Montag M, van der Ven H
Department of Endocrinology and Reproductive Medicine, University of Bonn, Sigmund-Freud-Str.25, D-53105 Bonn, Germany.
Croat Med J. 1999 Sep;40(3):398-403.
The use of a 1.48 um diode laser for assisted hatching was investigated in animal experimentation. Laser assisted hatching was offered to patients with advanced maternal age to evaluate a possible benefit.
Using the Fertilase(r) system we investigated the impact of openings with different size in the zona of mouse embryos on the hatching process, as well as that of two openings. Laser-drilling was performed at the blastocyst stage to look for differences in timing and efficacy of hatching. The possible benefit of assisted hatching was studied in 24 couples with advanced maternal age (38.8+2.1 years) and compared to a control group (37.8+2.5 years) treated in the same time period but without assisted hatching.
A certain diameter of a laser drilled opening in the zona pellucida is necessary for efficient hatching. When two openings are present in the zona, the embryo will use both openings for hatching and subsequently become trapped. Laser-drilling at th e expanded blastocyst stage causes an immediate collapse of treated blastocysts and the onset of hatching is retarded. Assisted hatching in 24 patients with advanced maternal age resulted in a significant increase (p<0.01) in the implantation rate when compared to 24 untreated patients.
The use of a 1.48 microm diode laser to drill an opening into the zona pellucida provides a good alternate to conventionally applied techniques. The procedure is efficient and safe as long as it is applied properly. In a human in vitro fertilization program, selected patients will have a benefit form assisted hatching.
在动物实验中研究使用1.48微米二极管激光进行辅助孵化。为高龄产妇提供激光辅助孵化以评估可能的益处。
使用Fertilase(r)系统，我们研究了小鼠胚胎透明带上不同大小的开口对孵化过程的影响，以及两个开口的影响。在囊胚阶段进行激光打孔，以寻找孵化时间和效率的差异。在24对高龄产妇（38.8±2.1岁）中研究辅助孵化的可能益处，并与同期接受治疗但未进行辅助孵化的对照组（37.8±2.5岁）进行比较。
透明带上激光打孔的特定直径对于有效孵化是必要的。当透明带上有两个开口时，胚胎会利用两个开口进行孵化，随后被困住。在扩张囊胚阶段进行激光打孔会导致处理后的囊胚立即塌陷，孵化开始延迟。与24名未治疗的患者相比，24名高龄产妇进行辅助孵化后着床率显著提高（p<0.01）。
使用1.48微米二极管激光在透明带上打孔为传统应用技术提供了一个很好的替代方法。只要应用得当，该程序是有效且安全的。在人类体外受精程序中，选定的患者将从辅助孵化中受益。
