What Is Assisted Hatching ?
This rather new technique, Assisted hatching (AH) is used during some of the IVF procedures. It is done to help the embryo hatch out of its protective layering and implant directly into the uterus.
In the initial stages of development, the embryo is placed in a layer of proteins, zona pellicuda made for protecting the embryo until it reaches the blastocyst stage of development. To successfully implant into the uterus, it is required that the embryo hatches out of it and attaches itself to the walls of the uterus.
Sometimes, the embryo has difficultly in hatching out of the layer, if the layer is too thick or if the embryo does not have enough pressure from the cells to break through. Assisted hatching helps in this release.
Who should consider Assisted Hatching ?
This process is recommended for the infertile couples in the following cases :
- If the woman is 38 years or older
- If the woman has a high follicle stimulating hormone level
- Unexplained infertility
- If the couple has failed to achieve a pregnancy in a prior IVF cycle
- If the embryos are fertilized using intracytoplasmic sperm injection (ICSI)
- Severe endometriosis
- Frozen-thawed embryos
Who Can Use Assisted Hatching?
Assisted hatching is used at the same time with in vitro fertilization process for improving the chances of implantation of the embryo. It is needed when :
- The advancing age of the female partner (more than 38 years)
- If the woman is suffering endometriosis, making the implantation of the embryo difficult
- When the egg quality is poor
- Implantation also becomes difficult when the follicle stimulating hormone gets elevated on the third day after the ovulation
- In couples who have tried in vitro fertilization cycles for once or twice previously, but have failed to conceive, despite otherwise good results.
Types of Assisted Hatching
Assisted Hatching is of 3 types:
Mechanical Hatching: The embryo cover is opened mechanically using a thin long drawn out glass needle. The machine used is called micromanipulator.
Chemical hatching : A hole is created in the zona pellucida of an oocyte and the embryo with the use acidic tyrode’s solution.
Laser Assisted Hatching : A gap is created in the zona pellucida of the chosen selected embryos using a 1.48 micron infrared diode laser.
Assisted Hatching procedure
This delicate procedure, needs great skill and sophisticated instrumentation. Following are the steps:
1. By drilling with Acidified Tyrode’s solution
The embryo is kept in a dish containing culture solution where a pipette is used to hold the embryo. The embryologist takes a hollow needle containing an acidic solution, places it next to zona pellucid and release a small amount of the solution. This creates a small hole. After washing the embryo in culture media, it is transferred into the uterus solution and placed back in an incubator .
2. Mechanical opening by glass micro needle – Also known as partial zona dissection
3. Laser photoablation – Either a hole is made on the zona pellicuda or partial zona thinning is done using a laser. When this process is computer assisted, there is more precision and takes less time too.
Because of Assisted hatching, the rate of embryo implantation has improved.
Benefits, Success Rate and Support for Assisted Hatching
According to evidences, AH improves the result of an IVF treatment, but they may vary according to individual cases. Age of woman is an important factor Woman between the age of 35 to 39 years experience 50 percent chance. Advanced age stages, lowers the success rate.
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