Assisted hatching is a laboratory technique used in assisted reproductive technology (ART), particularly during in vitro fertilization (IVF), to help embryos implant into the uterus.
During IVF, embryos are created in a lab and are enclosed by a protective outer shell called the zona pellucida. For successful implantation, the embryo must naturally break through this shell to attach to the uterine lining.
Assisted hatching involves creating a small hole or thinning the zona pellucida to facilitate this process.
The procedure is typically carried out on the third day of embryo development, when the embryo reaches around six to eight cells.
Using a micromanipulator or laser technology, embryologists create a tiny hole in the zona pellucida. This can also be done using acidic solutions like Tyrode's acid, although lasers are more commonly used due to their precision.
Assisted hatching can also be performed on previously frozen embryos that have been thawed. It requires a high degree of expertise to ensure that the embryo is not harmed during the procedure.
Assisted hatching is generally considered for specific cases where the chances of successful implantation are reduced:
- Advanced Maternal Age: Women older than 37 or 38 may have embryos with a harder zona pellucida, making natural hatching more difficult.
- Poor Embryo Quality: Embryos that show signs of slow development or high fragmentation may benefit from the procedure.
- Multiple Failed IVF Cycles: Patients who have had two or more unsuccessful IVF attempts may be candidates for assisted hatching.
- Elevated FSH Levels: High levels of follicle-stimulating hormone may indicate lower ovarian reserve, potentially benefiting from assisted hatching.
- Thick Zona Pellucida: Some embryos naturally have a thicker zona, which may hinder the hatching process.
Success rates for assisted hatching vary based on individual patient factors. Some studies report improved clinical pregnancy rates, particularly in poor prognosis patients.
However, systematic reviews and meta-analyses suggest that there is no significant improvement in live birth rates compared to standard IVF, especially in unselected patients or those with a normal prognosis.
The American Society for Reproductive Medicine states that assisted hatching may benefit certain groups, but it should not be routinely recommended for all IVF cycles.
Like any medical procedure, assisted hatching carries some risks:
- Embryo Damage: There is a risk of damaging the embryo or its internal structures, which could reduce the chances of implantation.
- Increased Risk of Twins: Studies show a slightly increased risk of monozygotic (identical) twinning, which can pose additional health risks for both the mother and babies.
- Maternal Side Effects: Some patients may experience mild symptoms such as cramping or discomfort.
- Higher Risk of Multiple Pregnancies: This increases potential complications during pregnancy and delivery.
It is essential that the procedure be performed by a skilled embryologist to minimize these risks.
Assisted hatching may have both positive and negative impacts on embryo quality:
Positive Effects:
- Enhances implantation potential in poor-quality embryos.
- May help embryos with insufficient energy to complete the natural hatching process.
Negative Effects:
- Potential for mechanical or thermal damage during the procedure.
- Inappropriate or poorly performed hatching can reduce implantation chances.
While there are no strict age restrictions, assisted hatching is most commonly recommended for women over the age of 37 or those with repeated IVF failures.
Clinics may have their own guidelines, but generally, the procedure is reserved for those with specific risk factors that could impact embryo implantation.
Before the Procedure:
- Patients may receive light sedation or anesthesia to ease discomfort.
- Embryos are carefully evaluated to determine if they are suitable for assisted hatching.
During the Procedure:
- The embryologist uses a micromanipulation system to hold the embryo in place.
- A laser is used to create a small hole in the zona pellucida.
- The embryo is returned to the incubator before being transferred to the uterus.
After the Procedure:
- Patients may experience mild cramping.
- Physical rest is generally recommended for a short period.
- Follow-up includes monitoring for implantation and early signs of pregnancy.
Assisted hatching is a useful technique in the context of IVF, especially for patients with advanced maternal age, poor embryo quality, or previous IVF failures.
While it may increase pregnancy rates in certain populations, it is not universally recommended for all IVF cases due to mixed evidence on its effectiveness and some associated risks.
Patients should discuss the potential benefits and drawbacks of assisted hatching with their fertility specialist to determine if it is appropriate for their specific situation.
No, assisted hatching is not recommended for all patients. It is typically advised for women over 37, those with poor embryo quality, or individuals who have had multiple failed IVF cycles.
There is a slightly increased risk of identical twins due to assisted hatching. However, this risk remains low and is considered manageable.
Yes, assisted hatching can be performed on embryos that have been previously frozen and thawed.
No, while it may increase the chance of implantation in some cases, assisted hatching does not guarantee a successful pregnancy or live birth.
The assisted hatching procedure is done in the lab and does not cause pain to the patient. Any discomfort experienced is usually from the embryo transfer process itself, which is minimal.
Risks include potential damage to the embryo, a slight increase in twin pregnancies, and mild maternal side effects like cramping or nausea.
The lab procedure itself takes only a few minutes per embryo, though overall IVF and embryo transfer timelines vary by patient.
Coverage depends on your insurance provider and plan. It’s best to consult with your clinic’s billing office or your insurance company directly.
If you're looking to boost your chances of IVF success, our specialized package is designed for couples facing challenges such as advanced maternal age or previous failed cycles.
HOME
