Journal of Assisted Reproduction and Genetics

, Volume 27, Issue 8, pp 457–461 | Cite as

Laser assisted zona thinning technique has no beneficial effect on the ART outcomes of two different maternal age groups

  • Pelin KutluEmail author
  • Ozhan Atvar
  • Omer Faruk Vanlioglu
Assisted Reproduction



Laser assisted zona thinning is a technique used for facilitating embryo’s hatching process and is commonly used for the embryos of poor prognosis patients with advanced maternal age, repeated implantation failures, poor embryo quality or thick zona pellucida. The aim of this study was to investigate the effect of zona thinning on both good or poor prognosis patients of two different age groups.


We investigated two different age groups (group 1: <35 years and group 2: ≥35 years ) and compared the effect of assisted zona thinning (groups 1A and 2A) versus not-thinned controls (groups 1B and 2B) in both groups.


The clinical pregnancy rates were 57% and 56% in groups 1A and 1B (p = 0.86), 43% and 38% in groups 2A and 2B (p = 0.59) respectively.


Our results suggest that laser assisted zona thinning of day 3 embryos has no beneficial effect on clinical pregnancy and implantation outcomes.


ART Maternal age Laser assisted zona thinning Zona pellucida 


  1. 1.
    Schiewe MC, Hazeleger NL, Sclimenti C, Balmaceda JP. Physiological characterization of blastocyst hatching mechanisms by use of a mouse antihatching model. Fertil Steril. 1995;63:288–94.PubMedGoogle Scholar
  2. 2.
    Cohen J, Elsner C, Kort H, Malter H, Massey J, Mayer MP, et al. Impairment of the hatching process following IVF in the human and improvement of implantation by assisting hatching using micromanipulation. Hum Reprod. 1990;5:7–13.PubMedGoogle Scholar
  3. 3.
    Tucker M, Graham J, Han T, Levy M, Sagoskin A, Stillman R. Enhanced implantation of day-6 blastocysts following assisted hatching with acidic tyrode’s medium. Fertil Steril. 1999;72:s20–1.Google Scholar
  4. 4.
    Blake DA, Forsberg AS, Johansson BR, Wikland M. Laser zona pellucida thinning- an alternative approach to assisted hatching. Hum Reprod. 2001;16:1959–64.CrossRefPubMedGoogle Scholar
  5. 5.
    Ali J, Rahbar S, Burjaq H, Sultan AM, Al Flamerzi M, Shahata MA. Routine laser assisted hatching results in significantly increased clinical pregnancies. J Assist Reprod Genet. 2003;20:177–81.CrossRefPubMedGoogle Scholar
  6. 6.
    Magli MC, Gianaroli L, Ferraretti AP, Ortini D, Aicardi G, Montanaro N. Rescue of implantation potential in embryos with poor prognosis by assisted zona hatching. Hum Reprod. 1998;13:1331–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Cohen J, Alikani M, Trowbridge J, Rosenwaks Z. Implantation enhancement by selective assisted hatching using zona drilling of human embryos with poor prognosis. Hum Reprod. 1992;7:685–91.PubMedGoogle Scholar
  8. 8.
    Stein A, Rufas O, Amit S, Avrech O, Pinkas H, Ovadia J, et al. Assisted hatching by partial zona dissection of human pre-embryos in patients with recurrent implantation failure after in vitro fertilization. Fertil Steril. 1995;63:838–41.PubMedGoogle Scholar
  9. 9.
    Schoolcraft WB, Schlenker T, Jones GS, Jones Jr HW. In vitro fertilization in women age 40 and older: the impact of assisted hatching. J Assist Reprod Genet. 1995;12:581–4.CrossRefPubMedGoogle Scholar
  10. 10.
    Montag M, van der Ven H. Laser-assisted hatching in assisted reproduction. Croat Med J. 1999;40:398–403.PubMedGoogle Scholar
  11. 11.
    Meldrum DR, Wisot A, Yee B, Garzo G, Yeo L, Hamilton F. Assisted hatching reduces the age-related decline in IVF outcome in women younger than age 43 without increasing miscarriage or monozygotic twinning. J Assist Reprod Genet. 1998;15:418–21.CrossRefPubMedGoogle Scholar
  12. 12.
    Balaban B, Urman B, Alatas C, Mercan R, Mumcu A, Isiklar A. A comparison of four different techniques of assisted hatching. Hum Reprod. 2002;17:1239–43.CrossRefPubMedGoogle Scholar
  13. 13.
    Chatzimeletiou K, Picton HM, Handyside AH. Use of a non-contact, infrared laser for zona drilling of mouse embryos: assessment of immediate effects of blastomere viability. Reprod Biomed Online. 2001;2:178–87.PubMedGoogle Scholar
  14. 14.
    Hsieh YY, Huang CC, Cheng TC, Chang CC, Tsai HD, Lee MS. Laser-assisted hatching of embryos is better than the chemical method for enhancing the pregnancy rate in women with advanced age. Fertil Steril. 2002;78:179–82.CrossRefPubMedGoogle Scholar
  15. 15.
    Malter HE, Cohen J. Blastocyst formation and hatching in vitro following zona drilling of mouse and human embryos. Gamete Res. 1989;24:67–80.CrossRefPubMedGoogle Scholar
  16. 16.
    Cohen J, Feldberg D. Effects of the size and number of ZP openings on hatching and trophoblast outgrowth in the Mouse embryo. Mol Reprod Dev. 1991;30:70–80.CrossRefPubMedGoogle Scholar
  17. 17.
    Ziebe S, Petersen K, Lindenberg S, Andersen AG, Galrielsen A, Andersen AN. Embryo morphology or cleavage stage: how to select the best embryos for transfer after in-vitro fertilization. Hum Reprod. 1997;12:1545–9.CrossRefPubMedGoogle Scholar
  18. 18.
    Sallam HN, Sadek S, Agameya A. Assisted hatching- a meta analysis of randomized controlled trials. J Assist Reprod Genet. 2003;20(8):332–42.CrossRefPubMedGoogle Scholar
  19. 19.
    Demirel LC, Evirgen O, Al-Hasani S. The role of assited hatching in human IVF. Middle East Fertil Soc J. 2002;7:6–12.Google Scholar
  20. 20.
    Edirisinghe WR, Ahnonkitpanit V, Promviengchai S, Suwanjanakorn S, Pruksananonda K, Chinpilas V, et al. A study failing to determine significant benefits from assisted hatching: patients selected for advanced age, zonal thickness of embryos, and previous failed attempts. J Assist Reprod Genet. 1999;16:294–301.CrossRefPubMedGoogle Scholar
  21. 21.
    Horng SG, Chang CL, Wu HM, Wang CW, Cheng CK, Huang HY, et al. Laser-assisted hatching of embryos in women of advanced age after in vitro fertilization: a premilimary report. Chang Gung Med J. 2002;25:531–7.PubMedGoogle Scholar
  22. 22.
    Hellebaut S, De Sutter P, Dozortsev D, Onghena A, Qian C, Dhont M. Does assisted hatching improve implantation rates after in vitro fertilization or intracytoplasmic sperm injection in all patients? A prospective randomized study. J Assist Reprod Genet. 1996;13:19–22.CrossRefPubMedGoogle Scholar
  23. 23.
    Sagoskin A, Levy M, Tucker M, Richter K, Widra E. Laser assisted hatching in good prognosis patients undergoing in vitro fertilization-embryo transfer: a randomized controlled trial. Fertil Steril. 2007;87:283–7.CrossRefPubMedGoogle Scholar
  24. 24.
    Silva CP, Silva V, Kommineni K, Keefe D. Effect of in vitro culture of mammalian embryos on the architecture of the zona pellucida. Biol Bull. 1997;193:235–6.PubMedGoogle Scholar
  25. 25.
    Carroll J, Depypere H, Matthews CD. Freeze-thaw-induced changes of the zona pellucida explain decreased rates of fertilization in frozen-thawed mouse oocytes. J Reprod Fertil. 1990;90:547–53.CrossRefPubMedGoogle Scholar
  26. 26.
    Ge HS, Zhou R, Zhang W, Lin JJ. Impact of assisted hatching on fresh and frozen-thawed embryos: a prospective, randomized study. Reprod Biomed Online. 2008;16(4):589–96.CrossRefPubMedGoogle Scholar
  27. 27.
    Huisman GJ, Fauser BC, Eijkemans MJ, Pieters MH. Implantation rates after in vitro fertilization and transfer of a maximum of two embryos that have undergone three to five days in culture. Fertil Steril. 2000;73:117–22.CrossRefPubMedGoogle Scholar
  28. 28.
    Fong CY, Bongso A, Sathananthan H, Ho J, Ng SC. Ultrastructural observations of enzymatically treated human blastocysts: zona-free blastocyst transfer and rescue of blastocysts with hatching difficulties. Hum Reprod. 2001;16:540–6.CrossRefPubMedGoogle Scholar
  29. 29.
    Cohen J. Assisted hatching of human embryos. J In Vitro Fert Embryo Transf. 1991;8:179–90.CrossRefPubMedGoogle Scholar
  30. 30.
    Cheon YP, Gye MC, Kim CH, Kang BM, Chang YS, Kim SR, et al. Role of actin filaments in the hatching process of mouse blastocysts. Zygote. 1999;7:123–9.CrossRefPubMedGoogle Scholar
  31. 31.
    Tucker MJ, Lueeke NM, Wiker SR, Wright G. Chemical removal of the outside of the zona pellucida of day 3 human embryos has no impact on implantation rate. J Assist Reprod Genet. 1993;10:187–91.CrossRefPubMedGoogle Scholar
  32. 32.
    Hurst B, Tucker M, Awoniyi A, Schlaff W. Assisted hatching does not enhance IVF success in good prognosis patients. J Assist Reprod Genet. 1998;15:62–4.CrossRefPubMedGoogle Scholar
  33. 33.
    Balakier H, Mandel R, Sojecki A, Motamedi G, Zaver S, Librach C. Laser zona thinning in women aged ≤37 years: a randomized study. Fertil Steril. 2009;91:1479–82.CrossRefPubMedGoogle Scholar
  34. 34.
    Hagemann A, Lawrence L, Jungheim E, Lanzendorf S, Ratts V, Odem R. Zona pellucida thickness does not predict pregnancy outcomes in patients less than 38 years of age undergoing in vitro fertilization: results from a prospective, randomized trial on assisted hatching. Fertil Steril. 2007;88:s132.CrossRefGoogle Scholar
  35. 35.
    Hagemann A, Lanzendorf S, Jungheim E, Chang A, Ratts V, Odem R. A prospective, randomized, double-blinded study of assisted hatching in women younger than 38 years undergoing in vitro fertilization. Fertil Steril. 2010;93:586–91. 34.CrossRefPubMedGoogle Scholar
  36. 36.
    Valojerdi M, Eftekhari-Yazdi P, Karimian L, Hassani F, Movaghar B. Effect of laser zona thinning on vitrified–warmed embryo transfer at the cleavage stage: a prospective, randomized study. Reprod Biomed Online. 2010;20:234–42.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Pelin Kutlu
    • 1
    Email author
  • Ozhan Atvar
    • 1
  • Omer Faruk Vanlioglu
    • 1
  1. 1.Medicana Camlica HospitalUskudar, IstanbulTurkey

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