One of the most frustrating aspects of assisted reproductive technology for patients and fertility professionals alike is having to deal with failure in fertility treatment. This is especially true in couples who have attempted assisted reproductive procedures many times, and also in those whose time is running out because of their age. Now, a recently developed technique, assisted hatching, is offering new hope to the couples who fall into these categories.
Assisted hatching is a laboratory technique used with IVF. It involves the use of laser to thin the outer shell (zone pellucida) of the fertilized egg, before the embryo is transferred into the uterus. Assisted hatching is used to enhance the embryos ability to hatch, and also implant, after transfer. The procedure is based on the fact that an alteration in zona pellucida (outer covering of egg) either by drilling a hole through it or by thinning it, will promote hatching or implantation of embryos that are otherwise unable to escape intact from the zona pellucida.
After a fertilized egg is returned to the uterus, several things must happen:
• It must continue to divide and grow (it is now called an embryo).
• The embryo must break out of the zona pellucida (usually called the zona) which is a hard protein shell that surrounds it.
• The embryo must then burrow into the lining of the uterus (called the endometrium) and continue to grow there.
It has been suggested that making a hole in or thinning this outer layer may help embryos to ‘hatch’, increasing the chances of the woman becoming pregnant in some cases. Assisted hatching is indicated for infertile couplesin following cases.
when the zona pellucida is noted to be excessively thick when measured on a day 3 embryo by the embryologist
with poor embryo quality
in women with an elevated Day 3 FSH
when a Flare stimulation protocol has been used
when the female partner age is 38 or older at the time of stimulation, or
with previous IVF implantation failure of embryos to implant though results were otherwise good
Frozen embryo replacements.
How does the procedure of Assisted Hatching work?
Assisted hatching is carried out in the laboratory by experienced embryologists. The assisted hatching procedure, like ICSI, is carried out by a technique known as micromanipulation. In small dishes the embryos, which now contain an average of six to eight cells, are stabilized by a holding pipette, while on the opposite side a small pipette containing acidified Tyrode's solution creates a small defect in the zona. Just before the embryos are replaced, whether they are fresh or frozen/thawed, a small hole is made in the zona, or by thinning it using a micromanipulation technique. The process is repeated for each embryo. The main methods currently in use for assisted hatching are: chemical, mechanical and laser. The process will damage about 1% of embryos.
Most IVF clinics will not perform assisted hatching if there is one embryo available because of possible damage to this embryo would result in no embryo transfer. The assisted hatched embryos are then transferred into the uterine cavity as usual. Some clinics will give the woman a course of antibiotics to prevent infection. (Assisted hatching deprives the embryo of its intact protective coat, which shields it from exposure to any harmful factors in the uterus).
Assisted Hatching using laser technology is probably the best technique. Laser assisted hatching is a gentle and safe way to weaken a part of zona pellucida. Several studies have shown that using a laser is superior to chemical and manual hatching. Minimal handling of the embryo and delivering fast and exact control over the drilling of the hole are the advantages of laser assisted hatching.
Advantages of using Assisted Hatching
This relatively small variation in the IVF procedure has yielded dramatic results in older patients and those with previously failed cycles.
1) It provides “mechanical advantage” to the embryos in breaking the zona for implantation.
2) It also ensures early contact of embryos with endometrium. This expedites enzymetic reaction between endometrium and embryos called “Embryo endometrium cross talk”.
3) Mechanical advantages and chemical advantage ensure better implantation rate and better pregnancy rate.
4) It helps women with previous failed IVF cycle.
The addition of assisted hatching to the standard IVF protocol does add extra laboratory manipulation and therefore added costs. There is a small risk of damage to the embryo during the micro manipulation process or at the time of transfer, and there is a slight increase in identical twinning . There is a greater chance of fetal complications and abnormalities in some identical twins. A rare complication of identical twinning is conjoined or "Siamese" twins. No higher rate of identical twins is observed than with routine IVF. This may relate to whether a large enough opening is made in the zona to prevent pinching of the embryo during the hatching process.
Assisted hatching of IVF embryos,is an Assisted Reproductive Technology procedure which is performed in IVF laboratory. It increases IVF success rates. Consult infertility expert at Blossom Fertility centre in Surat for complete medical advice for infertile couples.
At the Blossom Fertility and IVF Centre Surat,Laser Assisted Hatching technique is used to perform the assisted hatching procedure. Doctors and embryologist are well conversant with the latest technology in the field of ART (Assisted Reproductive Technology). You can contact the top IVF doctors,Fertility specialist Surat and embryologist in surat at http://www.blossomivfindia.com or at http://www.blossomivfindia.com/fertility-treatments
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