Dmitry M Kissin1, Jennifer F Kawwass2, Michael Monsour3, Sheree L Boulet3, Donna R Session4, Denise J Jamieson2. 1. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia. Electronic address: dkissin@cdc.gov. 2. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia. 3. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia. 4. Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia.
Abstract
OBJECTIVE: To assess trends and outcomes of assisted hatching among assisted reproductive technology (ART) cycles. DESIGN: Retrospective cohort analysis using National ART Surveillance System (NASS) data. SETTING: U.S. fertility centers reporting to NASS. PATIENT(S): Fresh autologous noncanceled ART cycles conducted from 2000-2010. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Implantation, clinical pregnancy, live-birth, miscarriage, multiple gestation. RESULT(S): Assisted hatching use statistically significantly increased in absolute number (from 25,724 to 35,518 cycles), percentages of day-3 (from 50.7% to 56.3%) and day-5 transfers (from 15.9% to 22.8%), and percentage of transfers among women ≥38 years (from 17.8% to 21.8%) or women with ≥2 prior ART cycles and no live birth(s) (from 4.3% to 7.4%). Both day-3 and day-5 cycles involving assisted hatching were associated with lower odds of implantation (adjusted odds ratios [aOR] 0.7 and 0.6, respectively), clinical pregnancy (aOR 0.8 and 0.7, respectively), live birth (aOR 0.8 and 0.7, respectively), and increased odds of miscarriage (aOR 1.4 and 1.4, respectively), as compared with cycles without assisted hatching. Assisted hatching was associated with lower odds of multiple gestation in day-5 cycles (aOR 0.8). In cycles for women with a "poor prognosis," the association of assisted hatching with pregnancy outcomes was not statistically significant. CONCLUSION(S): Assisted hatching use had an increasing trend but was not associated with improved pregnancy outcomes, even in poor-prognosis patients. Prospective studies are needed to identify the patients who may benefit from assisted hatching. Published by Elsevier Inc.
OBJECTIVE: To assess trends and outcomes of assisted hatching among assisted reproductive technology (ART) cycles. DESIGN: Retrospective cohort analysis using National ART Surveillance System (NASS) data. SETTING: U.S. fertility centers reporting to NASS. PATIENT(S): Fresh autologous noncanceled ART cycles conducted from 2000-2010. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Implantation, clinical pregnancy, live-birth, miscarriage, multiple gestation. RESULT(S): Assisted hatching use statistically significantly increased in absolute number (from 25,724 to 35,518 cycles), percentages of day-3 (from 50.7% to 56.3%) and day-5 transfers (from 15.9% to 22.8%), and percentage of transfers among women ≥38 years (from 17.8% to 21.8%) or women with ≥2 prior ART cycles and no live birth(s) (from 4.3% to 7.4%). Both day-3 and day-5 cycles involving assisted hatching were associated with lower odds of implantation (adjusted odds ratios [aOR] 0.7 and 0.6, respectively), clinical pregnancy (aOR 0.8 and 0.7, respectively), live birth (aOR 0.8 and 0.7, respectively), and increased odds of miscarriage (aOR 1.4 and 1.4, respectively), as compared with cycles without assisted hatching. Assisted hatching was associated with lower odds of multiple gestation in day-5 cycles (aOR 0.8). In cycles for women with a "poor prognosis," the association of assisted hatching with pregnancy outcomes was not statistically significant. CONCLUSION(S): Assisted hatching use had an increasing trend but was not associated with improved pregnancy outcomes, even in poor-prognosis patients. Prospective studies are needed to identify the patients who may benefit from assisted hatching. Published by Elsevier Inc.
Entities:
Keywords:
Assisted hatching; assisted reproductive technology (ART); in vitro fertilization (IVF); live birth rate; pregnancy outcome
Authors: Jeff G Wang; Nataki C Douglas; Cary Dicken; Gary S Nakhuda; Michael M Guarnaccia; Mark V Sauer Journal: Fertil Steril Date: 2007-05-16 Impact factor: 7.329
Authors: Denis A Vaughan; Robin Ruthazer; Alan S Penzias; Errol R Norwitz; Denny Sakkas Journal: J Assist Reprod Genet Date: 2015-11-18 Impact factor: 3.412
Authors: Jessica E McLaughlin; Byeong Y Choi; Qianqian Liu; Jonathan A Gelfond; Randal D Robinson; T Arthur Chang; Jennifer F Knudtson Journal: J Assist Reprod Genet Date: 2019-11-12 Impact factor: 3.412
Authors: Sheree L Boulet; Russell S Kirby; Jennita Reefhuis; Yujia Zhang; Saswati Sunderam; Bruce Cohen; Dana Bernson; Glenn Copeland; Marie A Bailey; Denise J Jamieson; Dmitry M Kissin Journal: JAMA Pediatr Date: 2016-06-06 Impact factor: 16.193