Fibrin glue improves pregnancy rates in women of advanced reproductive age and in patients in whom in vitro fertilization attempts repeatedly fail

Abstract

Objective: To evaluate the possible contribution of fibrin sealant to the ET stage of IVF.

Design: Case-control study.

Setting: An assisted reproductive technology unit that performed 2,535 treatment cycles from 1996-1997.

Patient(s): All consecutively seen patients who underwent ET from January 1996 to September 1997.

Intervention(s): All women who underwent ET with the aid of fibrin sealant during the study period were compared with those who underwent standard ET (controls). Thereafter, a case-control study was conducted on the first consecutively seen 174 women who underwent ET with fibrin sealant and a control group that was matched for age and number of previous unsuccessful cycles.

Main outcome measure(s): Patient age, number of previous unsuccessful IVF attempts, number of embryos transferred, and pregnancy rates.

Result(s): During the study period, ET was performed with fibrin sealant in 265 women and by the standard procedure in 1,402 women. Women in the fibrin sealant group were significantly older. The pregnancy rate was not significantly different between the groups in the whole-cohort study (20.4% versus 23.1%), but it was significantly higher in the fibrin sealant group in the case-control study (25.3% versus 14.9%). This also was true when the older women (>35 years) and the women with > or =4 previous failed IVF attempts were analyzed separately (23.2% versus 9.8% and 26.1% versus 13.4%, respectively).

Conclusion(s): The use of fibrin sealant in ET appears to be beneficial in women of advanced reproductive age and in patients in whom IVF attempts repeatedly fail.