Laser Assisted Hatching

LASER ASSISTED HATCHING

The success of implantation after IVF is highly dependent on embryo endometrium synchrony, the endometrium needs to be receptive to catch the embryo, equally the embryo has to be potentially good enough for implantation. Sometimes the embryo fails to hatch and implant, resulting in IVF failure.

Laser-assisted hatching is an advanced technology used in IVF cycles. The main function of zona pellicuda is to protect the embryo and maintain its integrity. The embryo should hatch out of zona pellicular to allow the interaction between the outer layer of embryo trophectoderm and endometrial cells. Assisted hatching is the process in which zona pellucid is artificially disrupted by micromanipulation, and when it is done by laser ray it is known as Laser Assisted hatching.

INDICATION

  1. Recurrent implantation failure(>2 -3 cycle).
  2. Thick zona pellicuda.
  3. Frozen embryo transfer.
  4. Advanced maternal age>35-37 years.
  5. Extended in vitro culture.
  6. Elevated basal FSG values.

METHODS

Laser-assisted hatching can be done in 2 ways, contact laser and noncontact laser. nowadays non contact lasers are mostly used. Laser beam produces superheating at the point of delivery causing lysis to zona pellicuda. This procedure helps in successful implantation leading to pregnancy.This involves precise procedures and a skilled technician to perform it. And the lab has to
have specialized instruments to dothis advanced procedure. The total process takes only a few seconds

ADVANTAGES

  1. It does not involve manual handling of the embryo; hence there are fewer chances of any damage.
  2. The accuracy of the laser is predetermined in the program, which ensures the safety of the embryo.
  3. Laser-assisted hatching increases the success rate of pregnancy.

DISADVANTAGES

  1. Risk is similar to other IVF or ICSI procedures.
  2. Can reduce the embryo viability and can be lethal to the embryo.
  3. LAH can also result in multiple pregnancies especially monozygotic twins. (But it does not increase the congenital defects.)

SUCCESS RATE

It increases the implantation rate and ongoing pregnancy rate but its role in patients with endometriosis is still not established.

CONCLUSION

It is an advanced technology when used precisely by a skilled embryologist before embryo transfer results in more successful implantation.