Initial IVF-ET experience with assisted hatching performed 3 days after retrieval followed by day 5 embryo transfer.
OBJECTIVE
To report our initial IVF-ET experience combining assisted hatching performed 3 days after oocyte retrieval with day 5 embryo transfer (ET).


METHODS
Retrospective review of 110 consecutive IVF cycles not involving donor oocytes, including 16 cycles that involved assisted hatching performed 3 days after oocyte retrieval in combination with day 5 ET.


METHODS
Academic teaching hospital IVF center.


METHODS
Eighty-six consecutive IVF patients undergoing ET.


METHODS
Assisted hatching using acid Tyrode's solution performed 3 days after oocyte retrieval in selected cases in combination with day 3 or 5 ETs.


METHODS
Clinical pregnancy rate per ET.


RESULTS
Of the 16 women undergoing day 5 ET following day 3 assisted hatching, 14 had a clinical pregnancy. These included 11 ongoing/delivered singletons and 2 ongoing/delivered twin pregnancies, neither of which was monochorionic. These clinical and ongoing/delivered pregnancy rates compared very favorably with those of 54% and 46%, respectively, for the 35 patients undergoing day 5 ETs without assisted hatching, even though the latter group appeared to be better IVF candidates based on the prognostic factors commonly used to predict success.


CONCLUSIONS
Our experience suggests that day 3 assisted hatching followed by day 5 ET may be a useful combination in selected patients. Although not seen in our small series, an increased risk of monochorionic pregnancies remains a theoretical concern when such a combination is used, since both assisted hatching and blastocyst transfers have been independently linked to an increased risk in some reports.
Graham
M C
MC
Department of Obstetrics-Gynecology, University of Rochester, Rochester, New York 14642, USA.
Hoeger
K M
KM
Phipps
W R
WR
D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007231:Infant, Newborn; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D012189:Retrospective Studies; D013997:Time Factors; D014430:Twins, Monozygotic