Two laser-assisted hatching methods of embryos in ART: a systematic review and meta-analysis

Kexin Chen; Mengying Gao; Yao Wu; Zhixin Hu; Lu Tang; Minyao Li; Mei Tian; Hao Cui; Yanrong Huang; Youzhen Han; Lei Li; Yonggang Li; Yunxiu Li; Ze Wu; Zouying Tang; Ronghui Zhang; Yuerong Wu; Yizhi Zhang; Yan Guo; Hongqing Zhang; Lifeng Xiang; Jiacong Yan

doi:10.1186/s12884-024-06380-8

BMC Pregnancy and Childbirth (Apr 2024)

Two laser-assisted hatching methods of embryos in ART: a systematic review and meta-analysis

Kexin Chen,
Mengying Gao,
Yao Wu,
Zhixin Hu,
Lu Tang,
Minyao Li,
Mei Tian,
Hao Cui,
Yanrong Huang,
Youzhen Han,
Lei Li,
Yonggang Li,
Yunxiu Li,
Ze Wu,
Zouying Tang,
Ronghui Zhang,
Yuerong Wu,
Yizhi Zhang,
Yan Guo,
Hongqing Zhang,
Lifeng Xiang,
Jiacong Yan

Affiliations

Kexin Chen: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Mengying Gao: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Yao Wu: The First People’s Hospital of Qujing
Zhixin Hu: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Lu Tang: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Minyao Li: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Mei Tian: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Hao Cui: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Yanrong Huang: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Youzhen Han: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Lei Li: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Yonggang Li: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Yunxiu Li: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Ze Wu: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Zouying Tang: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Ronghui Zhang: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Yuerong Wu: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Yizhi Zhang: Kunming Maternity and Child Care Hospital
Yan Guo: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Hongqing Zhang: Kunming Maternity and Child Care Hospital
Lifeng Xiang: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province
Jiacong Yan: Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, First People’s Hospital of Yunnan Province

DOI: https://doi.org/10.1186/s12884-024-06380-8
Journal volume & issue: Vol. 24, no. 1
pp. 1 – 12

Abstract

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Abstract Background Laser-assisted hatching (LAH) stands as the predominant technique for removing the zona pellucida (ZP) in embryos, primarily consisting of two methods: drilling laser-assisted hatching (D-LAH) and thinning laser-assisted hatching (T-LAH). Presently, both methods have limitations, and their comparative efficacy for embryo implantation and clinical pregnancy remains uncertain. Aim Evaluate the impact of D-LAH and T-LAH on clinical pregnancy rates within assisted reproductive technology (ART). Methods We systematically searched electronic databases including PubMed, Web of Science, and Cochrane Library until July 20, 2022. This study encompassed observational studies and randomized controlled trials (RCTs). A 95% confidence interval (CI) was utilized for assessing the risk ratio (RR) of pregnancy outcomes. The level of heterogeneity was measured using I2 statistics, considering a value exceeding 50% as indicative of substantial heterogeneity. Results The meta-analysis scrutinized 9 studies involving 2405 clinical pregnancies from D-LAH and 2239 from T-LAH. Findings suggested no considerable variation in the clinical pregnancy rates between the two techniques (RR = 0.93, 95% CI: 0.79–1.10, I2 = 71%, P = 0.41). Subgroup analyses also revealed no substantial differences. However, D-LAH exhibited a notably higher occurrence of singleton pregnancies compared to T-LAH (RR = 2.28, 95% CI: 1.08–4.82, I2 = 89%, P = 0.03). There were no noteworthy distinctions observed in other secondary outcomes encompassing implantation rate, multiple pregnancies, ongoing pregnancy, miscarriage, premature birth, and live birth. Conclusion Both the primary findings and subgroup analyses showed no marked variance in clinical pregnancy rates between D-LAH and T-LAH. Therefore, patients with varying conditions should select their preferred LAH technique after assessing their individual situation. However, due to the restricted number of studies involved, accurately gauging the influence of these laser techniques on clinical outcomes is challenging, necessitating further RCTs and high-quality studies to enhance the success rate of ART. Trial registration PROSPERO: CRD42022347066.

Published in BMC Pregnancy and Childbirth

ISSN: 1471-2393 (Online)
Publisher: BMC
Country of publisher: United Kingdom
LCC subjects: Medicine: Gynecology and obstetrics
Website: http://bmcpregnancychildbirth.biomedcentral.com

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