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Assisted Reproduction Techniques

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ASSISTED HATCHING
Assisted hatching is a technique where a gap is made in the shell or "pellucid zone" of the embryo prior to the embryo transfer. The idea is that this small slit in the shell of the embryo improves its ability to hatch out of the shell after it forms a blastocyst.

The egg is provided with a layer of proteins that protect it during its journey through the fallopian tube until implantation; this is the shell (pellucid zone). Hatching is described as a continuous expansion of the blastocyst on day 5, 6 of development; leading to a progressive thinning of the shell to break it. Subsequently, the blastocyst performs some series of contractions to complete its implantation in the uterus and finally release of the shell.

An embryo that cannot perform this process till the end will have a fault in the implementation. This is caused because some eggs have the shell thickness greater than normal (≥ 15um).  When this occur, assisted hatching technique should be performed to increase the possibility of implantation.

Assisted hatching is also used for thawed embryos as the vitrification process can harden the area, this mostly happen in patients older than 38 years as egg quality may be impaired ,  the technique is also recommended in patients with indication for  PGS study and also in patients with repeated failures of implantation.

There are several techniques of Assisted Hatching: mechanical, physical or chemical, but here in Biofertility Center, we perform this procedure with a team of leading technology. The gap is perfomed with a laser beam provided to the inverted microscope, this is the most effective technique for it accuracy without damaging the embryo.

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PROLONGED CULTURE TO BLASTOCYST STAGE
This process consists on leaving embryos on an extended culture to let them reach blastocyst stage, which occurs around the fifth day of development. The objective of this treatment is to help us selecting the embryos with the greatest implantation potential, exponentially increasing the rates of pregnancy.

At this stage of development, embryos present a structure of more than 200 cells, provided with a peripheral layer trophectoderm, that will result in formation of the placenta and an internal mass from which the embryo originates. It is the pre-implantation development.

Embryo development, especially at this stage of expanded blastocyst gives us many advantages compared with embryos transferred in the early stages. Some of these advantages are:

- Highest rates of implantation
- Decrease the quantity of embryos to be transferred
- Reduces the rate of multiple pregnancies
- Exists a better synchronization between the embryo and the endometrium at the time of the transfer

Prolonged cultive is indicated in patients with recurrent implantation failure, patients of advanced age and/or patients with poor sperm quality. It is also very useful for patients who need the preimplantation genetic screening for aneuploidy for diagnosis. 

With a prolonged / sequential culture we make a selection of the embryo that should be transferred, because only 60% of fertilized eggs achieve this stadium, since not all the embryos have the potential to sustain an embryonic development to implantation because of chromosomal abnormalities or a low energy production at the egg.

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