{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T18:26:54Z","timestamp":1755800814387,"version":"3.44.0"},"reference-count":33,"publisher":"Knowledge E DMCC","issue":"6","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":["knepublishing.com"],"crossmark-restriction":true},"short-container-title":["IJRM"],"abstract":"<jats:p>Background: Advances in assisted reproductive technology have led to improved outcomes through various innovations. The embryo must hatch from its acellular glycoprotein-based outer layer, the zona pellucida, before it can be implanted. Assisted hatching (AH) is a technique proposed to enhance embryo implantation.\r\nObjective: This study aimed to evaluate the efficacy of AH in improving pregnancy outcomes among women with poor ovarian response (POR) undergoing in vitro fertilization\/intracytoplasmic sperm injection.\r\nMaterials and Methods: A randomized controlled trial was conducted involving 170 women with POR (POSEIDON groups 3 and 4) undergoing in vitro fertilization\/intracytoplasmic sperm injection at the Yazd Reproductive Sciences Institute, Yazd, Iran from December 2023-June 2024. Participants were randomly assigned to either the hatching group or the control group. Clinical pregnancy, chemical pregnancy, ongoing pregnancy, and miscarriage rates were compared between the 2 groups.\r\nResults: No significant difference was observed between the hatching and control group in terms of chemical pregnancy (24.4% vs. 17.3%. p = 0.271), clinical pregnancy (23.1% vs. 14.8%, p = 0.183), ongoing pregnancy (16.7% vs. 11.1%, p = 0.310), and miscarriage rates (27.8% vs. 25.0%, p = 0.866). However, a significant difference was observed in the frozen embryo transfer subgroup, with the hatching group demonstrating significantly higher rates of ongoing and clinical pregnancies compared to the control group.\r\nConclusion: While AH did not demonstrate overall benefits in improving pregnancy outcomes in women with POR, it may enhance the chances of ongoing and clinical pregnancy in frozen embryo transfer cycles.<\/jats:p>","DOI":"10.18502\/ijrm.v23i6.19398","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T12:16:57Z","timestamp":1755692217000},"update-policy":"https:\/\/doi.org\/10.18502\/knecrossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of assisted hatching on pregnancy outcomes in women with poor ovarian response: An RCT"],"prefix":"10.18502","volume":"23","author":[{"given":"Razieh Dehghani","family":"Firouzabadi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nahid","family":"Homayoon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sahereh","family":"Arabian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatemeh","family":"Dehghanpour","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esmat","family":"Mangoli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamide","family":"Barzegar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sajad Zare","family":"Garizi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"7770","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"286802","doi-asserted-by":"crossref","unstructured":"[1] Vander Borght M, Wyns C. Fertility and infertility: Definition and epidemiology. Clin Biochem 2018; 62: 2\u201310.","DOI":"10.1016\/j.clinbiochem.2018.03.012"},{"key":"286803","doi-asserted-by":"crossref","unstructured":"[2] Sunderam S, Kissin DM, Zhang Y, Jewett A, Boulet SL, Warner L, et al. Assisted reproductive technology surveillance - United States, 2017. MMWR Surveill Summ 2020; 69: 1\u201320.","DOI":"10.15585\/mmwr.ss6909a1"},{"key":"286804","doi-asserted-by":"crossref","unstructured":"[3] Glujovsky D, Farquhar C, Quinteiro Retamar AM, Alvarez Sedo CR, Blake D. Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology. Cochrane Database Syst Rev 2016; 5: Cd002118.","DOI":"10.1002\/14651858.CD002118.pub5"},{"key":"286805","doi-asserted-by":"crossref","unstructured":"[4] Practice Committee of the American Society for Reproductive Medicine. The role of assisted hatching in in vitro fertilization: A guideline. 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Int J Reprod BioMed 2024; 22: 433\u2013440.","DOI":"10.18502\/ijrm.v22i6.16793"},{"key":"286818","doi-asserted-by":"crossref","unstructured":"[17] Hill GA, Freeman M, Bastias MC, Rogers BJ, Herbert III CM, Osteen KG, et al. The influence of oocyte maturity and embryo quality on pregnancy rate in a program for in vitro fertilization-embryo transfer. Fertil Steril 1989; 52: 801\u2013806.","DOI":"10.1016\/S0015-0282(16)61034-8"},{"key":"286819","doi-asserted-by":"crossref","unstructured":"[18] Khalili M. New perspectives on technical aspects of micromanipulation (ICSI) in clinical assisted reproduction. Biomed J Sci Tech Res 2023; 52: 43331\u201343339.","DOI":"10.26717\/BJSTR.2023.52.008200"},{"key":"286820","unstructured":"[19] Razi MH, Halvaei I, Razi Y. Laser assisted zona hatching does not improve live birth rate in patients undergoing their first ICSI cycles. Iran J Reprod Med 2013; 11: 1021\u20131026."},{"key":"286821","doi-asserted-by":"crossref","unstructured":"[20] Dashti S, Eftekhar M. Luteal-phase support in assisted reproductive technology: An ongoing challenge. Int J Reprod BioMed 2021; 19: 761\u2013772.","DOI":"10.18502\/ijrm.v19i9.9708"},{"key":"286822","doi-asserted-by":"crossref","unstructured":"[21] Dehghanpour F, Khalili MA, Mangoli E, Talebi AR, Anbari F, Shamsi F, et al. Free centrifuge sorting method for high-count sperm preparation improves biological characteristics of human spermatozoa and clinical outcome: A sibling oocytes study. Andrologia 2022; 54: e14554.","DOI":"10.1111\/and.14554"},{"key":"286823","doi-asserted-by":"crossref","unstructured":"[22] Sciorio R, Greco PF, Adel M, Maresca L, Greco E, Fleming S. Exploring the benefit of different methods to perform assisted hatching in the ART laboratory: A narrative review. Reprod Biol 2024; 24: 100923.","DOI":"10.1016\/j.repbio.2024.100923"},{"key":"286824","doi-asserted-by":"crossref","unstructured":"[23] Li D, Yang D-L, An J, Jiao J, Zhou Y-M, Wu Q-J, et al. Effect of assisted hatching on pregnancy outcomes: A systematic review and meta-analysis of randomized controlled trials. Sci Rep 2016; 6: 31228.","DOI":"10.1038\/srep31228"},{"key":"286825","doi-asserted-by":"crossref","unstructured":"[24] Zeng M, Su S, Li L. The effect of laser-assisted hatching on pregnancy outcomes of cryopreserved-thawed embryo transfer: A meta-analysis of randomized controlled trials. Lasers Med Sci 2018; 33: 655\u2013666.","DOI":"10.1007\/s10103-017-2372-x"},{"key":"286826","doi-asserted-by":"crossref","unstructured":"[25] Wang Y, Chen C, Liang J, Fan L, Liu D, Zhang X, et al. A comparison of the clinical effects of thinning and drilling on laser-assisted hatching. Lasers Med Sci 2022; 37: 1\u20139.","DOI":"10.1007\/s10103-020-03230-9"},{"key":"286827","doi-asserted-by":"crossref","unstructured":"[26] Lu X, Liu Y, Cao X, Liu S-Y, Dong X. Laser-assisted hatching and clinical outcomes in frozen-thawed cleavage-embryo transfers of patients with previous repeated failure. Lasers Med Sci 2019; 34: 1137\u20131145.","DOI":"10.1007\/s10103-018-02702-3"},{"key":"286828","doi-asserted-by":"crossref","unstructured":"[27] Pan JP, Liang SS, Huang MY, Zhao M, Kong PC, Liu YP, et al. Obstetric and neonatal outcomes after frozen-thawed embryos transfer with laser-assisted hatching: A retrospective cohort study. Arch Gynecol Obstet 2022; 305: 529\u2013534.","DOI":"10.1007\/s00404-021-06153-0"},{"key":"286829","doi-asserted-by":"crossref","unstructured":"[28] Dallagiovanna C, Vanni VS, Somigliana E, Busnelli A, Papaleo E, Villanacci R, et al. Risk factors for monozygotic twins in IVF-ICSI cycles: A case-control study. 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