Summary
This systematic review aimed to evaluate the efficacy and safety of assisted hatching (AH) performed in couples with advanced maternal age. We searched for randomized controlled trials (RCTs) in electronic databases, including MEDLINE, EMBASE and CENTRAL (from inception to January 2018); in addition, we hand-searched the reference lists of included studies and similar reviews. We included RCTs comparing AH versus no treatment (control). The meta-analysis was performed by RevMan 5.3 software. The search retrieved 943 records and 8 RCTs were included, comprising 870 cycles (n=440 for AH, and n=430 for control). There was no significant difference in the rates of live birth (RR 0.88, 95% CI 0.65 to 1.18, 3 RCTs, n=427, I2=0%), clinical pregnancy (RR 1.00, 95% CI 0.83 to 1.19, 8 RCTs, n=870, I2=22%), implantation (RR 1.07, 95% CI 0.83 to 1.39, 4 RCTs, n=1359, I2=0%), miscarriage (RR 1.13, 95% CI 0.66 to 1.94, 2 RCTs, n=116, I2=0%) and multiple pregnancy (RR 0.89, 95% CI 0.31 to 2.52, 1 RCT, n=97, I2=not applicable) between the treatment group and control group. No reasonable conclusions could be drawn regarding reproductive outcomes after AH in patients with advanced maternal age due to the small sample pooled in meta-analyses. Studies of high methodological quality and with adequate power are necessary to further investigate the value of AH in assisted conception of those patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Cohen J, Eisner C, Kort H, et al. Impairment of the hatching process following IVF in the human and improvement of implantation by assisting hatching using micromanipulation. HumReprod, 1990,5(1):7–13
Feng HL, Hershlag A, Scholl GM, et al. A retroprospective study comparing three different assisted hatching techniques. Fertil Steril, 2009,91(4 Suppl): 1323–1325
Alteri A, Vigano P, Maizar AA, et al. Revisiting embryo assisted hatching approaches: a systematic review of the current protocols. J Assist Reprod Genet, 2018,35(3):367–391
Frydman N, Madoux S, Hesters L, et al. Arandomized double-blind controlled study on the efficacy of laser zona pellucida thinning on live birth rates in cases of advanced female age. HumReprod, 2006,21(8):2131–2135
Li D, Yang DL, An J, et al. Effect of assisted hatching on pregnancy outcomes: a systematic review and meta-analysis of randomized controlled trials. Sci Rep, 2016,6:31228
Balaban B, Urman B, Alatas C, et al. A comparison of four different techniques of assisted hatching. Hum Reprod, 2002,17(5):1239–1243
Practice Committee of the American Society for Reproductive Medicine; Practice Committee of the Society for Assisted Reproductive Technology. Role of assisted hatching in in vitro fertilization: a guideline. Fertil Steril, 2014,102(2):348-351
Magli MC, Gianaroli L, Ferraretti AP, et al. Rescue of implantation potential in embryos with poor prognosis by assisted zona hatching. Hum Reprod, 1998,13(5): 1331–1335
Valojerdi MR Eftekhari-Yazdi P, Karimian L, et al. Effect of laser zona pellucida opening on clinical outcome of assisted reproduction technology in patients with advanced female age, recurrent implantation failure, or frozen-thawed embryos. Fertil Steril, 2008,90(1):84–91
Kanyo K, Zeke J, Kriston R, et al. The impact of laserassisted hatching on the outcome of frozen human embryo transfer cycles. Zygote, 2016,24(5):742–747
Shi W, Hongwei T, Zhang W, et al. A prospective randomized controlled study of laser-assisted hatching on the outcome of first fresh IVF-ET cycle in advanced age women. Reprod Sci, 2016,23(10): 1397–1401
Martins WP, Rocha IA, Ferriani RA, et al. Assisted hatching of human embryos: a systematic review and meta-analysis of randomized controlled trials. Hum Reprod Update, 2011,17(4):438–453
Carney SK, Das S, Blake D, et al. Assisted hatching on assisted conception (in vitro fertilisation (IVF) and intracytoplasmic sperminjection (ICSI)). Cochrane Database Syst Rev, 2012,12:CD001894
Zeng M, Su S, Li L. The effect of laser-assisted hatching on pregnancy outcomes of cryopreservedthawed embryo transfer: a meta-analysis of randomized controlled trials. Lasers Med Sci, 2017,33(3):655–666
Higgins JPT, Altaian DG, Sterne, et al. Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Elnahas T, Tawab N, Azmy O, et al. Prospective randomized trial on the use of laser assisted hatching for transfer of frozen/thawed embryos in human intracytoplasmic sperm injection. Middle East Fertil Soc J, 2017,22(4):309–312
Ge HS, Zhou W, Zhang W, et al. Impact of assisted hatching on fresh and frozen-thawed embryo transfer cycles: a prospective, randomized study. Reprod Biomed Online, 2008,16(4):589–596
Kutlu P, Atvar O, Vanlioglu OF. Laser assisted zona thinning technique has no beneficial effect on the ART outcomes of two different maternal age groups. J Assist Reprod Genet, 2010,27(8):457–461
Lanzendorf SE, Nehchiri F, Mayer JF, et al. A prospective, randomized, double-blind study for the evaluation of assisted hatching in patients with advanced maternal age. Hum Reprod, 1998,13(2):409–413
Petersen CG, Mauri AL, Baruffi RL, et al. Zona thinning with a noncontact diode laser in ICSI embryos from women of advanced age. J Assist Reprod Genet, 2002,19(11):512–516
Harbin Consensus Conference Workshop Group. Improving the Reporting of Clinical Trials of Infertility Treatments (IMPRINT): modifying the CONSORT statement. Fertil Steril, 2014,102(4):952-959
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
He, F., Zhang, Cy., Wang, Ls. et al. Assisted Hatching in Couples with Advanced Maternal Age: A Systematic Review and Meta-analysis. CURR MED SCI 38, 552–557 (2018). https://doi.org/10.1007/s11596-018-1913-2
Received:
Revised:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11596-018-1913-2