1.11 CME

Éclosion assistée par laser : aperçu

Conférencier: Dr Arpan Ghosal

Head Fertility specialist and Gynec-Laparoscopic surgeon at Fortis HospitalNew Delhi

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Description

Laser Assisted Hatching (LAH) is a cutting-edge reproductive technology employed in assisted reproductive treatments, like in vitro fertilization (IVF). This method involves using a laser to create a small opening in the outer shell of the embryo, known as the zona pellucida. This precise intervention aims to facilitate the embryo's implantation into the uterus, potentially enhancing the chances of a successful pregnancy. By promoting a more seamless interaction between the embryo and the uterine lining, Laser Assisted Hatching contributes to improving the overall success rates of assisted reproductive procedures.

Résumé

  • Laser-assisted hatching (LAH) is a procedure designed to assist embryo implantation by creating a small opening in the zona pellucida, the outer layer of the embryo. The zona pellucida serves vital functions such as allowing only one sperm to fertilize the egg and maintaining the embryo's shape during early development, especially during freezing processes.
  • Hatching is the natural process of the embryo breaking through the zona pellucida to implant in the uterus. However, in vitro culture can sometimes lead to hardening of the zona pellucida, hindering this process. LAH aims to address this by creating a hole, allowing the embryo to escape and implant more easily, potentially improving pregnancy rates in certain patient groups.
  • The procedure involves using a laser to create a small opening in the zona pellucida. This can be achieved through contact or non-contact laser systems. Non-contact lasers, delivered through a microscope objective, offer a more controlled and precise method, minimizing potential damage to the embryo.
  • LAH may be beneficial for patients with previous IVF failures, advanced maternal age, embryos with thickened zona pellucida, or when using frozen-thawed embryos. It can also assist in removing debris from damaged embryos, improving the quality of transferred embryos. Importantly, LAH is often combined with embryo biopsy for preimplantation genetic testing, where cells need to be extracted.
  • While LAH can improve pregnancy and implantation rates in specific patient groups, it's not a universally recommended procedure for all IVF cycles. There's evidence it can increase the risk of multiple pregnancies. A thorough discussion of risks and benefits with a fertility specialist is crucial before considering LAH. The process costs approximately 10,000 to 20,000 rupees in India.
  • Techniques like zona pellucida thinning offer a less invasive alternative, where the zona is thinned rather than breached entirely, minimizing the risk of damage. Studies show LAH increases chances of successful implantation and pregnancy. After the procedure, patients need hormonal support and medication. There is no disability and any effect to babies.

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