Baby on pillow

Assisted Hatching

If pregnancy does not occur after transferring a high-quality embryo, it may be due to the embryo not implanting to the uterus lining.

In some cases, Assisted Hatching can solve this problem.

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When the egg membrane does not hatch

A key factor for successful implantation is the breaking or “hatching” of the membrane surrounding the egg. Once the membrane breaks, the egg can attach to the uterine lining, allowing pregnancy to begin.

In most cases, this hatching occurs naturally as the fertilised egg divides repeatedly after transfer to the uterus. If the membrane is too thick or tough, it may not break as required. This can hinder implantation and prevent pregnancy.

This issue is most commonly seen in women over the age of 38–40.

To address hatching difficulties, we may recommend Assisted Hatching (AHA) in certain cases, where we believe it could improve your chances of pregnancy.

Assisted hatching (AHA)
Embryologist working with microscope

What is Assisted Hatching (AHA)?

Assisted Hatching (AHA) means “helping the egg to hatch.”

This procedure is performed in the laboratory by our experienced, ESHRE-certified embryologists. They create a small opening in the membrane of the fertilised egg just before it is transferred to the uterus.

The process takes only a few minutes. It is performed without removing the egg from its culture medium. This ensures the egg retains its quality and maximises the chances of successful implantation.

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Who can benefit from AHA?

Our experience and research show that Assisted Hatching (AHA) can improve pregnancy chances in specific situations:

  • Previous unsuccessful IVF treatments: If multiple IVF attempts have not resulted in pregnancy and no other causes for the lack of success have been identified.
  • Women aged 38–40 and above: As age increases, the egg’s membrane can become thicker, potentially preventing natural hatching.
  • Thick or compact membranes: When our embryologists determine that the egg’s membrane appears too tough to break naturally.
Mum's hands holding her baby's feet

Is there evidence that AHA works?

The latest review of studies on assisted hatching from the 2021 Cochrane Library shows that there is still uncertainty about whether Assisted Hatching generally increases the chances of having a live birth. There is insufficient research to determine this. However, the studies show that pregnancy rates increase slightly with AHA. In particular, pregnancy rates are increased in women where IVF or ICSI has previously failed.

Research from 2011 also suggests that Assisted Hatching can improve the chances of implantation and thus increase pregnancy rates in women with repeated failed IVF attempts.

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Risks of Assisted Hatching

AHA is generally a safe procedure, but as with all medical treatments, there can be some risks:

  1. Damage to the egg: Although very rare, there is a small chance of egg damage during the creation of the opening in the membrane.
  2. Twins: A 2021 review of studies on assisted hatching from the Cochrane Library suggests that there is a slightly increased risk of twin pregnancies with Assisted Hatching.

 

This article was written by Dr. Michala Bluhm Kracht, MD, Chief Medical Officer at Diers Fertility Clinic and specialist in gynaecology and obstetrics.

Dr. Michala Bluhm Kracht, MD, Chief Medical Officer at Diers Fertility Clinic

Frequently asked questions about Assisted Hatching

Assisted hatching (AHA) is a technique used in IVF and ICSI treatment to help the fertilised egg break through its membrane to increase the chances of it attaching to the lining of the uterus and establishing a pregnancy.

Assisted Hatching can be especially beneficial for:

  • Women aged 38–40 and above, where the egg’s membrane may be thicker.
  • Those who have experienced multiple unsuccessful IVF treatments.
  • Cases where our embryologists assess that the egg’s membrane is too compact to hatch naturally.

The procedure is performed in a laboratory by an experienced embryologist who creates a small hole in the membrane of the fertilised egg. This happens immediately before the egg is transferred to the uterus and takes only a few minutes, ensuring that the quality of the egg is preserved.

Although AHA is generally a safe procedure, in rare cases, damage to the egg can occur when the hole is made. In addition, there is a slight increased risk of twins or multiple pregnancies.

A review of studies from the Cochrane Library in 2021 suggests that AHA can increase pregnancy rates, especially for women who have had previous failed IVF attempts. However, there is still uncertainty about whether it increases the chances of having a live birth overall.