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Roberto Costillas Perez: New Insights on Assisted Hatching Efficacy in IVF
Roberto Costillas Perez/LinkedIn
Dec 26, 2025, 07:12

Roberto Costillas Perez: New Insights on Assisted Hatching Efficacy in IVF

Roberto Costillas Perez, Founder and CEO at Fertypharm, shared a post on LinkedIn about a paper by A. Kusamoto et al. published on Scientific Reports:

“New massive study on Assisted Hatching (AH) in IVF! Does it really improve clinical outcomes?

A retrospective analysis of 1,678,872 single embryo transfers (SET), based on the Japan Assisted Reproductive Technology Registry (2010-2019), sheds light on the true efficacy of AH. This procedure, applied in 55% of cycles, was evaluated in both crude and propensity score-adjusted analyses (considering maternal age, embryo type, stage, ART indication, and endometrial preparation).

Key Results

In crude data, AH showed higher rates of clinical pregnancy (32.8% vs 28%) and live birth (23.2% vs 20.3%). However, after statistical adjustments, the differences slightly reversed:

  • Clinical pregnancy: 31.3% with AH vs 29.6% without (difference of -1.64%).
  • Live birth: 22.4% vs 21.2% (difference of -1.20%).

These findings suggest the initial apparent benefit may be due to confounding factors.

Subgroup Analysis

The only clear benefit was seen in women under 35 years with thawed cryopreserved blastocyst transfer, where the live birth rate reached 37.7% with AH vs 36.6%. In contrast, reductions were noted in most subgroups, along with elevated risks:

  • ↑ Spontaneous abortion (+0.82%).
  • ↑ Multiple pregnancies (+0.23%).
  • ↑ Placenta accreta spectrum (+0.12%).

Clinical Implications

These results question the routine use of AH, as it worsens outcomes in most cases, especially in fresh cycles and older women. It is recommended to reserve it selectively for young patients with frozen blastocysts.”

Title: Effect of assisted hatching on pregnancy outcomes following 1,678,872 single embryo transfers based on the Japan Assisted Reproductive Technology Registry

Authors: A. Kusamoto, M. Harada, T. Kawahara, H. Koike, C. Kunitomi, Y. Fukui, Y. Sanada, N. Takahashi, M. Matsuo, T. Makabe, Y. Urata,G. Izumi, N. Ooi, O. Hiraike, Y. Osuga, Y. Hirota

Read the full article.

Roberto Costillas Perez

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