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Hyaluronate enriched pre-transfer culture medium (e.g. EmbryoGlue)
For most patients, having a routine cycle of proven fertility treatment is effective without using any treatment add-ons.
Our ratings indicate whether the evidence from studies shows that a treatment add-on is effective at improving treatment outcomes for someone undergoing fertility treatment. Our ratings do not tell you how much that treatment add-on improves your chances of having a baby – please discuss this with your clinic.
What is hyaluronate enriched pre-transfer culture medium?
Hyaluronate enriched pre-transfer culture 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 pre-transfer culture medium.
| Rated outcomes for hyaluronate enriched pre-transfer culture medium | |
|---|---|
| Rated amber for improving the chances of having a baby for most fertility patients
Yellow traffic light
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For most fertility patients the use of hyaluronate enriched pre-transfer culture medium is rated amber because, on balance, it is not clear whether this add-on is effective at improving the treatment outcome. This is because there is conflicting moderate/high quality evidence – in some studies the add-on has been found to be effective, but in other studies it has not. |
What do the ratings mean?
There are five ratings that indicate whether a treatment add-on is effective at improving treatment outcomes for someone undergoing fertility treatment, according to the evidence from studies. To make it easier to understand the scientific evidence for each treatment add-on we have a range of symbols and colours for each rated add-on below.
Green traffic light
On balance, findings from high quality evidence shows this add-on is effective at improving the treatment outcome.
Yellow traffic light
On balance, it is not clear whether this add-on is effective at improving the treatment outcome. This is because there is conflicting moderate/high quality evidence – in some studies the add-on has been found to be effective, but in other studies it has not.
Grey traffic light
We cannot rate the effectiveness of this add-on at improving the treatment outcome as there is insufficient moderate/high quality evidence.
Black traffic light
On balance, the findings from moderate/high quality evidence shows that this add-on has no effect on the treatment outcome.
Red traffic light
There are potential safety concerns and/or, on balance, findings from moderate/high quality evidence shows that this add-on may reduce treatment effectiveness.
All treatment add-ons on our list will have a rating to indicate whether the evidence shows that the treatment add-on is effective at improving the chances of having a baby for most fertility patients. Some treatment add-ons on our list may also have additional ratings for specific treatment outcomes. For example, whether the evidence shows that the treatment add-on reduces miscarriage. There may also be further ratings for specific patient groups, for example whether the evidence shows that the treatment add-on is effective for those who are aged over 40. Please see the individual webpages for each treatment add-on for their ratings.
An agreement between the HFEA and other professional and patient bodies (the 19th October 2023 consensus statement) stated that treatments that have no strong evidence of their safety and/or effectiveness should only be offered in a research setting. Patients should not be charged extra to take part in research, including clinical trials.
What’s the evidence for evidence for hyaluronate enriched pre-transfer culture medium?
Two high quality studies show that the use of hyaluronate enriched pre-transfer culture medium may be effective at improving the chance 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 pre-transfer culture medium.
At the July 2023 Scientific and Clinical Advances Advisory Committee (SCAAC) meeting the Committee evaluated the evidence base for hyaluronate enriched pre-transfer culture medium. Minutes of this discussion and the evidence used to inform this are available on the SCAAC webpage.
Is this treatment add-on safe?
Hyaluronate enriched pre-transfer culture 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.
Studies reviewed for this treatment add-on
The SCAAC have reviewed the following studies for hyaluronate enriched pre-transfer culture medium:
| Morbeck 2007 | NCT005882250 |
| Mahani 2007 | EMHJ 2007;13(4):876-80. |
| Friedler 2007 | 10.1093/humrep/dem220 |
| Korosec 2007 | RBM0 2007;15(6):701-7. |
| Hazlett 2008 | 10.1016/j.fertnstert.2007.05.063 |
| Urman 2008 | 10.1016/j.fertnstert.2007.07.1294 |
| Fancsovits 2015 | 10.1007/s00404-014-3541-9 |
| Singh 2015 | 10.4103/0974-1208.170398 |
| Kleijkers 2016 | 10.1093/humrep/dew156 |
| Yung 2021 | 10.1016/j.fertnstert.2021.02.015 |
What are treatment add-ons?
In vitro fertilisation (IVF) and intrauterine insemination (IUI) are established treatments that have been proven effective for most patients. Treatment add-ons are optional non-essential treatments that may be offered in addition to such proven fertility treatment. The HFEA provides information on add-ons that meet the following criteria:
- Additional treatments (to the core treatment e.g. IVF or IUI), that are being offered to the general patient population in licensed fertility clinics in the UK,
- Where there are published scientific studies which claim to demonstrate that the treatment add-on improves the chances of having a baby or other treatment outcomes rated by the HFEA; but
- where evidence of effectiveness for the use of the treatment in a clinical setting is lacking or absent; and
- where patients need unbiased information about the effectiveness and risks of this treatment.
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 to show that they are effective at improving your chances of having a baby and other relevant treatment outcomes. This provides useful information to patients and allows them to question the use of add-ons.
Review date: 19 October 2025
