Assisted Hatching and IVF

Assisted hatching is reproductive technology used in IVF treatment. Usually, this procedure is recommended for a patient with repeated unexplained IVF failure or a patient with a poor prognosis.

This technique is used to help the embryo in implantation and have a successful pregnancy. However, there is additional cost and risk associated with it. But if your doctor has recommended it, here are things you need to know.

Related Post: –Blastocyst Embryo Transfer: 10 things IVF Patients should know

What is Assisted Hatching?

It is an advanced technology combined with In Vitro fertilization (IVF) treatment. It is done to increase the rate of successful implantation of the embryo.

After fertilization, the eggs are monitored for three to six days and grow into embryos. And then, the best embryos are selected and transferred into the uterus. During this embryo development, it is covered by an external shell called Zona pellucida. This zona pellucid generally disintegrates while entering the uterus and enabling the embryo to embed in the uterus.

But in some patients, this out shell does not break because which embryo is not able to hatch out and implant in the uterus. So here assisted hatching process is performed.

In this process, a hollow in the zona is done. This helps in the easy hatching of the embryo without causing any injury to its cells.

Assisted hatching is done before the embryo is transferred into the uterus following an IVF or ICSI cycle. And can be done through physical or chemical methods. However, the laser is considered the safest and the most reliable method.

What Methods used for Assisted Hatching?

Few methods are available for assisted hatching, and every embryo lab approaches this differently. Every method has its pros and cons. So, to make an informed decision, gathering information as much as possible is important.

  • Mechanical Hatching
  • Chemical Hatching
  • Mechanical Expansion of the Shell
  • Drilling
  • Laser Assisted Hatching

Mechanical Hatching

This technique involves manual grinding away a section of the zona pellucida. It is carefully pierced using a microneedle. And then, to grind away a portion of the outer layer, it is trapped by the glass needle.

Chemical Hatching

This technique releases a tiny amount of acid near the zona pellucida. This acid solution creates a small hole in the zona pellucida until the shell is breached. And then, the embryo is cleaned quickly to avoid unnecessary acid exposure. This technique is also known as Zona dilling and is one of the most common assisted hatching methods.

Mechanical Expansion of the Shell

In this, hydrostatic pressure is introduced under the shell to cause it to expand. This idea comes from the natural expansion of the outer shell that occurs during the hatching process.

Drilling

Under this method, Piezo technology is used to create a conical opening

Laser Assisted Hatching

Under laser-assisted hatching, a specialized laser is used to breach the zona pellucid. It gives more precise and reliable compared to other methods. And is the safest and most effective of all the methods. It also takes much less time compared to other methods. This risk of damaging the embryo is also very less because of the least manual intervention.

Despite its benefits laser assisted clinics do not predominantly use hatching. It is the chemical hatching that is more commonly used. But the thing that can make a big difference is the skill and experience level of the embryologist.

What is the Risk Associated with Assisted Hatching?

There is always some risk involved with manipulation or interference with an embryo. Assisted hatching, done in several ways, including lasers, needles, or chemicals, can damage the embryo before or after the transfer. And in any case, it can result in a failed pregnancy.

Another risk associated with assisted hatching is that some women may develop twins that can cause more medical complications than normal single pregnancies. However, this risk is low.

In assisted hatching and embryo transfer, antibiotics and steroid hormones are sometimes recommended, which can rarely result in side effects from their consumption.

Frequently Asked Questions (FAQs)

Assisted hatching improves the chance of fertility in the following patient:

  • Women older than 38 years of age
  • Have poor embryo quality
  • Have two or more failed IVF cycles

It is also believed that in the case of frozen embryo transfer, it can be beneficial. Still, in a study, it is found that assisted hatching during a frozen embryo cycle may slightly decrease the chance of birth.

Replying to this question is a bit complex. As in research, it is found that assisted hatching does promote the chance of fertility but not live birth rates.

Live birth rates are more important than any clinical pregnancy rate because fertility treatment aims to take a baby home, not just get pregnant.

Another research found that the pregnancy rate decreases when assisted hatching is done with good-quality embryos. When assisted hatching is done on fair to poor quality, embryo results vary depending on the age. This implies that assisted hatching won’t help with an honest prognosis but will also harm their chances of success.

This procedure can be successful for couples who have previously failed IVF cycles. It can help a woman to conceive who suffers from the problem of thick shell embryos performed by a skilled embryologist. It may also increase the chance of implantation and birth rates.

In aged couples, this technique with IVF has resulted in great success. In some clinics, the cost of assisted hatching will be included in the IVF fees. And the clinic that charges their cost separately can range from INR 10,000 to 20,000.

After fertilization on day 6, hatching usually happens. It means it will take one to two days to hatch when the embryo is 5 days old. Therefore, it is possible to detect the HCG hormone in the blood.