Assisted Hatching For Greater IVF Success
In this article we take a look at this procedure and where it fits into the IVF treatment cycle, and also find out why it improves the chances of IVF success and who is most likely to benefit from it.
Since the first IVF baby was born in 1978, IVF has become the standard treatment for infertility and more than 8 million babies have been born worldwide as a result thereof.
IVF treatment is a process of assisted reproduction therapy (ART). During the IVF process – in very simplified terms – the egg and sperm are fertilised outside of the body to form an embryo, which is then transferred to the uterus to hopefully implant and become a pregnancy.
IVF treatment has an impressive success rate. The success rate for a single cycle of IVF treatment is around 20%, which is close to the rate of natural conception in couples with no fertility challenges. However, over three cycles of IVF treatment with tested embryos, the pregnancy rate increases to as high as 92.6%.
This is due to a number of techniques that have been developed over the last three decades to further improve the chances of a successful IVF treatment cycle, which is an IVF cycle that results in a pregnancy that culminates in the birth of a healthy baby.
Unfortunately, there are many reasons why an IVF cycle might fail, but one of the most common reasons for an IVF cycle to fail is because the embryo/s failed to implant.
Why embryos fail to implant
During fertilisation, the sperm must penetrate the hard shell surrounding the egg. This hard shell is called the zona pellucida.
Once the sperm has penetrated the egg, the zona hardens again to prevent any additional sperm from entering the egg. The fertilised egg is called an embryo. In nature, this fertilisation of the egg by sperm occurs in the fallopian tubes. During IVF treatment, the fertilisation occurs in a glass dish or “in vitro”, outside of the body.
During the days following the fertilisation, the embryo inside its hard, protective shell undergoes a series of development stages, from zygote to morula to blastocyst. In nature, when the embryos reach the blastocyst stage, they leave the fallopian tube and enter the uterine cavity. This usually occurs five days after fertilisation. During IVF treatment, the embryo is nurtured in the lab before being returned to the IVF-patient’s uterus around five days after fertilisation, where it will hopefully implant successfully in the lining of the uterus to become a pregnancy.
If hatching does not occur, the embryo will not be able to implant and a pregnancy will not occur.
There are many reasons why an embryo might fail to implant in the lining of the uterus, but one of the most common reasons is that the embryo is unable to hatch from its hard shell. A common cause of difficulties with hatching is that the shell is too thick or too hard.
In order to implant into the uterine lining, the embryo must first hatch out of the zona pellucida as the shell is called.
“Assisted hatching” (AH) is an IVF technique that involves creating a small opening in the zona pellucida surrounding the fertilised egg. Because assisted hatching weakens the wall of the embryo, the likelihood of successful hatching and embryo implantation are improved.
Dr Nicholas Clark, a qualified Gynaecologist and Obstetrician, and a director of Medfem Fertility Clinic in Sandton, Johannesburg, South Africa, explains the process as follows in a video you can watch here.
“In the normal process of implantation, the embryo has to break through its gel-like outer covering – the zona pellucida – prior to attaching to the endometrium, or uterus lining. Some embryos may have a tougher zona pellucida than others. If the embryo does not hatch, it cannot implant in the lining of the uterus, and the IVF cycle will not be successful. At Medfem Fertility Clinic, we use a technique called ‘laser assisted hatching’ to increase the chances of a successful implantation. Laser assisted hatching makes it possible to make a small aperture on the surface of the shell, using a laser, just before the embryo transfer. This technique weakens the shell, to make it easier for the embryo exit from the shell, which in turn allows it to implant in the lining of uterus.
While assisted hatching is not a procedure that benefits everyone undergoing IVF treatment, in specific cases it results in increased implantation of the blastocyst into the endometrium and therefore increased pregnancy rates.
Who is likely to benefit from Assisted Hatching?
Studies have shown that there are particular groups of IVF patients who will most benefit from this technique, such as women over the age of 38, as well as patients that have experienced recurrent implantation failure.
Speaking at the recent Fertility Show Africa 2023, Dr Antonio (Tony) Rodrigues – a reproductive medicine specialist and a founder and director of Medfem Fertility Clinic – explained: “Assisted hatching is among the processes we use at Medfem to improve the chances of IVF success, particularly after recurrent failures, because we have witnessed the positive impact it has on the chances of a successful IVF outcome.
“At Medfem we employ assisted hatching in cases such as elevated FSH, decreased ovarian reserve, thickened zona, and prior implantation failure. It is also used in cases of advanced reproductive age and it is a routine procedure at Medfem Fertility Clinic for IVF patients over the age of 38. Our patients are guided by our specialist laboratory staff when such techniques are beneficial in their particular case.”
Will assisted hatching benefit you?
If you would like to know more about assisted hatching and the other procedures we use at Medfem Fertility Clinic to give our IVF patients the very best chance of IVF success, we invite you to reach out to us.
Our IVF clinic treats over a thousand patients each year with success rates that have consistently remained high and well above the national averages. In fact, our success rates are in line with the highest reported amongst clinics worldwide. We are proud to have played a role in bringing more than 18,000 babies into the world.
At Medfem we believe in helping you reach your family dream through:
*World-Class Fertility for Everyone – we believe in making world-class fertility treatments available for everyone
*A Positive Fertility Journey – It is our joy and commitment to give you a positive outcome to your fertility journey
*Delivered With Empathy & Caring – So you may have a fond memory, of a feeling of empathy, caring and being part of the Medfem family
If you would like to meet one of our fertility specialists at Medfem Fertility Clinic, simply click here to book an initial consultation or contact us telephonically on +27 (11) 463 2244.
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We look forward to meeting you at Medfem Fertility Clinic!