Risk of major congenital anomalies after assisted hatching Analysis of three-year data from the national assisted reproduction registry in Japan

Capsule:
Assisted hatching alone does not increase the risk of major congenital anomalies.

Authors:
Junna Jwa, M.D., Seung Chik Jwa, M.D., Ph.D., M.P.H., Akira Kuwahara, M.D., Ph.D., Atsumi Yoshida, M.D., Ph.D., Hidekazu Saito, M.D., Ph.D.

Volume 104, Issue 1, Pages 71–78

Abstract:

Objective:
To assess perinatal risk of major congenital anomalies in children born after embryo transfer with assisted hatching (AH).

Design:
Retrospective cohort study.

Setting:
Not applicable.

Patient(s):
Cycles registered from 2010 to 2012 and conceived via single-embryo transfer were included for the analysis. Live births, still births after 22 weeks of gestation, and selectively terminated cases because of congenital anomalies were included.

Intervention(s):
None.

Main Outcome Measure(s):
Major congenital anomaly.

Result(s):
AH was performed in 35,488 cycles among 72,125 included cycles (49.2%). A total of 1,046 major congenital anomalies (1.4%) were identified (1.36% in AH group vs. 1.50% in non-AH group). Overall risks for major congenital anomalies were not significantly different between AH and non-AH groups adjusting for maternal age, calendar year, fetal sex, embryo stage at transfer, and status of cryopreservation. There were 1,009 cases of twins (1.5%) and 10 cases of triplets (0.015%) among all included cycles. No specific organ system demonstrated significant association between AH and non-AH groups. Subgroup analysis demonstrated no significant association between AH and non-AH groups in intracytoplasmic sperm injection cycles or in vitro fertilization in fresh cycles. Similar nonsignificant association was observed between early-cleavage or blastocyst stage at transfer in frozen-thawed cycles.

Conclusion(s):
Our results suggest that AH alone does not increase the risk of major congenital anomaly.

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