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Laser-assisted hatching zona thinning does not improve the pregnancy outcomes of poor-quality blastocysts in frozen-thawed embryo transfer cycle: a retrospective cohort study

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Abstract

It had been suggested, after facilitating the hatching process, improved pregnancy outcomes could be attained in embryos with thick and hard zona. This study aimed to determine the effect of zona thinning on pregnancy outcomes in poor-quality frozen-thawed blastocysts. This retrospective study included 230 women (≤ 40 years) who underwent frozen embryo transfer of poor-quality blastocysts (scored < 3BB). In total, 105 patients were in the assisted hatching group in which the zona was thinned by laser before transfer and 125 patients were in the control group in which the blastocysts were non-manipulated. Patients’ demographics, cycle characteristics, and pregnancy outcomes were compared between the assisted hatching group and the control group. Further, regression analysis was applied to test the correlation between assisted hatching and live birth. All parameters in the patients’ demographic characteristics and the cycle’s characteristics were not significantly different between two groups. As for pregnancy outcomes, the second trimester pregnancy loss was significantly higher in the assisted hatching group (P = 0.035). Other pregnancy outcomes, including implantation rate, clinical pregnancy rate, biochemical miscarriage rate, the first trimester pregnancy loss, ongoing pregnancy rate, and live birth rate were comparable between two groups. The logistic regression analysis demonstrated no association between live birth and assisted hatching (univariate, OR = 0.787, P > 0.05; multivariate, OR = 0.652, P > 0.05), and the area under the receiver operating characteristic curve of the regression model was almost 0.7. It suggested that zona thinning may not be supposed to perform on poor-quality, frozen-thawed blastocysts. The indications of assisted hatching were still needed to further investigate.

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Funding

This work was supported by the National Science Foundation (No. 81471508) and the Research Team of Female Reproductive Health and Fertility Preservation (201612065).

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Authors and Affiliations

  1. Center for Reproductive Medicine, Peking University Shenzhen Hospital, Futian District, Shenzhen, 518000, Guangdong, China

    Lan Geng, Rang Liu, Yu Shi, Qiu-Ju Zhang, Fei Liu, Jing-Jiang Liu & Xi Xia

  2. Shantou University Medical College, Shantou, 515063, Guangdong, China

    Jia-Qi Luo & Rang Liu

  3. Shenzhen Maternal & Child Healthcare Hospital Affiliated to Southern Medical University, Futian District, Shenzhen, 518000, Guangdong, China

    Jia-Qi Luo & Jia-Hui Wu

  4. Division of Reproductive Endocrinology & Infertility, Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, CT, 06510, USA

    Amanda Kallen

  5. Department of Hand Microsurgery, Peking University Shenzhen Hospital, Futian District, Shenzhen, 518000, Guangdong, China

    Yan-Bin Peng

  6. Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Haidian District, Beijing, 100191, China

    Jun-Sheng Li

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  1. Lan Geng
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  12. Xi Xia
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Contributions

Lan Geng and Jia-Qi Luo contributed to analysis, interpretation, manuscript drafting, and critical discussion. Rang Liu, Jia-Hui Wu, and Shi Yu contributed to the interpretation of data and manuscript drafting. Qiu-Ju Zhang, Jing-Jiang Liu, Fei Liu, and Jun-Sheng Li contributed to the acquisition, analysis, and interpretation of data. Amanda Kallen, Yan-Bin Peng, and Jun-Sheng Li contributed to the manuscript revising for important intellectual content. Xia Xi contributed to the study design, supervision, and critical discussion and validated the final version of the manuscript. All authors revised and approved the final version of the manuscript. All authors agreed to the submission of the manuscript.

Corresponding authors

Correspondence to Yan-Bin Peng, Jun-Sheng Li or Xi Xia.

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The study was approved by the Ethics Review Committee of Peking University Shenzhen Hospital.

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Lan Geng and Jia-Qi Luo are joint first authors.

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Geng, L., Luo, JQ., Liu, R. et al. Laser-assisted hatching zona thinning does not improve the pregnancy outcomes of poor-quality blastocysts in frozen-thawed embryo transfer cycle: a retrospective cohort study. Lasers Med Sci 37, 1605–1614 (2022). https://doi.org/10.1007/s10103-021-03409-8

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