Rescue of implantation potential in embryos with poor prognosis by assisted zona hatching

ISSN： 1460-2350

Source： Human Reproduction, Vol.13, Iss.5, 1998-05, pp. : 1331-1335

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Abstract

The effect of the assisted zona hatching (AZH) procedure was investigated on 135 cycles with a poor prognosis of pregnancy due to: (i) maternal age 38 years (45 cycles); (ii) three or more failed in-vitro fertilization (IVF) attempts (70 cycles), and (iii) patients possessing both inclusion criteria (20 cycles). The control groups (113 cycles) included patients possessing the same characteristics (42, 53 and 18 cycles respectively) and who did not undergo the AZH procedure. A total of 505 embryos was treated with AZH before transfer, resulting in: 14, 25 and 6 clinical pregnancies. The percentage of clinical pregnancies per cycle was significantly higher than controls for the first (31 vs 10% in control 1, P < 0.05)="" and="" second="" groups="" (36="" vs="" 17%="" in="" control="" 2,="">P < 0.05).="" no="" significant="" difference="" in="" percentage="" of="" clinical="" pregnancies="" was="" found="" for="" the="" third="" group="" (30="" vs="" 6%).="" similarly,="" higher="" rates="" of="" implantation="" were="" obtained="" (11.5,="" 15="" and="" 11%)="" compared="" to="" the="" respective="" controls="" (4%,="">P < 0.02;="" 6.3%,="">P < 0.01;="" and="" 1.5%).="" the="" rate="" of="" miscarriage="" in="" the="" azh="" groups="" was="" similar="" to="" that="" obtained="" in="" the="" controls="" (22="" vs="" 21%).="" finally,="" the="" morphological="" analysis="" of="" the="" embryos="" transferred="" revealed="" that="" the="" poor="" prognosis="" condition="" is="" associated="" to="" a="" significantly="" slower="" rate="" of="" development="" and="" a="" higher="" rate="" of="" fragmentation.="" the="" present="" results="" indicate="" that="" azh="" procedure="" improves="" pregnancy="" and="" implantation="" rates="" in="" patients="" with="" a="" poor="" prognosis="" of="" pregnancy="" by="" facilitating="" the="" hatching="" process="" in="" embryos="" which="" would="" otherwise="" be="" trapped="" inside="" the="" zona=""> Keywords:advanced maternal age/assisted zona hatching/implantation/IVF failures/poor prognosis patients