Sim PK, Samsudin L, Chandra Mohan P, Nadkarni P. Pilot study on the use of hyaluronan-rich transfer medium in frozen embryo transfer cycles. Poster A-0080 presented at the 33rd International Congress of the Obstetrical and Gynaecological Society of Malaysia (OGSM 2026), 9 to 12 July 2026, One World Hotel, Petaling Jaya, Selangor. KL Fertility & Gynaecology Centre, Kuala Lumpur, Malaysia.
Presented: OGSM 2026 | Last reviewed: October 2026
This page summarises findings from a conference poster presentation based on clinical data from KL Fertility & Gynaecology Centre. It is presented here for the clinical and scientific community and is not intended as a substitute for individualised patient counselling.
Funding and disclosures: No funding or competing-interest declarations are reported on this poster.
Background and Aim
Embryo implantation is a limiting step in assisted reproductive technology (ART). It takes place during the window of implantation, when the endometrium is receptive, approximately six to ten days after ovulation.
The surface of the endometrial epithelium carries an extracellular matrix (ECM), the first point of contact between the embryo and the uterine lining. The ECM is a three-dimensional scaffold of fibrous proteins, proteoglycans and glycosaminoglycans that supports cell adhesion, cell migration and communication between the embryo and the endometrium. Hyaluronan is one of the glycosaminoglycans in the ECM, with roles in tissue hydration, structural integrity and cell signalling, and earlier studies reported that it enhances cell-to-cell and cell-to-ECM adhesion. However, the findings of earlier studies are inconsistent.
This pilot study aimed to describe clinical pregnancy outcomes when a hyaluronan-rich transfer medium was used in frozen embryo transfer (FET) cycles at KL Fertility Centre.
Method: Study Design and Hyaluronan-Rich Transfer Medium in 14 FET Cycles
This was a retrospective pilot study covering one week, from 27 November to 2 December 2025. It included 14 FET cycles in women aged 29 to 41 years. A hyaluronan-rich transfer medium was used in every transfer, and the study had no comparison group. An average of 1.29 embryos were transferred per cycle. The primary outcome was clinical pregnancy, defined as a gestational sac seen on ultrasound.
Results: Clinical Pregnancy Rate After Frozen Embryo Transfer
Twelve of the 14 cycles (85.7%, 12/14) resulted in a clinical pregnancy.
Table 1. Results and Outcomes of the Pilot Study on the Use of Hyaluronan-Rich Transfer Medium in FET Cycles
Outcome | Result |
|---|---|
FET cycles included | 14 |
Clinical pregnancy rate | 85.7% (12/14) |
Average embryos transferred per cycle | 1.29 |
Share of pregnancies in cycles without PGT-A | 75% (pregnancy count not reported) |
Share of pregnancies from single embryo transfer cycles | 70% (pregnancy count not reported) |
Discussion: How These Findings Compare With Published Evidence
Published evidence on hyaluronan-enriched transfer media is mixed. A Cochrane review by Heymann and colleagues pooled 26 studies with 6,704 women undergoing in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). The review concluded that media with a high hyaluronic acid concentration probably increase live birth (risk ratio 1.21, moderate certainty) and clinical pregnancy (risk ratio 1.16, moderate certainty), compared with media containing little or none.
Studies restricted to frozen-thawed transfers point in different directions. A single-centre retrospective study by Yan and colleagues of 248 patients with recurrent implantation failure (RIF) reported a significantly higher clinical pregnancy rate with a hyaluronic acid-enriched medium and no significant difference in live birth. A retrospective cohort by Tran and colleagues of 840 FET cycles found no association between the enriched medium and positive human chorionic gonadotropin (hCG) results (40.7% against 41.8%) or live birth (27.9% against 28.9%).
Clinical Practice Implications
The pilot shows that clinical pregnancies occurred in 12 of 14 FET cycles in which a hyaluronan-rich medium was used. It cannot show that the medium improved implantation, because every transfer in the series used it.
- The finding is descriptive and from a very small series.
- The authors call for larger randomised studies to confirm whether the medium has any effect.
- Live birth, miscarriage and safety outcomes were not reported.
Limitations of This Retrospective Pilot Study
The research lists a small sample size and short duration as limitations. The points below add to that list.
- There was no control group, so any effect of the medium cannot be separated from patient age, embryo quality or transfer strategy.
- The sample was 14 cycles over one week, and the confidence interval around the pregnancy rate is wide.
- The outcome was gestational sac on ultrasound, not ongoing pregnancy or live birth.
Key Findings
- A retrospective pilot study of 14 FET cycles at KL Fertility Centre used a hyaluronan-rich transfer medium in every transfer.
- The clinical pregnancy rate was 85.7% (12/14), with clinical pregnancy defined as a gestational sac on ultrasound.
- The study had no control group, so it cannot show that the medium improved implantation.
- Published studies of hyaluronan-enriched media in frozen transfers report mixed results.
- The authors conclude that larger randomised studies are needed.
About the Researchers
- Poo-Keen Sim is a Chief Embryologist with over 20 years of experience in clinical embryology and IVF laboratory practice. She holds a Master’s degree in Clinical Embryology from Monash University and is a member of the Scientific Team at KL Fertility & Gynaecology Centre. (Poo-Keen Sim on LinkedIn)
- Lina Samsudin is a dedicated Clinical Embryologist with over a decade of specialized experience in reproductive science and high-precision laboratory practice. Holding a Master of Philosophy Degree (by Research) in Biology and Biochemistry, she combines advanced research methodology with technical expertise to optimize laboratory standards and patient outcomes. Throughout her 10-year career, her focus has remained on scientific innovation, quality assurance, optimizing patient outcomes and advancing excellence in clinical embryology. (Lina Samsudin on LinkedIn)
- Priyatarsini Chandra Mohan is a graduate of the National University of Malaysia (UKM) with over two years of professional experience as an embryologist in KL Fertility Centre. Experienced in various IVF laboratory procedures, including oocyte handling, sperm preparation, IVF/ICSI, embryo culture and assessment, cryopreservation, and embryo transfer preparation. Passionate about reproductive science, laboratory excellence, and supporting patients on their journey towards parenthood. (Priyatarsini Chandra Mohan on LinkedIn)
- Dato' Dr. Prashant Nadkarni is the Medical Director of KL Fertility Centre (MBBS, FRCOG). (Dr. Nadkarni’s profile)
References
- Heymann D, Vidal L, Or Y, Shoham Z. Hyaluronic acid in embryo transfer media for assisted reproductive technologies. Cochrane Database Syst Rev 2020;9:CD007421. doi:10.1002/14651858.CD007421.pub4
- Yan Q, Zhao M, Hao F, Zhao R, Teng X, He B, et al. Effect of hyaluronic acid-enriched transfer medium on frozen-thawed embryo transfer outcomes in RIF patients: a single-centre retrospective study. Front Endocrinol (Lausanne) 2023;14:1170727. doi:10.3389/fendo.2023.1170727
- Tran HP, Truong NT, Hoang TT, Tran HL, Do VN, Pham QV, et al. Effect of hyaluronic acid-enriched transfer medium on pregnancy outcomes in frozen embryo transfer cycles: a retrospective study. Asian Pac J Reprod 2026;15(3):140-146. doi:10.4103/apjr.apjr_273_25
- Sim PK, Samsudin L, Chandra Mohan P, Nadkarni P. Pilot study on the use of hyaluronan-rich transfer medium in frozen embryo transfer cycles. Poster A-0080. 33rd International Congress of the Obstetrical and Gynaecological Society of Malaysia (OGSM 2026), 9 to 12 July 2026, One World Hotel, Petaling Jaya, Selangor. KL Fertility & Gynaecology Centre, Kuala Lumpur, Malaysia.