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Assisted Hatching
Early embryos are surrounded by an outer coating called the zona pellucida. The zona holds the cells of an embryo together. After an embryo arrives in the uterus, the outer zona coating dissolves. This allows the embryo to "hatch" and grow larger. Implantation cannot occur until the embryo hatches.
Natural hatching is less likely to occur for certain women. A process called assisted hatching (AH) may help embryos from these women implant in the uterus during an in vitro fertilization (IVF) cycle. Embryo implantation is one of the greatest barriers to success for IVF cycles.
Candidates
Assisted hatching is recommended for infertile couples if:
- the woman is 38 years or older
-
the woman has a high follicle stimulating hormone level
- they have failed to achieve a pregnancy
in a prior IVF cycle, or
-
the embryos are fertilized using intracytoplasmic sperm injection (ICSI).
-
Frozen-thawed embryos
Benefits
AH increases the success rate of IVF for certain women.
Risks
The AH procedure may increase the rate of monozygotic twins. Rare side effects from the accompanying steroid treatment can include: elevation in blood pressure, salt or water retention, a higher susceptibility to infection, mood swings, insomnia, osteoporosis, nausea, and allergic reactions. The antibiotic used (usually doxycycline) may increase skin sensitivity to sunlight and may increase your risk for a vaginal yeast infection.
Procedure
On the day of IVF egg retrieval, the patient
should begin four days of treatment with steroids (to suppress the
mother's immune system) and antibiotics (to remove any infectious
agents in the uterus). On the third day after egg retrieval, the
laboratory staff will use a microscopic glass pipet to place an extremely
small amount of fluid on the outer coating of the embryo. This fluid
dissolves part of the outer coating. The embryos are then transferred
into the uterus as in a standard IVF cycle.
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