Department of Reproductive Medical Center, Guangdong Women and Children Hospital, No. 521 Xingnan Road, Panyu District, Guangzhou, 511442, Guangdong Province, China.
Lasers Med Sci. 2022 Feb;37(1):1-9. doi: 10.1007/s10103-020-03230-9. Epub 2021 Jan 13.
To systematically investigate the effects of two methods used for laser-assisted hatching (LAH) on clinical outcomes after day 4 (D4) on frozen-embryo-transfer (FET) cycles. Data from 11471 infertile patients who underwent FET cycles between January 2014 and October 2018 was retrospectively analyzed. The 1410 patients who met the inclusion criteria were further categorized into two groups based on the hatching procedure used: the thinning laser-assisted hatching group (T-LAH, 716 patients), and the drilling laser-assisted hatching group (D-LAH, 694 patients). The baseline characteristics of the patients were consistent between the two groups. However, the rates of implantation and clinical pregnancy were significantly higher in the T-LAH group compared to the D-LAH group (32.73% vs. 29.09%, P < 0.01, and 50.98% vs. 43.95%, P < 0.01). The proportion of live birth was also higher in the T-LAH group, but the difference was insignificant (39.11% vs. 36.89%, P > 0.05). Moreover, there were no significant differences in rates of miscarriages, multiple pregnancies, ectopic pregnancies, preterm births, and congenital disabilities between the two groups. Nonetheless, significantly higher rates of implantation and pregnancy were reported in the T-LAH group compared to the D-LAH group among patients aged <35 years, patients with at least one previously failed cycle, and patients with an endometrial thickness of 8-10 mm. T-LAH is superior to D-LAH in improving clinical implantation and pregnancy outcomes in D4 FET, particularly in patients aged <35 years with at least one previously failed cycle or an endometrial thickness of 8-10 mm. The findings of this study provide theoretical support for clinical individualized diagnosis and treatment of patients with infertility.
为了系统地研究在冻融胚胎移植（FET）周期第 4 天（D4）后使用两种激光辅助孵化（LAH）方法对临床结局的影响。回顾性分析了 2014 年 1 月至 2018 年 10 月期间接受 FET 周期的 11471 名不孕患者的数据。符合纳入标准的 1410 名患者根据使用的孵化程序进一步分为两组：变薄激光辅助孵化组（T-LAH，716 例）和钻孔激光辅助孵化组（D-LAH，694 例）。两组患者的基线特征一致。然而，T-LAH 组的着床率和临床妊娠率明显高于 D-LAH 组（32.73%比 29.09%，P<0.01；50.98%比 43.95%，P<0.01）。T-LAH 组的活产率也较高，但差异无统计学意义（39.11%比 36.89%，P>0.05）。此外，两组间流产率、多胎妊娠率、异位妊娠率、早产率和先天性残疾率均无显著差异。然而，在年龄<35 岁、至少有一次既往失败周期或子宫内膜厚度为 8-10mm 的患者中，T-LAH 组的着床率和妊娠率明显高于 D-LAH 组。在 D4 FET 中，T-LAH 优于 D-LAH，可提高临床着床和妊娠结局，尤其是在年龄<35 岁、至少有一次既往失败周期或子宫内膜厚度为 8-10mm 的患者中。本研究结果为临床个体化诊断和治疗不孕患者提供了理论支持。
