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Three-dimensional partial zona dissection for preimplantation genetic diagnosis and assisted hatching
J Cieslak1, V Ivakhnenko, G Wolf
1Reproductive Genetics Institute, Illinois Masonic Medical Center, Chicago 60657, USA. rgi@flash.net
Objective:
To develop a new approach to partial zona dissection of oocytes and embryos for facilitating preimplantation genetic sampling and assisted hatching.
Design:
Controlled clinical study.
Setting:
Preimplantation genetic diagnosis and IVF program, Reproductive Genetics Institute/IVF Illinois, Chicago, Illinois.
Patient(S):
Three hundred forty patients undergoing IVF in whom preimplantation genetic diagnosis or assisted hatching was required.
Intervention(S):
Three-dimensional partial zona dissection and conventional partial zona dissection were performed, with the use of a simple microneedle, on embryos before preimplantation genetic sampling or on day 3 of embryo development before ET.
Main Outcome Measure(S):
Pregnancy rate, implantation rate, and ease of preimplantation genetic sampling.
Result(S):
A pregnancy rate of 42% and an embryo implantation rate of 17.6% were obtained in the group in which three-dimensional partial zona dissection was performed, compared with a pregnancy rate of 33% and an implantation rate of 14.7% in the control group, which underwent conventional partial zona dissection. Preimplantation genetic sampling can be performed without distortion of the blastomere configuration in the embryo.
Conclusion(S):
Three-dimensional partial zona dissection is a safe and simple mechanical means of creating an opening sufficient for the atraumatic removal of material from oocytes and embryos for preimplantation genetic diagnosis and assisted hatching.