What is assisted hatching?

If you are considering in vitro fertilisation (IVF) treatment, some individuals may need additional help, such as assisted hatching, to enhance conception.

However, assisted hatching is not suitable for everyone. So, it’s important to know how it works and when it may be required.

How assisted hatching works

Assisted hatching helps with the hatching of embryos, improving the implantation process, and the chances of conception.

Embryos are surrounded by a thick layer called the zona pellucida. Before implantation takes place, the embryo must break out or hatch from this thick layer for the pregnancy to progress. If the embryo fails to hatch on its own, assisted hatching can help with the process.

When is assisted hatching done?

Assisted hatching usually takes place on the third or fourth day of the IVF treatment, which is when the embryo begins to attach deeper to the uterine lining and the implantation process starts. This is considered the optimal time to conduct assisted hatching, if needed.

To ensure the embryo is developing correctly, it is monitored using an EmbryoScope™, which is a special incubator with built-in cameras. This system provides a score and time-lapse of the embryo's growth. The embryo quality is graded from A to F, with A indicating high quality and F indicating lower quality. Rest assured, this will be discussed with your embryologist during your consultation.

The assisted hatching procedure

The procedure may seem a little daunting, but it is quite simple. During the process, an embryologist uses a laser to weaken or create a small opening in the zona pellucida, enabling the embryo to hatch and implant in the uterus. Assisted hatching can also be conducted on frozen embryos after they are thawed.

Benefits

The main benefit of assisted hatching is its potential to enhance embryo implantation and increase the chances of conception, particularly in older women. As women age, the zona pellucida – the outer layer of the embryo - can become thicker, making it more difficult for the embryo to hatch. Therefore, assisted hatching can help with this crucial step in the process. Moreover, individuals who have had failed IVF cycles may find this procedure beneficial.

Risks

While assisted hatching is generally considered safe, there are some risks that come with these types of procedures.

Although rare, there is a slight risk of causing damage to the embryo when using the laser or exposure to different temperatures, which is why embryologists conduct these procedures under controlled laboratory conditions. Additionally, there may be an increased likelihood of having identical twins.

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Who is assisted hatching for?

Assisted hatching is generally recommended for individuals with a lower chance of successful implantation.

This includes those who are older, generally over 37 years old as well as individuals who have experienced multiple failed IVF treatments. Additionally, those with poor-quality embryos or a low egg count may also benefit from this procedure.

Success rates

According to the Human Fertilisation and Embryology Authority (HFEA), the use of assisted hatching is rated grey as an add-on treatment. This means for most patients, there is insufficient evidence of this add-on to rate its effectiveness in improving the chances of having a baby.

However, this doesn’t mean it will not be effective for you. The medical team will evaluate your fertility assessment and decide whether assisted hatching is suitable for you.