Part 2 - Embryology in the 21st Century: Breakthroughs and Innovations
Laser Assisted Hatching & HLA Typing
Michael B. Yakass, Ph.D.
Laser Assisted Hatching
Assisted hatching (AH) generally is not necessarily a new technique in IVF but the use of laser technology is an innovative technique over the previous approaches of assisted hatching. Embryos from advanced age women are often thought and sometimes observed to have a thicker than average zona pellucida (ZP). Thicker ZP is thought to hamper blastocyst hatching and eventual implantation. To augment hatching, a small hole could be drilled/created in the ZP without affecting the viability of embryos. In previous approaches, acid tyrodes solution and mechanical drilling using specific zona drilling pipettes on the ICSI machine was used. The current laser assisted hatching technique involves firing a concentrated beam of laser through the objective lens to drill a hole in the ZP of an embryo. This procedure takes just about a second per embryo and the laser beams are focused on the ZP and not directly on the blastomeres. Indeed, AH is performed in some few IVF centres in Ghana (although any centre with an ICSI machine could do AH using the mechanical method) but to the best of my knowledge, the laser assisted hatching technique is available in only two centres in Ghana. Although some successes have been reported to show the benefits of assisted hatching on embryos with thick ZP, no randomized control trial (RCT) has provided strong evidence to suggest that AH truly improves pregnancy outcomes in IVF (Curfs et al., 2023).
HLA Typing
From PGT, we follow on directly with HLA typing because HLA typing in itself may not be considered a reproductive medicine innovation, however, when combined with IVF and PGT, this becomes a major breakthrough in medicine. Couples with a child affected by a particular disease that requires bone marrow transplant will often need a sibling child with a matching HLA. Such couples could undergo IVF to make embryos, perform PGT on these embryos to find the embryo with a matching HLA to the affected child. The resulting child from this IVF/PGT/HLA matching techniques could serve as a transplantation donor for the affected child.
In this series of 6 articles, we will take a daily look at some of the most recent advancements and innovations (in no particular order) in this rapidly growing field of medicine.
