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The effect of laser-assisted hatching on pregnancy outcomes of cryopreserved-thawed embryo transfer: a meta-analysis of randomized controlled trials

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Abstract

It is well known that laser-assisted hatching (LAH) is the most popular and ideal embryo hatching technology, but the relevance to pregnancy outcomes of cryopreserved-thawed embryo transfer (ET) is controversial. The purpose of this meta-analysis was to evaluate the effects of LAH on pregnancy outcomes of cryopreserved-thawed ET. We searched for relevant studies published in the PubMed, EMBASE, and Cochrane Central databases up to March 2017. This meta-analysis was primarily used to evaluate the effect of laser-assisted hatching on assisted reproductive outcomes: clinical pregnancy, embryo implantation, multiple pregnancy, miscarriage, and live birth. Using the Mantel-Haenszel fixed effects model and random effects model, we determined the summary odds ratios (OR) with 95% confidence intervals (CIs). There were 12 randomized controlled trials (more than 2574 participants) included in our analysis. The rates of clinical pregnancy (OR = 1.65, 95% CI = 1.24–2.19, I 2 = 49), implantation (OR = 1.59, 95% CI = 1.06–2.38, I 2 = 82%), multiple pregnancy (OR = 2.30, 95% CI = 1.30–4.07, I 2 = 33%), miscarriage (OR = 0.86, 95% CI = 0.50–1.48, I 2 = 0%), and live birth (OR = 1.09, 95% CI = 0.77–1.54, I 2 = 0%) revealed comparable results for both groups. In summary, this meta-analysis demonstrates that LAH is related to a higher clinical pregnancy rate, embryo implantation rate, and multiple pregnancy rate in women with cryopreserved-thawed embryos. However, LAH is unlikely to increase live birth rates and miscarriage rates. Due to the small sample evaluated in the pool of included studies, large-scale, prospective, randomized, controlled trials are required to determine if these small effects are clinically relevant.

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Author notes

  1. MeiFang Zeng and SuQin Su contributed equally to this work.

Authors and Affiliations

  1. Reproductive Medicine Center, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China

    MeiFang Zeng, SuQin Su & LiuMing Li

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  1. MeiFang Zeng
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  2. SuQin Su
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Correspondence to LiuMing Li.

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Zeng, M., Su, S. & Li, L. The effect of laser-assisted hatching on pregnancy outcomes of cryopreserved-thawed embryo transfer: a meta-analysis of randomized controlled trials. Lasers Med Sci 33, 655–666 (2018). https://doi.org/10.1007/s10103-017-2372-x

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  • DOI: https://doi.org/10.1007/s10103-017-2372-x

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