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What is assisted hatching?

Assisted hatching is a technique, performed as part of the IVF treatment to facilitate embryo hatching and implantation. The embryos formed as a result of IVF are surrounded by a hard outer layer called Zona Pellucida.

Zona Pellucida is like the shell of an embryo and for an embryo to implant into the endometrium it needs to hatch out of this shell. So, during assisted hatching, an embryologist tries to weaken this barrier by creating a small crack or perforation in the zona pellucida, which further increases the chances of implantation, as reported in various studies.

There are three methods for assisted hatching

  • Laser Assisted Hatching
  • Acid Tyrode’s Solution
  • Partial Zona Dissection (PZD)

Note: Assisted hatching is performed just before embryo transfer. Though the goal of all the above techniques is same, the methods are significantly different.

Laser Assisted Hatching (LAH)

  • This is a more modern approach wherein a software helps in positioning, intensity and focus of the laser.
  • In this method, thickening of the zona is first assessed before the zona is subjected to the laser, in order to minimize the heat delivered to the inner cell mass
  • This procedure is carried out on Day 3 when the embryos are still in the lab
  • The laser vaporizes the zona to create perforations in it. Typically, two to three laser pulses are required to create a gap
  • Once this is done, embryos are transferred back to the culture media and placed in the incubator until transfer
  • LAH is the safest and the most effective technique as the laser helps create an opening in the zona without coming in direct contact with the embryo and hence ensuring the safety of the same

Indications for LAH

  • Two or more failed IVF cycles
  • Advanced maternal age
  • Poor embryo quality
  • Elevated FSH levels
  • Unexplained infertility

Risks associated with LAH

The risks associated are similar to IVF and ICSI. Since this process interferes with the natural hatching process, it does involve a few risks:

  • Embryo might fail to hatch completely
  • Embryo might get lethally injured
  • LAH further increases the risk of multiple pregnancies (monozygotic twins)
  • Monozygotic twin pregnancy is associated with even higher risk for the mother and baby