The Happy Path in the Perfect World: Normally (in natural pregnancy and embryo transfers that don't use assisted hatching), the blastocyst embryo performs zona hatching - which is when it gets rid of the surrounding zona pellucida (its outer shell). This has to occur for the embryo to be able to implant in the uterus - which is a vital step in achieving pregnancy.
The Issue: Sometimes this zona pellucida of the blastocyst is toughened, which prevents the embryo from hatching. If the embryo doesn't hatch properly, it will not implant and will not result in a pregnancy. Frozen embryo transfers generally have a much lower success rate than fresh embryos transferred after IVF or ICSI. It is thought that one of the reasons for this is that the freezing process itself thickens the zona pellicuda, making it more difficult for the embryo to hatch out after it has been thawed.
The Solution: Assisted hatching is performed to try to increase the chances of implantation by placing a small opening in the blastocyst's zona pellucida. This assists the embryo in breaking out of this shell and implanting in the endometrium lining. This procedure is done by embryologists in the laboratory prior to the embryo transfer in IVF & FET cycles.
The Benefits: Several studies have shown that by performing assisted hatching on the thawed embryos (from FET cycles), they stand a much better chance of hatching out of their protective coating. Therefore, it also improves the likelihood that the embryo will implant and hopefully turn into a pregnancy!
The Risks: The main risk of assisted hatching is that statistics show that it increase the chance of having identical twins compared to other fertility treatments. This is because the technique used in assisted hatching could sometimes split the embryo into two halves. There is also a tiny increased risk of siamese twins, embryo damage (causing it to stop splitting), and physical deformity. The main factor affecting the amount of risk associated with assisted hatching is how experienced the embryologist carrying out the procedure is. One site said the risk of damage is very small (around 1%) when an experienced embryologist performs the procedure.
Our Feelings: As I mentioned before, the lab we're using performs assisted hatching on all frozen embryos. They did not perform assisted hatching for our fresh transfer during our IVF cycle. Even though we understand that there are risks associated with assisted hatching - we are completely onboard with them performing assisted hatching on our little embryos on Friday. Preferably done by an experienced embryologist! We will never know why I didn't get pregnant with our IVF transfer. But if by chance it was because the embryos didn't or couldn't hatch properly - then maybe this will help it work this time. In my mind this is one variable that is different from our last transfer - so let's hope this will help us get the baby (or babies) that we've been waiting for!
Tonight the weather was beautiful! Our co-ed softball league started a month ago, but the first 3 games have all been rained out. We FINALLY were able to play a game tonight. I'm always nervous about striking out - but my husband gave me some batting practice in our backyard before we headed out to the game. It must've paid off, because I didn't strike out once! I did hit the ball right to the pitcher a couple times and got out. One time I did get on base, but I got my husband out in the process. And my last at bat, I got out at first - but got a RBI since my hubby made it home. And we ended up winning the game in extra innings! Good times and nice to be out enjoying the warm weather. :) The softball fields where we play our games are actually really close to our doctor's office and the lab where our embryos are being stored. When we drove by I told them that we'd be back on Friday! I'm sure they were happy about our softball victory, too.
In closing, I'd like to shout out a happy birthday to my sister-in-law from another mother - Kelly!!
Today's FET Regimen:
- Prenatal vitamin - one a day
- Progesterone - 1cc via intramuscular shot at 7AM
- Medrol 16 mg pill - one a night