Abstract
BACKGROUND: Infertility is a prevalent reproductive issue, often requiring assisted reproductive techniques (ART) such as in vitro fertilization (IVF). Implantation failure remains a major challenge, especially in women of advanced maternal age, those with previous IVF failures, or embryos with a thick zona pellucida. Assisted hatching (AH) is a technique designed to improve implantation rates by facilitating embryo hatching. However, its effectiveness remains uncertain, particularly concerning live birth rates. OBJECTIVES: This study aims to evaluate the impact of assisted hatching techniques-laser hatching and mechanical hatching-on clinical pregnancy outcomes and implantation success in women with advanced maternal age, recurrent IVF failures, or embryos with a thick zona pellucida. The study also seeks to compare these techniques with a control group receiving no AH. METHODOLOGY: A total of 180 participants will be divided into three groups: laser hatching, mechanical hatching, and a control group (no assisted hatching), with 60 participants in each group. Embryos will be assessed for suitability, and AH will be performed using laser or mechanical techniques. Following embryo transfer, clinical pregnancy outcomes and implantation rates will be monitored and compared across the groups. EXPECTED RESULTS: It is anticipated that assisted hatching, particularly laser-assisted hatching, will lead to higher implantation and clinical pregnancy rates compared to the control group. The study aims to establish whether AH can significantly enhance IVF success in specific patient populations. STUDY IMPLICATIONS: Findings from this research could provide valuable insights into optimizing assisted hatching techniques for improving IVF outcomes. If AH proves beneficial, it may be recommended as a standard adjunct in ART, particularly for high-risk patient groups. Additionally, the study will contribute to understanding the limitations and cost-effectiveness of AH in clinical practice.