|
|
|
|
|
|
Hi Dr. Smith-
Do you use AH with all your IVF patients? I hear this is the natural routine with some clinics. My clinic will use it if your are over 40, have few eggs, unexplained fertility and a thick zona. Does AH increase your pregnancy rates? I was speaking to another RE and he told me because I had a chemical pregnancy(first IVF) and that I had implantatoin and that if would probably not be to my benefit. How do you feel about AH and when do you use it?
Thanks!
|
|
|
|
|
|
|
|
The benefit of hatching embryos on Day 3 has not been shown conclusively. One reason for this is that there is some lab-to-lab variation in how this procedure is performed (i.e. laser versus acidic Tyrode's medium; how big the hole is, etc.). Another reason is that embryos do not hatch naturally until they reach the blastocyst stage in Day 5-6. Hatching on Day 3 is "unatural" and may actually interfer with the "natural" hatching process.
We only transfer blastocyst stage embryos in my program. We routinely hatch the blastocysts 1-2 hours prior to transfer. In many cases the embryo has already begun to exit the protein coat at the time of transfer, thus making the surface of the embryo available for attachment and implantation at the time of transfer. This approach works very well for us.
|
|
|
|
|
|
|
Dr. Smith,
I had my embryos transferred on day 3: 1 8-cell no frag, 1 9-cell minimal frag. My RE usually does AH on day 3 embryos but didn't for us because he said the zona was already thinning on its own.
Wouldn't it have been better to do AH anyway, just to cover the bases?
Or, is it possible to predict that, since the zona was already thinning, the embryo would have no problems hatching on day 5?
|
|
|
|
|
|
|
I'm not sure what your RE meant by "already thinning". The zona pellucida does not begin thinng (actually, its stretching) until the embryo reaches the blastocyst stage on Day 5-6. If they routinely perform hatching on Day 3, I'm not really sure what happened. Anyway, the RE did not give you accurate information about the embryos. Because they were transferred on Day 3, I can't tell you about the chance of these embryos hatching on Day 5. Sorry.
|
