Assisted zona hatching

Assisted zona hatching (AZH) is a procedure of assisted reproductive technology in which a small hole is made in the zona pellucida, using a micromanipulator, thereby facilitating for zona hatching to occur.[1][1] Zona hatching is where the blastocyst gets rid of the surrounding zona pellucida to be able to implant in the uterus.


A systematic review and meta-analysis came to the result that assisted zona hatching is related to increased rates of clinical pregnancy and multiple pregnancy in women with previous repeated failure or frozen-thawed embryos.[2] However, it is unlikely to increase clinical pregnancy rates when performed in fresh embryos transferred to unselected women, to those without poor prognosis or to women of advanced maternal age.[2] Also, overall, there no evidence of a significant difference in live birth rate following assisted hatching compared with no assisted hatching.[3]


  2. Martins, W. P.; Rocha, I. A.; Ferriani, R. A.; Nastri, C. O. (2011). "Assisted hatching of human embryos: A systematic review and meta-analysis of randomized controlled trials". Human Reproduction Update. 17 (4): 438–453. doi:10.1093/humupd/dmr012. PMID 21474527.
  3. Farquhar, Cindy; Marjoribanks, Jane (2018-08-17). "Assisted reproductive technology: an overview of Cochrane Reviews". Cochrane Database of Systematic Reviews. 8: CD010537. doi:10.1002/14651858.cd010537.pub5. ISSN 1465-1858. PMID 30117155.

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