Assisted Hatching

This technique is offered to couples who have been unlucky with IVF or ICSI treatment. They may have undergone repeated cycles of either of these but with no success and are wondering what to do next.

A failure of the embryo to implant in the woman’s uterus following IVF/ICSI is usually why a treatment cycle is unsuccessful.

If you have undergone a failed IVF/ICSI cycle then one option open to you is that of assisted hatching.

Reason for assisted hatching

An embryo is a collection of cells which is encased within a shell called the zona pellucida. This is an important part of the embryo, especially in the early stages but this changes as time goes on. It becomes thinner and eventually breaks down which enables the cells to escape and implant themselves in the lining of the uterus.

This sounds relatively straightforward but things can wrong. If the zona pellucida is thicker than normal or fails to break down then implantation will not occur. This means no pregnancy either.

If this is the outcome of an IVF/ICSI cycle then it is said to have failed.

This is where help may be needed with ‘hatching’ out the embryo so that it manages to implant itself in the uterus and increase the chance of pregnancy.

Assisted hatching is a procedure in which a hole is made in the zona pellucida of the embryo which enables it to escape and then implant itself.

Another way of doing this is to reduce the thickness of the zona pellucida.

The assisted hatching procedure

This takes place under controlled conditions in a laboratory. A hole is made in the outer layer of the embryo, either by physical abrasion or an acid solution but these can damage the embryo.

Laser technology is the preferred method of treatment as this is less likely to injure the embryo.

The laser procedure is as follows:

  • The procedure is carried out on the 3rd day of embryo development. The specialist uses a microlaser to make a tiny hole in the outer layer of the embryo (zona pellucida).
  • The embryo is then transferred to the woman and implanted into the uterus.
  • The woman will be given antibiotics to prevent an infection. The reason for this is that because assisted hatching makes a hole in the embryo’s outer layer it does increase the risk of infection.

Success rates with assisted hatching

There is an ongoing debate as to whether this increases the chance of pregnancy or if there is no difference at all.

Those people in favour of this procedure argue that it is particularly beneficial for older women. The outer layer of the embryo tends to be thicker in the older woman so assisted hatching will help.

Keep in mind that success rates with this will depend on your age. The younger you are the greater your chance of having a baby.

Around 25 to 26% of women (under 35) who undergo assisted hatching with IVF and using their own eggs will have a live birth.

These figures decrease with age.

Side effects/risks of assisted hatching

All fertility treatments come with a small amount of risk and this is no different.

However, evidence shows that there is no more of a risk to the baby than IVF without assisted hatching. It is only the outer layer of the embryo that is treated and not the embryo itself so it should be fine.

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