The number of couples struggling with fertility issues is larger than you think—as many as 15% of couples. Certain fertility treatments, like IVF and assisted hatching, offer hope and provide alternatives that can increase the likelihood of successful conception. If you’re considering IVF and your doctor has suggested assisted hatching, you may have heard that it increases the possibility of twins. We’re here to set the record straight and give you all the information you need to understand whether or not assisted hatching makes sense for you and your situation. 

What is assisted hatching? 

Assisted hatching can be performed as an additional step in IVF or in-vitro fertilization to increase the chances of successful embryo implantation along the wall of the uterus. The process involves creating a small hole in the shell of the embryo (zona pellucida), increasing the probability that the embryo will hatch. Hatching refers to the process of the zona pellucida thinning and cracking open so that the embryo can emerge and implant within the uterine wall. Creating a minor defect in the zona pellucida helps the embryo implant into the uterus and is believed to improve pregnancy rates. 

Who are the primary patients for assisted hatching? 

Not all patients undergoing IVF treatment should consider assisted hatching. This procedure is typically recommended for patients that have not experienced success with IVF on multiple occasions for unexplained reasons or in specific circumstances such as:

• Are 35+ years old (esp. 38+ years)
• Have mild elevations in their third day FSH levels
• Have experienced multiple failures with assisted reproductive technology
• Have embryos with unusual shells

Does assisted hatching increase the chance of twins? 

While IVF treatment on its own can increase the chance of twins, do remember that the number of embryos transferred during the treatment process directly influences the chances of twins. In plainer terms, when more than one embryo is implanted in the uterus, the potential for a twin birth increases. These days single embryo transfer is more common, which means that conceiving twins through IVF is less common. 

There is a slightly increased risk of identical twins through assisted hatching. If the defect created on the zona pellucida is not the right size it can increase the chances of having identical twins, or in some cases, decrease the chance of pregnancy. 

Do we recommend assisted hatching? 

The short answer is no, we cannot recommend this treatment process. The assisted egg hatching process has not truly been clinically-proven. According to Dr. Gelety, there has only ever been one peer-reviewed study that showed any kind of success in the procedure. This review led to the oft-thought notion now that this procedure is best for women 37 or older. However, this procedure inherently decreases the quality of the embryos, causing a higher likelihood of unsuccessful or damaging procedures. We do not endorse procedures like assisted hatching that scientifically and statistically do not produce high-quality embryos. 

According to Dr. Gelety, another gimmicky procedure offered as an add-on to IVF is preimplantation genetic testing for aneuploidy (PGT-A), which is used to test for chromosomal anomalies. Like assisted hatching, there is little scientific evidence that these additional IVF add-ons as part of the IVF process have improved a woman’s chance of getting pregnant.  In fact, PGT-A has even been proven to harm women’s chances of pregnancy. It’s also important to note that many of these add-ons like assisted hatching and PGT-A are very expensive due to the process and technology used, making them lucrative services for many clinics while not substantially increasing pregnancy odds.

What is Arizona Center for Reproduction and Endocrinology’s alternative? 

At Arizona Center for Reproduction and Endocrinology, we believe reproductive health cannot be a one size fits all approach. Rather than offering expensive, gimmicky procedures that do not have a high likelihood of success, we are committed to our patients first. This means that we will work with you to create a fertility treatment plan that considers and eliminates any problems that might be interfering with implantation. We understand that the desire to have a baby can be so strong that hopeful parents are often willing to try as many available solutions as possible, like assisted hatching. At Arizona Center for Reproduction and Endocrinology, we aim to help deserving people meet their parental ambitions with science-based, clinically-proven fertility counseling.  

When you work with our fertility specialists, we will explore alternative treatments that provide the best outcome for you and your situation. Dr. Timothy Gelety, the Director of Arizona Center for Reproductive Endocrinology and Infertility in Tucson, AZ, has helped countless people make their dreams of a child come true. Our services are open to all people regardless of their gender preference or sexual orientation because we believe every deserving person should have the opportunity to raise a child of their own. If you have any questions feel free to call us at (520) 326-0001, or if you’re ready to set up a consultation, fill out this form, and we’ll get in touch with you soon.