This systematic review aimed to evaluate the efficacy and safety of assisted hatching （AH） performed in couples with advanced maternal age. We searched for randomized controlled trials （RCTs） in electronic databas...This systematic review aimed to evaluate the efficacy and safety of assisted hatching （AH） performed in couples with advanced maternal age. We searched for randomized controlled trials （RCTs） in electronic databases, including MEDLINE, EMBASE and CENTRAL （from inception to January 2018）; in addition, we hand-searched the reference lists of included studies and similar reviews. We included RCTs comparing AH versus no treatment （control）. The meta-analysis was performed by RevMan 5.3 software. The search retrieved 943 records and 8 RCTs were included, comprising 870 cycles （n=440 for AH, and n=430 for control）. There was no significant difference in the rates of live birth （RR 0.88, 95% CI 0.65 to 1.18, 3 RCTs, n-427,I^2=0%）, clinical pregnancy （RR 1.00, 95% CI 0.83 to 1.19, 8 RCTs, n=870, I^2=22%）, implantation （RR 1.07, 95% CI 0.83 to 1.39, 4 RCTs, n=1359, I^2=0%）, miscarriage （RR 1.13, 95% CI 0.66 to 1.94, 2 RCTs, n=116, I^2=0%） and multiple pregnancy （RR 0.89, 95% CI 0.31 to 2.52, 1 RCT, n=97,I^2=not applicable） between the treatment group and control group. No reasonable conclusions could be drawn regarding reproductive outcomes after AH in patients with advanced maternal age due to the small sample pooled in meta-analyses. Studies of high methodological quality and with adequate power are necessary to further investigate the value of AH in assisted conception of those patients.展开更多
Purpose: Impaired hatching is associated with implantation failure following in vitro fertilization (IVF). Thickening or hardening of the zona pellucida (ZP) has been proposed as a factor in this impairment. We examin...Purpose: Impaired hatching is associated with implantation failure following in vitro fertilization (IVF). Thickening or hardening of the zona pellucida (ZP) has been proposed as a factor in this impairment. We examined whether selective assisted hatching (AH) is beneficial with embryos having a thick ZP. Methods: This prospective, randomized controlled study was performed in the IVF unit of an obstetrics and gynecology department in a university-affiliated hospital. Only patients undergoing IVF and having a ZP thickness of ≥17 μm measured in all their embryos were included. In the intervention group, AH was applied to all embryos, before their transfer. In the control group, embryos were transferred without AH. Implantation, clinical pregnancy and live birth rates were the study endpoints. Results: Both study arms were comparable in most baseline parameters. The two groups did not differ in implantation rates (14.1% control vs. 8.92% intervention, odds ratio (OR) = 0.5974, 95% confidence interval (CI) 0.325 - 1.1), clinical pregnancy rates (36.7% vs. 25.8%, OR = 0.6025, 95% CI 0.274 - 1.325), or live birth rates (25% vs. 18.9%, OR = 0.7021, 95% CI 0.291 - 1.691). Conclusions: Selecting embryos for AH by their ZP thickness as a sole parameter was not found to be beneficial and to improve IVF outcome.展开更多
Objective: To determine whether laser-assisted hatching can improve clinical outcome of assisted reproductive techniques in both unselected patients and patients with advanced female age, with recurrent implantation f...Objective: To determine whether laser-assisted hatching can improve clinical outcome of assisted reproductive techniques in both unselected patients and patients with advanced female age, with recurrent implantation failure, or who are using frozen-thawed embryos. Study design: Prospective randomized study. Patients and methods: 179 consecutive women scheduled for intracytoplasmic sperm injection (ICSI) were randomised to either laser assisted hatching (LAH) or non LAH group. Patients were divided into 94 test and 85 control groups. On the day of embryo transfer, the zona pellucida of the selected embryos in the test group was thinned by using an infrared optical laser system, whereas in the control group they were left intact. Clinical pregnancy rates (CPR) and implantation rates (IR) were estimated. Result(s): Patients that underwent LAH (n = 94) had CPR, and IR of 35.1% and 50%, respectively. Patients that did not undergo LAH (n = 85) had lower CPR (28.2%, P = 0.324) and IR (33%, P = 230), with no statistically significant difference P Conclusion: The current study suggested that there is no need for the routine use of laser assisted hatching. However, there is evidence of laser assisted hatching benefit in selected展开更多
Objective To evaluate the safety and efficiency of an improved shape of opening for mechanical assisted hatching （AH） on the in virto development of mouse embryos. Methods A total of 622 KM BAI mouse embryos in 2-...Objective To evaluate the safety and efficiency of an improved shape of opening for mechanical assisted hatching （AH） on the in virto development of mouse embryos. Methods A total of 622 KM BAI mouse embryos in 2-cell-4-cell stage were randomly divided into group A, group B and control group. A new mechanical AH method by improving the shape of opening in the ZP was used in group A, and a ＂-/ ＂-shaped opening was created. A ＂＋ ＂ -shaped opening was made in group B, while no opening was made in control group. Comparisons have been made among the three groups with regard to the duration of AH, the blastocyst formation and complete hatching rate, etc. Results The duration of AH in group A （43.25 ±3.46 s） was significantly shorter than that in group B （52.81 ±4.32 s, P 〈0.05）. The blastocyst formation rate on d 5 was not significantly different among the three groups （92.27%, 93.66% and 94.92% respectively, P 〉0.05）. The complete hatching rate of blastocysts on d 6 between group A and group B was no statistical difference （94.09% vs 92.71%, P 〉0.05）, but significantly higher than that in control group （43.32%, P 〈0.001）. No significant difference in the percentage of grade 1 blastocysts was found among the three groups on d 5 （85.22%, 82.81% and 86.63% respectively, P 〉0.05）. Conclusion R could enhance the process of embryo hatching and facilitate the hatching rate of blastocysts by using the improved mechanical AH method, which is of safety and efficiency to mouse embryo in the in vitro development.展开更多
文摘This systematic review aimed to evaluate the efficacy and safety of assisted hatching （AH） performed in couples with advanced maternal age. We searched for randomized controlled trials （RCTs） in electronic databases, including MEDLINE, EMBASE and CENTRAL （from inception to January 2018）; in addition, we hand-searched the reference lists of included studies and similar reviews. We included RCTs comparing AH versus no treatment （control）. The meta-analysis was performed by RevMan 5.3 software. The search retrieved 943 records and 8 RCTs were included, comprising 870 cycles （n=440 for AH, and n=430 for control）. There was no significant difference in the rates of live birth （RR 0.88, 95% CI 0.65 to 1.18, 3 RCTs, n-427,I^2=0%）, clinical pregnancy （RR 1.00, 95% CI 0.83 to 1.19, 8 RCTs, n=870, I^2=22%）, implantation （RR 1.07, 95% CI 0.83 to 1.39, 4 RCTs, n=1359, I^2=0%）, miscarriage （RR 1.13, 95% CI 0.66 to 1.94, 2 RCTs, n=116, I^2=0%） and multiple pregnancy （RR 0.89, 95% CI 0.31 to 2.52, 1 RCT, n=97,I^2=not applicable） between the treatment group and control group. No reasonable conclusions could be drawn regarding reproductive outcomes after AH in patients with advanced maternal age due to the small sample pooled in meta-analyses. Studies of high methodological quality and with adequate power are necessary to further investigate the value of AH in assisted conception of those patients.
文摘Purpose: Impaired hatching is associated with implantation failure following in vitro fertilization (IVF). Thickening or hardening of the zona pellucida (ZP) has been proposed as a factor in this impairment. We examined whether selective assisted hatching (AH) is beneficial with embryos having a thick ZP. Methods: This prospective, randomized controlled study was performed in the IVF unit of an obstetrics and gynecology department in a university-affiliated hospital. Only patients undergoing IVF and having a ZP thickness of ≥17 μm measured in all their embryos were included. In the intervention group, AH was applied to all embryos, before their transfer. In the control group, embryos were transferred without AH. Implantation, clinical pregnancy and live birth rates were the study endpoints. Results: Both study arms were comparable in most baseline parameters. The two groups did not differ in implantation rates (14.1% control vs. 8.92% intervention, odds ratio (OR) = 0.5974, 95% confidence interval (CI) 0.325 - 1.1), clinical pregnancy rates (36.7% vs. 25.8%, OR = 0.6025, 95% CI 0.274 - 1.325), or live birth rates (25% vs. 18.9%, OR = 0.7021, 95% CI 0.291 - 1.691). Conclusions: Selecting embryos for AH by their ZP thickness as a sole parameter was not found to be beneficial and to improve IVF outcome.
文摘Objective: To determine whether laser-assisted hatching can improve clinical outcome of assisted reproductive techniques in both unselected patients and patients with advanced female age, with recurrent implantation failure, or who are using frozen-thawed embryos. Study design: Prospective randomized study. Patients and methods: 179 consecutive women scheduled for intracytoplasmic sperm injection (ICSI) were randomised to either laser assisted hatching (LAH) or non LAH group. Patients were divided into 94 test and 85 control groups. On the day of embryo transfer, the zona pellucida of the selected embryos in the test group was thinned by using an infrared optical laser system, whereas in the control group they were left intact. Clinical pregnancy rates (CPR) and implantation rates (IR) were estimated. Result(s): Patients that underwent LAH (n = 94) had CPR, and IR of 35.1% and 50%, respectively. Patients that did not undergo LAH (n = 85) had lower CPR (28.2%, P = 0.324) and IR (33%, P = 230), with no statistically significant difference P Conclusion: The current study suggested that there is no need for the routine use of laser assisted hatching. However, there is evidence of laser assisted hatching benefit in selected
基金This study was supported by Natural Science Foundation of Shanghai (No. 04ZR14103).
文摘Objective To evaluate the safety and efficiency of an improved shape of opening for mechanical assisted hatching （AH） on the in virto development of mouse embryos. Methods A total of 622 KM BAI mouse embryos in 2-cell-4-cell stage were randomly divided into group A, group B and control group. A new mechanical AH method by improving the shape of opening in the ZP was used in group A, and a ＂-/ ＂-shaped opening was created. A ＂＋ ＂ -shaped opening was made in group B, while no opening was made in control group. Comparisons have been made among the three groups with regard to the duration of AH, the blastocyst formation and complete hatching rate, etc. Results The duration of AH in group A （43.25 ±3.46 s） was significantly shorter than that in group B （52.81 ±4.32 s, P 〈0.05）. The blastocyst formation rate on d 5 was not significantly different among the three groups （92.27%, 93.66% and 94.92% respectively, P 〉0.05）. The complete hatching rate of blastocysts on d 6 between group A and group B was no statistical difference （94.09% vs 92.71%, P 〉0.05）, but significantly higher than that in control group （43.32%, P 〈0.001）. No significant difference in the percentage of grade 1 blastocysts was found among the three groups on d 5 （85.22%, 82.81% and 86.63% respectively, P 〉0.05）. Conclusion R could enhance the process of embryo hatching and facilitate the hatching rate of blastocysts by using the improved mechanical AH method, which is of safety and efficiency to mouse embryo in the in vitro development.
