Elnahas Ahmed, Elnahas Tamer, Azmy Osama, Elnoury Amro, Abdelhalim Ayman, Aboelghar Mohamed, Alhassani Safaa, Noureldin Ragya
a The Egyptian IVF-ET Center, National Research Center , National Institute of Laser Enhanced Science , Cairo , Egypt.
J Obstet Gynaecol. 2018 Jul;38(5):729. doi: 10.1080/01443615.2018.1444392.
Cryopreservation of human embryos has become an essential part of assisted reproduction. It limits the number of embryo transferred while supernumerary embryos can be transferred in subsequent cycles, however, it is associated with zonal hardening, which lowers the success rate in the majority of (ICSI) centres, associated with decreased implantation rate and clinical pregnancy rates. Assisted hatching has been used to induce microdissection of the zona pellucida. Many techniques have been used, such as mechanical, chemical, piezo and laser techniques.
To compare the efficacy of laser assisted hatching of vitrified embryos and fresh embryos with regards to implantation rate and clinical pregnancy rate.
Prospective randomised study.
One hundred twenty women with fresh embryos scheduled for (ICSI) were randomised in two groups; laser assisted hatching (LAH) group (test group), containing 60 women and the other is (non LAH) (control group). Second group with 120 women with frozen embryos were randomised in (LAH group) and (non LAH group). On the day of embryo transfer, 1.48 μm Infrared Diode laser, class 1 M, was used in test group to induce zonal microdissection, the quality and safety of embryos is assessed morphologically after hatching. On the other hand, the zona of the control group were left intact. Both clinical pregnancy and implantation rates were estimated.
Laser assisted hatching group had clinical pregnancy and implantation rates of 38% and 50%, respectively. Non laser assisted hatching group had lower clinical pregnancy and implantation rates; 30% (p = .442) and 33% (p = .095), respectively, with no statistically significant difference p < .05.
LAH does not improve statistically both pregnancy rate and implantation rate in fresh embryos. However, there is improvement in both implantation and pregnancy rate in Vitrified group.
人类胚胎冷冻保存已成为辅助生殖的重要组成部分。它限制了移植胚胎的数量，多余的胚胎可在后续周期移植，然而，它与透明带硬化有关，这在大多数（卵胞浆内单精子注射）中心降低了成功率，与着床率和临床妊娠率降低相关。辅助孵化已被用于诱导透明带的显微切割。已经使用了许多技术，如机械、化学、压电和激光技术。
比较激光辅助孵化玻璃化胚胎和新鲜胚胎在着床率和临床妊娠率方面的效果。
前瞻性随机研究。
120例计划进行（卵胞浆内单精子注射）的新鲜胚胎女性被随机分为两组；激光辅助孵化（LAH）组（试验组），包含60名女性，另一组为（非LAH）（对照组）。第二组120例有冷冻胚胎的女性被随机分为（LAH组）和（非LAH组）。在胚胎移植当天，试验组使用1.48μm红外二极管激光，1M类，诱导透明带显微切割，孵化后通过形态学评估胚胎的质量和安全性。另一方面，对照组的透明带保持完整。估计临床妊娠率和着床率。
激光辅助孵化组的临床妊娠率和着床率分别为38%和50%。非激光辅助孵化组的临床妊娠率和着床率较低；分别为30%（p = 0.442）和33%（p = 0.095），无统计学显著差异p < 0.05。
激光辅助孵化在新鲜胚胎中对妊娠率和着床率在统计学上没有改善。然而，在玻璃化组中着床率和妊娠率均有提高。
