Clin Exp Reprod Med.
2018 Sep;45(3):129-134. 10.5653/cerm.2018.45.3.129.
Thinning and drilling laser-assisted hatching in thawed embryo transfer: A randomized controlled trial
- Affiliations
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- 1Center for Reproductive Endocrinology and Infertility (HUECREI), Hue University of Medicine and Pharmacy, Hue, Vietnam.
- 2Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue, Vietnam.
- 3Department of Public Health, Hue University of Medicine and Pharmacy, Hue, Vietnam.
- 4Institute of Clinical Medicine, Department of Obstetrics and Gynecology, University of Tartu, Tartu, Estonia. Alar.Aints@ut.ee
- 5Competence Centre on Health Technologies, Tartu, Estonia.
- 6Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia.
- 7Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
- KMID: 2419529
- DOI: http://doi.org/10.5653/cerm.2018.45.3.129
Abstract
OBJECTIVE
In frozen and thawed embryos, the zona pellucida (ZP) can be damaged due to hardening. Laser-assisted hatching (LAH) of embryos can increase the pregnancy rate. This study compared thinning and drilling of the ZP before frozen embryo transfer (FET).
METHODS
Patients were randomly allocated into two groups for LAH using thinning or drilling on day 2 after thawing. Twenty-five percent of the ZP circumference and 50% of the ZP thickness was removed in the thinning group, and a hole 40 µm in diameter was made in the drilling group.
RESULTS
A total of 171 in vitro fertilization/intracytoplasmic sperm injection FET cycles, including 85 cycles with drilling LAH and 86 cycles with thinning LAH, were carried out. The thinning group had a similar β-human chorionic gonadotropin-positive rate (38.4% vs. 29.4%), implantation rate (16.5% vs. 14.4%), clinical pregnancy rate (36.0% vs. 25.9%), miscarriage rate (5.8% vs. 2.4%), ongoing pregnancy rate (30.2% vs. 23.5%), and multiple pregnancy rate (7.0% vs. 10.6%) to the drilling LAH group. There were no significant differences in pregnancy outcomes between subgroups defined based on age (older or younger than 35 years) or ZP thickness (greater or less than 17 µm) according to the LAH method.
CONCLUSION
The present study demonstrated that partial ZP thinning or drilling resulted in similar outcomes in implantation and pregnancy rates using thawed embryos, irrespective of women's age or ZP thickness.
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