Abstract
Objective: To determine whether laser-assisted hatching can improve clinical outcome of assisted reproductive techniques in both unselected patients and patients with advanced female age, with recurrent implantation failure, or who are using frozen-thawed embryos. Study design: Prospective randomized study. Patients and methods: 179 consecutive women scheduled for intracytoplasmic sperm injection (ICSI) were randomised to either laser assisted hatching (LAH) or non LAH group. Patients were divided into 94 test and 85 control groups. On the day of embryo transfer, the zona pellucida of the selected embryos in the test group was thinned by using an infrared optical laser system, whereas in the control group they were left intact. Clinical pregnancy rates (CPR) and implantation rates (IR) were estimated. Result(s): Patients that underwent LAH (n = 94) had CPR, and IR of 35.1% and 50%, respectively. Patients that did not undergo LAH (n = 85) had lower CPR (28.2%, P = 0.324) and IR (33%, P = 230), with no statistically significant difference P Conclusion: The current study suggested that there is no need for the routine use of laser assisted hatching. However, there is evidence of laser assisted hatching benefit in selected patients
Highlights
It has been reported that implantation rate per embryo transfer in IVF/intracytoplasmic sperm injection (ICSI) programs is 10% to 15% for day 2 or day 3 transfers and 23% to 25% for blastocyst transfers
The current study suggested that there is no need for the routine use of laser assisted hatching
Clinical pregnancy was defined as an intrauterine gestational sac and fetal heart motion noted on transvaginal ultrasound 4 weeks after ET, Implantation rate was defined as the number of gestational sacs seen on transvaginal ultrasound 4 weeks after ET divided by the total number of embryos transferred
Summary
It has been reported that implantation rate per embryo transfer in IVF/ICSI programs is 10% to 15% for day 2 or day 3 transfers and 23% to 25% for blastocyst transfers. Numerous approaches to improve the implantation rate have been proposed and practiced. These include, improving the technique of embryo transfer, improving endometrial receptivity, and improving the capacity of the embryo to implant. Assisted hatching (AH) has been proposed as a method for improving the capacity of the embryos to implant [3]. Since the first assisted hatching technique that used a mechanical method, several approaches have been proposed including mechanical incision of the zona [5] chemical zona drilling with acidic medium [6] chemical zona thinning [7], laser-assisted [8] and, more recently, piezo technology [9]. Elhussieny et al / Open Journal of Obstetrics and Gynecology 3 (2013) 18-23 reproductive techniques in both unselected patients and patients with advanced female age, with recurrent implantation failure, or who are using frozen-thawed embryos
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