1
|
The Current Practice of Assisted Hatching for Embryos in Fertility Centres: a General Survey. Reprod Sci 2022; 29:2664-2673. [PMID: 35411451 PMCID: PMC9444829 DOI: 10.1007/s43032-022-00931-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/24/2022] [Indexed: 11/29/2022]
Abstract
At present, there is no standardised protocol for assisted hatching (AH) and the field is beset with contradictory data. We hypothesised that such contradiction may be related to inconsistencies in clinical practice. This study aimed to investigate the application, preferences, and variations of AH in current clinical practice prior to embryo transfer (AHpET) and biopsy (AHpBP). An online voluntary survey, consisted of 25 questions regarding different aspects of AH, was circulated amongst different fertility centres via newsletters between October 2019 and March 2020. One-hundred twenty-nine different fertility centres participated in the survey. AHpBP was widely used (90.6% [48/53]) amongst these centres, especially for trophectoderm biopsy (92.2% [47/51]). In contrast, only 64.6% (73/113) of centres administrated AHpET; the application of AHpET was even lower in UK-based centres (36.6% [15/41]). Although laser pulses have become the predominant technique for AH, significant variation existed in the precise strategy. Zona pellucida (ZP) drilling was the main method for AHpBP, whilst both ZP drilling and ZP thinning were applied equally for AHpET. Furthermore, the ZP manipulation varied widely with regards to the size of the ZP opening and the extension of ZP thinning. This is the first representative survey relating to the current practice of AH. Laser-assisted AH is used extensively, especially for AHpBP. However, there is significant disparity in clinical practice across different centres. Future research should aim to create a standardised protocol for AH to help reduce the evident variation in clinical practice and investigate the true value of AH.
Collapse
|
2
|
Laser-assisted hatching zona thinning does not improve the pregnancy outcomes of poor-quality blastocysts in frozen-thawed embryo transfer cycle: a retrospective cohort study. Lasers Med Sci 2021; 37:1605-1614. [PMID: 34480664 DOI: 10.1007/s10103-021-03409-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/23/2021] [Indexed: 02/05/2023]
Abstract
It had been suggested, after facilitating the hatching process, improved pregnancy outcomes could be attained in embryos with thick and hard zona. This study aimed to determine the effect of zona thinning on pregnancy outcomes in poor-quality frozen-thawed blastocysts. This retrospective study included 230 women (≤ 40 years) who underwent frozen embryo transfer of poor-quality blastocysts (scored < 3BB). In total, 105 patients were in the assisted hatching group in which the zona was thinned by laser before transfer and 125 patients were in the control group in which the blastocysts were non-manipulated. Patients' demographics, cycle characteristics, and pregnancy outcomes were compared between the assisted hatching group and the control group. Further, regression analysis was applied to test the correlation between assisted hatching and live birth. All parameters in the patients' demographic characteristics and the cycle's characteristics were not significantly different between two groups. As for pregnancy outcomes, the second trimester pregnancy loss was significantly higher in the assisted hatching group (P = 0.035). Other pregnancy outcomes, including implantation rate, clinical pregnancy rate, biochemical miscarriage rate, the first trimester pregnancy loss, ongoing pregnancy rate, and live birth rate were comparable between two groups. The logistic regression analysis demonstrated no association between live birth and assisted hatching (univariate, OR = 0.787, P > 0.05; multivariate, OR = 0.652, P > 0.05), and the area under the receiver operating characteristic curve of the regression model was almost 0.7. It suggested that zona thinning may not be supposed to perform on poor-quality, frozen-thawed blastocysts. The indications of assisted hatching were still needed to further investigate.
Collapse
|
3
|
Huo P, Deng K, Wang L, Li M, Yao J, Le J, Lei X, Zhang S. The effect of laser-assisted hatching on the methylation and expression pattern of imprinted gene IGF2/H19 in mouse blastocysts and offspring. J Assist Reprod Genet 2020; 37:3057-3067. [PMID: 33089439 DOI: 10.1007/s10815-020-01975-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/07/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study aimed to determine the effects of drilling and thinning treatment of laser-assisted hatching on the expression and methylation of imprinted gene IGF2/H19 in embryos and offspring. METHODS The prehatching blastocysts with treatment of drilling or thinning, or control prehatching blastocysts, were transplanted in surrogate uteri. The DNA methylation of IGF2/H19 imprinting control region (ICR) and the expression of IGF2 and H19 were respectively evaluated using bisulfite conversion-mediated sequencing and real-time PCR. RESULTS The drilling group showed a significant increase in the development rate of hatched blastocysts in comparison with the control and thinning group. DNA methylation level of IGF2/H19 ICR of hatched blastocysts in the thinning group was 27.33% in comparison with the 38.67% and 36% observed in the control and drilling group. The thinning treatment increased the DNA methylation level of IGF2/H19 ICR in the placenta in comparison with the control and drilling group. The drilling and thinning treatment decreased the expression level of H19 mRNA in prehatching and hatched blastocysts as well as placenta, while a significant increase in the expression level of H19 mRNA of offspring was observed in the thinning group. The thinning treatment increased the expression level of IGF2 mRNA of prehatching blastocysts and offspring and a significant decrease in placenta, while the drilling treatment resulted in a significant increase in the expression level of IGF2 mRNA of hatched blastocysts and placenta. CONCLUSION These observations suggested that drilling used for hatching of in vitro cultured mouse blastocysts may improve the production of offspring.
Collapse
Affiliation(s)
- Peng Huo
- School of Public and Health, Guilin Medical University, Guilin, 541004, China
| | - Kai Deng
- Guangxi High Education Key Laboratory for Animal Reproduction and Biotechnology, State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, Guangxi University, Nanning, China
| | - Lulu Wang
- Guangxi High Education Key Laboratory for Animal Reproduction and Biotechnology, State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, Guangxi University, Nanning, China
| | - Man Li
- Department of Reproductive Medical Center, The Affiliated Hospital of Guilin Medical University, Guilin, 541001, China
| | - Jun Yao
- Department of Reproductive Medical Center, The Affiliated Hospital of Guilin Medical University, Guilin, 541001, China
| | - Jianghua Le
- Department of Reproductive Medical Center, The Affiliated Hospital of Guilin Medical University, Guilin, 541001, China
| | - Xiaocan Lei
- Clinical Anatomy & Reproductive Medicine Application Institute, Department of Histology and Embryology, University of South China, Hengyang, 421001, China.
| | - Shun Zhang
- Department of Reproductive Medical Center, The Affiliated Hospital of Guilin Medical University, Guilin, 541001, China.
| |
Collapse
|
4
|
Davidson LM, Liu Y, Griffiths T, Jones C, Coward K. Laser technology in the ART laboratory: a narrative review. Reprod Biomed Online 2019; 38:725-739. [DOI: 10.1016/j.rbmo.2018.12.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 11/01/2018] [Accepted: 12/11/2018] [Indexed: 11/27/2022]
|
5
|
Lu X, Liu Y, Cao X, Liu SY, Dong X. Laser-assisted hatching and clinical outcomes in frozen-thawed cleavage-embryo transfers of patients with previous repeated failure. Lasers Med Sci 2019; 34:1137-1145. [DOI: 10.1007/s10103-018-02702-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 12/03/2018] [Indexed: 11/24/2022]
|
6
|
Alteri A, Viganò P, Maizar AA, Jovine L, Giacomini E, Rubino P. Revisiting embryo assisted hatching approaches: a systematic review of the current protocols. J Assist Reprod Genet 2018; 35:367-391. [PMID: 29350315 PMCID: PMC5904073 DOI: 10.1007/s10815-018-1118-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/04/2018] [Indexed: 11/29/2022] Open
Abstract
Zona pellucida (ZP) manipulation, termed "assisted hatching" (AH), has been introduced in order to favor embryo hatching and ultimately improve assisted reproductive technology success but with poor proofs of safety and biological plausibility. We herein provide a systematic review of clinical outcomes following the application of different methods of ZP manipulation on fresh or frozen/thawed embryos at different developmental stages in different groups of patients. Out of the 69 papers that compared the clinical outcomes deriving from hatched versus non-hatched embryos, only 11 considered blastocysts while the rest referred to cleavage stage embryos. The ZP thinning of fresh embryos either by chemical or laser approach was shown to provide very limited benefit in terms of clinical outcomes. Better results were observed with procedures implying a higher degree of zona manipulation, including zona removal. Studies comparing the mechanical or chemical procedures to those laser-mediated consistently reported a superiority of the latter ones over the former. Literature is consistent for a benefit of ZP breaching in thawed blastocysts. This review provides the current knowledge on the AH procedure in order to improve its efficacy in the appropriate context. Embryologists might benefit from the approaches presented herein in order to improve Assisted Reproduction Technologies (ART) outcomes.
Collapse
Affiliation(s)
- Alessandra Alteri
- Obstetrics and Gynaecology Department, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
| | - Paola Viganò
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Ahmad Abu Maizar
- California Fertility Partners, 11818 Wilshire Blvd, Los Angeles, CA, 90025, USA
| | - Luca Jovine
- Department of Biosciences and Nutrition & Center for Innovative Medicine, Karolinska Institutet, Hälsovägen 7, SE-141 83, Huddinge, Sweden
| | - Elisa Giacomini
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Patrizia Rubino
- HRC Fertility, 333 South Arroyo Parkway, Pasadena, CA, 91105, USA
| |
Collapse
|
7
|
Zeng M, Su S, Li L. The effect of laser-assisted hatching on pregnancy outcomes of cryopreserved-thawed embryo transfer: a meta-analysis of randomized controlled trials. Lasers Med Sci 2017; 33:655-666. [PMID: 29116610 DOI: 10.1007/s10103-017-2372-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 10/23/2017] [Indexed: 11/28/2022]
Abstract
It is well known that laser-assisted hatching (LAH) is the most popular and ideal embryo hatching technology, but the relevance to pregnancy outcomes of cryopreserved-thawed embryo transfer (ET) is controversial. The purpose of this meta-analysis was to evaluate the effects of LAH on pregnancy outcomes of cryopreserved-thawed ET. We searched for relevant studies published in the PubMed, EMBASE, and Cochrane Central databases up to March 2017. This meta-analysis was primarily used to evaluate the effect of laser-assisted hatching on assisted reproductive outcomes: clinical pregnancy, embryo implantation, multiple pregnancy, miscarriage, and live birth. Using the Mantel-Haenszel fixed effects model and random effects model, we determined the summary odds ratios (OR) with 95% confidence intervals (CIs). There were 12 randomized controlled trials (more than 2574 participants) included in our analysis. The rates of clinical pregnancy (OR = 1.65, 95% CI = 1.24-2.19, I 2 = 49), implantation (OR = 1.59, 95% CI = 1.06-2.38, I 2 = 82%), multiple pregnancy (OR = 2.30, 95% CI = 1.30-4.07, I 2 = 33%), miscarriage (OR = 0.86, 95% CI = 0.50-1.48, I 2 = 0%), and live birth (OR = 1.09, 95% CI = 0.77-1.54, I 2 = 0%) revealed comparable results for both groups. In summary, this meta-analysis demonstrates that LAH is related to a higher clinical pregnancy rate, embryo implantation rate, and multiple pregnancy rate in women with cryopreserved-thawed embryos. However, LAH is unlikely to increase live birth rates and miscarriage rates. Due to the small sample evaluated in the pool of included studies, large-scale, prospective, randomized, controlled trials are required to determine if these small effects are clinically relevant.
Collapse
Affiliation(s)
- MeiFang Zeng
- Reproductive Medicine Center, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - SuQin Su
- Reproductive Medicine Center, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - LiuMing Li
- Reproductive Medicine Center, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
| |
Collapse
|
8
|
Li D, Yang DL, An J, Jiao J, Zhou YM, Wu QJ, Wang XX. Effect of assisted hatching on pregnancy outcomes: a systematic review and meta-analysis of randomized controlled trials. Sci Rep 2016; 6:31228. [PMID: 27503701 PMCID: PMC4977517 DOI: 10.1038/srep31228] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 07/15/2016] [Indexed: 11/30/2022] Open
Abstract
Emerging evidence suggests that assisted hatching (AH) techniques may improve clinical pregnancy rates, particularly in poor prognosis patients; however, there still remains considerable uncertainty. We conducted a meta-analysis to verify the effect of AH on pregnancy outcomes. We searched for related studies published in PubMed, Web of Science, and Cochrane library databases from start dates to October 10, 2015. Totally, 36 randomized controlled trials with 6459 participants were included. Summary odds ratios (ORs) with 95% confidence intervals (CIs) for whether by AH or not were estimated. We found a significant increase in clinical pregnancy (OR = 1.16, 95% CI = 1.00–1.36, I2 = 48.3%) and multiple pregnancy rates (OR = 1.50, 95% CI = 1.11–2.01, I2 = 44.0%) with AH when compared to the control. Numerous subgroup analyses stratified by hatching method, conception mode, extent of AH, embryos transfer status, and previous failure history were also carried out. Interestingly, significant results of clinical pregnancy as well as multiple pregnancy rates were observed among women who received intracytoplasmic sperm injection, and who received AH which the zona were completely removed. In summary, this meta-analysis supports that AH was associated with an increased chance of achieving clinical pregnancy and multiple pregnancy. Whether AH significantly changes live birth and miscarriage rates needs further investigations.
Collapse
Affiliation(s)
- Da Li
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Da-Lei Yang
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Jing An
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Jiao Jiao
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Yi-Ming Zhou
- Department of Medicine, Brigham and Women's Hospital, Harvard Institutes of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Xiu-Xia Wang
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| |
Collapse
|
9
|
Park SB, Kim HJ, Choi YB, Ahn KH, Lee KH, Yang JB, Yu CS, Seo BB. The effect of various assisted hatching techniques on the mouse early embryo development. Clin Exp Reprod Med 2014; 41:68-74. [PMID: 25045630 PMCID: PMC4102692 DOI: 10.5653/cerm.2014.41.2.68] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 04/03/2014] [Accepted: 04/14/2014] [Indexed: 11/17/2022] Open
Abstract
Objective In search of an ideal method of assisted hatching (AH), we compared the effects of conventional micropipette-AH and laser-AH on the blastocyst formation rate (BFR) and blastocyst cell numbers. Methods Four- to five-week-old ICR female mice were paired with male mice after superovulation using Pregnant mare's serum gonadotropin (PMSG) and hCG. The two-cell embryos were flushed from the oviducts of female mice. The retrieved two-cell embryos underwent one of five AH procedures: single mechanical assisted hatching (sMAH); cross mechanical assisted hatching (cMAH); single laser assisted hatching (sLAH); quarter laser assisted hatching (qLAH); and quarter laser zona thinning assisted hatching (qLZT-AH). After 72 hours incubation, double immunofluorescence staining was performed. Results Following a 72 hours incubation, a higher hatching BFR was observed in the control, sMAH, cMAH, and sLAH groups, compared to those in the qLAH and qLZT-AH groups (p<0.05). The hatched BFR was significantly higher in the qLAH and qLZT-AH groups than in the others (p<0.05 for each group). The inner cell mass (ICM) was higher in the control and sMAH group (p<0.05). The trophectoderm cell number was higher in the cMAH and qLAH groups (p<0.05). Conclusion Our results showed that the hatched BFR was higher in groups exposed the the qLAH and qLZT-AH methods compared to groups exposed to other AH methods. In the qLAH group, although the total cell number was significantly higher than in controls, the ICM ratio was significantly lower in than controls.
Collapse
Affiliation(s)
| | - Hye Jin Kim
- Department of Obstetrics and Gynecology, Chungnam National Hospital, Daejeon, Korea
| | | | - Kwang Hwa Ahn
- Fertility Clinic, Mirae Ladies Hospital, Daejeon, Korea
| | - Kee Hwan Lee
- Department of Obstetrics and Gynecology, Chungnam National Hospital, Daejeon, Korea
| | - Jung Bo Yang
- Department of Obstetrics and Gynecology, Chungnam National Hospital, Daejeon, Korea
| | - Chang Seok Yu
- Department of Animal Resources, Daegu University, Gyeongsan, Korea
| | - Byoung Boo Seo
- Department of Animal Resources, Daegu University, Gyeongsan, Korea
| |
Collapse
|
10
|
Laser-assisted hatching improves clinical outcomes of vitrified-warmed blastocysts developed from low-grade cleavage-stage embryos: a prospective randomized study. Reprod Biomed Online 2014; 28:582-9. [PMID: 24631166 DOI: 10.1016/j.rbmo.2014.01.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 01/15/2014] [Accepted: 01/15/2014] [Indexed: 11/23/2022]
Abstract
The aim of this study was to evaluate the effects of quarter zona-pellucida (ZP) opening by laser-assisted hatching (QLAH) on the clinical outcomes following transfer of vitrified-warmed blastocysts developed from low-grade cleavage-stage embryos in patients with all high-grade and fair-grade cleavage-stage embryos transferred without achieving pregnancy. Patients were randomized into two groups: QLAH (n=101) and control (n=102). The implantation and clinical pregnancy rates were significantly higher in the QLAH group compared with the control group (P=0.021 and P=0.034, respectively). The live birth rate of the QLAH group was also higher, although not significantly. When the clinical outcomes according to the day of blastocyst vitrification were compared between the groups, the implantation, clinical pregnancy and live birth rates of the QLAH group were significantly higher (P<0.05) than those of the control group for day 6 blastocysts, but not for day 5 or day 5/day 6 blastocysts. These results suggest that QLAH improves the clinical outcomes of vitrified-warmed blastocysts, especially of day 6 vitrified blastocysts, developed from low-grade cleavage-stage embryos.
Collapse
|
11
|
Karipcin FS, Moragianni VA, Milette B, Kinzer DR, Thornton KL, Barrett B, Penzias AS. Effect of steroid and antibiotic treatment during assisted hatching on IVF outcomes. HUM FERTIL 2012. [PMID: 23190298 DOI: 10.3109/14647273.2012.739721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
There are limited data on the use of steroids and antibiotics in assisted reproductive technology (ART). Our aim was to evaluate the impact of these treatments on the outcome of IVF cycles in which Assisted Hatching (AH) was performed. We studied a retrospective cohort in a large university-affiliated infertility centre. Data from 1126 AH cycles performed between 2007 and 2009 were reviewed. Cycles were categorized as "treatment" (n = 640) and "no treatment" (n = 486), depending on whether they received steroids and antibiotics. The primary outcome was live birth. Secondary outcomes included implantation, spontaneous abortion, biochemical, clinical and ectopic pregnancy. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI). OR were adjusted (AOR) for age, BMI, baseline FSH, peak estradiol, cycle number, number of oocytes retrieved, number of embryos that underwent AH, number of high-implantation potential embryos, number of embryos transferred and physician in charge. The AOR (95% CI) of live birth was 1.91 (1.08-3.38), of clinical pregnancy, 1.75 (1.08-2.83) and of biochemical pregnancy, 0.24 (0.07-0.85). Our study suggests that treatment with steroids and antibiotics during AH cycles significantly increases the odds of live birth.
Collapse
Affiliation(s)
- Fethiye Sinem Karipcin
- Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | | | | | | | | | | | | |
Collapse
|
12
|
Martins WP, Rocha IA, Ferriani RA, Nastri CO. Assisted hatching of human embryos: a systematic review and meta-analysis of randomized controlled trials. Hum Reprod Update 2011; 17:438-453. [DOI: 10.1093/humupd/dmr012] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
|
13
|
Laser assisted zona hatching: What is the evidence to justify its use? MIDDLE EAST FERTILITY SOCIETY JOURNAL 2011. [DOI: 10.1016/j.mefs.2011.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
14
|
Laser assisted zona hatching: What is the evidence to justify its use? MIDDLE EAST FERTILITY SOCIETY JOURNAL 2011. [DOI: 10.1016/j.mefs.2011.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
15
|
Hammadeh ME, Fischer-Hammadeh C, Ali KR. Assisted hatching in assisted reproduction: a state of the art. J Assist Reprod Genet 2011; 28:119-28. [PMID: 21042844 PMCID: PMC3059528 DOI: 10.1007/s10815-010-9495-3] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Accepted: 10/11/2010] [Indexed: 11/26/2022] Open
Abstract
The World Health Organization estimates that one in six couples experience some delay in conception and an increasing number require treatment by the assisted conception (AC) procedures of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).The implantation rate of embryos resulting from in vitro fertilization cycles is generally less than 20%. The exposure of oocytes and embryos to the artificial conditions of in vitro culture may have negative effects on the embryo's ability to undergo normal hatching, resulting in low rates of implantation following IVF and embryo transfer. Human embryos resulting from superovulation develop more slowly in vitro compared to embryos in vivo, manifest a relatively high degree of cytogenetic abnormalities and undergo cellular fragmentation. Artificially disrupting the zona pellucida is known as assisted hatching (AH) and there is some evidence that embryos that have undergone zona manipulation for assisted hatching tend to implant one day earlier than unhatched embryos. A variety of techniques have since been employed to assist embryo hatching, including partial mechanical zona dissection, zona drilling and zona thinning, making use of acid tyrodes, proteinases, piezon vibrator manipulators and lasers. This review will consider the impact of IVF conditions on zona pellucida physiology, zona hardening, different techniques of assisted hatching, who may benefit from assisted hatching and potential hazards.
Collapse
Affiliation(s)
- Mohamad Eid Hammadeh
- Obstetrics and Gynaecology Department, Assisted Reproduction Technology Unit, University of Saarland, Homburg/Saar, Germany.
| | | | | |
Collapse
|
16
|
A prospective, randomized, double-blinded study of assisted hatching in women younger than 38 years undergoing in vitro fertilization. Fertil Steril 2010; 93:586-91. [DOI: 10.1016/j.fertnstert.2009.01.116] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2008] [Revised: 12/24/2008] [Accepted: 01/19/2009] [Indexed: 11/18/2022]
|
17
|
Abstract
Various predictors of fertility have been described, suggesting that none are ideal. The literature on tests of ovarian reserve is largely limited to women undergoing in vitro fertilization, and is reliant on the use of surrogate markers, such as cycle cancellation and number of oocytes retrieved, as reference standards. Currently available prediction models are far from ideal; most are applicable only to subfertile women seeking assisted reproduction, and lack external validation. Systematic reviews and meta-analyses of predictors of fertility are limited by their heterogeneity in terms of the population sampled, predictors tested and reference standards used. There is an urgent need for consensus in the design of these studies, definition of abnormal tests, and, above all, a need to use robust outcomes such as live birth as the reference standard. There are no reliable predictors of fertility that can guide women as to how long childbearing can be deferred.
Collapse
Affiliation(s)
- Abha Maheshwari
- Assisted Conception Unit, Department of Obstetrics & Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, Aberdeen, UK
| | | | | |
Collapse
|
18
|
Feng HL, Hershlag A, Scholl GM, Cohen MA. A retroprospective study comparing three different assisted hatching techniques. Fertil Steril 2008; 91:1323-5. [PMID: 18394610 DOI: 10.1016/j.fertnstert.2008.02.133] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Revised: 02/19/2008] [Accepted: 02/19/2008] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to determine the effect of four different assisted hatching techniques on pregnancy rates in women with prior IVF failure in fresh IVF cycles. The results suggested that assisted hatching utilizing laser, chemical, or microsurgical techniques increases both implantation and pregnancy rates.
Collapse
Affiliation(s)
- Huai L Feng
- Center for Human Reproduction, North Shore University Hospital, NYU School of Medicine, Manhasset, New York 11030, USA.
| | | | | | | |
Collapse
|