Abstract
Purpose
Our purpose was to examine the benefits of assisted hatching in our program and to determine whether the procedure increases the implantation of nonviable embryos or monozygotic twinning.
Methods
Consecutive in vitro fertilization cycles using assisted hatching were compared with historical controls. The impact of assisted hatching was analyzed according to the woman’s age. Outcome measures were clinical pregnancy, implantation rate, delivery rate, multiple pregnancy, spontaneous abortion, and incidence of monozygotic twins.
Results
The implantation rate was increased in women aged 35–39 and markedly increased in women aged 40–42. There was no change in spontaneous abortions and no increase in monozygotic twins.
Conclusions
Assisted hatching is a safe and highly effective adjunct to in vitro fertilization for women aged 35–42 and did not increase spontaneous abortion or monozygotic twinning.
Key words: assisted hatching, in vitro fertilization, monozygotic twins, spontaneous abortion
Full Text
The Full Text of this article is available as a PDF (304.5 KB).
References
- 1.Cohen J, Inge KL, Suzman M, Wiker SR, Wright G. Videocinematography of fresh and cryopreserved embryos: A retrospective analysis of embryonic morphology and implantation. Fertil Steril. 1989;51:820–827. doi: 10.1016/s0015-0282(16)60673-8. [DOI] [PubMed] [Google Scholar]
- 2.Cohen J, Alikani M, Trowbridge J, Rosenwaks Z. Implantation enhancement by selective assisted hatching using zona drilling of human embryos with poor prognosis. Hum Reprod. 1992;7:685–691. doi: 10.1093/oxfordjournals.humrep.a137720. [DOI] [PubMed] [Google Scholar]
- 3.Stein A, Rufas O, Amit S, Avrech O, Pinkas H, Ovadia J, Fisch B. Assisted hatching by partial zona dissection of human preembryos in patients with recurrent implantation failure after in vitro fertilization. Fertil Steril. 1995;63:838–841. doi: 10.1016/s0015-0282(16)57490-1. [DOI] [PubMed] [Google Scholar]
- 4.Wiemer KE, Hu Y, Cuervo M, Genetis P, Leibowitz D. The combination of coculture and selective assisted hatching: Results from their clinical application. Fertil Steril. 1994;61:105–110. doi: 10.1016/s0015-0282(16)56461-9. [DOI] [PubMed] [Google Scholar]
- 5.Schoolcraft WB, Schlenker T, Gee M, Jones GS, Jones HW. Assisted hatching in the treatment of poor prognosis in in vitro fertilization candidates. Fertil Steril. 1994;62:551–554. doi: 10.1016/s0015-0282(16)56944-1. [DOI] [PubMed] [Google Scholar]
- 6.Check JH, Hoover L, Nazari A, O’Shaughnessy A, Summers D. The effect of assisted hatching on pregnancy rates after frozen embryo transfer. Fertil Steril. 1996;65:254–257. doi: 10.1016/s0015-0282(16)58080-7. [DOI] [PubMed] [Google Scholar]
- 7.Slotnick RN, Ortega JE. Monoamniotic twinning and zona manipulation: A survey of U.S. centers correlating zona manipulation procedures and high risk twinning frequency. J Assist Reprod Genet. 1996;13:381–385. doi: 10.1007/BF02066168. [DOI] [PubMed] [Google Scholar]
- 8.Assisted reproductive technology in the United States and Canada: 1994 results generated from the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology Registry. Fertil Steril 1996:66:697-705 [DOI] [PubMed]
- 9.Meldrum DR, Chetkowski R, Hamilton M. Evolution of a highly successful in vitro fertilization-embryo transfer program. Fertil Steril. 1987;48:86–93. doi: 10.1016/s0015-0282(16)59295-4. [DOI] [PubMed] [Google Scholar]
- 10.Meldrum DR, Wisot A, Hamilton F, Gutlay AL, Kempton W, Huynh D. Routine pituitary suppression with leuprolide before ovarian stimulation for oocyte retrieval. Fertil Steril. 1989;51:455–59. doi: 10.1016/s0015-0282(16)60553-8. [DOI] [PubMed] [Google Scholar]
- 11.Cohen J, Malter H, Eisner C, Kort H, Massey J, Mayer MP. Immunosuppression supports implantation of zona pellucida dissected embryos. Fertil Steril. 1990;53:662–665. doi: 10.1016/s0015-0282(16)53460-8. [DOI] [PubMed] [Google Scholar]