Guide to Assisted Hatching

Advantages of the Assisted Hatching Procedure
A lot of couples who are undergoing the IVF process decide to have the addition of the assisted hatching technique carried out on their embryos.  This is because the procedure is known to result in the following benefits:

• There is a greater likelihood of implantation occurring
• It is still possible for embryos to be cultured to the blastocyst stage
• Increased success means that fewer embryos are needed for transfer

Studies of babies born to couples who had the laser-assisted hatching procedure carried out on their embryos during fertility treatment show no alteration in the genetic material of their cells and no rise in congenital abnormalities.

Risks Associated with Assisted Hatching

The main factor affecting the amount of risk associated with assisted hatching IVF is how experienced the embryologist carrying out the procedure is.  The risk of damage is very small (around 1%) when an experienced embryologist performs the procedure.

The main risk of assisted hatching is that statistics show that it increases the chance that the woman will have identical twins compared to other fertility treatments.  The cause of this is that the technique used to thin out the protective layer can also sometimes split the embryo into two halves.

There is also a tiny increased risk of:

• Siamese twins
• Embryo damage, causing it to stop splitting
• Physical deformity

Success rates after Assisted Hatching

Across the world different clinics have widely varying success rates.  This will be partly down to the experience of their embryologist in performing the procedure, which method of assisted hatching is used and differences in the groups of people being treated at the clinic.  Some clinics see no increase in their rates of pregnancy when the procedure is performed on all their patients.  However, increases in implantation rates and pregnancy rates are generally reported when clinics choose specific groups of patients to use assisted hatching on.

The assisted hatching procedure has been linked to very good success rates when it is performed by an experienced practitioner. In fact, in women aged between 35 and 39 some clinics have achieved rates as high as 50%.  Another category which really benefits is the over 40 age group, who traditionally have much lower success rates. Success rates can be increased by up to 10% for this group.

Who is Assisted Hatching recommended for?

• women over the age of 37
• women with elevated FSH on day 3 of their menstrual cycle
• couples who have experienced repeated failed IVF treatment
• couples whose embryos have a particularly thick zona pellicuda

Assisted hatching is a procedure performed on embryos produced during IVF treatment on couples with decreased fertility.  80% of couples will conceive within a year of trying and 90% within two years if they don’t use contraception and have regular intercourse. There are many factors affecting fertility: one such factor is the age of the partners; a woman’s fertility decreases with increasing age. About 30% of women aged over 35 years will experience some sort of fertility problems. Other factors could be hormonal, having medical problems such as PCOS and reduced sperm quality or quantity.  Unfortunately for many couples their infertility may be ‘unexplained’.  The definition of  infertility is not being able to conceive despite regular, unprotected intercourse for 2 or more years.

There are some factors in a couple’s history which may indicate having tests before 2 years.  In the male partner this would be having had un-descended testicles as a child or having suffered from mumps.  In the female partner being over 35 years old, having a history of abnormal menstrual periods, having had surgery in the pelvic or abdominal regions or having a known condition such as PCOS (polycystic ovary syndrome).

Treatment for infertility

There are many different types of fertility treatments but as assisted hatching is performed during the  IVF process this is the treatment that we will concentrate on here.

IVF is the process of fertilising a woman’s eggs outside her body in a test tube. Since the first IVF baby, Louise Brown, was born in Britain in 1978 IVF has produced over one million babies worldwide. As the procedure has been improved and refined the rate of pregnancy and live births have increased steadily year on year, resulting in a large increase in the number of IVF treatment cycles performed worldwide.

For whom is IVF is advised?

IVF is often recommended to certain groups of people, these include:

• Women with damaged or blocked fallopian tubes or whose tubes have been removed after an ectopic pregnancy or for other reasons.
• Endometriosis sufferers.
• Women with cervical mucus which is too scarce, sticky or acidic.
• Men with poor morphology, motility or quantity.
• Men or women with immunological infertility problems.
• Couples with unexplained infertility.

There are further criteria used to determine whether assisted hatching should be performed on the embryos produced during IVF and these will be discussed later on.