Objective: To compare clinical outcomes after laser or mechanical techniques of assisted hatching (AH) in women of advanced age undergoing IVF or intracytoplasmic sperm injection (ICSI).
Design: Prospective randomized study.
Setting: Center for Human Reproduction, Genesis Clinic, Athens, Greece.
Patients: Three hundred and sixteen consenting women of advanced age (> or =39 years) with primary infertility undergoing IVF/ICSI programs and having available embryos for transfer on day 3. Patients were randomized into laser or mechanical AH of their transferred embryos.
Interventions: Controlled ovarian hyperstimulation, oocyte retrieval, IVF/ICSI, laser or mechanical AH, and embryo-transfer.
Main outcome measures: Implantation rate, clinical pregnancy rate, and viable pregnancy rate.
Results: The implantation rate was significantly higher in the laser AH group. Clinical and viable pregnancy rates were higher (but not significantly) in the laser AH group.
Conclusions: Laser AH of embryos may result in better clinical outcomes when compared to the mechanical technique in women of advanced age undergoing IVF or ICSI.