Ojinmed IVF Center, Ulaanbaatar, Mongolia.
Department of Molecular Biology and Genetics, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
Lasers Med Sci. 2024 Jan 29;39(1):51. doi: 10.1007/s10103-024-04002-5.
Laser-assisted hatching (LAH) is a widely used and unavoidable technique in assisted reproductive technology after frozen embryo transfer (FET). We aimed to investigate the safety and efficacy of completely ZP (zona pellucida) removed by an assisted laser group compared to an intact group after FET. This retrospective study involved 320 SVBT single vitrified-warmed blastocyst transfers of 213 patients who underwent clomiphene citrate (CC) based minimal stimulation protocol. This study compared 160 SVBT with ZP that were completely removed using laser-assisted (laser beams of 10-15, a wavelength of 1.48 μm, and duration of 1.8-2.2 ms) to 160 cases of intact SVBT. Fisher's exact test, chi-squared test, and logistic regression are used for statistical analysis. The women's age, cause of infertility, BMI, transferred embryo day, insemination methods, and blastocyst grade were not significantly different between two groups. The implantation rate (66.2% vs. 51.2%, P < 0.01), the clinical pregnancy rate (CPR, 52.5% vs. 39.3%, P = 0.01), and the live birth rate (LBR, 43.7% vs. 29.3%, P < 0.01) were significantly higher in the completely ZP removed than the intact group. In logistic regression analysis, the laser-assisted hatching group showed about 2 times higher implantation rate and CPR and LBR than the control group. But miscarriage, gestational weeks, gender, birth weight, and twin births were insignificant between two groups. Our study suggests ZP free embryo transfer by assisted laser is more effective and safer than intact embryo transfer.
激光辅助孵化（LAH）是冷冻胚胎移植（FET）后辅助生殖技术中广泛使用且不可避免的技术。我们旨在研究 FET 后完全去除透明带（ZP）的辅助激光组与完整组的安全性和有效性。这项回顾性研究涉及 213 名接受枸橼酸氯米酚（CC）基础的微刺激方案的患者的 320 个单囊胚玻璃化冷冻-解冻胚胎移植（SVBT）。本研究比较了 160 个使用激光辅助（10-15 激光束，波长 1.48μm，持续时间 1.8-2.2ms）完全去除 ZP 的 SVBT 与 160 个完整 SVBT 的情况。Fisher 确切检验、卡方检验和逻辑回归用于统计分析。两组患者的年龄、不孕原因、BMI、移植胚胎日、授精方法和囊胚等级无显著差异。完全去除 ZP 组的着床率（66.2% vs. 51.2%，P<0.01）、临床妊娠率（CPR，52.5% vs. 39.3%，P=0.01）和活产率（LBR，43.7% vs. 29.3%，P<0.01）均显著高于完整组。逻辑回归分析显示，激光辅助孵化组的着床率和 CPR、LBR 比对照组高约 2 倍。但两组间流产率、妊娠周数、性别、出生体重和双胞胎分娩无显著性差异。本研究表明，与完整胚胎移植相比，辅助激光去除 ZP 的胚胎移植更有效且更安全。
