{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T02:51:00Z","timestamp":1790650260625,"version":"4.1.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Reprod. Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The journey of assisted reproductive technology (ART) for couples facing recurrent implantation failure (RIF) is fraught with emotional and physical challenges. RIF, often characterized by the failure of high-quality embryos to implant after multiple ART cycles, has directed attention towards interventions like laser-assisted hatching (LAH). However, discrepancies in the literature necessitate a comprehensive review of LAH's efficacy and safety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Following a thorough search of PubMed, Embase, Cochrane, and Web of Science databases up to November 2023, retrospective studies or RCT were considered for inclusion. Summary effect sizes [odds ratio (OR) or risk ratio (RR) with 95% confidence interval (CI)] were calculated for each outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results and conclusion<\/jats:title><jats:p>Eight studies comprising 2,634 patients were included. LAH significantly improved implantation rates (OR: 1.26, 95% CI: 1.05\u20131.51). Clinical pregnancy rates increased in patients who had fresh embryos transferred (OR: 1.29, 95% CI: 1.05\u20131.58). Notably, LAH was associated with higher miscarriage rates in frozen embryo transfers (OR: 1.45, 95% CI: 1.04\u20132.02). No significant increase in ectopic or multiple pregnancy rates was observed. For patients with RIF, especially older women, LAH presents a potential avenue to improve implantation. Its impact on clinical pregnancy rates is less substantial. However, its impact on final live birth rates and the increased miscarriage risk in frozen transfers necessitate a cautious and individualized approach. The technique's safety, while generally upheld, requires careful application and consideration of the specific challenges RIF patients face.\n<\/jats:p><jats:p><jats:bold>Systematic Review Registration:<\/jats:bold><jats:uri>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42024497329<\/jats:uri>, PROSPERO (CRD42024497329).<\/jats:p><\/jats:sec>","DOI":"10.3389\/frph.2025.1581529","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T05:35:25Z","timestamp":1746768925000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Unlocking the potential of embryos: insight of systematic review and meta-analysis into laser-assisted hatching\u2019s role in conquering recurrent implantation failure"],"prefix":"10.3389","volume":"7","author":[{"given":"Tingting","family":"Du","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zanche","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxuan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"Cd010537","DOI":"10.1002\/14651858.CD010537.pub5","article-title":"Assisted reproductive technology: an overview of cochrane reviews","volume":"8","author":"Farquhar","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"B2","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.fertnstert.2023.02.014","article-title":"Recurrent implantation failure: reality or a statistical mirage?: consensus statement from the July 1, 2022 lugano workshop on recurrent implantation failure","volume":"120","author":"Pirtea","year":"2023","journal-title":"Fertil Steril"},{"key":"B3","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.rbmo.2013.08.011","article-title":"Recurrent implantation failure: definition and management","volume":"28","author":"Coughlan","year":"2014","journal-title":"Reprod Biomed Online"},{"key":"B4","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1186\/s12958-018-0414-2","article-title":"Recurrent implantation failure-update overview on etiology, diagnosis, treatment and future directions","volume":"16","author":"Bashiri","year":"2018","journal-title":"Reprod Biol Endocrinol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1159\/000016734","article-title":"Zona hardening, zona drilling and assisted hatching: new achievements in assisted reproduction","volume":"166","author":"De Vos","year":"2000","journal-title":"Cells Tissues Organs (Print)"},{"key":"B6","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1186\/s13048-021-00844-7","article-title":"Laser-assisted hatching in lower grade cleavage stage embryos improves blastocyst formation: results from a retrospective study","volume":"14","author":"Xu","year":"2021","journal-title":"J Ovarian Res"},{"key":"B7","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1080\/19396368.2016.1217952","article-title":"Laser assisted zona hatching does not lead to immediate impairment in human embryo quality and metabolism","volume":"62","author":"Uppangala","year":"2016","journal-title":"Syst Biol Reprod Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/s0015-0282(02)03172-2","article-title":"Laser-assisted hatching of embryos is better than the chemical method for enhancing the pregnancy rate in women with advanced age","volume":"78","author":"Hsieh","year":"2002","journal-title":"Fertil Steril"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1016\/j.fertnstert.2022.02.020","article-title":"Practice Committee of the American Society for Reproductive Medicine, Practice Committee of the Society for Assisted Reproductive Technology. 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