Does Embryo Glue Improve IVF Success Rates?

Quick Answer

Yes, embryo glue is associated with a modest improvement in IVF success rates. A 2020 Cochrane review of 26 studies and 6,704 participants found that, among the 10 trials reporting live birth outcomes, hyaluronan-enriched transfer media was associated with a higher live birth rate than standard or low-hyaluronan media, with a relative increase of about 21% (RR 1.21, 95% CI 1.11–1.31). Source: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007421.pub4/full

At Markham Fertility Centre, embryo glue is included for all patients undergoing embryo transfer at no additional cost.

What Is Embryo Glue?

Despite the name, embryo glue is not an actual glue. It is a specialized embryo transfer medium enriched with hyaluronan (hyaluronic acid), a substance that is naturally present in the uterus at the time of implantation.

How it works:

• Hyaluronan increases the viscosity of the transfer medium, making it more similar to the natural uterine environment
• It supports cell adhesion between the embryo and the uterine lining
• It facilitates communication between the embryo and the endometrium
• It may reduce embryo drifting after transfer, helping the embryo stay in the optimal implantation zone

Embryo glue is used at the final step of IVF, during embryo transfer. The embryo is placed in the hyaluronan-enriched medium for a short period (typically 20 to 30 minutes) before being transferred to the uterus via catheter.

What the Evidence Says

The most comprehensive evidence comes from three Cochrane reviews (2010, 2014, 2020). The 2020 update analyzed 26 randomized controlled trials involving 6,704 patients:

Outcome	Effect of embryo glue	Evidence quality
Live birth rate	Increased by ~21% (from 33% to 37-44%)	Moderate
Clinical pregnancy rate	Increased by ~16%	Moderate
Miscarriage rate	Slightly reduced in some studies, not statistically significant overall	Low
Adverse events	No increased risk identified	Moderate

In practical terms: If the chance of a live birth without embryo glue is approximately 33%, using embryo glue raises it to between 37% and 44%. This translates to approximately 1 additional live birth for every 14 embryo transfers.

Patients who may benefit most:

• Women who have experienced recurrent implantation failure (multiple failed transfers)
• Women aged 35 or younger (strongest evidence in this age group)
• Patients using frozen embryo transfers (a 2024 multicenter study showed live birth rates of 60.6% vs. 47.5% with embryo glue)

What Embryo Glue Does Not Do

It is important to set realistic expectations:

• Embryo glue does not guarantee implantation or pregnancy
• It does not improve embryo quality (quality depends on age, genetics, and lab conditions)
• It does not replace other critical factors such as uterine receptivity, proper hormone support, and embryo selection
• It is one component of an evidence-based transfer protocol, not a standalone solution

IVF success comes from a combination of high-quality embryos, a receptive uterine environment, and individualized, evidence-based care.

How Clinics Handle Embryo Glue Differently

Not all clinics approach embryo glue the same way:

Approach	Description
Included for all patients	Part of standard protocol at no extra cost
Offered as a paid add-on	Patients choose whether to add it, typically $100 to $400 extra
Not offered	Some clinics do not use hyaluronan-enriched media

This variation reflects differences in clinical philosophy and how each clinic interprets the available evidence.

When embryo glue is offered as a paid add-on, patients can face uncertainty about whether it is essential or worth the additional cost. This pressure is particularly stressful during an already emotionally demanding process.

How Markham Fertility Centre Approaches Embryo Glue

At MFC, embryo glue is included for all patients undergoing embryo transfer, at no additional cost. This applies to both funded and private cycles, fresh and frozen transfers.

MFC’s rationale:

• The Cochrane evidence supports a modest but meaningful benefit
• Including it as standard care removes the decision pressure from patients
• It aligns with MFC’s philosophy that patients should not feel pressured to “upgrade” core aspects of care
• Transparency is essential: patients should know what is included and what is not

Important distinction: While embryo glue is included as standard, other optional IVF techniques (such as advanced sperm selection methods or assisted oocyte activation) may be recommended in specific clinical situations and may involve additional cost. These are offered selectively, based on individual patient needs and the available evidence.

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FAQ

Does embryo glue really work?

The best available evidence (2020 Cochrane review, 26 studies, 6,704 patients) shows that embryo glue is associated with a ~21% increase in live birth rates. The benefit is modest but statistically significant. It is not a guarantee of success, and individual results vary.

Is embryo glue effective for frozen embryo transfers?

Yes. A 2024 multicenter study of nearly 1,300 cycles found higher live birth rates (60.6% vs. 47.5%) and higher clinical pregnancy rates (69.5% vs. 57.6%) when embryo glue was used in frozen embryo transfers.

Is embryo glue safe?

Yes. Embryo glue has been used clinically since 2003. No adverse effects for patients or children born from embryo glue-assisted transfers have been identified in any published studies, including the Cochrane reviews.

When is embryo glue used?

Embryo glue is used during the embryo transfer step of IVF. The embryo is placed in the hyaluronan-enriched medium for approximately 20 to 30 minutes before being transferred to the uterus. It can be used for fresh or frozen transfers and for all embryo developmental stages (cleavage-stage, blastocyst, biopsied embryos).

How long does embryo glue last?

The hyaluronan in embryo glue mimics the natural uterine environment and supports the initial phase of implantation. Its effects are relevant during the transfer and the critical hours immediately afterward as the embryo begins to interact with the uterine lining. It is not a long-lasting substance; it serves its purpose during the implantation window.

Do I need to request embryo glue at my clinic?

This depends on your clinic’s approach. Some clinics include it routinely, others offer it as a paid add-on, and some do not offer it at all. At Markham Fertility Centre, embryo glue is included for all embryo transfers at no additional cost.