Assisted hatching – Patient information

Mature eggs (oocytes) are surrounded by a shell or a glycoprotein coat called zona
pellucida. This coat protects and continues to surround the fertilised egg and embryo until it
reaches the blastocyst stage (day 5 or 6 post fertilisation). The embryo must then hatch out
of its outer coat (zona), make physical contact with the lining of the uterus (endometrium)
and then implant. This process is called “hatching”. Under normal conditions, the zona
gradually thins and ruptures allowing the blastocyst to escape. If the zona fails to hatch, the
embryo cannot implant and pregnancy fails to occur. It is hence thought that one of the
reasons for failure of implantation of good quality embryos in IVF is an inability of the
embryo to hatch.
What is assisted hatching?
Assisted hatching is a procedure carried out on embryos immediately prior to embryo
transfer during an IVF cycle to improve their ability to implant. The aim of assisted hatching
is to create a weakness in the zona without causing a complete hole. This allows easy
subsequent hatching of the embryo and also prevents injury to the cells.
This can be performed through physical or chemical methods. Of these, laser is considered
to be the safest and most reliable. The advantage of laser lies in its ability to make a precise,
accurate and quick defect in the zona.
Who can benefit from assisted hatching?
There are some groups of patients who may benefit from assisted hatching based on
current evidence. These include women over 37 years of age; previous failed IVF cycles;
frozen embryo transfer or those with thick zona. Evidence shows that there may be an
improvement in clinical pregnancy rates but there has been no proven benefit in increasing
live birth rate.
Available evidence does not recommend assisted hatching for all patients.
You may opt for laser assisted hatching if you are over 35 years, if you have had prior failed
IVF cycles or if you are undergoing frozen embryo transfer cycles. There may be an
improvement in clinical pregnancy rates.
Is assisted hatching safe?
As the laser causes only a weakness in the zona and not a complete hole, there is no
damage to the inner cells of the embryo. Laser does not increase risk of physical or
chromosomal abnormalities in the baby.