| Objective:To assess the effect of assisted reproductive technology with assisted hatching (AH) in the treatment of patients with repeated implantation failure (RIF).Methods:All randomized controlled trials (RCTs) about AH in the treatment of patients with RIF were retrieved from databases including Cochrane Library, MEDLINE, CNKI, VIP and Wanfang databases update to Oct.2013. Information was collected by two researchers independently. The quality of included RCTs was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions, and the Cochrane Collaboration’s software RevMan5.0was used for meta-analysis. Results:There were7RCTs (1621participants) included. The clinical pregnancy rate in the AH group (OR=1.99,95%CI1.22to3.23, P=0.006) was significantly increased compared to the control group. The implantation rate in the AH group (OR=2.11,95%CI1.17to3.80, P=0.01) was significantly increased compared to the control group too. To compare with the live birth rate, AH group was higher than that in the control group and the difference of that has statistically significance (OR=2.04,95%CI1.07to3.89, P=0.03). To compare with the multiple pregnancy rate, the control group was lower than that in AH group and the difference between the two groups has statistically significance (OR=1.58,95%CI1.05to2.37, P=0.03). The differences of the miscarriage rate between the two groups has no statically significance (OR=1.62,95%CI0.75to3.50, P=0.22). Conclusions:Current evidence shows that AH was related to improve the clinical pregnancy, the implantation and live birth rates in women with previous repeated implantation failure. AH was unlikely to increase the miscarriage rate, but it may increased the multiple pregnancy rate. However, considering the limitation of the methodological quality and sample size of the included studies, more high-quality, large-scale RCTs are still needed to confirm this conclusion. |
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