1. Assisted hatching of vitrified-warmed blastocysts prior to embryo transfer does not improve pregnancy outcomes
- Author
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Sarah Garrow, Charis Ng, Julius Hreinsson, Crystal Chan, Taryn Nichols, Marta Wais, and Zhong-Cheng Luo
- Subjects
Adult ,medicine.medical_specialty ,Pregnancy Rate ,Reproductive medicine ,Zona thinning ,lcsh:Gynecology and obstetrics ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,medicine ,Humans ,030212 general & internal medicine ,Blastocyst ,Embryo Implantation ,Prospective cohort study ,lcsh:RG1-991 ,Retrospective Studies ,Gynecology ,030219 obstetrics & reproductive medicine ,business.industry ,Twinning, Monozygotic ,Research ,Zona breach ,Obstetrics and Gynecology ,Retrospective cohort study ,Embryo ,Embryo Transfer ,Vitrification ,Embryo transfer ,Vitrified-warmed blastocyst ,Abortion, Spontaneous ,Assisted hatching ,medicine.anatomical_structure ,Oncology ,embryonic structures ,Female ,Live birth ,business ,Live Birth ,Maternal Age - Abstract
Objective This study aims to determine the impact of assisted hatching (AH) on pregnancy outcomes in vitrified-warmed blastocyst transfers, and evaluate if embryo expansion or morphology influences outcomes. Methods A retrospective cohort study was performed including vitrified-warmed blastocyst transfers at our clinic between 2013 and 2017. Of the 2165 embryo transfers, 1986 underwent laser AH and 179 were non-assisted hatched (NAH). The primary outcome was live birth. Secondary outcomes included conception, implantation, clinical pregnancy, clinical pregnancy loss, and monozygotic twinning (MZT). Results AH and NAH groups had similar rates of conception (38.7% vs 42.1%), implantation (26.2% vs 27.3%), clinical pregnancy (29.1% vs 30.3%), clinical pregnancy loss (24.0% vs 17.8%), live birth (19.9% vs 20.5%), and MZT (2.08% vs 2.86%). Five pairs of dichorionic/diamniotic twins resulted from single embryo transfers. AH of embryos with expansion grades ≤3 was associated with lower rates of conception (32.5% vs 44.3%%, p p Conclusion AH prior to transfer of vitrified-warmed blastocysts was not associated with improved pregnancy outcomes. The identification of dichorionic/diamniotic twins from single blastocyst transfers challenges the previously held notion that dichorionic/diamniotic MZTs can only occur from division prior to the blastocyst stage. Prospective studies are needed to validate the novel finding of lower rates of conception and clinical pregnancy after AH in embryos with lower expansion grade.
- Published
- 2020