The journey to parenthood through in vitro fertilization (IVF) is filled with critical steps. One of the most important steps occurs before the embryo even reaches the uterus: hatching. For an embryo to implant successfully, it must break free from its protective outer shell, the zona pellucida. Assisted hatching is a precise, advanced lab technique that helps this process by creating a tiny opening in that shell.
At ONE Fertility Kitchener Waterloo, our expertise in this procedure ensures it is performed with the utmost care. Our practice aligns with the most current guidelines from leading Canadian (CFAS) and international bodies, making sure you receive the best possible treatment.
We understand that patients often have many questions about this specialized treatment. Our goal in this article is to answer the top five assisted hatching questions patients have, ensuring you feel confident and informed.
Question #1: How Does the Procedure Work, and Why Use a Laser?
The procedure used in assisted hatching, known as micromanipulation, is performed under a high-powered microscope. An embryologist carefully stabilizes the embryo and then uses a highly focused laser to create a small opening in the zona pellucida.
Modern Canadian clinics, including ONE Fertility, exclusively use laser-assisted hatching in IVF for several key reasons:
- Precision: The laser delivers short, concentrated pulses of energy, allowing the embryologist to create a precise opening without affecting the embryo itself.
- Control: It gives the embryologist exact control over the size and depth of the opening. This can involve drilling a small hole or simply thinning a section of the shell, always performed away from the critical inner cell mass that develops into the fetus.
- Speed: The process takes only a few seconds per embryo. This speed is crucial as it minimizes the time the embryo spends outside the stable, controlled environment of the incubator.
It’s important to understand that this opening is very subtle. It is designed to gently assist the embryo’s natural hatching process, not force it.
Question #2: When Is Assisted Hatching Recommended?
A core principle of modern fertility care is that assisted hatching is not a routine procedure for every IVF cycle. It is reserved for specific patients where scientific evidence supports its benefit.
So, when is assisted hatching recommended? Here are the key indications:
- Frozen Embryo Transfer (FET): This is the most common reason for recommending assisted hatching. The process of freezing (vitrification) and thawing can naturally harden the zona pellucida, making it more difficult for the embryo to hatch on its own.
- Advanced Maternal Age (Typically 38+): As women age, their eggs may naturally produce a zona that is thicker or tougher, which can impede hatching.
- Recurrent Implantation Failure (RIF): This applies to patients who have had two or more failed IVF cycles despite transferring good-quality embryos. In these cases, assisted hatching is considered a potential way to overcome an implantation barrier.
- Thick or Abnormal Zona: During observation, if an embryologist notes that an embryo’s zona pellucida is visibly thicker than average, they may recommend assisted hatching to improve its chances.
Furthermore, assisted hatching is a mandatory preliminary step for any embryo undergoing preimplantation genetic testing (PGT). The opening created by the laser is necessary to allow the embryologist to safely perform a biopsy and retrieve the cells needed for genetic analysis.
Question #3: Is Assisted Hatching an Extra Cost, and Is It Covered in Canada?
Assisted hatching is considered a specialized, technical “IVF Add-On” service. It requires specific equipment and highly trained embryologists, placing it outside the scope of a standard IVF cycle.
In Canada, while some provinces like Ontario and Quebec offer public funding for the core IVF cycle, this funding often does not extend to add-on procedures. As a result, assisted hatching typically incurs an extra, out-of-pocket fee for patients. The exact cost can vary, and it is crucial to have a clear understanding of all potential expenses before beginning treatment.
Need a Fee Estimate? Contact our financial team to understand the exact cost and coverage status for your specific provincial plan.
Question #4: Does Assisted Hatching Guarantee a Pregnancy?
It is essential to have realistic expectations. Assisted hatching helps prepare an embryo for implantation, but it cannot fix a genetically non-viable embryo or compensate for a non-receptive uterus. A successful pregnancy depends on many factors, and assisted hatching is just one tool that can help in specific situations.
What does the data say about the laser-assisted hatching success rate?
The evidence is most positive for the specific patient groups mentioned earlier. For patients with recurrent implantation failure, those using frozen-thawed embryos, or those of advanced maternal age, meta-analyses have shown that assisted hatching can lead to a significant increase in clinical pregnancy rates.
However, it is also important to note the broader consensus. Both the Canadian Fertility and Andrology Society (CFAS) and the American Society for Reproductive Medicine (ASRM) have guidelines stating that when assisted hatching is applied routinely to all IVF patients, it does not significantly increase live birth rates. This is why its use is targeted and not universal.
The skill and experience of the embryology team are paramount. At ONE Fertility, our success rates with assisted hatching for indicated patient populations reflect our team’s high level of expertise.
Question #5: What Are the Risks, Especially Monozygotic Twinning?
Patient safety is our highest priority, so any discussion of a procedure must include its risks.
The most common fear is potential damage to the embryo. In the hands of an experienced embryologist using modern laser technology, this risk is extremely low—less than one percent. The laser’s precision ensures that the embryo’s cells remain untouched.
A more significant, though still small, risk is an increased chance of monozygotic twinning (MZT), which results in identical twins. The theory is that the opening created in the zona pellucida may increase the likelihood of the inner cell mass splitting after the embryo is transferred to the uterus. MZT pregnancies are considered higher-risk than typical (dizygotic) twin pregnancies. This risk, while small, is an essential part of the informed consent process, and your care team will discuss it thoroughly with you.
Moving Forward with Confidence
Assisted hatching is a specialized and powerful tool in modern fertility treatment. It is not a one-size-fits-all solution but is highly effective for specific patient groups, particularly those undergoing frozen embryo transfers, facing recurrent implantation failure, or requiring genetic testing. When performed by skilled professionals using advanced laser technology, it is a safe procedure that could significantly improve the chances of pregnancy.
Your fertility journey is unique. The best way to know if assisted hatching is right for you is through a personal consultation. ONE Fertility is here to guide you through every choice.
Book a consultation with a physician and embryologist at ONE Fertility to create a personalized treatment plan for your unique journey.
