Samer Tannus1, Yoni Cohen2, Sara Henderson2, Weon-Young Son2, Togas Tulandi2. 1. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University Health Centre, 1001 Decarie Blvd, Montreal, Québec, Canada, H4A 3J1. sr.tannus@gmail.com. 2. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University Health Centre, 1001 Decarie Blvd, Montreal, Québec, Canada, H4A 3J1.
Abstract
OBJECTIVE: Assisted hatching (AH) was introduced 3 decades ago as an adjunct method to in vitro fertilization (IVF) and embryo transfer (ET) to improve embryo implantation rate. Limited data are available on the effect of AH on live birth rate (LBR) in advanced maternal age. The objective of this study is to investigate the effect of AH on LBR in women aged 40 years and older. MATERIALS AND METHODS: A retrospective study conducted at a single academic reproductive center. Women aged ≥40 years, who were undergoing their first IVF cycle were included. Laser-assisted hatching was the method used for AH and single or double embryos were transferred. Embryo transfer was performed at the cleavage or blastocyst stage. Separate analysis was performed on each ET stage. Live birth rate was the primary outcome. RESULTS: A total of 892 patients were included. Of these, 681 women underwent cleavage ET and 211 underwent blastocyst ET. The clinical pregnancy rate in the entire group was 15.3% and the LBR was 10.2%. Baseline and cycle parameters between the AH group and the control group were comparable. Assisted hatching in the cleavage stage was associated with lower clinical pregnancy rate (odds ratio [OR], 0.52; confidence interval [CI], 0.31-0.86; P = .012) and lower LBR (OR, 0.36; CI, 0.19-0.68; P = .001). Assisted hatching did not have any effect on outcomes in blastocyst ET. CONCLUSION: Assisted hatching does not improve the reproductive outcomes in advanced maternal age. Performing routine AH for the sole indication of advanced maternal age is not clinically justified.
OBJECTIVE: Assisted hatching (AH) was introduced 3 decades ago as an adjunct method to in vitro fertilization (IVF) and embryo transfer (ET) to improve embryo implantation rate. Limited data are available on the effect of AH on live birth rate (LBR) in advanced maternal age. The objective of this study is to investigate the effect of AH on LBR in women aged 40 years and older. MATERIALS AND METHODS: A retrospective study conducted at a single academic reproductive center. Women aged ≥40 years, who were undergoing their first IVF cycle were included. Laser-assisted hatching was the method used for AH and single or double embryos were transferred. Embryo transfer was performed at the cleavage or blastocyst stage. Separate analysis was performed on each ET stage. Live birth rate was the primary outcome. RESULTS: A total of 892 patients were included. Of these, 681 women underwent cleavage ET and 211 underwent blastocyst ET. The clinical pregnancy rate in the entire group was 15.3% and the LBR was 10.2%. Baseline and cycle parameters between the AH group and the control group were comparable. Assisted hatching in the cleavage stage was associated with lower clinical pregnancy rate (odds ratio [OR], 0.52; confidence interval [CI], 0.31-0.86; P = .012) and lower LBR (OR, 0.36; CI, 0.19-0.68; P = .001). Assisted hatching did not have any effect on outcomes in blastocyst ET. CONCLUSION: Assisted hatching does not improve the reproductive outcomes in advanced maternal age. Performing routine AH for the sole indication of advanced maternal age is not clinically justified.
Authors: Dmitry M Kissin; Jennifer F Kawwass; Michael Monsour; Sheree L Boulet; Donna R Session; Denise J Jamieson Journal: Fertil Steril Date: 2014-07-17 Impact factor: 7.329
Authors: Jennifer F Knudtson; Courtney M Failor; Jonathan A Gelfond; Martin W Goros; Tiencheng Arthur Chang; Robert S Schenken; Randal D Robinson Journal: Fertil Steril Date: 2017-08-30 Impact factor: 7.329