Hatching: how to select the clinical indications

Abstract

Currently, most fertility centers around the world use assisted hatching (AH) techniques to help embryo release out of the zona pellucida (ZP) and thus increase the implantation rate. For the last 13 years, several retrospective and prospective studies, assessing AH in different clinical indications, have given disparate results, making the selection of patients or embryos in need of this treatment complex. The most relevant conclusion obtained so far is that AH has a beneficial effect in women with repeated failures of embryo implantation. The place of AH in clinical practice in comparison with other approaches has to be reevaluated based on the selection of viable embryos using strict morphometric criteria and/or prolonged culture up to the blastocyst stage. Finally, the potential value of AH for indications other than repeated failure has to be weighed carefully to make sure that AH does not reduce the chances of implantation.