The use of fibrin sealant for embryo transfer: development and clinical studies

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Abstract
Many embyro transfers after In-vitro fertilization may fail because of expulsion of the embryos from the uterus. Approximately 5–8% of pregnancies resulting from embryo transfer are ectopic. The aim of our study was to find a technique to avoid ectopic pregnancies and to improve the pregnancy rate. We used a two-component fibrin sealant which also contains a fibrinolysis inhibitor (aprotinin) at various concentrations. After gaining experience with mouse embryos, the sealant was used in human embryo transfer with great success. Hie results of a pilot study encouraged us to perform a prospective randomized study on 546 patients (270 with fibrin sealant, 276 conventional embryo transfers). Tliere were 47 (17.0%) orthotopk pregnancies and 6 (2.2%) ectopic pregnancies in the control group, whereas there were 51 (18.9%) intrauterine and no ectopic pregnancies in the treatment group. The difference hi ectopic pregnancies was statistically significant (P < 0.05). With regard to the aprotinin concentration, there was a trend towards better results with 100–150 klU (28.5% clinical pregnancies) in comparison to 250–300 klU (19.2%) or no aprotinin (20.4%) (not significant). Further improvements of the technique may raise the pregnancy rate when fibrin sealant is used. As shown in our prospective randomized study, ectopic pregnancies may be completely avoided.

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