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Initial IVF-ET experience with assisted hatching performed 3 days after retrieval followed by day 5 embryo transfer
M C Graham1, K M Hoeger, W R Phipps
1Department of Obstetrics-Gynecology, University of Rochester, Rochester, New York 14642, USA.
Objective:
To report our initial IVF-ET experience combining assisted hatching performed 3 days after oocyte retrieval with day 5 embryo transfer (ET).
Design:
Retrospective review of 110 consecutive IVF cycles not involving donor oocytes, including 16 cycles that involved assisted hatching performed 3 days after oocyte retrieval in combination with day 5 ET.
Setting:
Academic teaching hospital IVF center.
Patient(S):
Eighty-six consecutive IVF patients undergoing ET.
Intervention(S):
Assisted hatching using acid Tyrode's solution performed 3 days after oocyte retrieval in selected cases in combination with day 3 or 5 ETs.
Main Outcome Measure(S):
Clinical pregnancy rate per ET.
Result(S):
Of the 16 women undergoing day 5 ET following day 3 assisted hatching, 14 had a clinical pregnancy. These included 11 ongoing/delivered singletons and 2 ongoing/delivered twin pregnancies, neither of which was monochorionic. These clinical and ongoing/delivered pregnancy rates compared very favorably with those of 54% and 46%, respectively, for the 35 patients undergoing day 5 ETs without assisted hatching, even though the latter group appeared to be better IVF candidates based on the prognostic factors commonly used to predict success.
Conclusion(S):
Our experience suggests that day 3 assisted hatching followed by day 5 ET may be a useful combination in selected patients. Although not seen in our small series, an increased risk of monochorionic pregnancies remains a theoretical concern when such a combination is used, since both assisted hatching and blastocyst transfers have been independently linked to an increased risk in some reports.
