| Objective:The aim of this study was to evaluate the effects of laser assisted hatching(LAH) on the outcome following the transfer of vitrified–warmed embryos,To clarify What kind of patients can really benefit from LAH, and provide reliable basis for accurate clinical indications.Method:A retrospective cohort analysis was carried out, that spanned a one and a half years period(2012.01-2014.06),a total of 270 FETcycles were included. Laser- assisted hatching was carried out on D-3 thawed and warmed embryos before transfer.①The total cycles were divided into two groups: LAH(n=145) and NLAH(n=125). The implantation, clinical pregnancy, live birth and multiple pregnancy rates were compared; and then according to the different age groups and different ways of fertilization(IVF and ICSI), the LAH and NLAH cycles were divided into age < 35 and ≥35 years old, IVF and ICSI groups,the outcomes of the implantation, clinical pregnancy, live birth and multiplepregnancy rates were were compare respectively.Resouts:① The general condition of the patients:A totle of 270 cycles were included, The age range of the patients is from 20-42 yeas; The body mass index(BMI) range of the patients is from 18-25(Kg/m2);the span of infertility is 1-25 years; the total number of thawed embryos were 655, the number of portable embryos after throughnight culture were 566;fertilization by IVF cycles were 175,the IVF rate is 64.81%(175/270);Laser assisted hatching 145 cycles, the LAH rate is 53.70%(145/270).② The total FET outcome:Clinical pregnancy cycles were 103,the CPR is 38.15%(103/270);Multiple pregnancy cycles were 23,the MPR is 22.33%(23/103);The live birth cycles were 87,the LBR is 84.47%(87/103).③The impact of LAH on FET outcomes: The significantly higher implantation(25.81% versus17.74%) and clinical pregnancy(44.14% versus 31.2%) rates were observed in the LAH group(all P < 0.05,table 2); There was no statistically significant difference between the general condition of the LAH-<35 ages group and NLAH-<35ages group patiens(P>0.05,table 3),Statistically significantly higher implantation(30.04% versus13.64%) and clinical pregnancy(48.72% versus 31.73%) rates were observed in the LAH-<35group(P < 0.05,table4);Statistically significantly higher average age was observed in the LAH-≥35years group and NLAH- ≥ 35 years group patiens, and no statistically significant difference was observed in the outcome of FET and there is no multiple pregnancies occur(P > 0.05, table 4);④The influence of LAH in the IVFand ICSI FET outcomes :In IVF- FET LAH group,the implantation rate is higher than NLAH group, the statistically significant were observed(P < 0.05, table 6);in ICSI- FET LAH group,the statistically significance of implantation,clinical pregnancy,live birth and multiple rates had not been observed(P > 0.05, table 6). There was no statistically significant difference between the general condition of the LAH-IVF<35 ages group and NLAH-IVF<35ages group patiens( P>0.05,table 7),Statistically significantly higher implantation(29.49% versus16.15%) and clinical pregnancy(46.67%versus27.42%) rates were observed(P < 0.05,table8), and in the LAH-IVF≥35ages group and NLAH-≥35 ages group,there were no obvious differences in the FET outcome; in the ICSI-FETgroups,there had no Statistically significantly FET outcomes in each age groups was observed(P > 0.05, table10).Conclusions: 1. Laser assisted hatching(LAH) can overall improve the implantation and clinicalpregnancy rates of the FETcycles in IVF patients of < 35 ages; 2. Laser assisted hatching(LAH)is safe and effective. |
PDF Full Text Request