Laser-assisted hatching (LAH) is an advanced IVF technique to help fertilized egg (embryo) hatch and implant in the uterus. Assisted hatching procedure is performed in the laboratory on cleavage phase embryos or day 3 of invitro development using a laser. Later it is transferred into the patient's womb. The process aims to overcome the issue of embryo implantation failure and ensure a successful pregnancy.
Laser-Assisted Hatching: Reasons
Doctors often recommend laser-assisted hatching if a woman has experienced IVF failure due to unexplained causes. However, it is essential to note that not all couples undergoing IVF will be directed for LAH.
Assisted hatching is performed to improve the overall pregnancy rate in the following conditions:
Advanced maternal age: With age, women tend to produce eggs with a thicker outer layer (zona pellucida). It can make it difficult for the fertilized eggs to get hatched and be implanted in the uterus. LAH assisted by creating a hole in the zona pellucida, making it easier to implant the egg into the womb successfully.
Failed IVF: In conditions of two or more failed IVF, the doctor will recommend laser-assisted hatching to improve the overall success rate of implantation.
Poor implantation: Some women may have a poor history of implantation, which obstructs the fertilized egg from attaching to the uterus. Performing LAH helps improve implantation chances and the successful hatching of an embryo.
Poor embryo development: Embryos with poor development rates find it hard to hatch, wherein LAH can increase the chances of successful implantation.
Frozen Embryos: LAH improves hatching and implantation using frozen embryos with a thick zona pellucida.
Increased level of FSH: Increased follicle-stimulating hormone levels can thicken the embryo's outer shell, making it difficult to hatch. An LAH is the most viable technique to increase the chance of implantation.
Laser-Assisted Hatching: Procedure
Laser-assisted hatching (LAH) procedure is conducted in a laboratory setting. It is combined with the invitro fertilization treatment or intracytoplasmic sperm injection (ICSI) cycle. The process is performed on the 3rd day after the IVF cycle when the embryo is still kept in the lab.
A specialized laser (intense light beam) under a microscope creates a shell gap to bring the embryo out. It takes hardly a few seconds to make a small crack on the zona pellucida and later transferred to the uterus to attach itself to the uterus lining and continue division.
Note: The laser will not directly connect with the embryo and is performed by expert technicians with utmost precision to ensure the safety of the embryo.
Laser-Assisted Hatching: Advantage:
Laser-assisted hatching is considered beneficial compared to other types of assisted hatching, including manual and chemical-assisted hatching. These include:
- Minimal handling of the embryo
- Guarantees fast control over drilling for opening the shell
- Does not directly come in contact with the embryo and hence lays no adverse effect on the egg
- Boosts the overall success rate of pregnancy and embryo implantation
Laser-Assisted Hatching: Risks and Complications
Laser-assisted hatching risks are similar to other ICSI and IVF procedures. However, as the technique involves interference with the natural hatching process, it also includes a few risks. These include:
- Multiple pregnancies: LAH technique may increase the chances of multiple pregnancies, such as twins, triplets or more. It is associated with maternal immunity risk and low birth weight for babies.
- Embryo damage: Although the laser is aimed at the embryo's outer layer with minimal invasion technique, there is a small risk that the laser may damage the embryo's inner cell mass.
- Ectopic pregnancy: It is a rare complication that occurs when the fertilized egg gets implanted outside the uterus, generally in the fallopian tubes
- Premature birth: Chances of multiple pregnancies may result in premature birth and increase the risk for newborns.
- Congenital disabilities: Although there is no evidence of LAH increasing congenital disability, any medical procedure can lay a small risk of complication.
It is essential to note that the risks related to laser-assisted hatching are relatively low and each case can be unique and recommended to get better guidance. Besides, it is necessary to understand that not all IVF cycles require LAH. Consequently, it is best to consult a specialist to know if it's a good option. Connect with expert fertility specialists at Apollo Fertility at JP Nagar, Bengaluru, to gain professional guidance and understanding of the entire process. Call 1800-500-4424 for appointments.
The success rate of LAH depends on various factors, from the woman's age, the cause of infertility and the number of LAH attempts. However, on average, the success rate ranges from 10-15% per cycle.
The number of cycles will depend on the couple's situation. On average, 3 to 6 cycles are recommended before moving to advanced fertility treatments.
The embryo is generally transferred within 24 to 48 hours after the LAH process.
The LAH procedure is performed under a microscope using a laser to create a small incision in the zona pellucida (outer layer of the embryo).
Yes, LAH can be performed on frozen embryos.