title: Assisted hatching--a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  To conduct a meta-analysis of randomized controlled trials (RCTs) on assisted hatching.
  
  
  METHODS
  One hundred sixty-five studies were retrieved from the literature, but only 13 of them fitted our selection criteria. The meta-analysis was conducted using the RevMan software with the Peto-modified Mantel-Haenszel method.
  
  
  RESULTS
  Assisted hatching increases the pregnancy [OR (+/-95% CI) = 2.51 (1.91-3.29)], implantation [OR (+/-95% CI) = 2.38 (1.87-3.03)], and ongoing pregnancy rates [OR (+/-95% CI) = 2.65 (1.85-3.79)] significantly in poor prognosis patients undergoing IVF or ICSI. For patients with repeated IVF failures, the OR (+/-95% CI) were 2.84 (1.99-4.06) for pregnancy, 2.53 (1.85-3.47) for implantation, and 3.51 (2.12-5.82) for ongoing pregnancy rates, in favor of assisted hatching.
  
  
  CONCLUSIONS
  Assisted hatching increases the pregnancy, implantation, and ongoing pregnancy rates significantly in patients with a poor prognosis undergoing IVF or ICSI, particularly those with repeated failures.
authors.affiliation: Department of Obstetrics and Gynecology, the University of Alexandria, Alexandria, Egypt. hnsallam@link.net
authors.forename: Hassan N
authors.initials: HN
authors.lastname: Sallam
authors.forename: Sameh S
authors.initials: SS
authors.lastname: Sadek
authors.forename: Abdel Fattah
authors.initials: AF
authors.lastname: Agameya
mesh_terms: D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D020554:Sperm Injections, Intracytoplasmic; D015044:Zona Pellucida