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Hum. Reprod. Advance Access published online on June 13, 2006
Human Reproduction, doi:10.1093/humrep/del149
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© The Author 2006. 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@oxfordjournals.org
Received July 28, 2005
Revised April 3, 2006
Accepted April 7, 2006

Article

A prospective randomized study to assess the benefit of partial zona pellucida digestion before frozen-thawed embryo transfers

C. Sifer 1, A. Sellami 1, C. Poncelet 2, P. Kulski 1, B. Martin-Pont 1, J. Bottero 3, R. Porcher 3, I. Cedrin-Durnerin 2, J.N. Hugues 2, and J.P. Wolf 1 *

1 Service d’Histologie-Embryologie-Cytogénétique, Laboratoire de Biologie de la Reproduction, Bondy, France
2 Service de Médecine de la Reproduction, Hôpital Jean Verdier, Assistance Publique - Hôpitaux de Paris, Bondy
3 Service de Biostatistique et d’Informatique Médicale, CHU Saint-Louis, Assistance Publique - Hôpitaux de Paris, 75475 Paris cedex 10, France

* To whom correspondence should be addressed.
J.P. Wolf, E-mail: jean-philippe.wolf{at}jvr.ap-hop-paris.fr


  Abstract

BACKGROUND: Assisted hatching (AH) in fresh embryo transfer (ET) could be associated with increased implantation rates. However, very few prospective randomized studies have specifically addressed the issue of AH during frozen-thawed embryo transfers (FET) cycles, those that have reported controversial results. The aim of this study was to evaluate the benefit of an enzymatic zona pellucida treatment of frozen-thawed embryos before transfer. METHODS: This was a prospective study including 125 non-donor FET cycles from 125 infertile couples. FETs were randomly allocated into AH group (n = 61, embryos pretreated with pronase 5 IU/ml for 1 min at 37°C) or control group (n = 64, untreated embryos). Zona pellucida thickness was measured for each transferred embryo. The main outcome parameters were clinical pregnancy and implantation rates. RESULTS: The two groups were comparable regarding mean women’s age, duration and indications of infertility, IVF outcome after fresh ETs, numbers and quality of fresh and frozen embryos, frozen-thawed embryo survival rates and blastomeres survival indexes. Despite a statistically significant decrease of zona pellucida thickness after pronase treatment [(mean ± SD) 18.5 ± 2.25 versus 14.5 ± 2.75 µm; P < 0.0001], implantation (9.6 versus 9.2%) and clinical pregnancy rates (18.0 versus 17.2%) were not statistically different after FETs, with a similar mean number of embryos transferred between AH and control groups, respectively. CONCLUSION: Within the constraints of our protocol, partial enzymatic digestion of zona pellucida by pronase was not related with any benefit of the FET outcome especially concerning the implantation ability of frozen-thawed embryos.

Keywords: frozen-thawed embryo transfers outcome/partial digestion/zona pellucida.
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