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Hyaluronate enriched medium (e.g. EmbryoGlue)

Treatment add-on with limited evidence

For most patients, having a routine cycle of proven fertility treatment is effective without using any treatment add-ons.


Hyaluronate enriched medium is rated amber because there is conflicting evidence from randomised controlled trials (RCTs) to show that it is effective at improving the chances of having a baby for most fertility patients. 

What does this traffic light rating mean?

Our traffic-light rated list of add-ons consists of three colours that indicate whether the evidence, in the form of high-quality RCTs, shows that a treatment add-on is effective at improving the chances of having a baby for most fertility patients. 

We give an amber symbol for an add-on where there is conflicting evidence from RCTs to show that an add-on is effective at improving the chances of having a baby for most fertility patients. This means that the evidence is not conclusive and further research is required, and the add-on should not be recommended for routine use.

Our traffic light ratings only indicate the effectiveness of a treatment add-on, at improving your chances of having a baby. Specific safety concerns about a treatment add-on are included under the dedicated section ‘Is this treatment add-on safe?’.

What is hyaluronate enriched medium?

Hyaluronate enriched medium contains a substance called hyaluronan, which may improve the chance of the embryo implanting in the womb. It is added to the solution in the dish in which the embryos are kept before being transferred to the patient. EmbryoGlue is an example of a hyaluronate enriched medium.

What’s the evidence for Hyaluronate enriched medium?

There is one high quality study in this review which shows that the use of hyaluronate enriched medium may be effective at improving your chances of having a baby, other studies in the review were of moderate quality. Further high-quality studies are needed before doctors can be confident of the benefits of hyaluronate enriched medium.

At the October 2019 Scientific and Clinical Advances Advisory Committee (SCAAC) meeting the Committee evaluated the evidence base for hyaluronate enriched medium. Minutes of this discussion and the evidence used to inform this discussion are available on the SCAAC webpage.

This Cochrane review has further information on the evidence for hyaluronate enriched medium, which we are currently considering.

Is this treatment add-on safe?

Hyaluronate enriched medium does not carry any additional known risks for the person undergoing fertility treatment or the child born as a result of fertility treatment.

If you have any questions about the safety and risks, your clinic will be able to discuss whether a treatment add-on would be safe for you to use considering your specific medical history and circumstances.

What are treatment add-ons?

  • optional additional treatments, also referred to as ‘supplementary’, ‘adjuvants’ or ‘embryology treatments’.
  • often claim to be effective at improving the chances of having a baby (live birth rate) but the evidence to support this for most fertility patients is usually missing or not very reliable.
  • likely to involve an additional cost on top of the cost of a routine cycle of proven fertility treatment. Some treatment add-ons can cost hundreds or thousands of pounds each.

It is important to keep in mind that for most patients, having a routine cycle of proven fertility treatment is effective without using any treatment add-ons. If you are paying directly for your own treatment, you may want to think about whether it might be more effective and/or affordable to pay for multiple routine proven treatment cycles, rather than spending large sums of money on a single treatment cycle with treatment add-ons that haven’t been proven to be effective at increasing the likelihood of you having a baby.

We aim to publish clear and reliable information about some of the treatment add-ons that don’t have enough evidence, from high-quality randomised control trials (RCTs), to show that they are effective at improving your chances of having a baby.

To make it easier to understand the scientific evidence for each treatment add-on we have developed our traffic-light rated list of add-ons.


Review date: 19 April 2023

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