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Assisted Hatching
Assisted hatching (AH) is a technique used to, potentially, improve implantation rates. Once an egg has been fertilized (by either conventional IVF or ICSI), the embryo is then assessed to determine its quality. Part of this assessment is measurement of the shell thickness (zona pellucida) around the embryo. If the zona pellucida is thicker than normal, this is an indication for assisted hatching.
Assisted hatching is usually done on the 3rd day (8-cell embryo) or the 4th day (morula stage). At the Markham Fertility Centre, we use a small amount of acid to create a small defect (hole) in the zona, itself. In theory, by having this small hole in the shell of the embryo, once the embryo reaches the blastocyst stage, it can break out of its shell easier to allow for better implantation rates. Many embryos have a normal or thin zona pellucida that is extremely tough or hard to hatch. One cannot determine how hard the zona is until you actually do the assisted hatching procedure itself.
Indications for assisted hatching include:
Thick zona pellucide measured via IVF
An elevated FSH level
Age >38 years of age
Previously failed IVF embryo transfers without assisted hatching
Occasionally, embryo quality can be improved by removing fragmented debris through the hole created by the assisted hatching procedure. At the Markham Fertility Centre, we still prefer to do a blastocyst transfer for your 1st IVF/ICSI procedure. If a pregnancy is not achieved after your 1st attempt, and it is determined that you have a good blastocyst rate, it is reasonable to tray a day 3 or 4 transfer associated with assisted hatching for a following IVF cycle. We have had very good success rates when assisted hatching is used in conjunction with IVIg therapy.
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