PURPOSE: The objective of this study was to determine if the zona thinning (ZT) technique improved the rates of implantation and clinical pregnancy for patients aged > or = 38 years submitted to an ICSI program. METHODS: A total of 100 patients submitted to ICSI and aged > or = 38 years were divided in a prospective and randomized manner into two groups: Group I - patients submitted to ZT (n = 50); a laser diode with 1.48 microm wavelength (Fertilaser) was used for the ZT procedure with 1-2 irradiations of 10 ms applied to four different positions on the zona pellucida (ZP) of each embryo to thin 60-90% of the ZP (each point with a 15-20 microm length of ZT). Group II - patients with no ZT (n = 50). In both groups, embryo transfer was performed on the second or third day. RESULTS: The age of Group I patients (39.8 +/- 1.3) did not differ (p = 0.67) from that of Group II patients (40 +/- 1.9). The number of oocytes retrieved at metaphase II from Group I (6.4 +/- 4.2) and Group II (6.8 +/- 5) was similar (p = 0.94). Normal fertilization rates and cleavage rates were similar (p = 0.78 and p = 0.63, respectively) for Group I (71.5 +/- 22% and 96.7 +/- 11%) and Group II (73.5 +/- 19.7% and 96 +/- 11%, respectively). The number of embryos transferred was similar (p = 0.53) for the two groups (Group I = 3.1 +/- 1.3; Group II = 2.9 +/- 1.1). The thickness of the ZP of Group I embryos (16.9 +/- 2.4 microm) did not differ (p = 0.97) from that of Group II embryos (16.9 +/- 2.3 microm). The rates of embryo implantation and clinical pregnancy per embryo transfer were similar (p = 0.67, p = 0.61) for Group I (7 and 16%, respectively) and for Group II (8.2 and 22%, respectively). CONCLUSIONS: These results suggest that ZT in the population aged > or = 38 years may have no impact on ICSI success rates. However, this conclusion is limited to a situation in which length of the laser ZT was < or = 20 microm and the laser was applied to four different positions.
RCT Entities:
PURPOSE: The objective of this study was to determine if the zona thinning (ZT) technique improved the rates of implantation and clinical pregnancy for patients aged > or = 38 years submitted to an ICSI program. METHODS: A total of 100 patients submitted to ICSI and aged > or = 38 years were divided in a prospective and randomized manner into two groups: Group I - patients submitted to ZT (n = 50); a laser diode with 1.48 microm wavelength (Fertilaser) was used for the ZT procedure with 1-2 irradiations of 10 ms applied to four different positions on the zona pellucida (ZP) of each embryo to thin 60-90% of the ZP (each point with a 15-20 microm length of ZT). Group II - patients with no ZT (n = 50). In both groups, embryo transfer was performed on the second or third day. RESULTS: The age of Group I patients (39.8 +/- 1.3) did not differ (p = 0.67) from that of Group II patients (40 +/- 1.9). The number of oocytes retrieved at metaphase II from Group I (6.4 +/- 4.2) and Group II (6.8 +/- 5) was similar (p = 0.94). Normal fertilization rates and cleavage rates were similar (p = 0.78 and p = 0.63, respectively) for Group I (71.5 +/- 22% and 96.7 +/- 11%) and Group II (73.5 +/- 19.7% and 96 +/- 11%, respectively). The number of embryos transferred was similar (p = 0.53) for the two groups (Group I = 3.1 +/- 1.3; Group II = 2.9 +/- 1.1). The thickness of the ZP of Group I embryos (16.9 +/- 2.4 microm) did not differ (p = 0.97) from that of Group II embryos (16.9 +/- 2.3 microm). The rates of embryo implantation and clinical pregnancy per embryo transfer were similar (p = 0.67, p = 0.61) for Group I (7 and 16%, respectively) and for Group II (8.2 and 22%, respectively). CONCLUSIONS: These results suggest that ZT in the population aged > or = 38 years may have no impact on ICSI success rates. However, this conclusion is limited to a situation in which length of the laser ZT was < or = 20 microm and the laser was applied to four different positions.