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Human Reproduction 2005 20(5):1430; doi:10.1093/humrep/deh731
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions{at}oupjournals.org

Reply: Assisted hatching improves implantation rates on cryopreserved–thawed embryos. A randomized prospective study

A. Gabrielsen1,3, I. Agerholm2 and J. Fedder2

1 Ciconia Fertility Clinic, Århus, DK-8270 Højbjerg and 2 The Fertility Clinic, Brædstrup Hospital, DK-8740 Brædstrup, Denmark

3 To whom correspondence should be addressed. Email: ag{at}ciconia.dk

Sir,

We would like to thank Meyer de Moraes and de Miranda Cota for their comments on our recent paper (Gabrielsen et al., 2004Go). We found a significantly increased implantation rate after assisted hatching of cryopreserved–thawed embryos compared to a control group. However, the pregnancy rate, determined by positive {beta}-hCG, was not increased in the group receiving assisted hatching. Therefore, we agree with Meyer de Moraes and de Miranda Cota that this study may not be sufficient to convince fertility clinics that assisted hatching should be recommended on cryopreserved–thawed embryos.

One possible explanation for the discrepancy between pregnancy and implantation rates might be that the embryos not undergoing assisted hatching do not hatch sufficiently. That might mean that only small fragments of the inner cell mass are expelled through a small gap in the zona pellucida, giving rise to a positive {beta}-hCG. However, due to the incomplete hatching process, implantation may not be obtained (Cohen et al., 1990Go). An additional explanation may be a higher frequency of multiple pregnancies in the assisted hatching group in the present study.

References

Cohen J, Elsner C, Kort H, Malter H, Massey, Mayer MP and Wiemer K (1990) Impairment of the hathing process following IVF in the human and improvement of implantation by assisting hatching using micromanipulation. Hum Reprod 5, 7–13.[Free Full Text]

Gabrielsen A, Agerholm I, Toft B, Hald F, Petersen K, Aagaard J, Feldinger B, Lindenberg S and Fedder J (2004) Assisted hatching improves implantation rates on cryopreserved–thawed embryos. A randomized prospective study. Hum Reprod 19, 2258–2262.[Abstract/Free Full Text]

Submitted on November 25, 2004; accepted on December 10, 2004.


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This Article
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