Ghannadi Alireza, Kazerooni Marjaneh, Jamalzadeh Fatemeh, Amiri Sahar, Rostami Parifar, Absalan Forouzan
Faculty of Nursing and Midwifery, Islamic Azad University, Larestan Branch, Larestan, Iran. ; Shiraz Infertility and Limited Surgical Center, Shiraz, Iran.
Shiraz Infertility and Limited Surgical Center, Shiraz, Iran.
Iran J Reprod Med. 2011 Spring;9(2):95-8.
For infertile women aged over 35 years, failure of the ZP (zona pellucida) to rupture is believed to be associated with a decreased implantation rate in in vitro fertilization (IVF) or intra cytoplasmic sperm injection (ICSI).
In this research, laser assisted hatching (LAH) was offered to patients with advanced maternal age to evaluate a possible benefit.
Nine hundred thirty two cycles of IVF/ICSI in females were analyzed. Women included in this study were allocated in 4 groups. In group I and II, embryos were cultured and transferred with and without LAH in women aged ≤35, whereas embryos of group III and IV were examined with and without LAH in women aged ≥ 35. Laser manipulations were performed using a suturn-Tm3 system using 2-3 pulses of 0.8 millisecond with 400 voltage duration. The size of the hole made in the zona was measured to be 5-10 µm, depending on the zona thickness of each individual embryo.
The performance of LAH significantly increased clinical pregnancy rates in all patients. In group I and II, the chemical (50.99% and 31.61% respectively), clinical (50% and 30.69% respectively) and multiple pregnancies (22.27% and 5.94% respectively) significantly differ between these groups. In the patients with advanced female age ≥35 the performance of LAH significantly increased chemical (30.12%) and clinical pregnancy (27.71%) rates compared to whom without LAH (18.96% and 16.37% respectively).
Our data demonstrate in the patients who were less than 35 years old, multiple pregnancy rates were significantly increased compared to other groups who aged over 35 years old. In addition benefit of LAH in improving pregnancy rates after IVF or ICSI in women of advanced age (≥35) was shown.
对于35岁以上的不孕女性，透明带（ZP）未能破裂被认为与体外受精（IVF）或卵胞浆内单精子注射（ICSI）的着床率降低有关。
在本研究中，为高龄产妇提供激光辅助孵化（LAH），以评估其可能的益处。
分析了932个女性IVF/ICSI周期。本研究纳入的女性分为4组。在第一组和第二组中，年龄≤35岁的女性胚胎分别在有和没有LAH的情况下进行培养和移植，而第三组和第四组的胚胎则在年龄≥35岁的女性中有和没有LAH的情况下进行检查。使用suturn-Tm3系统进行激光操作，采用2-3个脉冲，脉冲宽度为0.8毫秒，电压持续时间为400。根据每个胚胎的透明带厚度，在透明带上形成的孔的大小测量为5-10微米。
LAH显著提高了所有患者的临床妊娠率。在第一组和第二组中，两组之间的生化妊娠率（分别为50.99%和31.61%）、临床妊娠率（分别为50%和30.69%）和多胎妊娠率（分别为22.27%和5.94%）存在显著差异。在年龄≥35岁的高龄女性患者中，与未接受LAH的患者相比（分别为18.96%和16.37%），LAH显著提高了生化妊娠率（30.12%）和临床妊娠率（27.71%）。
我们的数据表明，年龄小于35岁的患者与年龄大于35岁的其他组相比，多胎妊娠率显著增加。此外，还显示了LAH对改善高龄（≥35岁）女性IVF或ICSI后的妊娠率有益。
