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- Title
The impact of assisted hatching on live birth rates and outcomes of assisted conception: a systematic review.
- Authors
Edmond Edi-Osagie; Lee Hooper; Mourad W. Seif
- Abstract
BACKGROUND: During the past decade in the UK, only one in six cycles of assisted conception has resulted successfully in a live birth. Assisted hatching (AH) has been proposed to improve outcome. This systematic review of randomized controlled trials addresses primary outcomes of live birth, clinical pregnancy and embryo implantation. METHODS: Trials on post-fertilization disruption of the zona pellucida were identified from the Cochrane Controlled Trials Register, MEDLINE, EMBASE and published bibliographies. Outcomes were analysed using random effects meta-analysis, sensitivity analysis, sub-grouping and meta-regression. RESULTS: Of 23 included trials recruiting 2572 women, only six reported live birth data. AH had no significant effect on live birth (OR 1.21, 95% CI 0.821.78). There was a significant benefit of AH on clinical pregnancy (OR 1.63, 95% CI 1.272.09), especially in the sub-group of women with previous failure of assisted conception (OR 2.33, 95% CI 1.633.34). Meta-regression suggested that AH might be more useful in older women. Implantation data were not considered valid for statistical analysis. The methodological quality of included trials was sub-optimal. CONCLUSIONS: AH probably enhances clinical pregnancy, especially in women with previous failure of assisted conception treatment and in older women; however, trials were of poor quality and so may be biased. Better quality trials reporting live birth are required to confirm any positive effects on the take-home-baby rate.
- Subjects
CHILDBIRTH; CONCEPTION; PREGNANCY; HUMAN reproductive technology
- Publication
Human Reproduction, 2003, Vol 18, Issue 9, p1828
- ISSN
0268-1161
- Publication type
Article
- DOI
10.1093/humrep/deg334