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Efficiency and safety of laser-assisted hatching on vitrified-warmed blastocyst transfer cycles: a prospective control trial

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Abstract

To clarify the efficiency and safety of laser-assisted hatching (LAH) application on vitrified-warmed blastocyst transfer (VBT) cycles, we designed the non-randomized concurrent control trial included 4039 VBT cycles in the Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, during the even days from November 2014 to December 2015. The VBT cycles were divided into LAH group (n = 1932) and non-LAH group (n = 2107) according to the date of blastocyst thawing. Laser-partial zona pellucida dissection was performed on all blastocysts thawed on that day every 4 days, and those blastocysts were assigned to the LAH group. There were a higher biochemical pregnancy rate (66.87% vs 63.69%; P = 0.034; rate ratio for LAH vs non-LAH group [RR], 1.050; 95% confidence interval [CI], 1.004–1.098) and an increased live birth rate (48.81% vs 45.51%; P = 0.036; RR, 1.072; 95% CI, 1.005–1.145) with comparable ectopic pregnancy, twin or multiple pregnancies, spontaneous abortion and birth defect rates of the LAH group than those of the non-LAH group. Subgroup analysis showed that live birth rate, birth defect rate, and other pregnancy outcomes were comparable for patients younger than 35 years when blastocyst transfer, patients with endometrium thickness less than 0.9 cm during ovulation or the initiation of progesterone treatment, ICSI blastocysts, AC or BC blastocysts according to Gardner morphological criteria and day 5 blastocysts of the LAH group than it of non-LAH group. LAH could be performed selectively on vitrified-warmed blastocysts before transfer for better pregnancy outcomes. Trial registration number: ChiCTR2000032975. Date of registration: May 17, 2020. Retrospectively registered.

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Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Code availability

None.

Abbreviations

VBT:

Vitrified-warmed blastocyst transfer

OHSS:

Ovarian hyperstimulation syndrome

ZP:

Zona pellucida

AH:

Assisted hatching

LAH:

Laser-assisted hatching

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Acknowledgements

We thank all the participants of this study. We also thank all research staff at Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, for their cooperation throughout the study. We give special thanks to Guo-Peng Li for his professional and rigorous guidance in the process of data statistical analysis.

Funding

This study is funded by the National Natural Science Foundation of China (81401266), the National Key Research and Development Program of China (2017YFC1001504), the National Key Research and Development Program of China (2018YFC1004000), the Natural Science Foundation of Shandong Province (ZR2013HQ053) and the Foundation for Distinguished Young Scholars of Shandong Province (JQ201816).The funding source had no role in the study design, collection, analysis, or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.

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Authors and Affiliations

  1. Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Shandong, 250012, Jinan, China

    Changjian Yin, Lian-Jie Li, Shuiying Ma, Hui Zhao, Lihong Xu, Cheng Li, Haibin Zhao, Qing Li, Kai Xu & Mei Li

  2. Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China

    Changjian Yin, Lian-Jie Li, Shuiying Ma, Hui Zhao, Lihong Xu, Cheng Li, Haibin Zhao, Qing Li, Kai Xu & Mei Li

  3. Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China

    Changjian Yin, Lian-Jie Li, Shuiying Ma, Hui Zhao, Lihong Xu, Cheng Li, Haibin Zhao, Qing Li, Kai Xu & Mei Li

  4. Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China

    Changjian Yin, Lian-Jie Li, Shuiying Ma, Hui Zhao, Lihong Xu, Cheng Li, Haibin Zhao, Qing Li, Kai Xu & Mei Li

  5. National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China

    Changjian Yin, Lian-Jie Li, Shuiying Ma, Hui Zhao, Lihong Xu, Cheng Li, Haibin Zhao, Qing Li, Kai Xu & Mei Li

  6. Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China

    Lihong Xu

  7. The Second Hospital, Cheeloo College of Medicine, Shandong University, Shandong, 250014, China

    Mei Li

  8. Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, No. 157, Jingliu Road, Shizhong District, Shandong, 250001, Jinan, China

    Mei Li

Authors
  1. Changjian Yin
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  2. Lian-Jie Li
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  4. Hui Zhao
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  6. Cheng Li
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  7. Haibin Zhao
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  8. Qing Li
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  9. Kai Xu
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  10. Mei Li
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Contributions

Mei Li and Lian-Jie Li put forward the study question and designed the trial. Changjian Yin and Lian-Jie Li analysed the date. Changjian Yin drafted the manuscript and Mei Li revisited it critically. All authors were involving in the acquisition of data and approval the version to be published.

Corresponding author

Correspondence to Mei Li.

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Ethics approval

This clinical trial was reviewed and approved by the Ethics Committee of Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University (Jinan, China).

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All patients signed written informed consent forms.

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Not applicable.

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The authors declare no conflict of interest.

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The authors consider that the Changjian Yin and Lian-Jie Li should be regarded as joint first authors.

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Yin, C., Li, LJ., Ma, S. et al. Efficiency and safety of laser-assisted hatching on vitrified-warmed blastocyst transfer cycles: a prospective control trial. Lasers Med Sci 37, 1931–1942 (2022). https://doi.org/10.1007/s10103-021-03453-4

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  • DOI: https://doi.org/10.1007/s10103-021-03453-4

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