Thinning or Opening: A Randomized Sibling-Embryo Pilot Trial on the Efficacy of Two Laser-Assisted Hatching Modes During the Extended Culture of Highly Fragmented Cleavage Embryos

Zhang, Ling; Zhou, Yier; Wu, Yuejin; Wu, Limei; Li, Shishi; Zhang, Lin; Jin, Zhen; Shu, Chongyi; Xu, Wei-Hai; Shu, Jing

doi:10.3389/fendo.2022.927834

Cited by 3 publications

(4 citation statements)

References 43 publications

(78 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A research group in 2022 compared the T-LAH to D-LAH and they concluded that there is no privilege to any of them on the other regarding chemical and clinical pregnancy. This was in agreement with our research when we compared the thinning and drilling group with all age groups but we found that thinning has an advantage over the control group above the age of 35 years old while Drilling did not show any significance [27]. Also, in agreement with our study Mostafa et.al study proved that both chemical and clinical pregnancy rate improved significantly after a quarter LAH for embryos of poor prognosis women in ICSI cycles (P= 0.024).…”

Section: F O R P U B L I C a T I O Nsupporting

confidence: 93%

Laser assisted thinning versus drilling in cryopreserved embryo transfer cycles

Elnahas,

Abdel Rasheed,

Nasr

et al. 2024

Ital J Gynaecol Obstet

View full text Add to dashboard Cite

Objective. Human embryo cryopreservation is a crucial aspect of Assisted Reproduction (AR). Nonetheless there is a potential concern regarding zonal hardening, which may have a negative impact on AR outcome. Assisted hatching (AH) has been employed to facilitate microdissection of the zona pellucida. Both laser assisted thinning and drilling techniques have been used to address this issue. However insufficient studies compared laser thinning versus opening technique. We aimed to study the effect of laser assisted hatching on cryopreserved embryos, comparing both laser assisted thinning and laser assisted drilling techniques and their effects on both implantation rate chemical and clinical pregnancies.Patients and Methods. 300 women were randomized into 3 equal groups (thinning, drilling and control group) and prepared for transfer of frozen/thawed embryos. The thinning and opening techniques were performed on the day of embryo transfer while the zona of the control group was left intact. M a n u s c r i p t a c c e p t e d f o r p u b l i c a t i o nResults. Both the chemical and clinical pregnancy rates were higher in laser-thinning group over the control group in all women enrolled in the study (p-value, 0.04, 0.031 respectively) and specifically above age of 35 years old (p-value, 0.003, 0.006 respectively) with a significant implantation rate (p-value 0.043) on addition. However, laser-drilling group showed no advantage over neither the control group or the thinning group. Conclusions.Laser thinning technique for cryopreserved embryos increased both the chemical and clinical pregnancy rates in frozen embryo transfer especially above age of 35 years old and it seems to have the upper hand in relation to laser opening technique.

show abstract

Section: F O R P U B L I C a T I O Nsupporting

confidence: 93%

Laser assisted thinning versus drilling in cryopreserved embryo transfer cycles

Elnahas,

Abdel Rasheed,

Nasr

et al. 2024

Ital J Gynaecol Obstet

View full text Add to dashboard Cite

show abstract

“…1 depicted the complete filtering procedure. Nine studies totaling 4 RCT [ 16 , 28 – 30 ] and 5 non-RCT [ 12 , 23 , 24 , 26 , 27 ] were included. The particular information traits that were examined are listed in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…After applying exclusion criteria using EndNote, 209 studies met the requirements for quantitative analysis. These studies were selected based on the reviewers' evaluation of the titles, abstracts, and full texts of the remaining 205 studies [ 12 , 16 , 23 , 24 , 26 – 30 ]. The literature search specifically focused on English papers, as depicted in Fig.…”

Section: Introductionmentioning

confidence: 99%

Two laser-assisted hatching methods of embryos in ART: a systematic review and meta-analysis

Chen,

Gao,

et al. 2024

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background Laser-assisted hatching (LAH) stands as the predominant technique for removing the zona pellucida (ZP) in embryos, primarily consisting of two methods: drilling laser-assisted hatching (D-LAH) and thinning laser-assisted hatching (T-LAH). Presently, both methods have limitations, and their comparative efficacy for embryo implantation and clinical pregnancy remains uncertain. Aim Evaluate the impact of D-LAH and T-LAH on clinical pregnancy rates within assisted reproductive technology (ART). Methods We systematically searched electronic databases including PubMed, Web of Science, and Cochrane Library until July 20, 2022. This study encompassed observational studies and randomized controlled trials (RCTs). A 95% confidence interval (CI) was utilized for assessing the risk ratio (RR) of pregnancy outcomes. The level of heterogeneity was measured using I2 statistics, considering a value exceeding 50% as indicative of substantial heterogeneity. Results The meta-analysis scrutinized 9 studies involving 2405 clinical pregnancies from D-LAH and 2239 from T-LAH. Findings suggested no considerable variation in the clinical pregnancy rates between the two techniques (RR = 0.93, 95% CI: 0.79–1.10, I2 = 71%, P = 0.41). Subgroup analyses also revealed no substantial differences. However, D-LAH exhibited a notably higher occurrence of singleton pregnancies compared to T-LAH (RR = 2.28, 95% CI: 1.08–4.82, I2 = 89%, P = 0.03). There were no noteworthy distinctions observed in other secondary outcomes encompassing implantation rate, multiple pregnancies, ongoing pregnancy, miscarriage, premature birth, and live birth. Conclusion Both the primary findings and subgroup analyses showed no marked variance in clinical pregnancy rates between D-LAH and T-LAH. Therefore, patients with varying conditions should select their preferred LAH technique after assessing their individual situation. However, due to the restricted number of studies involved, accurately gauging the influence of these laser techniques on clinical outcomes is challenging, necessitating further RCTs and high-quality studies to enhance the success rate of ART. Trial registration PROSPERO: CRD42022347066.

show abstract

“…The enzymatic approach employs proteolytic enzymes such as pronase, proteinase K, or trypsin, which selectively destroy certain proteins of the zona pellucida and result in gradual thinning [ 27 , 28 ]. However, acidic solutions such as hydrochloric or triode acids produce a chemical reaction that weakens the structure of the zona, making hatching easier [ 29 , 30 ]. Each technique attempts to achieve a selective opening in the zona pellucida, thus enhancing implantation potential for the embryo.…”

Section: Reviewmentioning

confidence: 99%

Unlocking the Potential of Assisted Hatching in Assisted Reproductive Technology: A Narrative Review

Deotalu,

More,

Karadbhajne

et al. 2024

Cureus

View full text Add to dashboard Cite

The present study is set in the broad field of assisted reproductive technologies (ARTs) and examines various procedures under assisted hatching (AH). It also reviews their effects on implantation success rates. The primary emphasis is on explaining who has benefited and how many have benefited from these interventions. The most important factor determining the success rate of ART is implantation. To increase these rates, we use AH in our clinics to enhance each embryo’s chances at life and substantially improve overall results. This comprehensive review includes various approaches, such as chemical-based measures (such as applying Tyrode’s solution) and mechanical techniques (such as zona drilling and partial zona dissection). The individual techniques are carefully scrutinized, considering their mechanical detailing, methods of applying therapeutic effects, and the appropriateness of matching present social circumstances. The review begins by analyzing the basic nature of AH as a medium for embryo implantation and then focuses on how this detailed view reveals the advantages and drawbacks of various methods. Moreover, the articles discuss improvements in AH technology and many of the most modern technological developments that can help fine-tune ART issues. A major problem with these methodologies is that they involve serious risks and legal complications. However, a broad assessment of these topics allows us to understand their impact on fertility treatments. This review is written as a guidebook for physicians and researchers working in reproductive medicine. It compiles all current knowledge, providing literature to build on successes that will make breakthroughs possible in ART. Indeed, this is a valuable reference for guiding us in navigating complex AH procedures. It advances ARTs step by step toward perfection.

show abstract

Thinning or Opening: A Randomized Sibling-Embryo Pilot Trial on the Efficacy of Two Laser-Assisted Hatching Modes During the Extended Culture of Highly Fragmented Cleavage Embryos

Cited by 3 publications

References 43 publications

Laser assisted thinning versus drilling in cryopreserved embryo transfer cycles

Laser assisted thinning versus drilling in cryopreserved embryo transfer cycles

Two laser-assisted hatching methods of embryos in ART: a systematic review and meta-analysis

Unlocking the Potential of Assisted Hatching in Assisted Reproductive Technology: A Narrative Review

Contact Info

Product

Resources

About