Role of pronase hatching in enhancing the effectiveness of assisted reproductive technology programs
Background. Hatching from the zona pellucida is one of the most important stages of human preimplantation embryo development and spontaneous hatching inability is one of the causes of implantation failure in assisted reproductive technology (ART) cycles. The use of mechanical integrity disorders or complete destruction of the zona pellucida (assisted hatching) can be an effective way to enhance the effectiveness of infertility treatment programs using ART techniques.Dolgushina N.V., Ibragimova E.O., Romanov A.Yu., Makarova N.P., Dovgan A.A., Syrkasheva A.G., Kalinina E.A.
Objective. To assess the results of ART programs depending on the performance and type of assisted hatching.
Material and methods. The prospective cohort investigation enrolled 309 patients treated for infertility with in vitro fertilization (IVF). According to the type and performance of assisted blastocyst hatching, the patients were divided into 3 groups: 1) 106 patients undergoing laser hatching with partial removal of the zona pellucida; 2) 103 patients having pronase hatching with complete removal of the zona pellucida; 3) 100 patients with no assisted blastocyst hatching. The degree of maturity and the quality of oocytes and embryos were assessed; hatching was monitored using light microscopy.
Results. The pregnancy rates were noted to be statistically higher in Group 1 than in Groups 2 and 3; the multiple pregnancy rates were significantly lower in Group 1.
Conclusion. Complete zona pellucida removal is a new approach to assisted hatching, in which, firstly, there is no mechanical separation of the cells forming the embryo, and, secondly, there is a rapid contact with endometrial cells during implantation. This contributes to the reduction of the risk of monozygotic pregnancies during the transfer of one morphologically normal blastocyst, by enhancing the effectiveness of ART programs.
Keywords
in vitro fertilization
assisted reproductive technologies
blastocyst hatching
zona pellucida
Supplementary Materials
- Table. Clinical and laboratory parameters in the observation groups
- Figure. Outcomes of ART programs in the observation groups, p <0.05 *
References
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Received 09.06.2017
Accepted 23.06.2017
About the Authors
Dolgushina Nataliya Vitalievna, M.D., Ph.D., M.P.H., Head of R&D Department, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954384977. E-mail: n_dolgushina@oparina4.ruIbragimova Espet Omarbekovna, PhD student of ART Department, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954382501. E-mail: Espet2007@yandex.ru
Romanov Andrey Yurievich, clinical resident, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79031589400. E-mail: romanov1553@yandex.ru
Makarova Nataliya Petrovna, PhD, Researcher of ART Department, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: np_makarova@oparina4.ru
Dovgan Alina Anatolievna, postgraduate I.M. Sechenov 1st Moscow State Medical University. 117997, Russia, Moscow, Trubetskaya str. 8. E-mail: lina.dongan@gmail.com
Syrkasheva Anastasia Grigorievna, M.D., Ph.D., Researcher of the Department of assistive reproductive technology in the treatment of infertility, Research Center
of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: a_syrkasheva@oparina4.ru
Kalinina Elena Anatolievna, M.D., Ph.D., Head of Department of assistive technologies in infertility treatment, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: e_kalinina@oparina4.ru
For citations: Dolgushina N.V., Ibragimova E.O., Romanov A.Yu., Makarova N.P., Dovgan A.A., Syrkasheva A.G., Kalinina E.A. Role of pronase hatching in enhancing
the effectiveness of assisted reproductive technology programs.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (3): 70-4. (in Russian)
https://dx.doi.org/10.18565/aig.2018.3.70-74
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