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Assisted Hatching



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An 8-cell embryo in the process of assisted hatching

Holding pipette on left, hatching needle on right
As the shell (or zona pellucida) around the embryo is dissolved, the needle is advanced to the left until a small opening is made

     "Assisted hatching" (AH) is a procedure that involves creating a small hole in the zona pellucida, a shell-like protein investiture surrounding the fertilized egg. On or around the fifth day, the zona pellucida "hatches" and the embryo, now called a blastocyst, is ready to implant. Studies have suggested that a certain subgroup of IVF patients stand a better chance of success with the procedure. This includes patients having culture in a laboratory setting, high doses of ovulation medication, advanced age, higher FSH levels, thick zona and previous IVF failures.

     Studies have shown, however, that AH is of no benefit when performed on every embryo. In fact, the procedure is time consuming, adds to the cost of IVF and may in fact damage healthy embryos. So, avoiding this on the first go-around is the normal policy unless factors would indicate you would likely benefit. 

Who should be treated with assisted hatching?

The most commonly used indications for assisted hatching with IVF case are:

Age Facto - Couples having IVF with the female partner's age over 37

Egg quantity an quality factor - Couples in which the female's day 3 follicle stimulating hormone (FSH) is elevated

Embryo quality facto - Couples having IVF with poor quality embryos (excessive fragmentation or slow rates of cell division)

Zona Factor - Couples having IVF with embryos that have a thick outer shell (zona pellucida)

Previous failures - Couples having IVF that have had one or more previous IVF cycles that failed

How is assisted hatching performed?

1. The embryo is held with a specialized holding pipette.

2. A very delicate, hollow needle is used to expel an acidic solution against the outer "shell" (zona pellucida) of the embryo.

3. A small hole is made in the shell by digesting it with the acidic solution.

4. The embryo is then washed and put back in culture in the incubator.

5. The embryo transfer procedure is done shortly after the hatching procedure. Embryo transfer places the embryos in the woman's uterus where they will hopefully implant and develop to result in a live birth.

Pregnancy rates

Pregnancy rates for in vitro fertilization procedures with assisted hatching have been shown in some published studies to be higher than for IVF without hatching. There is an improvement in implantation and pregnancy rates in our IVF clinic with the use of assisted hatching. This is not seen in all IVF programs.

It is possible to damage embryos with hatching and lower the pregnancy rate in a program. Therefore, it is essential that if assisted hatching is done, it must be expertly performed by properly trained embryologists.

The actual pregnancy and live birth rates seen in an individual IVF center will vary according to the hatching technique used, the overall quality of the laboratory, the skill of the individual performing the hatching, the embryo transfer skills of the physician, and other factors

Advantages of the Assisted Hatching Procedure

Many couples elect to pursue assisted hatching during their IVF procedures. This is because the technique is associated with a number of benefits including:

  • fewer embryos required for transfer

  • increased implantation success rates

  • allows for blastocyst culture

Disadvantages of the Assisted Hatching Procedure
Unfortunately, assisted hatching does have its drawbacks. Specifically, assisted hatching is:

  • only suitable for certain groups of women
  • can be associated with an increased risk of dangerous pregnancy complications

Success Rates of Assisted Hatching
Assisted hatching is associated with a fairly high success rate, especially when performed by a skilled micromanipulator. In fact, pregnancy rates are as high as 49% in women who are between the ages of 35 and 39. Women who are over the age of 40 generally have lower success rates, but assisted hatching still provides them with a better opportunity for conception than would IVF performed without the procedure.

Additional Cost: $500.00


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