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Assisted hatching: The treatment

Assisted hatching: The treatment

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The most common reason for an IVF or ICSI cycle to fail is because embryos fail to implant.  Before an embryo can implant into the lining of the uterus it must ‘hatch’ out of this shell.  This usually occurs five or six days following fertilisation.

There are many reasons why successful implantation does not occur.  One of these reasons may be due to the fact that the embryo is unable to ‘hatch’ because the zona pellucida is too thick, or too hard.

Who could benefit from assisted hatching?

The patients who could benefit from assisted hatching include all patients whose embryos have thickened zonae or hardened zonae.  Patients who may fall into this category include:

  • Women with a high baseline FSH level.  Oocytes from these women are more likely to have thicker or harder zonae.
  • Women who, regardless of age, have had two or more embryo transfers but no implantation.
  • Patients whose embryos have a zona pellucida that appears to be thicker than average, as determined by an embryologist during an IVF or ICSI cycle.
  • Women who are undergoing FER (frozen embryo replacement cycles).

What is involved?

Assisted hatching is a laboratory procedure whereby a hole is made in the zona pellucida of a two or three-day old embryo in order to help in the ‘hatching’ process and therefore, help with the implantation of the embryo into the uterus.

Several techniques including a laser, an acid or a very sharp needle can be used to make a hole in the zona pellucida.  The first assisted hatching techniques were carried out in the early 1990’s.  Most IVF clinics use this procedure and many babies have been born as a result of assisted hatching.  There have been no reports of an increase in abnormalities of babies born as a result of assisted hatching.

Disadvantages

As with any procedure involving the manipulation of oocytes and embryos there is a very small risk that an embryo will be damaged as a result of the procedure.

Hospitals and clinics cannot guarantee that the assisted hatching technique will improve the chances of implantation.  There have been several studies to assess the benefits of assisted hatching and the results have been contradictory, with some centres finding significant improvements in implantation rates and others finding no difference.  There have not been any studies suggesting that using the assisted hatching technique is detrimental to the chances of implantation.

Some hospitals charge an additional fee for carrying out the assisted hatching procedure.  

Thinking about getting infertility treatment?

Download our free PDF guide

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