title: Is assisted hatching beneficial in patients with recurrent implantation failures?
abstract: OBJECTIVE
  To assess the possible role of assisted hatching in patients with recurrent implantation failure during IVF cycles.
  
  
  METHODS
  Prospective randomized study.
  
  
  METHODS
  IVF unit of an academic medical center.
  
  
  METHODS
  Women who underwent IVF after at least three failed IVF-ET attempts.
  
  
  METHODS
  Patients were prospectively randomized to undergo assisted hatching of their embryos prior to their replacement by mechanical partial zona dissection.
  
  
  RESULTS
  The study (assisted hatching) and control groups included 104 and 103 patients, respectively. There were no significant between-group differences in patient age, cause of infertility, mean number of previous IVF trials, number of oocytes retrieved, fertilization rate, or number of embryos transferred. No difference in pregnancy rate was noted on comparison of the whole study group, to the whole control group (21% and 27%, respectively). However, when the results were re-analyzed by age groups, assisted hatching was found to be harmful in the youngest group (< 34 years), significantly decreasing pregnancy rates (15% vs 35%, p < 0.05).
  
  
  CONCLUSIONS
  Repeated implantation failure alone is not an indication for assisted hatching. Although assisted hatching appears to be effective in a selected group of older patients, in younger patients it may further hamper implantation and should be avoided.
authors.affiliation: Infertility & IVF Unit, Department of Obstetrics & Gynecology, Rabin Medical Centre, Beilinson Campus, Petach-Tikva, Israel.
authors.forename: O
authors.initials: O
authors.lastname: Rufas-Sapir
authors.forename: A
authors.initials: A
authors.lastname: Stein
authors.forename: R
authors.initials: R
authors.lastname: Orvieto
authors.forename: O M
authors.initials: OM
authors.lastname: Avrech
authors.forename: N
authors.initials: N
authors.lastname: Kotler
authors.forename: H
authors.initials: H
authors.lastname: Pinkas
authors.forename: J
authors.initials: J
authors.lastname: Bar
authors.forename: B
authors.initials: B
authors.lastname: Fisch
mesh_terms: D000328:Adult; D001755:Blastocyst / Q000502:physiology*; D010064:Embryo Implantation; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008846:Micromanipulation; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome; D015044:Zona Pellucida