THE EFFECT OF ASSISTED HATCHING AND DEFRAGMENTATION ON IVF OUTCOME IN PATIENTS WITHOUT GOOD QUALITY EMBRYOS FOR TRANSFER

SUMMARY Objective: To evaluate the effect of assisted hatching and defragmentation applied to poor quality human embryos regarding the implantation and pregnancy rates. Materials and methods: A retrospective analysis was performed in patients (n=168) of all ages with no good quality embryos for transfer (Veeck classification embryos>grade 1 and/or >10% fragmentation). The first group consisted of cycles in which mAHA was performed to all transferred grade 2 embryos. The second group included transfer cycles where all the embryos were highly fragmented (between 10-50% fragmentations, grade 3) and aAHA and microsurgical fragment removal were applied to all of them. Results: In first group positive shCG was 33%, clinical pregnancy (fetal heart beat) rate was 27% and implantation rate was 11,28%. These rates were 37,1%; 28,8% and %16,19 respectively in the aAHA plus defragmentation group. In cases over 35 years of age in aAHA plus defragmentation group acceptable implantation (14,46%) and clinical pregnancy (31,58%) rates were achieved. Conclusion: In patients with no good qualitytransferable embryos AHA combined with defragmentation can be utilised with acceptable success rates in laboratorieswhere there are experienced personnel available for this procedure otherwise only AHA can be the best option.