Methods of Assisted Hatching (AH)

Assisted Hatching is an assisted reproductive technology that can be sometimes done along with in vitro fertilization (IVF) treatment. It is usually recommended to the women who are facing unexplained IVF failure or for women with a poor prognosis. But Assisted Hatching is not recommended by the American Society of Reproductive Medicine (ASRM) as it hasn’t been shown to improve live birth rates and there are also additional costs and risks associated with this technology. There are many different methods available for Assisted Hatching that works differently. Each method involves their own pros and cons and the skill of the technician always matters a lot.

Mechanical hatching:

This method is also known as Partial Zona dissection.With the help of a pipette, the embryologist keeps the embryo steady. A micro-need is used to puncture through the zona pellucida to reach the shell for a bit and then come out the other end. After that, the space between the two punctures is softly rubbed until a small tear take place. But with this method, the control the size of the opening is bit difficult.

Chemical hatching:

This technique involves using mouth controlled acid which is Tyrode on the external surface. Very small amounts of acid are applied to the zona pellucida until the shell is broken. Then the embryo is quickly washed to avoid the harmful effects of acid exposure.

Laser Hatching:

Laser-assisted hatching offers more control on the size of the hole created than mechanical hatching with a needle. In this method, the Zona is pierced by using non-contact mode controlled by a computer. The special designed computer software enables more focus and measurement of embryos and find out a suitable position of embryos. For better performance three different laser intensities – low, medium and high are used.

Drilling:

This technique uses another technology something known as Piezo technology. It this technique vibratory movements are used to create a conical opening.

Assisted hatching by Pronase thinning of Zona pellucid:

In this technique, diluted solution of Pronase is used. The process is starts by transferring of embryos to Pronase diluted solution in the G2 medium. The main goal of this technique is to make thin ZP without removing it completely.

Of all the hatching methods, laser-assisted hatching may be considered as the safest and most effective. A Laser-assisted Hatching is more superior to chemical and manual hatching as it is a safe and gentle way to thin and weaken a small section of the zona pellucida which allow the embryo to hatch.It also offers many advantages including least handling of the embryo and giving fast and exact control over the entrance procedure. But chemical hatching is more commonly used hatching methods. The skill and experience level of the embryologist is an important factor responsible for the success of any methods.

You may Contact Dr Shivani Sachdev Gour for your all Assisted Hatching related questions. She is recognized as one of the best gynecologists and infertility specialist based in Delhi.

Ectopic Pregnancy: Diagnosis and Treatment

Ectopic pregnancies are diagnosed by your doctor, who performed a pelvic exam to locate tenderness, pain or a mass in the abdomen. Your doctor will recommend an ultrasound examination to determine developing fetus in the uterus or elsewhere. The ultrasound can be performed using a wand-like device in your vagina early in pregnancy.It uses sound waves to create images of your fallopian tubes and uterus ovaries. A transvaginal ultrasound images allows your doctor to identify the exact location of your pregnancy. Abdominal ultrasound may also be used to confirm your problems with your pregnancy or evaluate for internal bleeding. The measurement of HCG (human chorionic gonadotropin) levels also plays an important role. The lower level of an hCG than expected is one of the primary reasons to suspect an Ectopic pregnancy. If your doctor confirms that you have an Ectopic pregnancy, she will recommend you about the best available treatment based on future plans for pregnancy and your present medical condition. Low levels of progesterone in your body could be a sign of an Ectopic pregnancy, so your doctor may also test your progesterone levels for diagnosing an Ectopic pregnancy. Apart from progesterone levels tests, your doctor may perform a culdocentesis, which is a process in which a needle is inserted into a space at the top of the vagina, in front of the rectum and behind the uterus. The sign of blood in this area may suggest bleeding from a ruptured fallopian tube.

Treatment of an Ectopic pregnancy depends on the physical health conditions of the woman and the size and location of the Ectopic pregnancy. The injection of methotrexate could be a treatment against early Ectopic pregnancy case as it stops the growth of the embryo.If the pregnancy is farther along, the fertilization of egg can’t able to develop and survive outside of the uterus. In such conditions the patient immediately needs a surgery to remove the abnormal pregnancy so the tissue has to be removed successfully to safe the patient having serious complications. Few years ago, this complication requires a major operation and requiring a large incision across the pelvic area. But this can still be necessary in cases of extensive internal injury or emergency. Your doctor can apply an injection of methotrexate (Trexall) if your pregnancy hasn’t progressed very far and fallopian tube hasn’t ruptured. It stops the cells from further growth and your body can be able to absorb them. Early detection of Ectopic pregnancies can be treated with methotrexate.If the condition worst and severe a surgery is required. The most common surgery is laparoscopy. In this surgery a very small incisions in your lower abdomen has been done and a thin, flexible instrument (laparoscope) has been inserted to remove the Ectopic pregnancy. If the condition of the fallopian tube is bad, the doctor recommends removing it as well. You might need an immediate emergency surgery with a larger incision, if you’re bleeding to a great extent or your doctor suspects your fallopian tube is ruptured. This condition is called laparotomy.