What is assisted hatching technology?

What is assisted hatching technology?

Assisted hatching is a type of assisted reproduction technology that is occasionally used in conjunction with IVF. The experts at Nisha IVF Centre, Ahmedabad's IVF centre, would want to shed some light on this technology. So, the theory behind assisted hatching, according to them, is that it might help with embryo implantation. This technique is usually indicated when there has been a history of unexplained IVF failures or when the patient's prognosis is poor.

In addition, like with any reproductive technology, assisted hatching comes with additional costs and its own difficulties. Here's what you need to know if your doctor has advised assisted hatching.

What Is Assisted Hatching and How Does It Work? 

Fertilization takes place in the lab during IVF treatment. However, having a fertilized embryo does not guarantee a pregnancy, as any couple who has had IVF therapy knows. For pregnancy to occur, the transferred embryo must implant itself into the endometrium and "stick."

The percentage of embryo transfers that "stuck" (implantation rate) for women under 35 is around 50%. However, it is less than 10% for women over the age of 42. 2

There are a few theories as to why this occurs, according to infertility specialists  in India, one of which is that the embryo does not hatch properly. This failure to hatch could be due to the embryo's intrinsic hard shell. On the other hand, it could be due to something in the lab environment, such as the cultures used to keep the embryo alive or the cryopreservation (freezing) chemicals artificially disrupting the hatching process.

Assisted hatching is a method of overcoming obstacles that hinder eggs from hatching. It's also hoped that it may increase the chances of successful implantation and, as a result, a pregnancy.

Methods Employed

You would think that aided hatching necessitates a little "break" or rip in the zone pellucida. However, this is not the case. Instead, there are a few options, and each embryo facility takes a different strategy.

Every method has advantages and disadvantages, and the technician's ability is crucial. Nisha IVF ,the IVF Centre in Ahmedabad offers these technologies for assisted hatching and provides us with a thorough explanation of the subject.

• Mechanical hatching: In this procedure, the embryologist uses a pipette to maintain the embryo steady while puncturing the zona pellucida with a micro-needle, going just beneath the shell for a few seconds and then coming out the other end. (Imagine a fragile line running parallel to the embryo.) Then, carefully touch the region between the two punctures until a small tear appears. This approach makes it difficult to manage the size of the opening.

• Mechanical expansion of the shell: The zona pellucida is not broken open using this approach. Instead, hydrostatic pressure is applied to the shell right beneath it, causing it to expand. The natural expansion of the outer shell during the hatching process inspired this strategy.

• Enzymatic hatching: Using a diluted and harmless proteolytic enzyme, the embryologist dissolves a portion of the zona. A tiny microneedle is used in the fluid to introduce a small amount of enzyme to the zona through direct contact. To keep the embryo from moving, the embryologist utilizes a specialized holding pipette.

The enzyme dissolves on the zona and enters the embryo, causing a tiny hole to form. The embryologist washes the embryo after making the hole. Then, put them back in the culture mixture and incubate them until the embryos are ready to be transferred.

The enzyme solution is a well-known and widely used way of assisting hatching. Despite this, clinics avoid using this procedure since it injects partially disintegrated zona and enzymes into the growing embryo.

• Laser-assisted hatching: Another option is to use a specialized laser to break through the zona pellucida. Compared to mechanical hatching using a needle, laser-assisted hatching gives you a lot more control over the size of the hole you make (as described above).

Laser-assisted hatching may be the safest and most effective approach of all. However, not every embryology lab has the necessary equipment to execute this procedure. Therefore, chemical hatching is the most prevalent method of hatching. The embryologist's ability and experience level can make a significant difference in all of these approaches.

Dangers

 Any alteration or tampering with an embryo carries a certain amount of risk. One risk of aided hatching is that the embryo will be injured to the point of death. This injury might happen before or after the embryo transfer. Pregnancy would not occur in either instance.

Another risk of assisted hatching, somewhat ironically, is that the embryo's natural hatching process will be disrupted, and the embryo will fail to hatch from the zona pellucida properly.

Meanwhile, twinning, particularly monozygotic twinning, can occur as a result of aided hatching. Monozygotic twins are identical twins born from the same egg and sperm. Twinning is already a possibility during traditional IVF, and research suggests that assisted hatching may increase it even more. While all multiple pregnancies are risky, monozygotic twin pregnancies pose an even more significant threat to the mother and her unborn children. Nonetheless, twinning is uncommon, occurring in less than 1% of cases.

You might be wondering if assisted hatching increases your chances of having a child with birth problems. The likelihood of congenital abnormalities was "marginally related" with assisted hatching, according to a significant retrospective analysis of nearly 65,000 assisted reproduction babies. Still, the elevated risk could have been attributable to other factors. 

Effectiveness

Of course, the big question is whether it's worthwhile. Is it possible to take a baby home with the help of assisted hatching? The solution is a little more complicated. A review of aided hatching indicated that it only modestly enhanced clinical pregnancy rates, based on 31 studies with 1,992 pregnancies and 5,728 women. However, the rate of live births did not improve.

Because the goal of any fertility treatment is to take home a baby, not just a positive pregnancy test, live birth rates are more crucial to examine than clinical pregnancy rates.

Unfortunately, most assisted hatching studies have only reported clinical pregnancy rates rather than live birth rates. Those studies that looked at live birth rates found no benefit. As a result, more investigation is required.

Another study discovered that aided hatching on "good quality" embryos reduced conception chances.

When assisted hatching was done on fair- to poor-quality embryos, the results differed depending on the age group. These findings suggest that aided hatching will not only not benefit those who have a favorable prognosis but may worsen their chances of survival. 

Who is assisted hatching beneficial to?

According to the doctors of the IVF centre in Ahmedabad, assisted hatching has been shown to enhance clinical pregnancy rates in patients who:

• You've had two or more failed IVF cycles.

• Have a poor quality embryo

• You're over the age of 38.

Assisted hatching was thought to be worth a shot with frozen embryo transfer cycles; however, that may not be the case. One study found that aided hatching in a frozen embryo cycle may reduce a small percentage's chances of live birth. 

Is it possible that assisted hatching will harm my embryo or pregnancy?

Assisted hatching can occasionally cause harm to the embryo, rendering it useless.

When assisted hatching is used, the risk of identical twins may be somewhat raised. Identical twin pregnancies have more medical difficulties than singleton pregnancies.

Antibiotics and steroid hormones are frequently provided around the period of assisted hatching and embryo transfer. Side effects are uncommonly associated with the usage of these drugs.