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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2024

Open Access 01-12-2024 | Laser | Research

Two laser-assisted hatching methods of embryos in ART: a systematic review and meta-analysis

Authors: Kexin Chen, Mengying Gao, Yao Wu, Zhixin Hu, Lu Tang, Minyao Li, Mei Tian, Hao Cui, Yanrong Huang, Youzhen Han, Lei Li, Yonggang Li, Yunxiu Li, Ze Wu, Zouying Tang, Ronghui Zhang, Yuerong Wu, Yizhi Zhang, Yan Guo, Hongqing Zhang, Lifeng Xiang, Jiacong Yan

Published in: BMC Pregnancy and Childbirth | Issue 1/2024

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Abstract

Background

Laser-assisted hatching (LAH) stands as the predominant technique for removing the zona pellucida (ZP) in embryos, primarily consisting of two methods: drilling laser-assisted hatching (D-LAH) and thinning laser-assisted hatching (T-LAH). Presently, both methods have limitations, and their comparative efficacy for embryo implantation and clinical pregnancy remains uncertain.

Aim

Evaluate the impact of D-LAH and T-LAH on clinical pregnancy rates within assisted reproductive technology (ART).

Methods

We systematically searched electronic databases including PubMed, Web of Science, and Cochrane Library until July 20, 2022. This study encompassed observational studies and randomized controlled trials (RCTs). A 95% confidence interval (CI) was utilized for assessing the risk ratio (RR) of pregnancy outcomes. The level of heterogeneity was measured using I2 statistics, considering a value exceeding 50% as indicative of substantial heterogeneity.

Results

The meta-analysis scrutinized 9 studies involving 2405 clinical pregnancies from D-LAH and 2239 from T-LAH. Findings suggested no considerable variation in the clinical pregnancy rates between the two techniques (RR = 0.93, 95% CI: 0.79–1.10, I2 = 71%, P = 0.41). Subgroup analyses also revealed no substantial differences. However, D-LAH exhibited a notably higher occurrence of singleton pregnancies compared to T-LAH (RR = 2.28, 95% CI: 1.08–4.82, I2 = 89%, P = 0.03). There were no noteworthy distinctions observed in other secondary outcomes encompassing implantation rate, multiple pregnancies, ongoing pregnancy, miscarriage, premature birth, and live birth.

Conclusion

Both the primary findings and subgroup analyses showed no marked variance in clinical pregnancy rates between D-LAH and T-LAH. Therefore, patients with varying conditions should select their preferred LAH technique after assessing their individual situation. However, due to the restricted number of studies involved, accurately gauging the influence of these laser techniques on clinical outcomes is challenging, necessitating further RCTs and high-quality studies to enhance the success rate of ART.

Trial registration

PROSPERO: CRD42022347066.
Appendix
Available only for authorised users
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Metadata
Title
Two laser-assisted hatching methods of embryos in ART: a systematic review and meta-analysis
Authors
Kexin Chen
Mengying Gao
Yao Wu
Zhixin Hu
Lu Tang
Minyao Li
Mei Tian
Hao Cui
Yanrong Huang
Youzhen Han
Lei Li
Yonggang Li
Yunxiu Li
Ze Wu
Zouying Tang
Ronghui Zhang
Yuerong Wu
Yizhi Zhang
Yan Guo
Hongqing Zhang
Lifeng Xiang
Jiacong Yan
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2024
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-024-06380-8

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