Obstetric and Neonatal Outcomes Following Assisted Hatching Treatment

Introduction: Assisted hatching (AH) technique involves artificial disruption of the zona pellucida prior to implantation, thus exposing the embryo to potential thermal or mechanical damage. The safety of this procedure and its effect on obstetrical and neonatal outcomes in singleton pregnancies is still a subject of debate.

Aim: To assess the safety of AH technique and examine its effect on obstetrical outcomes, perinatal and neonatal outcomes and risk of developmental delay.

Materials and methods: We performed a retrospective cohort of ART cycles using laser AH technique carried out at Sheba Medical Center between the years 1998-2011. The study group consisted of 120 cases of AH cycles resulting in singleton pregnancies and live births compared with 113 control cases.

Results: No significant differences were found between the groups in all obstetrical and perinatal outcomes examined including PPROM, GDMA, hypertensive diseases of pregnancy, delivery by cesarean section, gestational age at delivery, low birth weight (LBW0.05). No significant differences were observed between AH and control group in risk of non-chromosomal birth defects (5.8% vs. 4.4% respectively, OR 1.33; 95% CI, 0.41-4.34) and developmental delay (19.2% vs. 12.8% respectively, OR 1.62; 95% CI, 0.74-3.52). For developmental delay, results did not change after adjustment for PTL, LBW and birth defects.

Conclusions: AH did not increase the risk of obstetrical and neonatal complications in singleton pregnancies, including non-chromosomal birth defects and child developmental delay. AH should therefore be considered a safe method of ART.