Laser‐assisted hatching on clinical and neonatal outcomes in patients undergoing single vitrified Blastocyst transfer: A propensity score–matched study

Endo, Yuji; Mitsuhata, Shingo; Hayashi, Momoko; Fujii, Yoshitaka; Motoyama, Hiroaki

doi:10.1002/rmb2.12366

Cited by 12 publications

(5 citation statements)

References 39 publications

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“…The debate surrounding the two LAH methods for achieving clinical pregnancy persisted [ 37 , 38 ]. Some studies indicate positive clinical pregnancy outcomes for T-LAH [ 26 ], while others report contrary findings or observe no significant differences between the two techniques [ 23 , 24 ].…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…During the development of fertilization and pre-implantation, the zona pellucida is structural and functional. It is involved in the binding of sperm, the stimulation of acrosome reactions, and the fusing of eggs [24][25]. The discovery that fertilized embryos with artificial gaps in their zona pellucida appear to have high implantation rates and that divided embryos with an excellent prognosis for implantation have lessened the thickness of the zona led to the clinical introduction of assisted hatching.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Laser-Assisted Hatching on Pregnancy and Live-Birth Rates of Human Frozen-Thawed Embryos

El-Toukhy,

El-Desouky,

Mansour

et al. 2023

Journal of Scientific Research in Science

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Unexplained repeated in-vitro fertilization (IVF) failure is a major problem that faces both genders. The present study aims to estimate the influence of the laser-assisted hatching (LAH) technique on implantation, clinical pregnancy and live-birth rates using human cryopreserved-thawed embryos produced by intracytoplasmic sperm injection (ICSI). Materials and methods: A total of 208 subjects was divided randomly into 100 subjects in the control group (Non-LAH), in which the uterine frozen embryo transfer (FET) was done directly; and 108 subjects in LAH group, in which laser shots were applied on day-3 frozenthawed embryos before uterine transfer. All groups were further subdivided into three female age categories (22-30; 31-35 & 36-40 years). Number of mature, fertilized oocytes, fertilization, clinical pregnancy and live-birth rates were determined according to age distribution. Results: Both pregnancy (37.0 %) and live-birth (57.5 %) rates in LAH group were insignificantly lower than Non-LAH control group having pregnancy and live-birth rates of (45.0 % and 73.3 %, respectively). LAH caused a mild increase in clinical outcomes in females aged over 36 years, but in contrast, no improvement was observed in younger subjects. Conclusion: Our experimental study did not support using LAH as a routine strategy in frozen-thawed embryo transfer cycles.

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“…Previous research suggested that the cryopreservation process could cause abnormalities in the ZP, such as hardening and thickening, thus leading to hatching difficulties [ 22 ]. Indeed, AH has been demonstrated to improve the pregnancy outcomes of frozen/thawed embryos at different stages of embryonic development [ 15 , 23 – 26 ]. However, a previous meta-analysis reviewed 12 RCTs and found that when performed on cryopreserved-thawed embryos, AH was correlated with a higher clinical pregnancy rate and implantation rate but had little effect on live birth rate [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

The Current Practice of Assisted Hatching for Embryos in Fertility Centres: a General Survey

2022

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At present, there is no standardised protocol for assisted hatching (AH) and the field is beset with contradictory data. We hypothesised that such contradiction may be related to inconsistencies in clinical practice. This study aimed to investigate the application, preferences, and variations of AH in current clinical practice prior to embryo transfer (AHpET) and biopsy (AHpBP). An online voluntary survey, consisted of 25 questions regarding different aspects of AH, was circulated amongst different fertility centres via newsletters between October 2019 and March 2020. One-hundred twenty-nine different fertility centres participated in the survey. AHpBP was widely used (90.6% [48/53]) amongst these centres, especially for trophectoderm biopsy (92.2% [47/51]). In contrast, only 64.6% (73/113) of centres administrated AHpET; the application of AHpET was even lower in UK-based centres (36.6% [15/41]). Although laser pulses have become the predominant technique for AH, significant variation existed in the precise strategy. Zona pellucida (ZP) drilling was the main method for AHpBP, whilst both ZP drilling and ZP thinning were applied equally for AHpET. Furthermore, the ZP manipulation varied widely with regards to the size of the ZP opening and the extension of ZP thinning. This is the first representative survey relating to the current practice of AH. Laser-assisted AH is used extensively, especially for AHpBP. However, there is significant disparity in clinical practice across different centres. Future research should aim to create a standardised protocol for AH to help reduce the evident variation in clinical practice and investigate the true value of AH.

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Laser‐assisted hatching on clinical and neonatal outcomes in patients undergoing single vitrified Blastocyst transfer: A propensity score–matched study

Cited by 12 publications

References 39 publications

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

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

Efficacy of Laser-Assisted Hatching on Pregnancy and Live-Birth Rates of Human Frozen-Thawed Embryos

The Current Practice of Assisted Hatching for Embryos in Fertility Centres: a General Survey

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