Assisted hatching and live births in first-cycle frozen embryo transfers

Abstract

Objective To assess the effect of assisted hatching (AH) on live birth rates in a retrospective cohort of patients undergoing first-cycle, autologous frozen embryo transfer (FETs). Design Longitudinal cohort using cycles reported to the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System between 2004 and 2013. Setting Not applicable. Patient(s) Women who underwent first cycle, autologous, FETs with (n=70,738) and without (n=80,795) AH reported from 2004 to 2013. Propensity matching was used to account for confounding covariates and a logistic regression model was constructed to identify the predictors of live birth rates in relationship to AH. Interventions Not applicable. Main Outcome Measure Live births. Results In all first-cycle FETs, there was a slight, but statistically significant decrease in live birth rate with AH compared to no AH (34.2% v 35.4%). AH was associated with decreased live births in older patients and in years 2012–2013. Live birth rates and number of AH cycles performed prior to FETs varies by geographical clinic location. Conclusions AH slightly decreases live birth rates in first cycle, autologous FETs. Its use should be carefully considered especially in patients 38 years old and above. Prospective, clinical studies are needed to improve our knowledge of the impact of AH.

The Effect of Assisted Hatching on Live Birth Rate Following Fresh Embryo Transfer in Advanced Maternal Age

“…They found that AH was associated with a slight but a significantly reduced LBRs (34.2 vs 35.4, P < .001) compared to controls. 10 They also reported that AH had a significant negative effect especially among women with advancing age. Compared to the control group, the LBRs were reduced by 18% (26.7% vs 38.7%) and 43% (14% vs 30%) in women aged 41 to 42 years and older than 42 years, respectively.…”

“…7,8 Data from the Society for Assisted Reproductive Technology (SART) showed that AH was performed in 56% of cleavage embryos and in 22% of blastocysts in fresh ET cycles in 2010 9 and in 47% of frozen ET cycles between the years 2004 and 2013. 10 However, the benefit of AH on the reproductive outcomes remains unclear. 11 This is related to the heterogeneity between studies, including the methods of AH, the clinical indications, and the study populations.…”

ALADDIN study: does assisted hatching of vitrified/warmed blastocysts improve live birth rate? Protocol for a multicentric randomised controlled trial

“… 28 29 Despite this and according to the SART CORS database, the number of patients receiving AH in the USA increased every year between 2004 and 2013 and near half of the frozen embryo transfers have been performed using an AH procedure. 30 Considering the economic burden and possible risks, new good-quality data are urgently required. The present trial, focusing on the live birth rate as a primary outcome in a multicentric setting, will add valuable information to the current literature and, although with limited power according to the sample size, it will contribute to the definition of secondary outcomes and associated risks.…”

The Present and Future of Embryo Cryopreservation

“…Embryos with thicker zona pellucida could benefit the most after AH. A large study by Knudtson et al with more than 150,000 FET cycles reported a slightly decreased live birth rate in the first autologous FET cycle after AH [31]. Therefore, the application of AH should be carefully considered, and prospective studies should be carried out in order to elucidate its benefits and negatives.…”