Day-3 vs Day-5 Assisted Hatching: Impact on Blastocyst Morphology and PGT-A Outcomes
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Assisted Hatching.
- Кому может быть актуально
- Состояния в реестре: Infertility; In Vitro Fertilization; Embryo Development. Базовые параметры: 20 лет — 45 лет · Женщины.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Вьетнам
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
Randomized Controlled Trial of Assisted Hatching Timing (Day-3 vs Day-5) and Its Impact on Blastocyst Morphology and Genetic Outcomes in IVF Cycles Undergoing PGT-A
Обзор
This randomized controlled trial evaluates the effect of assisted hatching (AH) timing on embryo development and genetic outcomes in in vitro fertilization (IVF) cycles with preimplantation genetic testing for aneuploidy (PGT-A). Eligible patients undergoing IVF with PGT-A will have embryos randomized to receive assisted hatching either on Day-3 or Day-5 of culture, prior to trophectoderm biopsy. The primary outcome is the rate of aneuploid blastocysts. Secondary outcomes include blastocyst morphology, expansion stage, and the correlation between morphology and genetic results. The study aims to determine whether earlier or later assisted hatching affects embryo viability and the accuracy of genetic testing. The trial will provide evidence to optimize laboratory protocols in IVF centers.
Подробное описание
This prospective randomized controlled trial compares two standardized laboratory procedures of assisted hatching (AH) timing in IVF cycles undergoing PGT-A. In Arm A, AH will be performed on Day-3 embryos; in Arm B, AH will be performed on Day-5 blastocysts prior to trophectoderm biopsy. A total of approximately 200 IVF cycles, involving around 650 embryos, will be included. Randomization will be conducted using block randomization. The primary outcome is the proportion of aneuploid blastocysts identified by next-generation sequencing (NGS). Secondary outcomes include blastocyst morphology (ICM, TE, expansion), biopsy efficiency, and correlation between morphological parameters and genetic outcomes.
All procedures are part of the routine IVF-PGT workflow, and no additional risks to patients are introduced beyond standard care. The trial has been approved by the Institutional Review Board of 16A Ha Dong General Hospital.
Вмешательства
- Процедура Assisted Hatching
Laser-assisted zona drilling performed either on Day-3 or Day-5 of culture, depending on randomization arm.
Первичные конечные точки
- Proportion of aneuploid blastocysts [Срок оценки: At the time of trophectoderm biopsy and PGT-A result (Day 5-6 of embryo culture).]
Вторичные конечные точки (2)
- Blastocyst morphology (ICM and TE grade) [Срок оценки: Day 5-6 of culture]
- Mosaicism rate [Срок оценки: Day 5-6 of culture]
Критерии участия
Критерии включения
- IVF cycles with PGT-A
- Oocyte age 20-45 years (donor cycles: donor's age)
- AMH 1-10 ng/mL within 12 months
- AFC ≥5 follicles (2-9 mm, both ovaries, day 2-5)
- Controlled ovarian stimulation: antagonist or PPOS protocols
- Stratified analysis by age (<30, 30-34, 35-39, ≥40)
- Sperm source: ejaculated samples prepared by density-gradient or swim-up
- No surgical sperm retrieval
- No advanced sperm selection (IMSI, PICSI, MACS)
Критерии исключения
- History of ≥3 failed IVF cycles or ≥3 consecutive miscarriages
- Indication for PGT-M or PGT-SR (monogenic disorders, translocations)
- Severe medical/autoimmune conditions affecting oocytes/embryos (e.g. uncontrolled diabetes, active lupus)
- No MII oocytes available for ICSI
- Embryos not eligible for biopsy per SOP (early zona hatching, degeneration, poor expansion)
- Sperm from surgical retrieval or advanced sperm selection (IMSI, PICSI, MACS)
- PCOS diagnosed by Rotterdam criteria (≥2/3 features)
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Распределение
- Рандомизированное
- Модель
- Параллельные группы
- Маскирование
- Простое слепое
- Основная цель
- Лечение
Центры проведения
Вьетнам · 1 центр
- Center for Reproductive Support, 16A Ha Dong General Hospital — Hanoi
Публикации
- ESHRE Working Group on Recurrent Implantation Failure; Cimadomo D, de Los Santos MJ, Griesinger G, Lainas G, Le Clef N, McLernon DJ, Montjean D, Toth B, Vermeulen N, Macklon N. ESHRE good practice recommendations on recurrent implantation failure. Hum Reprod Open. 2023 Jun 15;2023(3):hoad023. doi: 10.1093/hropen/hoad023. eCollection 2023. PMID 37332387
- McArthur SJ, Leigh D, Marshall JT, de Boer KA, Jansen RP. Pregnancies and live births after trophectoderm biopsy and preimplantation genetic testing of human blastocysts. Fertil Steril. 2005 Dec;84(6):1628-36. doi: 10.1016/j.fertnstert.2005.05.063. PMID 16359956
- Capalbo A, Rienzi L, Cimadomo D, Maggiulli R, Elliott T, Wright G, Nagy ZP, Ubaldi FM. Correlation between standard blastocyst morphology, euploidy and implantation: an observational study in two centers involving 956 screened blastocysts. Hum Reprod. 2014 Jun;29(6):1173-81. doi: 10.1093/humrep/deu033. Epub 2014 Feb 26. PMID 24578475
Идентификаторы
NCT: NCT07154875 · AH-PGTA-2025 · 16A-IRB-2025