Hum. Reprod. Advance Access originally published online on August 19, 2004
Human Reproduction 2004 19(10):2258-2262; doi:10.1093/humrep/deh434
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Assisted hatching improves implantation rates on cryopreserved–thawed embryos. A randomized prospective study
1 Ciconia Fertility Clinic, Aarhus, DK-8270 Højbjerg and 2 The Fertility Clinic, Braedstrup Hospital, DK-8740 Brædstrup, Denmark
3 To whom correspondence should be addressed. Email: ag{at}ciconia.dk
BACKGROUND: Focus on the hatching process has so far been in the field of fresh embryos. Cryopreserved–thawed embryos have a lower rate of pregnancy than fresh embryos, which might be due to hardening of the zona pellucida. METHODS: During a 2 year period, a prospective randomized study enrolling 253 cryopreserved–thawed cycles was performed on day 2 embryos. Pseudorandomization to assisted hatching or a control group was done on the basis of even and odd dates for thawing. One hour before embryo transfer, hatching was carried out using acidic Tyrode's solution. RESULTS: Among 136 embryos exposed to assisted hatching, 11.4% (30) were implanted compared with only 5.8% (13) of 117 embryos not exposed to assisted hatching (P<0.05, 
2 test). No difference in the rate of clinical pregnancy and positive serum HCG was observed between the two groups. Very few women >38 years old were included in the study, and no significant difference according to age could be found between the groups. CONCLUSIONS: These results show that assisted hatching using acidic Tyrode's solution increases the implantation rate of cryopreserved–thawed embryos (P<0.05).
Key words: acidic Tyrode's solution/assisted hatching/cryospreserved–thawed/implantation rates/pregnancy
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