Effect(s) of assisted hatching on assisted conception (IVF & ICSI)

Area of Science:

• Reproductive Medicine
• Infertility Treatment
• Assisted Reproductive Technology (ART)

Background:

• Blastocyst implantation failure can hinder conception.
• Assisted hatching (AH) is a technique to disrupt the zona pellucida, potentially improving conception success rates in assisted reproduction.

Purpose of the Study:

• To evaluate the effectiveness of assisted hatching (AH) in facilitating live births, clinical pregnancy, and implantation.
• To assess the impact of AH on negative outcomes such as miscarriage.

Main Methods:

• A systematic review and meta-analysis of 23 randomized controlled trials involving 2572 women.
• Included trials compared assisted hatching (mechanical, chemical, or laser disruption) with no intervention prior to embryo replacement.
• Outcomes were analyzed using random-effects meta-analysis, with sensitivity analyses and meta-regression where applicable.

Main Results:

• No significant difference in live birth rates was observed between AH and control groups (OR 1.21, 95% CI 0.82 to 1.78).
• Women undergoing AH showed significantly higher odds of clinical pregnancy (OR 1.63, 95% CI 1.27 to 2.09), though study heterogeneity was noted.
• Insufficient data were available to analyze implantation rates and the impact of AH on outcomes like monozygotic twinning or congenital abnormalities.

Conclusions:

• Current evidence is insufficient to determine AH's effect on the 'take-home-baby rate' in assisted conception.
• Limited data on miscarriage rates and adverse events prevent extrapolation of AH's impact on live births from improved clinical pregnancy rates.