancy rates and IRs were compared with regard to day of embryo transfer , women 's age , quality of the transferred embryos , and presence of previous implantation failures . RESULT ( S ) Overall CPRs and IRs significantly increased with the use of HETM ( CPR : 54.6 % vs. 48.5 % , odds ratio : 1.28 , 95 % confidence interval : 1.03 - 1.59 ; IR : 32 % vs. 25 % , odds ratio : 1.43 , 95 % confidence interval : 1.23 - 1.66 , for HETM and control groups , respectively ) . The number needed to treat ( NNT ) for one additional pregnancy with routine use of HETM was 17 . The beneficial effect was more prominent in women who were > 35 years of age ( NNT = 7 ) , in women who had previous failed cycles ( NNT = 7 ) , and in women who had poor- quality embryos ( NNT = 8) . CONCLUSION ( S ) The enrichment of transfer medium with hyaluronan increases CPRs and IRs , both for day 3 and day 5 embryo transfers . The beneficial effect was most evident in women who were > 35 years of age , in women who had only poor- quality embryos available for transfer , and in women who had previous implantation failures BACKGROUND We aim ed to examine the efficacy of using an embryo transfer medium enriched with hyaluronan ( HA ) to improve implantation in a selected group of patients aged < 43 years with repeated ( > 4 ) implantation failures after IVF-embryo transfer . METHODS About 101 patients , meeting our selection criteria , were r and omly allocated to undergo embryo transfer either using our routine embryo transfer medium without HA ( control group ) or a HA enriched commercial embryo transfer medium ( study group ) . The primary outcome was clinical pregnancy rate . RESULTS After a similar treatment protocol , the ovarian hormonal response , the mean number of ova retrieved and injected per patient , fertilization and cleavage rates and mean embryo quality were comparable between the study and control groups . Although a similar number of embryos was transferred in both groups ( 3.1 + /- 0.7 versus 2.9 + /- 0.6 , mean + /- SD ) , a significantly higher implantation rate ( 16.3 % versus 4.8 % , P = 0.002 ) and clinical pregnancy rate ( 35.2 % versus 10.0 % , P = 0.004 ) and delivered or ongoing pregnancy rate ( 31.3 % versus 4.0 % , P = 0.0005 ) were observed in the study group . When mean implantation rate per patient was calculated , the difference between the study ( 0.148 + /- 0.23 ) and control ( 0.04 + /- 0.13 ) group was significant ( P = 0.003 ) . CONCLUSIONS In this selected group of patients after multiple IVF-embryo transfer failures , the use of HA enriched embryo transfer medium is beneficial This study was undertaken to compare the outcome of day 3 , day 5 , and frozen-thawed embryo transfer cycles where embryo culture was undertaken using the G1.2-G2.2 versus GIII series sequential media . A total of 400 day 3 , 73 day 5 and 126 frozen-thawed embryo transfer cycles were analysed . Treatment cycles were quasi-r and omized on the day of oocyte retrieval to embryo culture in G1.2-G2.2 versus GIII series sequential media . R and omization was undertaken according to alternating weekdays . Significantly more embryos were of grade 1 or 2 quality on day 3 in the GIII group ( P < 0.05 ) . Likewise , more embryos in the GIII group had eight blastomeres on day 3 ( P < 0.05 ) and were able to hatch spontaneously ( P < 0.05 ) . For day 3 embryo transfer cycles , implantation and clinical pregnancy rates were 14.4 and 25.7 % versus 37.8 and 50.3 % in G1.2-G2.2 and GIII groups respectively ( P < 0.05 ) . For day 5 embryo transfer cycles , implantation rates were significantly higher ( 29 versus 45 % ; P < 0.05 ) in the GIII group . There was a trend towards higher pregnancy rates ; however , this did not reach statistical significance due to fewer cycles analysed in this group . In-vitro culture in GIII series sequential media yields better quality embryos that implant more efficiently , compared with culture in G1.2-G2.2 media The purpose of this prospect i ve r and omized study was to evaluate use of a hyaluronan-rich transfer medium in fresh and frozen-thawed single blastocyst transfer . The study included 279 single blastocyst transfers in women aged<37 years in their first , second or third treatment cycle . According to the type of single blastocyst transfer ( fresh elective or frozen-thawed ) the women were divided into two study and two control groups . In both study groups ( n=130 ) transfers were performed using hyaluronan and in the control groups ( n=149 ) a conventional transfer medium was used . The results indicate that fresh elective single blastocyst transfer with hyaluronan results in significantly higher pregnancy rates in a selected subgroup of women ; those with > or=2 blastocysts developed to day 5 and a previous implantation failure ( 55 % versus 10 % ; P=0.012 ) . Overall pregnancy rates after fresh elective and frozen-thawed single blastocyst transfer were similar in both study and control groups Purpose To compare the effects of 2 different media on embryo morphology and development at days 2/3 . MethodS ix hundred seventy-six attempts from 512 couples were included in this prospect i ve auto-controlled study . Sibling oocytes of all couples undergoing an IVF ( n = 286 ) or ICSI ( n = 390 ) attempt were r and omly assigned to either GIII series ( Vitrolife ) or ISM ( Medicult ) media . Primary end points were fertilization and embryo morphology rates . Results Fertilization rates in GIII series and ISM ( IVF : 59.9 vs 62.0 % and ICSI : 65.7 vs 66.8 % ) respectively were not different . GIII series showed an increase , compared to ISM , of early cleavage rate , ( IVF : 25.8 vs 16.2 % ( p = 0.005 ) ; ICSI : 40.8 vs 25.5 % ( p < 0.0001 ) , and good embryo morphology rate at day 2 [ IVF : 64.6 vs 57.3 % ( p = 0.01 ) ; ICSI : 74.2 vs 69.4 ( p = 0.03 ) ] and at day 3 [ IVF : 57.5 vs 49.0 % ( p = 0.02 ) ; ICSI : 67.2 vs 61.6 % ( p = 0.01 ) ] . Conclusions Embryo morphology at days 2/3 was significantly enhanced when the embryos were cultured in GIII series OBJECTIVE To evaluate the role of fibrin sealant for embryo transfer ( ET ) and the effect of patient mobilization after ET on pregnancy rates . DESIGN A prospect i ve , r and omized , controlled study . METHODS Two hundred eleven patients who were admitted to the IVF Unit over a period of 6 months participated in the study . Patients who had three or more embryos were r and omly divided into two groups : group 1 ( study group ) , in which ET was performed using fibrin sealant , and group 2 , who served as the controls . Ovulation induction was carried out using the long GnRH-a suppression protocol . RESULTS Comparison of the results regarding the implantation and pregnancy rates and ectopic pregnancy rate revealed a nonsignificant difference between the two groups . However , analysis of the results according to the patients ' age revealed a significant increase in pregnancy ( P < .05 ) and implantation ( P < .01 ) rate in elderly patients ( aged 39 - 42 ) using fibrin sealant for ET as 
    Output:
    
No evidence was found of a treatment effect of fibrin sealant as an adherence compound .
Evidence suggests improved clinical pregnancy and live birth rates with the use of functional concentrations of HA as an adherence compound in ART cycles .
The increase in multiple pregnancy rate may be the result of use of a combination of an adherence compound and a policy of transferring more than one embryo .