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대한생식의학회지 제25권 제3호 2010년
적응 요인에 따른 보조부화술(Assited Hatching, AH)의 효과
피엘산부인과 체외수정 연구실, 효성병원 체외수정 연구실1, 강산부인과 체외수정 연구실2, 김석제산부인과 체외수정 연구실3
김지수, 손인표, 권윤정, 강승호, 김수경, 전한식, 이제규, 최규완,
The Effects of Assisted Hatching (AH) According to The Indications
Kim js, Son ip, Kwon yj, Kang sh, Kim sk, Chun hs, Lee jg, Choi kw
Implantation rates remain low following human in vitro fertilization (IVF). Suboptimal culture conditions may limit the ability of embryos to hatch as blastocysts, and artificial opening of the zona pellucida has been proposed as a means to promote subsequent hatching (assisted hatching). In this study, assisted hatching (AH) by zona drilling using acidic Tyrode's solution was performed in 320 patients, due to their age of more than 38 years (group A), the thick zona pellucida (group Z; ZP≥18 μm), and failures in implantation more than 3 times in previous IVF-ET trial (group P). This study was designed firstly, to study the effects of AH on the outcomes of IVF-ET according to the indications and secondly, to verify the appropriate application of AH. The results were as follows; 1. There was no difference in pregnancy rate between AH group (26.6%) and non-AH group (26.5%). 2. Assisted hatching (AH) showed significantly higher pregnancy rate of the patients with thick zona pellucida than those of the patients with age factor and with the history of repeated implantation failure. But in the patients with age factor only, AH resulted in higher pregnancy rate. 3. Interestingly, the patients with complex factors including zona factor (Z: 33.9%; ZA: 30.4%; ZP: 31.6%; ZAP: 21.4%) showed higher pregnancy rates than other complex factors excluding zona factor(A: 24.4%, P: 0%; AP: 10.8%). From these results, AH is more helpful to the patients with thick zona pellucida rather than patients with older age and/or previous repeated implantation failure.
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