What is assisted hatching in IVF ?

Assisted Hatching IVF is considered one of the complementary treatments for patients for whom IVF has failed several times and this failure was the result of the embryo implanting problem in the uterus.
Assisted Hatching IVF is highly recommended for women with a poor prognosis for the IVF cycle. It is an option to improve the chances of a successful pregnancy. When it comes to assisted hatching, we should talk about the zona pellucida (the eggshell). Experts have found that the IVF implantation cycle is more successful when the embryos have a thinner zona pellucida. In this process, embryologists create a small hole in the zona pellucid.
There is a need to be aware of the zona pellucid, the outer layer of the embryo. This layer is one of the protective layers of the embryo. On top of that, it is there to prevent so many sperms entering the egg. Besides, it controls the first cell divisions of the embryo. Zona pellucid helps embryo cells to be together for four days; So, implanting is prevented during these days, to let the embryo get mature.
Implantation of the embryo is one of the essential steps in assisted reproductive treatment. If we want this process to end up to a positive pregnancy, the embryo should get rid of this shell to be implanted into the uterus. This is the place where assisted hatching is needed. This procedure is performed in order to hatch the embryo by creating a small crack in the zona pellucid.

How does the assisted hatching procedure work?

Although a majority of people think that assisted hatching IVF tears the zona pellucida apart, it isn’t the truth. It is a complicated procedure, and every lab is doing that in their way. There are a lot of methods available, and every method has advantages and disadvantages. That is your responsibility as a patient to choose the lab that is doing these methods in the best way. So, collect your information before making a decision.

Mechanical hatching: in this technique, the pipette is used to help the embryo steady. A micro-needle is used to puncture through the outer layer (zona pellucida). The needle goes underneath the shell, then comes out to the other end. Afterward, the embryologist gently rubs the area between the two punctures until a small tear occurs. One of the drawbacks of this method is that it’s hard to control the size of the opening.

Mechanical expansion of the shell: in this technique, the outer layer (zona pellucida) is not opened. Alternatively, hydrostatic pressure is introduced just under the shell, in order to expand it. If you wonder about the idea of this method you should know that it comes from the outer shell natural expansion during the hatching IVF process.

Chemical hatching: a chemical known as Tyrone’s solution is involved in this technique. This way, a few amounts of acid will be injected in order to breach the shell. After that, the embryo would be cleaned in order to avoid acid exposure. A specialized holding pipette is used to limit embryo movement. When zona is melted with acid, it can create a small hole in it. After that, the embryo is washed and placed back in the culture medium until the embryo transfer time. This method used to be one of the most effective methods, but thanks to technological advances, nowadays it is not used a lot because of the potential to introduce partially dissolved zona and acid into the developing embryo.

Drilling: This technique is also known as Piezo technology. With drilling, they use vibratory movements in order to create a conical opening.

Laser-assisted hatching: this method is more modern than other methods. It utilizes specialized software that helps in lasers’ positioning, intensity, and focus. In this state-of-the-art method, the thickness of the zona is measured, so embryologists have access to minimize the temperature delivered to the inner cell mass. Nowadays, an increasing number of clinics use this method because of its safety for the embryo. On top of that, embryologists are able to set up laser-assisted hatching since the speed of this method is higher than others.

Embryo hatching after the thaw

After freezing the embryo, when it’s time to use it, the cryoprotectant should be removed, and water should be replaced. It’s crucial to rehydrate the cells. It takes about 20 minutes to thaw the embryos, which is faster than freezing them. It is suggested to be fast in order to not damage the cells. These embryos can be used for about 13 years from the freezing time. The process of hatching embryos after thaw is like the fresh embryo, and there are no differences. Another vital issue is that their quality is like fresh ones. The success rate between fresh and frozen embryos is comparable. But all the embryos can’t survive the freezing, and some of them would be missed. For Women who are 35 years old and younger the chance of pregnancy is high. It’s over a 60 percent per transfer.

Assisted hatching implantation timeline

When a woman gets pregnant naturally, there is a procedure. Fertilization takes place when sperm and egg combine. After that, the embryo goes to the uterus for implantation, grows in size, and divides cells. Pregnancy starts when the implantation is done, and the embryo finds the spot in the uterus line. As a result, 7 to 14 days after sex, embryo implantation is done. So, about two weeks are required to get the pregnancy result.
Regarding IVF, the fertilized eggs typically start to implant about 1 or 2 days after the 5th day of the IVF blastocyst transfer. The definition is that the time of implantation is about 7 to 8 days after fertilization. So, the implantation in both normal pregnancy and pregnancy through IVF is like each other, and the time needed for them is the same as others.
The best time for performing Assisted Hatching IVF is on day three after fertilization. At this time, the embryo has about eight cells, but its size hasn’t changed yet.

Who are the ideal candidates for assisted hatching?

Considering the fact that hatching is a complicated method, it doesn’t perform for everyone. There are some criteria for candidates. For some patients, the benefits of this method are more. For using this method, the best candidates would be evaluated.
Patients with previous IVF failures: Despite the highest rate of success in IVF, there are some failures. It is worth mentioning that IVF is one of the best infertility treatments and has the most successful result. But some women can’t make their dreams come true even through IVF. However, the assisted hatching IVF method is highly recommended for women undergoing two or more unsuccessful IVF cycles. IVF involves nearly every conception phase, including ovulation, fertilization, egg retrieval, and embryo transfer. Assisted hatching IVF typically is not included in IVF. Just in some cases, doing this technique is recommended. If a woman possesses an embryo of good quality but fails on the previous try, adding assisted hatching IVF can have a successful result for the patient.
Women over the age of 37: Nobody can deny the effect of aging on fertility. Although people usually are interested in ignoring age, when it comes to infertility for both men and women, it is vital to consider it. Infertility can be seen more in Women over the age of 37. They have lower fertility treatment success rates, and IVF is no exception. Due to the importance of age in this process, using assisted hatching IVF for all women over 37 is highly recommended for the first time trying to do IVF.
Patients with high FSH levels: Another critical issue that should be considered in women with high FSH levels is the follicle-stimulating hormone. This valuable hormone regulates egg stimulation in the ovaries and the menstrual cycle. Women with this problem have thicker zona pellucid shells. And this matter can decrease the chances of a successful IVF treatment. The thicker the embryo’s outer layer is, the more difficult it will be for the embryo to break through the lining. With this problem is hard to implant along the uterine wall. In cases where this lining is thick, implanting an embryo is impossible.

Assisted hatching ivf pros and cons

Assisted hatching procedure is a technical method for increasing the success rate of IVF and helping people to live their dreams. This procedure has a lot of advantages. Many women with the difficulty of being pregnant can have a baby this way, which is the best advantage of this method.
It is an opportunity to implant Hatched embryos one day earlier than those left to hatch on their own. So assisted hatching IVF raises the success rate for pregnancy by a better chance of implantation.
Although the disadvantages are not as prevalent as the advantages, they do exist.

Embryo damage: One of the potential drawbacks is that this procedure can damage the embryo. Before, during, and after transferring the embryo, there is a chance of damage. So, there wouldn’t be any pregnancy.

Cost: the cost of this process can be very high. All the people are not able to do that. Fortunately doing hatching IVF in Iran and in TebMedTourism clinics is less than everywhere else.

Risk of twin birth: Last but not least is that it can increase the rate of identical twins’ birth, which is not pleasant for many parents. Identical twins stem from one egg and sperm. Not only can IVF increase the twin’s rate but assisted hatching can increase it further. The problem is that the risk of complications rises for the mother and babies when the mother is pregnant with twins. However, the risk of twin birth is low, it’s not more than 1% of the time. The assisted hatching doesn’t increase the risk of congenital disabilities. So, it is safe, and there is nothing to worry about.

Assisted hatching IVF success rates

Assisted hatching IVF is done to increase the pregnancy rate in women who have trouble with IVF. This means they had done IVF before but were not successful. In case the woman’s embryos are considered poor for fertilization, it is required that assisted hatching be done to improve the chance of pregnancy within an IVF cycle. Keep in mind that this procedure is not as easy as it might seem, so the difficulty is part of the process. So, the embryologist’s skills and experience are essential to the success rate. Be informed about the experts in this way before choosing this method.
A lack of research related to assisted hatching can be seen. Although the number of research in this regard is low, the results are inspiring. Thanks to new studies we found out that assisted hatching IVF increases the chance of implantation for transferred embryos. In some studies, the pregnancy rate in assisted hatching IVF has been shown to be higher than the pregnancy rate for IVF without hatching.
Fortunately, there is an improvement in the pregnancy rate with assisted hatching in Iran and especially in TebMedTourism clinics. Of course, this benefit can’t be seen in all IVF programs.
Remember that this process can also harm the embryo if the best expert doesn’t perform it. So be sure that properly trained embryologists are doing the complicated process.
So many factors can affect the success rate in clinics. Pregnancy and live birth rates can be very different in every clinic. Factors like the embryo transfer skills of the physician, the overall quality of the laboratory and the hatching technique used can be effective in this method.

Are there any risks associated with assisted hatching?

The risks might be different due to the different approaches regarding this treatment. There are some methods, and each one can cause different risks. One of the compliments of this method is the possibility of damaging individual embryonic cells while weakening the wall.

Another risk associated with assisted hatching IVF is the high possibility of pregnancy with monozygotic twins. There is a chance that the zona pellucida has been thinned too much.

Owing to the fact that the outer shell is a protective for embryo, during the early stages of development against the foreign attacker, by assisted hatching, there is a slight chance of some risk related to the embryo. These include:

Harmful chemicals and microorganisms might find a way to attack the developing embryo.

The laser hatching process can increase some risks during the process. It can damage the cell because localized heat is applied to facilitate the opening in the zona pellucida.

There is also a tiny chance of entrapping the embryo during the procedure, causing monozygotic twins.

Assisted hatching IVF cost

Although assisted hatching IVF is not recommended for everyone, it is an effective way for many patients. The cost might vary from one clinic to another, and there is no stable expense. Every clinic uses some methods, and the price might be different. In some clinics, the cost of assisted hatching IVF is included in the IVF cost, and you shouldn’t be worried about the cost. It’s better to talk to your doctor and be aware of the process you are going through. It helps you to be informed about the cost and other expenses. Finding clinics with lower cost and higher quality would be perfect help. The tebmedtourism clinics can help you in this way.

Assisted hatching IVF twins

It is evident that IVF may increase the number of multiple births, but when it comes to assisted hatching, this number will increase to a great extent. Based on studies, there is a positive correlation between assisted hatching IVF and monozygotic twins. Expert strongly advises that women not interested in having twins should avoid this procedure, although it improves the IVF success rate.

Having twins can be a source of problems for many parents. Many people are not passionate about dealing with two kids at home. Not only economically but also culturally, people can’t stand this situation. Parents should weigh the risk and rewards of all the fertility treatments and then decide. Our colleagues are here to help you to decide which method suits your desire. Don’t hesitate to ask your questions and be informed about all the available treatments.

Patients with the correct information about the process can make the best decisions. It’s our responsibility in Tebmedtourism to help and empower them.