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Monozygotic twinning associated with mechanical assisted hatching
A Hershlag1, T Paine, G W Cooper
1Department of Obstetrics and Gynecology, North Shore University Hospital-New York University Medical College, Manhassett 11030, USA.
Objective:
To determine the effect of mechanical assisted hatching on the pregnancy rate (PR).
Design:
A retrospective comparative analysis of hatched versus nonhatched consecutive assisted reproductive technology (ART) cycles.
Setting:
A hospital-based ART program.
Patient(S):
Patients undergoing ART treatment with assisted hatching (1994-1996) were compared with patients who did not have assisted hatching (1990-1993).
Intervention(S):
None.
Main Outcome Measure(S):
Pregnancy rate, multiple PR, and rate of monozygotic twinning.
Result(S):
With hatching, the clinical PR per ET increased from 25.2% to 37.1% and the multiple PR per ET increased from 6.8% to 13.1%. In the nonhatched series, there were no monozygotic twins compared with eight cases in the hatched series (1.2% per ET).
Conclusion(S):
Mechanical assisted hatching increases the PR but concomitantly elevates the rate of multiple gestation and multiple gestation of high order. There is a particularly high risk of monozygotic twinning with mechanical hatching.