A randomized double-blind controlled study on the efficacy of laser zona pellucida thinning on live birth rates in cases of advanced female age.
BACKGROUND
It is conceivable that defective embryo hatching plays a part in the mechanisms involved in the decrease of embryo implantation rates with advancing age. In an effort to test this hypothesis, we tested the effectiveness of assisted hatching (AH) in women > or =37 years of age.


METHODS
We prospectively studied 103 IVF-embryo transfer patients undergoing 103 embryo transfers. All of them were > or =37 years of age and had <3 previous IVF-embryo transfer attempts. Laser-AH of transferred embryos was either performed (AH group, n = 49) or not (control group, n = 54) according to randomized and double-blind methodology. Primary outcome was live birth rate.


RESULTS
Population characteristics were comparable in AH and control groups as well as the mean number of embryos transferred (2.7 +/- 0.6 versus 2.7 +/- 0.6) and the prevalence of top quality embryos transferred (65 versus 59%, respectively). We failed to find any statistically significant difference between AH and control groups with regard to implantation (16.1 versus 16.7%, respectively) and live birth rates (22.4 versus 29.6%, respectively).


CONCLUSIONS
The present study indicates that AH does not improve IVF-embryo transfer outcome in women aged > or =37 years.
Frydman
N
N
Department of Genetic and Reproduction, Hospital Antoine Béclère, Clamart, France. nelly.frydman@abc.ap-hop-paris.fr
Madoux
S
S
Hesters
L
L
Duvernoy
C
C
Feyereisen
E
E
Le Du
A
A
Tachdjian
G
G
Frydman
R
R
Fanchin
R
R
D000328:Adult; D004311:Double-Blind Method; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008423:Maternal Age; D011247:Pregnancy; D018873:Pregnancy Rate; D015044:Zona Pellucida