Assisted hatching on assisted conception (in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI))

Lacey, Lauren; Hassan, Sibte; Franik, Sebastian; Seif, Mourad W.; Akhtar, Masood

doi:10.1002/14651858.cd001894.pub6

Cited by 45 publications

(27 citation statements)

References 117 publications

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“…Embryos that underwent drilling treatment in frozen/thawed embryo transfer displayed a higher implantation rate but no increase in pregnancy rate ( 173 ). A recent meta-analysis showed that it was uncertain of the effect of AH on live birth rates ( 174 ). In selected patients such as those with RIF, AH might be beneficial.…”

Section: Discussionmentioning

confidence: 99%

Recurrent implantation failure: A comprehensive summary from etiology to treatment

Gao

2023

Front. Endocrinol.

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Implantation is the first step in human reproduction. Successful implantation depends on the crosstalk between embryo and endometrium. Recurrent implantation failure (RIF) is a clinical phenomenon characterized by a lack of implantation after the transfer of several embryos and disturbs approximately 10% couples undergoing in vitro fertilization and embryo transfer. Despite increasing literature on RIF, there is still no widely accepted definition or standard protocol for the diagnosis and treatment of RIF. Progress in predicting and preventing RIF has been hampered by a lack of widely accepted definitions. Most couples with RIF can become pregnant after clinical intervention. The prognosis for couples with RIF is related to maternal age. RIF can be caused by immunology, thrombophilias, endometrial receptivity, microbiome, anatomical abnormalities, male factors, and embryo aneuploidy. It is important to determine the most possible etiologies, and individualized treatment aimed at the primary cause seems to be an effective method for increasing the implantation rate. Couples with RIF require psychological support and appropriate clinical intervention. Further studies are required to evaluate diagnostic method and he effectiveness of each therapy, and guide clinical treatment.

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Section: Discussionmentioning

confidence: 99%

Recurrent implantation failure: A comprehensive summary from etiology to treatment

Gao

2023

Front. Endocrinol.

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“…Hardening of the zona pellucida is involved in in vivo aging, prolonged in vitro culture, or embryo freezing. 11 Assisted hatching slightly improves clinical pregnancy rates (OR: 1.20, 95% CI: 1.09–1.33) 80 but may increase the risk of multiple pregnancy 81 ; hence, the ability of this technique to improve livebirth rates still remains controversial. 80 Notably, using a small hole size during assisted hatching has been associated with poor pregnancy outcomes 82 and increased risk for zygotic splitting via herniating of the blastocyst at hatching.…”

Section: Tests and Treatments For Implantation Failurementioning

confidence: 99%

“… 11 Assisted hatching slightly improves clinical pregnancy rates (OR: 1.20, 95% CI: 1.09–1.33) 80 but may increase the risk of multiple pregnancy 81 ; hence, the ability of this technique to improve livebirth rates still remains controversial. 80 Notably, using a small hole size during assisted hatching has been associated with poor pregnancy outcomes 82 and increased risk for zygotic splitting via herniating of the blastocyst at hatching. 83 Therefore, when the hole is drilled in zona at biopsy is small, additional zona pellucida incision through laser‐assisted hatching is recommended after thawing.…”

Section: Tests and Treatments For Implantation Failurementioning

confidence: 99%

Management strategies following implantation failure of euploid embryos

Kuroda

2024

Reprod Medicine & Biology

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BackgroundEuploid blastocyst implantation failure may result from embryonic factors undetectable by preimplantation genetic testing for aneuploidy (PGT‐A); however, various nonembryonic factors can also intricately interfere with implantation. This review seeks to clarify evidence‐based testing and treatments for implantation failure after euploid embryo transfer.MethodsWe conducted a review of the literature on implantation failure after euploid embryo transfer or multiple embryo transfer cycles, which mainly included systematic reviews and meta‐analyses.ResultsThe recommended tests for implantation failure include (1) hysteroscopy, (2) endometrial CD138 immunohistochemistry and bacterial culture, (3) serum 25‐hydroxyvitamin D3, and (4) thrombophilia screening. Based on diagnostic findings, the following treatments have been recommended: (1) antibiotics for chronic endometritis, (2) vitamin D replacement, (3) lifestyle modification, and (4) low‐dose aspirin starting from the postimplantation period for thrombophilia. Moreover, frozen–thawed single euploid blastocyst transfer using assisted hatching and hyaluronan‐enriched transfer medium may support embryo implantation.ConclusionTo ensure a successful pregnancy in subsequent embryo transfers, simple, inexpensive, and evidence‐based tests and treatments should be selected.

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“…The effect of AH on the live birth rate remains uncertain at present [ 3 , 7 ]. Lacey et al's systematic review and meta-analysis aimed to evaluate AH's impact on ART outcomes; however, the study's results did not offer conclusive evidence regarding its effect on live birth rates [ 8 ]. Although AH might enhance clinical pregnancy rates, the current research articles lack quality, demanding further high-quality studies for definitive conclusions [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Two laser-assisted hatching methods of embryos in ART: a systematic review and meta-analysis

Chen,

Gao,

et al. 2024

BMC Pregnancy Childbirth

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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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Assisted hatching on assisted conception (in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI))

Cited by 45 publications

References 117 publications

Recurrent implantation failure: A comprehensive summary from etiology to treatment

Recurrent implantation failure: A comprehensive summary from etiology to treatment

Management strategies following implantation failure of euploid embryos

Two laser-assisted hatching methods of embryos in ART: a systematic review and meta-analysis

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