Journal of Human Reproductive Science
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ORIGINAL ARTICLE Table of Contents   
Year : 2013  |  Volume : 6  |  Issue : 3  |  Page : 183-188
Transfer of spontaneously hatching or hatched blastocyst yields better pregnancy rates than expanded blastocyst transfer


1 Department of Embryology; Department of Endocrinology, Vaunshdhara Clinic and Assisted Conception Centre, Nagpur, Maharashtra, India
2 Department of Embryology, Vaunshdhara Clinic and Assisted Conception Centre, Nagpur, Maharashtra, India
3 Department of Biochemistry Research Laboratory, Vaunshdhara Clinic and Assisted Conception Centre, Nagpur, Maharashtra, India
4 Department of Embryology; Department of Biochemistry Research Laboratory, Vaunshdhara Clinic and Assisted Conception Centre, Nagpur, Maharashtra, India

Correspondence Address:
Natachandra M Chimote
9, Humpyard Road, Congress Nagar, Nagpur 440 012, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-1208.121420

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Context: Blastocyst stage embryo transfer (ET) has become routine practice in recent years. However, probably due to limitations of assisted hatching techniques, expanded blastocyst transfer (EBT) is still the preferred mode. Inexplicably, not much consideration has been given to spontaneously hatching/hatched blastocyst transfer (SHBT). Aim: This study aimed to investigate developmental potential of spontaneously hatching/hatched blastocyst against EBT in in vitro fertilization (IVF) cycles. Settings and Design: Prospective study of 146 women undergoing their first IVF- ET cycle. SUBJECTS AND Methods: On the basis of blastocyst status, women were classified into SHBT and EBT groups. Intracytoplasmic sperm injection cycles were excluded to remove male factor bias. Implantation rate (IR), clinical pregnancy rate, and live birth rate were the main outcome measures. Statistical Analysis: Graph-pad Prism 5 statistical package. Results: SHBT group showed significantly higher blastocyst formation rate (53.3 ± 17.5 vs. 43.1 ± 14.5%, P = 0.0098), top-quality blastocysts (71.8 vs. 53.7%, P = 0.0436), IR (43.6 vs. 27.9%, P = 0.0408), pregnancy rate (59.4 vs. 45.1%, P = 0.0173), and live birth rate (36.8 vs. 22.8%, P = 0.003) compared to EBT group. Multiple pregnancy rates remained comparable between the two groups. Implantation correlated strongly with top-quality blastocysts (Pearson, r = 0.4441) in SHBT group, while the correlation was nonsignificant in EBT group. Conclusion: Extending culture of expanded blastocysts by a few hours to allow transfer of spontaneously hatching/hatched blastocysts gives higher implantation and pregnancy rates with no added risk of multiple gestations. Spontaneously hatching/hatched blastocysts have a better potential to implant and develop into a positive pregnancy.


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