THE HUMAN ENDOMETRIUM AND EMBRYO DURING IMPLANTATION ADHESIVE ABILITY ENHANCING PERSPECTIVES

Infertility is a global problem. According to the data of the World Health Organization, 17.5% of people, or one in six people worldwide, suffer from infertility as of 2023. Experts believe that by 2050, a critical decline in the birth rate will lead to a reduction in the number of children under 15 by 40% or more. In Russia, statistics reflect global trends. Therefore, the search for new, effective infertility treatments is a pressing issue in modern medicine. The objective of this review was to analyze and evaluate current data on the use of a hyaluronic acid-enriched medium during embryo transfer to increase implantation rates in infertility treatment cycles using assisted reproductive technologies. The sources of specialized literature used in this review were electronic libraries of scientific publications and medical databases such as Google Scholar, PubMed, and elibrary.ru. The review included relevant publications found through a search using the following keywords: "assisted reproductive technologies," "hyaluronic acid," "embryo," and "endometrium." The study found that the Russian Federation ranks first among European countries and fourth globally in the number of assisted reproductive technology cycles performed (140,931 cycles in 2020 and 158,893 in 2021). However, according to the Russian Association of Human Reproduction and the European Society of Human Reproduction and Embryology, the effectiveness of assisted reproductive technology programs is no more than 40%. Infertility treatment with assisted reproductive technology can be unsuccessful for a number of key factors, including the lack of effective embryo implantation in the endometrium. One of the leading causes of implantation failure of a competent embryo is the failure to form an adhesive matrix between the embryo and the endometrium. The coordinated differentiation of endometrial cells and their interaction with the embryo play a crucial role in this process. It is hypothesized that the use of hyaluronic acid-enriched culture media during embryo transfer may help address the problem of implantation failure in assisted reproductive technology programs. A systematic review of the literature on the use of hyaluronic acid-enriched culture media during embryo transfer to improve assisted reproductive technology outcomes was conducted. Possible mechanisms of action for this medium during assisted reproductive technology embryo transfer are described.

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