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Kim JH, Park EA, Yoon TK, Kim MJ, Lee JH, Lee KA, Hur YJ, Choi SY, Jo EH, Kim YS. In vitro Fertilization Outcomes of Frozen-thawed Embryo Transfer with Hatched Blastocysts versus with Hatching Blastocysts. Reprod Sci 2024:10.1007/s43032-024-01499-7. [PMID: 38811454 DOI: 10.1007/s43032-024-01499-7] [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: 06/06/2023] [Accepted: 02/09/2024] [Indexed: 05/31/2024]
Abstract
This study aimed to elucidate the effect of hatching status on in vitro fertilization (IVF) outcomes in frozen-thawed blastocyst transfer cycles. Frozen-thawed embryo transfer (FET) cycles performed at a single fertility center between 2016 and 2021 were retrospectively assessed. Analyses were restricted to 6,821 frozen-thawed blastocyst transfers in women aged 24-47 years. For optimal comparability, double embryo transfer (ET) cycles consisting of one hatching and one hatched blastocyst were excluded. The implantation and pregnancy rates were evaluated and compared between the hatching and hatched blastocyst transfer groups based on patients' age (<38 vs. ≥38 years), blastocyst grade (good vs. bad grade), and the number of transferred embryos (single ET vs. double ET). Hatched blastocyst transfer was associated with higher implantation and clinical pregnancy rates in the single ET group (15.7% and 15.6%, respectively; p<0.001). The transfer of two hatched blastocysts had higher implantation and clinical pregnancy rates compared to the transfer of two hatching blastocysts (19.5% and 20.4%, respectively; p<0.001) in the double ET group. In the hatched blastocyst transfer group, the clinical pregnancy and implantation rates were higher, regardless of each woman's age and embryo quality. The IVF treatment outcomes were improved when the blastocysts were hatched during FET cycles. Hence, hatched blastocyst transfer in FET cycles could be considered a superior method in IVF practice.
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Affiliation(s)
- Ji Hye Kim
- CHA Fertility Center Seoul Station, CHA University, 416 Hangangdaero, Joongku, Seoul, Republic of Korea
- Department of Obstetrics and Gynecology, CHA Fertility Center Seoul Station, CHA Gangnam Medical Center, CHA University, Gyeonggi-do, Republic of Korea
| | - Eun A Park
- Fertility laboratory, CHA Fertility Center Seoul Station, Seoul, Republic of Korea
- Department of Biomedical Science, College of Life Science, CHA University, Gyeonggi-do, Republic of Korea
| | - Tae Ki Yoon
- CHA Fertility Center Seoul Station, CHA University, 416 Hangangdaero, Joongku, Seoul, Republic of Korea
- Department of Obstetrics and Gynecology, CHA Fertility Center Seoul Station, CHA Gangnam Medical Center, CHA University, Gyeonggi-do, Republic of Korea
| | - Myung Joo Kim
- CHA Fertility Center Seoul Station, CHA University, 416 Hangangdaero, Joongku, Seoul, Republic of Korea
- Department of Obstetrics and Gynecology, CHA Fertility Center Seoul Station, CHA Gangnam Medical Center, CHA University, Gyeonggi-do, Republic of Korea
| | - Jung Hyun Lee
- Fertility laboratory, CHA Fertility Center Seoul Station, Seoul, Republic of Korea
| | - Kyung-Ah Lee
- Department of Biomedical Science, College of Life Science, CHA University, Gyeonggi-do, Republic of Korea
| | - Yun Jung Hur
- CHA Fertility Center Seoul Station, CHA University, 416 Hangangdaero, Joongku, Seoul, Republic of Korea
- Department of Obstetrics and Gynecology, CHA Fertility Center Seoul Station, CHA Gangnam Medical Center, CHA University, Gyeonggi-do, Republic of Korea
| | - Seung Young Choi
- CHA Fertility Center Seoul Station, CHA University, 416 Hangangdaero, Joongku, Seoul, Republic of Korea
| | - Eun-Hye Jo
- CHA Fertility Center Seoul Station, CHA University, 416 Hangangdaero, Joongku, Seoul, Republic of Korea
| | - You Shin Kim
- CHA Fertility Center Seoul Station, CHA University, 416 Hangangdaero, Joongku, Seoul, Republic of Korea.
- Department of Obstetrics and Gynecology, CHA Fertility Center Seoul Station, CHA Gangnam Medical Center, CHA University, Gyeonggi-do, Republic of Korea.
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Endo Y, Mitsuhata S, Hayashi M, Fujii Y, Motoyama H. Laser-assisted hatching on clinical and neonatal outcomes in patients undergoing single vitrified Blastocyst transfer: A propensity score-matched study. Reprod Med Biol 2021; 20:182-189. [PMID: 33850451 PMCID: PMC8022098 DOI: 10.1002/rmb2.12366] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/24/2020] [Accepted: 12/25/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study determined the effect of laser-assisted hatching on the clinical and neonatal outcomes of single vitrified blastocyst transfer. METHODS From June 2014 to March 2018, 289 matched pairs after propensity score matching were analyzed. During the blastocyst warming procedure, a small section of the zona pellucida area in the empty perivitelline space was sliced off using multiple laser beams. The clinical and neonatal outcomes of the laser-treated group and non-treatment control were analyzed. RESULTS In the laser-assisted hatching group, significantly higher rates of clinical pregnancy (40.8% vs 29.4%, P < .01) and live delivery (34.3% vs 22.5%, P < .01) were observed compared to the control group. Other variables such as the average gestational weeks, the sex of the baby, birthweight, or congenital malformations were found to have no significant differences in neonatal outcomes. Moreover, all babies were singleton live births. CONCLUSIONS Single vitrified blastocyst transfer treated with laser-assisted hatching increases the live birth rate and has no adverse effects on neonatal outcomes.
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Affiliation(s)
- Yuji Endo
- IVF CenterKurashiki Medical ClinicKurashikiJapan
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Kirienko KV, Apryshko VP, Naumova AA, Kharitonova MA, Klepukov AA, Bolt AI, Ermilova IY, Mironova AG, Bozina YV, Lebedeva EB, Simonenko EY, Vajta G, Yakovenko SA. Mechanical zona pellucida removal of vitrified-warmed human blastocysts does not affect the clinical outcome. Reprod Biomed Online 2019; 39:745-749. [PMID: 31530444 DOI: 10.1016/j.rbmo.2019.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 05/24/2019] [Accepted: 06/05/2019] [Indexed: 10/26/2022]
Abstract
RESEARCH QUESTION Does complete mechanical removal of the zona pellucida modify the outcome of transfer of vitrified-warmed human blastocysts? DESIGN In a prospective randomized controlled study, 419 couples were allocated to either zona pellucida-free (n = 209) or zona intact (n = 210) vitrified-warmed embryo transfer. Main outcome measures included clinical pregnancy, implantation and ongoing pregnancy rates. RESULTS Transfer of zona pellucida-free blastocysts resulted in clinical pregnancy, implantation and ongoing pregnancy rates (35,9%, 33,9% and 32,1%, respectively), similar to those achieved with zona intact control embryos (39%, 36,4% and 33,1%, respectively). CONCLUSION Total mechanical removal of the zona pellucida did not affect the tested parameters of clinical outcomes.
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Affiliation(s)
| | - Valentina P Apryshko
- Altravita IVF Clinic, 4A Nagornaya 117186, Moscow, Russia; Lomonosov Moscow State University, Faculty of Biology, 1/12 Leninskie gori, Moscow 119234, Russia
| | - Anna A Naumova
- Altravita IVF Clinic, 4A Nagornaya 117186, Moscow, Russia
| | | | | | - Anton I Bolt
- Altravita IVF Clinic, 4A Nagornaya 117186, Moscow, Russia
| | | | - Anna G Mironova
- Altravita IVF Clinic, 4A Nagornaya 117186, Moscow, Russia; Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Kosygina st., 4., Moscow 119334, Russia
| | - Yana V Bozina
- Altravita IVF Clinic, 4A Nagornaya 117186, Moscow, Russia
| | | | - Ekaterina Y Simonenko
- Lomonosov Moscow State University, Faculty of Physics, Biophysics Department, 1/2 Leninskie gori, Moscow 119991, Russia
| | - Gabor Vajta
- RVT Australia, 20 Slate Close, Brinsmead QLD 4870, Australia.
| | - Sergey A Yakovenko
- Altravita IVF Clinic, 4A Nagornaya 117186, Moscow, Russia; Lomonosov Moscow State University, Faculty of Physics, Biophysics Department, 1/2 Leninskie gori, Moscow 119991, Russia
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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.
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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
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Ueno S, Ezoe K, Yabuuchi A, Uchiyama K, Okimura T, Okuno T, Kobayashi T, Kato K. Complete zona pellucida removal from vitrified-warmed human blastocysts facilitates earlier in-vitro attachment and outgrowth. Reprod Biomed Online 2016; 33:140-8. [DOI: 10.1016/j.rbmo.2016.05.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 05/14/2016] [Accepted: 05/17/2016] [Indexed: 01/19/2023]
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Wang EH, Wang AC, Wang BS, Li B. Outcomes of vitrified-warmed cleavage-stage embryo hatching after in vitro laser-assisted zona pellucida thinning in patients. Biomed Rep 2016; 5:376-382. [PMID: 27602216 DOI: 10.3892/br.2016.716] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 07/08/2016] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to determine whether the size of the zona pellucida (ZP) thinning area by laser-assisted hatching affected the potential development of vitrified-warmed embryos. A total of 196 vitrified-warmed cleavage-stage embryos (from 49 patients, four sister embryos per patient) were used in the study, i.e., four sister embryos from each patient were randomly assigned to four groups: a control group of embryos that were not zona-manipulated (zona intact, group A); one experimental group of embryos in which a quarter of the zona pellucida was thinned using laser-assisted ZP thinning (group B); a second experimental group of embryos in which half of ZP was thinned (group C); and a third group in which two-thirds of the ZP was thinned (group D). Subsequent blastocyst development was assessed. Microscopy was performed to study the hatching process of the embryos after zona thinning. The blastocyst formation rates were 71.43% in group A, 67.35% in group B, 65.31% in group C, and 51.02% in group D (groups B-D vs. group A, P=0.661, P=0.515, P=0.038, respectively). The rates of complete hatching were 30.61% in group A, 38.78% in group B, 61.22% in group C, and 48.98% in group D (groups B-D vs. group A, P=0.396, P=0.002, P=0.063, respectively). For a subgroup of patients, there was a significant difference in the complete hatching in all the groups for women aged <35 years (P=0.011), and there was a significant difference in the complete hatching in all the groups for secondary infertility women (P=0.022). There was no significant difference in the blastocyst formation rates in the different groups of women aged ≥35 years (P=0.340). In addition, there was no significant difference in the complete hatching in the different groups among women aged ≥35 years (P=0.492). The results of the present study showed that in vitrified-warmed embryo transfers at the cleavage-stage, and the two-thirds zona pellucida thinning group demonstrated a significantly decreased blastocyst formation rate compared with the control group, while the half zona pellucida thinning group demonstrated a significantly increased complete hatching rate compared with the control group, which may have a high value in clinical application.
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Affiliation(s)
- En-Hua Wang
- Department of Genetic Teaching and Research Section, Shandong Medical College, Linyi, Shandong 276000, P.R. China
| | - An-Cong Wang
- Department of Reproductive Medicine, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China; Department of Obstetrics and Gynecology, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
| | - Bao-Song Wang
- Department of Reproductive Medicine, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
| | - Bin Li
- Department of Reproductive Medicine, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China
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Ren X, Liu Q, Chen W, Zhu G, Zhang H. Effect of the site of assisted hatching on vitrified-warmed blastocyst transfer cycles: a prospective randomized study. J Assist Reprod Genet 2013; 30:691-7. [PMID: 23558770 DOI: 10.1007/s10815-013-9984-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 03/15/2013] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To assess the effect of assisted hatching (AH) site on the clinical outcomes in vitrified-warmed blastocyst transfer cycles. METHODS A total of 160 women who underwent vitrified-warmed blastocyst transfer cycles were randomized to either the ICM group (AH performing at the site near the inner cell mess, ICM), or the TE group (AH performing at the site opposite to the ICM). AH with laser zona drilling was performed 20 or 30 min after thawing once the ICM can be detected. Clinical pregnancy rate, implantation rate, live birth rate and the occurrence rate of monozygotic twins (MZT) pregnancy after transfer of these two groups were compared. RESULTS No significant difference was found in the clinical pregnancy rate (63.8% vs. 67.5%), implantation rate (51.7% vs. 53.6%) and live birth rate (57.5% vs. 62.5%) between the ICM group and the TE group. The occurrence rate of MZT was comparable between the two groups (3.9% vs. 5.6%). CONCLUSIONS The site of assisted hatching has no influence on the implantation, pregnancy and live birth rate in human vitrified-warmed blastocyst transfer cycles.
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Affiliation(s)
- Xinling Ren
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
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Effect of laser zona thinning on vitrified–warmed embryo transfer at the cleavage stage: a prospective, randomized study. Reprod Biomed Online 2010; 20:234-42. [DOI: 10.1016/j.rbmo.2009.11.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Revised: 04/07/2009] [Accepted: 11/03/2009] [Indexed: 11/19/2022]
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Hiraoka K, Hiraoka K, Horiuchi T, Kusuda T, Okano S, Kinutani M, Kinutani K. Impact of the size of zona pellucida thinning area on vitrified-warmed cleavage-stage embryo transfers: a prospective, randomized study. J Assist Reprod Genet 2009; 26:515-21. [PMID: 19830543 DOI: 10.1007/s10815-009-9350-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Accepted: 10/01/2009] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim of this study was to determine if the size of zona pellucida thinning area by laser assisted hatching could affect the rates of pregnancy and implantation for vitrified-warmed embryo transfers at the cleavage-stage. METHODS A total of 120 vitrified-warmed cleavage-stage embryo transfers were randomly assigned to either quarter or half of zona pellucida thinning group. RESULTS The rates of clinical pregnancy (46.7 versus 25.0%) and implantation (32.0 versus 16.2%) were significantly greater in the half thinning group than in the quarter thinning group (P = 0.0218 and P = 0.0090, respectively). CONCLUSIONS The results of this investigation show that, in vitrified-warmed embryo transfers at the cleavage-stage, the size of zona pellucida thinning area by laser assisted hatching impacts the rate of clinical pregnancy and implantation and that half of zona pellucida thinning significantly increases both of these results compared with quarter of zona pellucida thinning.
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Affiliation(s)
- Kenichiro Hiraoka
- Kinutani Women's Clinic, 8-23-4F, Hondori, Naka-ku, Hiroshima 730-0035, Japan.
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Hiraoka K, Fujimoto Y, Tateaki Y, Hiraoka K, Horiuchi T, Okano S, Kinutani M, Kinutani K. Case report: two successful pregnancies following the transfer of re-vitrified human day 7 blastocysts developed from vitrified cleaved embryos. J Assist Reprod Genet 2008; 25:503-9. [PMID: 18853246 DOI: 10.1007/s10815-008-9259-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Accepted: 09/26/2008] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To report successful pregnancies after the transfer of re-vitrified human day 7 blastocysts developed from vitrified cleaved embryos. METHODS AND RESULTS A total of five day 7 blastocysts developed from vitrified cleaved embryos were re-vitrified and re-warmed. All of five re-vitrified day 7 blastocysts (100%) survived after warming and were transferred to three patients. Two of the women became clinically pregnant. Of these women, one woman delivered a healthy baby and the other pregnancy is ongoing at 26 weeks of gestation. CONCLUSIONS This is the first report of successful pregnancies after the transfer of re-vitrified human day 7 blastocysts developed from vitrified cleaved embryos.
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Affiliation(s)
- Kenichiro Hiraoka
- Kinutani Women's Clinic, 8-23-4F, Hondori, Naka-ku, Hiroshima 730-0035, Japan.
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Ge HS, Zhou W, Zhang W, Lin JJ. Impact of assisted hatching on fresh and frozen-thawed embryo transfer cycles: a prospective, randomized study. Reprod Biomed Online 2008; 16:589-96. [PMID: 18413070 DOI: 10.1016/s1472-6483(10)60466-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of this study was to determine if assisted hatching (AH) could improve the rates of pregnancy and implantation for both fresh and frozen-thawed embryo transfer cycles. A total of 760 fresh embryo transfer cycles and 200 frozen-thawed embryo transfer cycles were randomly assigned to either the treatment group (AH) or the control group (no AH). Zona thinning by laser was performed just before embryo transfer. In fresh embryo transfer cycles, the AH group and control group results were comparable. There were no significant differences in the rates of positive human chorionic gonadotrophin (HCG; 47.5 versus 48.8%), clinical pregnancy (42.4 versus 42.6%), or implantation (26.3 versus 25.2%) between the two groups. However, in frozen-thawed embryo transfer cycles, the rates of positive HCG (32.0 versus 17.0%), clinical pregnancy (25.0 versus 14.0%) and implantation (16.7 versus 7.3%) were significantly greater in the AH group than in the control group (P <: 0.05). The results of this investigation show that in the fresh embryo transfer cycles, laser-assisted hatching by zona thinning has no impact on the rates of positive HCG, clinical pregnancy and implantation, whereas in frozen-thawed cycles, assisted hatching by zona thinning significantly increases all three of these rates.
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Affiliation(s)
- Hong-Shan Ge
- Reproductive Health Center, The Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, Wenzhou, Zhejiang Province, 325009 PR China
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Hiraoka K, Fuchiwaki M, Hiraoka K, Horiuchi T, Okano S, Kinutani M, Kinutani K. Vitrified human day-7 blastocyst transfer: 11 cases. Reprod Biomed Online 2008; 17:689-94. [DOI: 10.1016/s1472-6483(10)60317-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sher G, Keskintepe L, Mukaida T, Keskintepe M, Ginsburg M, Agca Y, Maassarani G, Bayrak A. Selective vitrification of euploid oocytes markedly improves survival, fertilization and pregnancy-generating potential. Reprod Biomed Online 2008; 17:524-9. [DOI: 10.1016/s1472-6483(10)60240-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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