Laser Assisted Hatching (LAH), Risks & Benefits

What is laser hatching?

Laser hatching is a procedure used in fertility treatments where a laser is used to create an opening in the outer protective layer of an embryo, making it easier for the embryo to hatch and implant in the uterus. Laser hatching is a technique used in assisted reproductive technologies (ART) to improve the chances of embryo implantation during IVF.

Why is laser hatching effective?

By making the small hole, embryologists hope to make it easier for the embryo to hatch out of its shell and implant itself into the lining of the uterus.
Laser hatching is typically performed on embryos that have failed to implant after multiple rounds of IVF or when a couple has had recurrent miscarriages.
The process usually takes place on day three after fertilization when the embryos are at their eight-cell stage. A trained embryologist will use precision lasers to create small openings in each embryo's zona pellucida.

Note: Zona Pellucida is the protective membrane surrounding an embryo

Laser-assisted hatching is considered minimally invasive and does not harm or alter embryos' genetic makeup. However, risks associated with any ART procedures exist and should be discussed at length with your fertility specialist before starting treatment.

When is Laser Assisted Hatching (LAH) recommended?

Laser Assisted Hatching (LAH) is a procedure that can improve the chances of success in In Vitro Fertilization (IVF).

LAH is recommended for couples who have had multiple unsuccessful IVF cycles or who have poor-quality embryos.
Women over 38 years old may also benefit from LAH as their eggs tend to have thicker shells which makes it harder for them to hatch naturally.

It's important to note that not all fertility clinics offer LAH as standard practice, and some may only recommend it on a case-by-case basis. Your doctor will assess your situation and determine whether LAH is appropriate for you.

As with any medical procedure, there are risks associated with LAH. These include damage to the embryo or However, these risks are generally low when performed by experienced professionals.

When considering your options for IVF treatment, be sure to discuss the potential benefits and risks of laser-assisted hatching with your doctor.

Risks and Benefits

What are the risks of laser-assisted hatching?

Laser-assisted hatching is a relatively safe procedure; however, as with any medical intervention, there are some risks associated with it.

One of the main concerns is that laser energy can potentially damage the embryo during the process. This risk, though small, should always be considered by your fertility specialist before proceeding with LAH.
Another potential risk of laser hatching is that it could cause an opening in the zona pellucida to become too large or jagged which may result in premature rupture and ultimately eliminate any chance for implantation or even fertilization. The timing and technique used during this procedure need to be precise to avoid such issues.
Reduced implantation due to excessive manipulation during hatching.
There is 22% chance it may lead to multiple pregnancies.

Alert: Not all clinics offer LAH because they do not have adequate equipment or experienced specialists who can carry out such a delicate treatment safely. It's essential that patients only consider undergoing this procedure at licensed clinics where highly trained professionals perform it.

While there are certain risks associated with laser-assisted hatching procedures when handled by inexperienced practitioners or under unsuitable conditions, generally speaking, when carried out correctly by an expert fertility specialist team using top-tier technology, these risks are minimized significantly.

What is the success rate of laser hatching?

The success rate of laser hatching can vary depending on several factors. Age, infertility diagnosis, and the quality of embryos are all contributing factors to the outcome of an IVF cycle with LAH.

Studies have shown that younger women tend to have higher success rates than older women when using LAH. This is likely due to better egg quality in younger individuals.
Infertility diagnoses such as male factor infertility or endometriosis may also affect the success rate of LAH. It's important for couples undergoing IVF with LAH to discuss their specific situation and potential outcomes with their fertility specialist.
The quality of embryos is another crucial factor in determining the success rate of laser hatching. Embryos that are deemed high-quality are more likely to result in a successful pregnancy following IVF with LAH.
Research suggests that using laser-assisted hatching may increase the chances of a successful pregnancy by about 50%. While this percentage seems small, it can make a significant difference for couples struggling with infertility.

Note: However, there is not enough evidence to suggest that LAH is universally effective for all patients undergoing IVF treatments. Some studies have shown no significant difference in pregnancy rates between patients who underwent LAH versus those who did not receive it.

What are the advantages of laser-assisted hatching?

Laser-assisted hatching (LAH) is a technique that has been used in fertility treatments to increase the success rate of in vitro fertilization (IVF). The main advantage of using LAH during IVF is that it can improve the chances of successful implantation, which ultimately increases the chances of pregnancy.

LAH can be especially helpful for women who have had multiple failed IVF attempts or are above the age of 35. As women age, their eggs become less likely to develop into viable embryos, and LAH provides an opportunity for these embryos to hatch and implant more easily.
Another advantage of LAH is that it's a minimally invasive procedure that doesn't require any additional medication or anaesthesia beyond what's used during standard IVF treatment. And because laser technology is so precise, there's little risk of damaging the embryo during the procedure.
Since its introduction over two decades ago, LAH has helped many couples struggling with infertility achieve their goal of starting a family. While not every couple may be suitable candidates for this procedure, those who are may find it offers them renewed hope for achieving pregnancy through IVF.

Procedure Details

How is laser hatching treatment done?

Laser hatching treatment is a medical procedure that requires the use of specialized equipment and skilled healthcare professionals. The process involves creating a small opening in the outer layer (zona pellucida) of an embryo using a fine laser beam.

To start, the patient undergoes standard IVF treatment to retrieve mature eggs. Once fertilization occurs, embryologists evaluate the resulting embryos for quality and select the ones that are most likely to implant successfully. These embryos are then transferred into the uterus after undergoing LAH.
The procedure itself usually takes only a few minutes per embryo and is painless for both the mother and embryo. It is typically performed on day three or four following fertilization when embryos consist of six to eight cells.
During laser hatching treatment, a micro-manipulator holds each embryo steady while an embryologist uses laser technology to make several tiny holes in its zona pellucida. This allows for easier implantation by allowing the developing blastocyst to "hatch" from its shell.

While relatively simple in practice, laser-assisted hatching requires precision and expertise from fertility specialists who have been trained specifically in this technique.

Key Takeaway:

Laser hatching is a technique in assisted reproductive technologies that increases the chances of implantation during in vitro fertilization (IVF).
By creating an opening in the embryo's outer layer, known as zona pellucida, embryologists allow the embryo to hatch from its shell and implant itself into the uterus lining.
Laser hatching is typically performed on embryos that have failed to implant after multiple rounds of IVF or when a couple has had recurrent miscarriages.
It is considered minimally invasive, does not harm or alter the embryo's genetic makeup, and has a success rate of about 5-10%.

Frequently asked questions:

Is hatching blastocyst a good sign?
Is hatching good for transfer?
Can a hatching embryo split into twins?
Yes, but the chances are quite low

Reference

Dr Purva Singh

MBBS MS OBGYN
IVF Specialist