Laser-assisted hatching improves pregnancy outcomes in frozen-thawed embryo transfer cycles of cleavage-stage embryos: a large retrospective cohort study with propensity score matching

Wei, Chaofeng; Xiang, Shufen; Liu, Danqi; Wang, Chenggang; Liang, Xiaoyu; Wu, Haicui; Lian, Fang

doi:10.1007/s10815-022-02711-w

Cited by 11 publications

(7 citation statements)

References 43 publications

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“…The decision to transfer one or two embryos was made by the clinician prior to the procedure. Vitri ed embryos were thawed on the morning of the transfer day, following procedures outlined in previous reports [21] .…”

Section: Ovarian Stimulation and Laboratory Protocolsmentioning

confidence: 99%

Effect of Triggering with hCG Alone, GnRH Agonist Alone, or in Combination (Dual Trigger) in Letrozole-Stimulated Cycles for Frozen-Thawed Embryo Transfer: A Retrospective Cohort Study

Guan,

Wu,

et al. 2024

Preprint

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Objective The objective of this study was to evaluate the effects of triggering strategies on pregnancy outcomes in letrozole-stimulated cycles for frozen-thawed embryo transfer (L-FET), employing the gonadotropin-releasing hormone agonist (GnRHa) and human chorionic gonadotropin (hCG) combination, the conventional hCG trigger alone and the GnRHa trigger alone. Materials and Methods 773 women undergoing L-FET were enrolled in this retrospective study. The grouping of the participants was based on the trigger method employed. The dual trigger group (N = 105) was given 0.1 mg GnRHa and 2000 IU hCG, the hCG trigger group (N = 430) was administered 4000–10000 IU hCG, and the GnRHa trigger group (N = 238) was injected with 0.1 mg GnRHa alone. Binary logistic regression analysis was conducted to evaluate the influence of potential confounding factors on pregnancy outcomes. Additionally, subgroup analysis was performed in accordance with the hCG trigger dose. Results A lower miscarriage rate was observed in GnRHa trigger group (adjusted odds ratio (aOR) = 0.484, 95% CI 0.244–0.962, P = 0.038) and hCG trigger group (aOR = 0.395, 95% CI 0.196–0.798, P = 0.010) compared with dual trigger group. The positive pregnancy rate, clinical pregnancy rate and ectopic pregnancy rate were slightly higher in dual trigger group, nevertheless, the differences were not statistically significant (P values were 0.764, 0.892 and 0.705 respectively). The live birth rate was slightly higher in hCG trigger group (40.2%) compared to the GnRHa trigger group (38.2%) and dual trigger group (34.3%), but the difference was not significant (P = 0.521). In the subgroup analysis, no significant difference was found on pregnancy outcomes among different hCG trigger dose groups (P > 0.05). Conclusion Dual trigger could increase miscarriage rate in women undergoing L-FET. Hence, the routine use of dual trigger for ovulation induction is not recommended in L-FET. Moreover, luteal support should be given flexibly and cautiously whenever employed. Noteworthily, these findings indicate that the 4000 IU hCG trigger could be a potentially better alternative for patients undergoing L-FET, particularly when considering cost-effectiveness.

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Section: Ovarian Stimulation and Laboratory Protocolsmentioning

confidence: 99%

Effect of Triggering with hCG Alone, GnRH Agonist Alone, or in Combination (Dual Trigger) in Letrozole-Stimulated Cycles for Frozen-Thawed Embryo Transfer: A Retrospective Cohort Study

Guan,

Wu,

et al. 2024

Preprint

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“…Finally, two recent studies again reported divergent findings. Wei and colleagues analysed 3,535 FETs, out of which 2,297 were non-AH cycles and in 1,238 laser AH was applied (Wei et al, 2023). Their results found a higher LBR in the AH group compared to the non-AH group (34.9% versus 31.4%, p = 0.024).…”

Section: Blastocyst Shrinkage Before Vitrification and Assisted Hatch...mentioning

confidence: 99%

Vitrification of human blastocysts for couples undergoing assisted reproduction: an updated review

Sciorio,

Tramontano,

Campos

et al. 2024

Front. Cell Dev. Biol.

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Over the past 40 years there has been a worldwide critical change in the field of assisted reproduction technology (ART), leading to the increased application of single blastocyst transfer, which is extremely important to avoid the risks of multiple pregnancy and associated complications for both mother and babies. Indeed, advancements in ART over the last few decades have been obtained thanks to several improvements, including ovarian stimulation, embryo culture conditions and, of course, progress in cryopreservation methods, especially with the application of vitrification. The ability to cryopreserve human embryos has improved significantly with vitrification compared to the initially adopted slow-freezing procedures. Since the introduction of vitrification, it has become the gold standard method to effectively cryopreserve human blastocysts. However, some new protocols are now being explored, such as the short warming procedure and even shorter exposure to the equilibration solution before vitrification, which seem to provide optimal results. Therefore, the main aim of the current narrative review, will be to illustrate the benefit of vitrification as an effective method to cryopreserve the human blastocyst and to illustrate new protocols and variations which in future may increase the performance of vitrification protocols.

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“…Significantly, LAH appears more effective in enhancing pregnancy rates than chemical acidification [ 14 ]. Furthermore, frozen embryos subjected to LAH exhibit notably higher live birth rates than those no-LAH [ 15 ].…”

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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Laser-assisted hatching improves pregnancy outcomes in frozen-thawed embryo transfer cycles of cleavage-stage embryos: a large retrospective cohort study with propensity score matching

Cited by 11 publications

References 43 publications

Effect of Triggering with hCG Alone, GnRH Agonist Alone, or in Combination (Dual Trigger) in Letrozole-Stimulated Cycles for Frozen-Thawed Embryo Transfer: A Retrospective Cohort Study

Effect of Triggering with hCG Alone, GnRH Agonist Alone, or in Combination (Dual Trigger) in Letrozole-Stimulated Cycles for Frozen-Thawed Embryo Transfer: A Retrospective Cohort Study

Vitrification of human blastocysts for couples undergoing assisted reproduction: an updated review

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

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