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Chen K, Gao M, Wu Y, Hu Z, Tang L, Li M, Tian M, Cui H, Huang Y, Han Y, Li L, Li Y, Li Y, Wu Z, Tang Z, Zhang R, Wu Y, Zhang Y, Guo Y, Zhang H, Xiang L, Yan J. Two laser-assisted hatching methods of embryos in ART: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2024; 24:300. [PMID: 38649878 PMCID: PMC11034172 DOI: 10.1186/s12884-024-06380-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 02/29/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Laser-assisted hatching (LAH) stands as the predominant technique for removing the zona pellucida (ZP) in embryos, primarily consisting of two methods: drilling laser-assisted hatching (D-LAH) and thinning laser-assisted hatching (T-LAH). Presently, both methods have limitations, and their comparative efficacy for embryo implantation and clinical pregnancy remains uncertain. AIM Evaluate the impact of D-LAH and T-LAH on clinical pregnancy rates within assisted reproductive technology (ART). METHODS We systematically searched electronic databases including PubMed, Web of Science, and Cochrane Library until July 20, 2022. This study encompassed observational studies and randomized controlled trials (RCTs). A 95% confidence interval (CI) was utilized for assessing the risk ratio (RR) of pregnancy outcomes. The level of heterogeneity was measured using I2 statistics, considering a value exceeding 50% as indicative of substantial heterogeneity. RESULTS The meta-analysis scrutinized 9 studies involving 2405 clinical pregnancies from D-LAH and 2239 from T-LAH. Findings suggested no considerable variation in the clinical pregnancy rates between the two techniques (RR = 0.93, 95% CI: 0.79-1.10, I2 = 71%, P = 0.41). Subgroup analyses also revealed no substantial differences. However, D-LAH exhibited a notably higher occurrence of singleton pregnancies compared to T-LAH (RR = 2.28, 95% CI: 1.08-4.82, I2 = 89%, P = 0.03). There were no noteworthy distinctions observed in other secondary outcomes encompassing implantation rate, multiple pregnancies, ongoing pregnancy, miscarriage, premature birth, and live birth. CONCLUSION Both the primary findings and subgroup analyses showed no marked variance in clinical pregnancy rates between D-LAH and T-LAH. Therefore, patients with varying conditions should select their preferred LAH technique after assessing their individual situation. However, due to the restricted number of studies involved, accurately gauging the influence of these laser techniques on clinical outcomes is challenging, necessitating further RCTs and high-quality studies to enhance the success rate of ART. TRIAL REGISTRATION PROSPERO: CRD42022347066.
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Affiliation(s)
- Kexin Chen
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China
| | - Mengying Gao
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China
| | - Yao Wu
- The First People's Hospital of Qujing, Qujing, Yunnan, China
| | - Zhixin Hu
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China
| | - Lu Tang
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China
| | - Minyao Li
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China
| | - Mei Tian
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China
| | - Hao Cui
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China
| | - Yanrong Huang
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China
| | - Youzhen Han
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China
| | - Lei Li
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China
| | - Yonggang Li
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China
| | - Yunxiu Li
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China
| | - Ze Wu
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China
| | - Zouying Tang
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China
| | - Ronghui Zhang
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China
| | - Yuerong Wu
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China
| | - Yizhi Zhang
- Kunming Maternity and Child Care Hospital, Kunming, Yunnan, China
| | - Yan Guo
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China
| | - Hongqing Zhang
- Kunming Maternity and Child Care Hospital, Kunming, Yunnan, China.
| | - Lifeng Xiang
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China.
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China.
| | - Jiacong Yan
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People's Hospital of Yunnan Province, Kunming, China.
- KUST-YPFPH Reproductive Medicine Joint Research Center, Kunming, Yunnan, China.
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