Clinical Pregnancy After Assisted Hatching Rate in Young women undergoing Intra Cytoplasmic Sperm Injection

Al-Sunaidi Al-Sunaidi

doi:10.3844/ajassp.2012.794.797

Abstract

Problem statement: The ability of a blast cyst to hatch, or escape, f rom the Zona Pellucida (ZP) that surrounds and protects the embryo during its first few days of development is one of many critical events that must occur for successful repr oduction. Implantation of the embryo in the uterine lining is impossible unless hatching occurs. Hard o r thick ZP will therefore impaire the implantation process and reduce the pregnancy rate. Approach: Retrospective analysis of patients' records who ha d ICSI cycles comparing pregnancy rate for women with and without assisted hatching between Jan and Dec 2010, this was to evaluate the overall effect o f AH on pregnancy rates in younger women (less than 37 years old) undergoing ICSI cycles at Mustasharak medical center, ABHA, Saudi Arabia. The studied population was divided into four different subgroup s according to age and the differences in clinical pregnancy rate among the assisted hatching group and control group were calculated. Results: Clinical pregnancy rate was found to be significantly higher statistically in young women who underwent laser assisted hatching after ICSI. Conclusion: Laser assisted hatching has a positive impact on th e clinical pregnancy rate following ICSI in young age group.

Highlights

Using mechanical, chemical, or more recently implemented laser manipulations of the human zonaIntra Cytoplasmic Sperm Injection (ICSI), a technique allowing the microinjection of a single spermatozoon into the oocyte cytoplasm, has been applied worldwide to treat severe male factor infertility and dysfunction of fertilization
Recent comprehensive reviews and metaanalyses of 23 prospective randomized clinical trials have suggested that assisted hatching may be beneficial for only a select group of patients, those with repeated unexplained implantation failures and possibly older women (Seif et al, 2006) Existing trials provide insufficient data to zona hatching techniques Assisted Hatching (AH) have determine the impact of assisted hatching on several been developed to improve the implantation and important clinical outcomes, including live birth rates, clinical pregnancy rates after IVF treatment (Martins et monozygotic twining, congenital malformations and al., 2011; Ebner et al, 2005; Fleiss, 1981)
A comparison of pregnancy rates between AH group and the control group was performed with x2 tests of independence and confidence intervals for the difference of two proportions

Summary

Introduction

Chemical, or more recently implemented laser manipulations of the human zonaIntra Cytoplasmic Sperm Injection (ICSI), a technique allowing the microinjection of a single spermatozoon into the oocyte cytoplasm, has been applied worldwide to treat severe male factor infertility and dysfunction of fertilization. Most of them nonrandomized, have shown either no improvement in clinical outcome in the assistedhatching versus control groups or significantly increased implantation/pregnancy rates (TPPAE, 2006). Recent comprehensive reviews and metaanalyses of 23 prospective randomized clinical trials have suggested that assisted hatching may be beneficial for only a select group of patients, those with repeated unexplained implantation failures and possibly older women (Seif et al, 2006) Existing trials provide insufficient data to zona hatching techniques Assisted Hatching (AH) have determine the impact of assisted hatching on several been developed to improve the implantation and important clinical outcomes, including live birth rates, clinical pregnancy rates after IVF treatment (Martins et monozygotic twining, congenital malformations and al., 2011; Ebner et al, 2005; Fleiss, 1981)

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