- Laser Assisted Hatching - Laser-assisted hatching is a laboratory technique used in assisted reproductive technology (ART) procedures such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). This technique facilitates the embryo to break or hatch through its outer layer (which is a membrane also known as the zonal pellucida) by creating an opening. In some cases, this layer is unusually thick and/or hardened. The more difficult the embryo to hatch, the less likely to attach the embryo to the uterine wall which in turn could lead to infertility. Some of the situations when laser assisted hatching is recommended are:
Woman’s age factor
Previously failed IVF
Higher FSH levels
Embryos with a thick zona pellucida
Frozen-thawed embryo
Poor quality embryo
It involves using laser to create a small opening in the outer shell (zona pellucida) of the embryo before it is transferred into the woman's uterus. This technique is used to potentially improve the chances of successful implantation of the embryo into the uterine lining.
Typically, a laser-assisted hatching involves the following processes:
Embryo culture: After fertilization, embryos are cultured in the laboratory for 3 days until they reach a certain stage of development.
Laser procedure: A specialized laser is used to create a small opening or thinning in the zona pellucida, the outer protective layer of the embryo. This opening is made in a precise location that is usually away from the inner cell mass, which contains the cells that will develop into the fetus.
Embryo transfer: After laser-assisted hatching, the embryos are transferred into the woman's uterus as part of the IVF or ICSI procedure. The goal is to facilitate the hatching process, allowing the embryo to easily break out of its protective shell and implant into the uterine lining.
However, it's important to note that laser-assisted hatching is not always necessary or appropriate for every IVF or ICSI cycle. The decision to use this technique should be made based on individual patient factors and in consultation with a fertility specialist. Additionally, while laser-assisted hatching may improve implantation rates in some cases, it does not guarantee pregnancy, and success rates can vary depending on various factors, most importantly the individuals concerned.
- Preimplantation Genetic Testing - Preimplantation Genetic Testing (PGT) is a technique used during in vitro fertilization (IVF) to screen embryos for genetic abnormalities before they are transferred into the uterus. It involves analyzing cells from embryos to identify genetic conditions or any chromosomal abnormalities. There are two main types of PGT:
PGT-A (formerly known as PGS - Preimplantation Genetic Screening): This type of testing is used to screen embryos for numerical chromosomal abnormalities, such as aneuploidy, which involves missing or extra chromosomes. PGT-A can help identify embryos with the correct number of chromosomes, which can improve the chances of successful implantation and reduce the risk of miscarriage.
PGT-M (formerly known as PGD- Preimplantation Genetic Diagnosis): PGT-M is used to screen embryos for specific genetic mutations or disorders that are known to run in the family. This type of testing is particularly useful for couples who are carriers of genetic diseases and want to prevent passing them on to their children. PGT-M can identify embryos that are unaffected by the genetic condition, allowing those embryos to be selected for transfer.
The process of preimplantation genetic testing typically involves the following steps:
IVF procedure: The woman undergoes ovarian stimulation and egg retrieval, and the eggs are fertilized with sperm in the laboratory to create embryos.
Embryo culture: The embryos are cultured in the laboratory for a few days until they reach a suitable stage for testing. This is typically around the blastocyst stage, which is planned five or six days after fertilization.
Embryo biopsy: A few cells are removed from each embryo for genetic testing. This biopsy is usually performed using a small laser or microsurgical technique.
Genetic analysis: The cells obtained from the embryo biopsy are analyzed using various genetic testing methods, such as polymerase chain reaction (PCR), fluorescence in situ hybridization (FISH), or next-generation sequencing (NGS), depending on the type of testing being performed (PGT-A or PGT-M).
Embryo selection: Once the genetic testing is completed, embryos that are determined to be chromosomally normal (in the case of PGT-A) or unaffected by the genetic condition (in the case of PGT-M) are selected for transfer into the woman's uterus.
Preimplantation genetic testing can help improve the chances of a successful pregnancy in couples undergoing IVF, particularly for those with a history of recurrent miscarriages, advanced maternal age, or genetic disorders. However, it's important to note that PGT is not suitable for all couples undergoing IVF, and the decision to undergo testing should be made in consultation with a fertility specialist or genetic counselor. Additionally, PGT can increase the cost and complexity of IVF treatment.
