Assisted hatching on assisted conception (IVF & ICSI)
Notice bibliographique
Résumé
BACKGROUND: Failure of implantation and conception may result from an inability of the blastocyst to escape from its outer coat, know as the zona pellucida. In vitro culture conditions and/or advancing maternal age may alter the architecture of the zona pellucida and result in hatching difficulties. Artificial disruption of this coat is known as assisted hatching (AH) has been proposed as a method of improving the success of assisted conception. OBJECTIVES: To determine whether assisted hatching (AH) of embryos facilitates live births and clinical pregnancy and whether it impacts on negative outcomes (such as multiple pregnancy and miscarriage). SEARCH STRATEGY: We searched the Cochrane Menstrual Disorders and Subfertility Group trials register (1 June 2005), the Cochrane Controlled Trials Register (Cochrane Library Issue 2, 2005), MEDLINE (1996 to June 2003), EMBASE (1980 to June 2005) and reference lists of articles. Authors were contacted for missing and/or unpublished data. SELECTION CRITERIA: Trials were identified and independently screened by two reviewers. Randomised controlled trials of AH (mechanical, chemical or laser disruption of the zona pellucida prior to embryo replacement) versus no AH that reported live birth, clinical pregnancy or implantation rates were included. DATA COLLECTION AND ANALYSIS: Qualitative assessments and data extraction were performed independently by two reviewers. Outcomes were extracted as rates and combined using random effects meta-analysis, sensitivity analysis, sub grouping and meta-regression where appropriate. MAIN RESULTS: Twenty-three randomised controlled trials consisting of 2668 women reported on 849 pregnancy outcomes. There was no significant difference in the odds of live births in the AH compared with control groups (6 RCTs; OR 1.19 95% CI 0.81 to 1.73; 163 births from 516 women). Women undergoing assisted hatching were significantly more likely to achieve clinical pregnancy (23 RCTs, OR 1.33, 95% CI 1.12 to 1.57). Miscarriage rates per woman were similar in both groups (12 RCTs OR 1.23 (95% CI 0.73 to 2.05). Multiple pregnancy rates per woman was increased in women who were randomised to AH compared with control women (9 RCTs OR 1.83 (95% CI 1.19 to 2.83). The improvement in clinical pregnancy rate means for a clinic with a success rate of 25% could anticipate improving the CPR to between 28 and 39%, all things being equal. The trials provided insufficient data to investigate the impact of assisted hatching on several important outcomes, including monozygotic twinning, embryo damage, congenital and chromosomal abnormalities, and in vitro blastocyst development. AUTHORS' CONCLUSIONS: Despite significantly improved odds of clinical pregnancy, there is insufficient evidence to determine any effect of AH on live birth rates. The increased multiple pregnancy rate is of concern although it likely that with a policy of single embryo transfer this may be lowered. Currently, there is insufficient evidence to recommend assisted hatching.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,037 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,007 | 0,005 |
| Bibliométrie | 0,004 | 0,004 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,003 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,012 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».