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pArtiaL zonA pelluciDa Removal by assisteD hatchINg of Blastocysts

Not Applicable
Completed
Conditions
Infertility
Interventions
Procedure: Laser assisted hatching
Registration Number
NCT03623659
Lead Sponsor
IRCCS San Raffaele
Brief Summary

The aim of study is to assess the possible impact of assisted hatching on delivery rate after transfer of vitrified-warmed human blastocysts.

Detailed Description

Zona pellucida (ZP) manipulation, termed "assisted hatching" (AH), has been introduced in order to favor embryo hatching and ultimately improve assisted reproductive technology success but with poor proofs of safety and biological plausibility.

Vitrifying and warming of blastocysts may impair the successful hatching process of the embryo out of its ZP and its following implantation into the uterus. Theoretically, AH may facilitate the hatching process and subsequently increase implantation rates.

In this prospective randomized controlled trial (RCT), the hypothesis is to test whether the application of a partial AH to vitrified/warmed blastocysts might affect patients' delivery rate.

Patients with vitrified blastocysts will be randomized at the time of blastocyst warming to a study group (with AH) or a control group (without AH). AH will be performed at the expanded blastocyst stage using a laser technique and a laser opening will be initiated at the 1 o'clock position. Consecutive laser shots will be applied to reach the 5 o'clock position of the blastocyst. The blastocysts will then be cultured at least 2 h and subsequently transferred into the patient's uterus.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
700
Inclusion Criteria
  • single embryo transfer of vitrified/warmed blastocyst (SET)
  • first or second frozen IVF (with or without Intracytoplasmic Sperm Injection) cycle of blastocysts
  • first or second oocyte retrieval
Exclusion Criteria
  • Preimplantation Genetic Testing (PGT) cycle
  • BMI > 35 kg/m2
  • severe male factor
  • abnormal uterine cavity

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
AH groupLaser assisted hatchingSubjects whose vitrified/warmed blastocysts will be subjected to the treatment of laser assisted hatching
Primary Outcome Measures
NameTimeMethod
Delivery rate38 weeks after embryo transfer

Number of deliveries, that result in a live birth, per transferred blastocyst

Secondary Outcome Measures
NameTimeMethod
Clinical Pregnancy rate4 weeks after transfer

the ultrasonographic demonstration of an intrauterine gestational sac divided by the number of included women

obstetrical and neonatal complication rateafter birth; 9-10 months after transfer

condition that adversely affects women and their foetal health during delivery

Implantation rate6-7 weeks after transfer

the number of gestational sacs observed at echographic screening at 6 weeks of pregnancy divided by the number of transferred embryos

Ongoing pregnancy rate20 weeks after transfer

the ultrasonographic demonstration of an intrauterine gestational sac with fetal hearth divided by the number of included women

Multiple pregnancy rate4 week after transfer

a pregnancy in which more than one fetus develops in the uterus at the same time divided by the number of women with a clinical pregnancy

congenital anomalies rateafter birth, 9-10 months after transfer

birth defects, congenital disorders, congenital malformations, or congenital abnormalities, are conditions of prenatal origin that are present at birth, potentially impacting an infant's health, development and/or survival divided by the number of livebirths

Biochemical pregnancy rate4 week after transfer

Pregnancies failing to progress to the point of ultrasound confirmation divided by the number of women with a positive pregnancy test on blood

Trial Locations

Locations (2)

IRCCS San Raffaele

🇮🇹

Milan, Italy

Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico

🇮🇹

Milan, Italy

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