Clinical Investigation

The outcome of assisted hatching and defragmentation in patients with poor quality embryos on IVF outcome

10.5505/tjod.2013.52297

  • Ahmet Zeki Işık
  • Gamze Sinem Çağlar
  • Eran Sözen
  • Cem Akarsu
  • Görkem Tuncay
  • Kubilay Vicdan

Turk J Obstet Gynecol 2013;10(3):138-142

Objective:

To evaluate the effects of assisted hatching in combination with defragmentation applied to day 3 poor quality human embryos, on implantation and pregnancy rates.

Materials and Methods:

A retrospective analysis was performed in patients (n=168) of all ages with no good quality transferable embryos (Veeck classification embryos >grade 1 and/or >10% fragmentation). The first group was consisted of cycles in which mAHA was performed to all transferred grade 2 embryos. The second group included transfer cycles where all the embryos were highly fragmented (between 10-50% fragmentations, grade 3) and aAHA and microsurgical fragment removal were applied to all of them.

Results:

In first group positive βhCG was 33%, clinical pregnancy (fetal heart beat) rate was 27% and implantation rate was 11,28%. These rates were 37, 1%; 28, 8% and %16,19 respectively in the aAHA plus defragmentation group. In cases over 35 years of age in aAHA plus defragmentation group acceptable implantation (14,46%) and clinical pregnancy (31,58%) rates were achieved.

Conclusion:

In patients with no good quality transferable embryos AHA combined with defragmentation can be utilised with acceptable success rates in laboratories where there are experienced personnel available for this procedure otherwise only AHA can be the best option.

Keywords: Assisted hatching, defragmentation, embryo fragmentation, embryo quality, ICSI