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Laser Assisted Hatching – Procedure, Advantages and Cost of LAH

What is Laser-Assisted Hatching?

Advancements in science and technology have greatly improved people’s lives. Technology has helped us in every segment, from work to the production of goods and even reproduction. Laser-assisted Hatching is one technological advancement that has been

around for a long time. It can be considered one of the technological gifts for women of older age.

Laser Assisted Hatching is a technique used in In-Vitro Fertilization. This technique helps to improve the implantation of embryos into a woman’s uterine lining. The process creates an opening into the patient’s uterine lining, allowing the embryonic cells to hatch. It is a safe technique which helps to weaken and thin a small section of the zona pellucida. If the zona pellucida is harder, the case becomes more complicated. This happens because the eggs will not hatch or may use excessive energy to get out. This can end up with an aversion to the woman’s uterus and reduces the likelihood of implantation. Reasons accompanying the same include the age of the patient because women above 37 years generally produce eggs with a more complex or thicker zona pellucida as compared to younger women, another reason supporting the reduction of implantation in women with a high level of Follicle- Stimulating Hormone (FSH).

Procedure of Laser Assisted Hatching

This procedure is performed in a lab. Here, the laser beam is used to hatch the outer shell to facilitate embryo implantation. For this purpose, a circle of the coloured beam of light is fixed. This circle locates the point where the laser will fire. This laser beam is invisible; we can only see its effects.

A laser beam issues energy into the embryo shell and dissolves it. The laser is

pulsated three times to create a whole gap in the shell. However, this particular technique may vary based on the power settings, method, and spot size. For a successful pregnancy, this Hatching is performed without affecting the embryo.

When Laser Assisted Hatching is Recommended

Laser-Assisted Hatching is recommended in the following cases:

  • Patients who are more than 37 years
  • Patients having Frozen Embryo Replacement (FER)
  • Patients who have faced a failed IVF or ICSI treatment
  • Those who are going for IVF/ ICSI for the first time. They are considered poor responders because they require a high dose of It is a kind of infertility drug for a poor ovarian response.
  • Those with poor quality and quantity of embryos
  • Those who have had a low fertilization rate in earlier IVF cycle
  • Couples going for IVF treatment with embryos that have a thick outer shell called zona pellucida

Advantages of Laser Assisted Hatching

Laser-Assisted Hatching with IVF has many benefits:

  • In this treatment, only a fewer embryos are required to be transferred
  • Assisted Hatching can Increase the implantation success rates
  • It allows for blastocyst culture
  • Reduces the chance of multiple pregnancies

Other Assisted Hatching Methods

Assisted Hatching is not always assumed to make a small break or tear in the egg. There are other methods, too, that are practised by different labs accordingly. Some of the methods are mentioned as follows:

Mechanical Hatching: There is a risk of controlling the size of the opening (zona

pellucida) with this technique. As an embryologist keeps the embryo steady with the help of a pipette while puncturing the zona pellucida using a micro-needle. (Imagining a very thin line alongside the embryo).

Mechanical Expansion of the Shell: Through this technique, hydrostatic pressure is presented just under the shell, making it expand. This method’s idea comes from the normal expansion of the outer shell throughout the hatching process.

Chemical Hatching: A chemical known as Tyrode’s acid is used in this treatment while

treating the patient. A small amount of Tyrode’s acid is applied to the zona pellucida until the shell is breached. There is a risk of chemical exposure of the embryo under this treatment.

Drilling: In this technique, vibrations are created for a conical opening. This technique uses another technology called Piezo technology.

Of all the methods mentioned above, chemical hatching is one of the commonly used techniques, as not every embryology lab is equipped with Laser Assisted Hatching process.

Risks Associated with Assisted Hatching

There are multiple risks with laser-assisted Hatching. They are:

Manipulation or interference with an embryo can lethally damage it, which ironically means that embryo’s natural capacity is challenged and will somehow result in non-pregnancy of the woman. (7)

Another risk of assisted Hatching is twinning, specifically monozygotic twins. It is an identical twin, which comes from an egg and a sperm. During the IVF treatment, chances of twinning are already increased, and researchers have found that assisted Hatching may further increase the risk. However, all multiple pregnancies carry risk, but monozygotic twin pregnancies come with some more and can be dangerous for both the mother and the baby.

Assisted laser hatching can cause complications for the female partner. These complications include nausea, vomiting, swelling of the face, water retention, and headache. However, these problems are not that big and can be diagnosed with simple medication.

Success Rate of Laser Assisted Hatching

One of the foremost questions is asking about the success rate. The success rate, in this case, is how many couples have come along with a baby in their hand after the

treatment. The success rate of IVF along with laser-assisted hatching increases by up to 50

%. A Cochrane review considering a collection of 31 studies have found hatching process has improved the clinical pregnancy rates. However, the same lack of live birth rates. Ultimately, the results matter and here the live birth rates. The goal for any fertility treatment is taking a baby home, not just getting a positive pregnancy test. Embryologist’s experience plays

a bigger part in making the process successful.

Factors that Affect Laser-Assisted Hatching Success Rate

There are some factors which can influence the success rate of Laser Assisted Hatching:

  • Experience of the embryologist
  • Expertise deployed during the procedure
  • The nature of the embryo basically the thickness of the shell
  • Quality of the infertility Centre

Treatment Cost for Laser Assisted Hatching

The cost of the treatment depends on many factors. Various clinics offering IVF treatment along with Laser-assisted Technique include the cost of both the treatments. It is affordable treatment in India as compared to other countries. It ranges from Rs. 20,000 to 30,000 only. Many factors that affect the cost of the treatment are mentioned as follows:

  • Type of infertility center
  • City selected
  • Experience of the Embryologist
  • Type of For example, after IVF or ICSI
  • Number of embryos used