For couples struggling with infertility, advancements in reproductive medicine offer renewed hope. Assisted hatching is one such technique that enhances the likelihood of embryo implantation during in vitro fertilisation (IVF). This procedure has sparked interest due to its potential to improve success rates, particularly for individuals with a history of implantation failures.
But what exactly is assisted hatching, and how does it influence IVF outcomes?
What is Assisted Hatching?
Assisted hatching is a specialised laboratory technique used in IVF to improve embryo implantation. The procedure involves creating a small opening in the zona pellucida, the protective outer shell of an embryo, to facilitate its ability to hatch and attach to the uterine lining.
During natural conception, an embryo naturally breaks through this layer before implanting. However, this hatching process may be impaired in some cases, particularly in patients with advanced maternal age or poor embryo quality. Assisted hatching can help overcome this hurdle.
How is assisted hatching performed?
Assisted hatching is conducted in a controlled laboratory setting, typically using one of the following methods:
- Mechanical hatching: A fine needle is used to puncture the zona pellucida.
- Chemical hatching: A weak acidic solution is applied to thin or breach the outer shell.
- Laser-assisted hatching: A precise laser is used to create a small opening with minimal risk of embryo damage.
Laser-assisted hatching is the most preferred method due to its accuracy and reduced risk of harming the embryo.
Does assisted hatching speed up implantation?
Assisted hatching does not necessarily accelerate implantation but may increase the chances of successful implantation, particularly in specific patient groups. Factors such as maternal age, embryo quality, and the history of IVF play a crucial role in determining whether this technique will be beneficial.
Typically, implantation occurs within six to ten days after fertilisation. Assisted hatching aids the embryo in this process but does not significantly alter the timeline.
What are the side effects of assisted hatching?
While assisted hatching is generally considered safe, there are potential risks, including:
- Embryo damage: Any manipulation of the embryo carries a small risk of harm to the embryo.
- Increased risk of identical twins: Breaching the zona pellucida may lead to embryo splitting, resulting in monozygotic (identical) twin pregnancies.
- Failure to implant: While assisted hatching can help certain patients, it does not guarantee implantation success.
It is crucial for patients to discuss the benefits and risks with their fertility specialist to determine if assisted hatching is the right choice for their specific situation.
How much does assisted hatching increase the chance of twins?
One of the concerns associated with assisted hatching is its potential to increase the likelihood of twin pregnancies. Studies suggest that the procedure can slightly raise the incidence of monozygotic twinning. However, the overall impact depends on multiple factors, including the embryo’s natural tendency to split and the technique used.
While twin pregnancies can be a desired outcome for some, they also come with higher risks, such as preterm labour and low birth weight. Fertility specialists consider these risks when recommending assisted hatching to their patients.
Conclusion
Assisted hatching is a valuable technique in IVF that may improve implantation rates for certain patients. While it does not speed up implantation, it can enhance the embryo’s ability to attach to the uterine lining, particularly for older women or those with previous IVF failures. However, the procedure carries some risks, including a slightly increased chance of identical twins.
Couples considering assisted hatching should consult with a doctor or fertility specialist to weigh the potential benefits and risks based on their unique medical history.
