Laser application in IVF (embryo shaving / assisted nesting)

Laser application in IVF (embryo shaving / assisted nesting)

Anadolu Health Center IVF Department Director Op.Dr.Aytuğ Kolankaya and Embryologist Pelin Kutlu It gives information about embryo shaving, a technique used to increase the likelihood of pregnancy after several attempts of in vitro fertilization but failed treatments…

The microinjection method, which is one of the assisted reproduction techniques, involves the process of fertilization of human egg and sperm cells in the laboratory and subsequent return of the formed embryo to the uterus.
From the beginning, the egg cells from the mother are covered with an elastic outer membrane called zona pellucida. This membrane is constantly present around the developing embryo during fertilization and until the time it is delivered to the uterus. The task of this membrane is to prevent fertilization of the egg by more than one sperm, to keep the cells in its contents together during the first 4 days of development of the embryo and to allow the cell to expand sufficiently on the fifth day.

After that the embryo no longer needs a membrane. Once an embryo with the potential to produce pregnancy is returned to the uterus, it tears out its outer membrane and clings to the intrauterine wall. This is called hatching. Here the embryo completes its development until birth. However, in some cases, the ability of the embryo to tear the membrane may deteriorate. In such cases, pregnancy does not occur because the embryo that cannot go out cannot hold onto the uterus.

How is the embryo shaving method applied?

Embryo assisted hatching is a process that helps the embryo to escape from the membrane when it is transferred to the uterus and is based on the formation of a tear in the outer membrane or thinning of the membrane. Different methods are used for this purpose. These:

• chemical hatching
• Mechanical hatching and
• Laser hatching methods.

Chemical hatching weakened acid solution on the membrane
Sprayed. This process, which is carried out under observation, is terminated when the membrane is sufficiently thin.
Mechanical hatching In the method, a needle is passed through the outer membrane and the part remaining on the needle is cut with another needle. Thus, a rupture is formed on the membrane.
Laser method is the most modern method that is used nowadays and results in a short time. It is based on the formation of a hole in the membrane by firing the laser of appropriate size and dose on the membrane. Thus, common damage to the membrane in chemical and mechanical systems is completely prevented. Therefore, it is the most preferred method both in terms of safety and in terms of keeping the embryos out of the environment for a short time.

Who is it applied to?

Assisted hatching applications microinjection therapy is not required in all patients. The result of numerous applications to date is that this method should be applied in the presence of one or more of the following conditions:

• female age is 37 and over,
• poor embryo quality,
• obtaining a small number of embryos,
• 2 or more attempts fail,
• thawing of frozen embryos,
• the shingles are thicker than normal.

According to the common conclusion of this year's American Congress of Reproductive Medicine, the chances of pregnancy may be higher after the embryo shaving procedure applied in the above cases. Studies have shown that this method gives better results especially in the in vitro fertilized group but not in pregnancy and in the advanced age group.