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Background <p>Laser-assisted hatching (LAH) has been reported to improve implantation and pregnancy rates, yet its efficacy and safety profile require rigorous evaluation. To assess the impact of LAH on pregnancy-related outcomes and safety metrics within Assisted Reproductive Technologies (ART) procedures, we conducted a systematic review and meta-analysis.</p> Methods <p>Electronic databases were searched from inception to November 30, 2023. Studies, comparing LAH with other hatching methods or no intervention within ART frameworks, were included. The quality of the included studies was rigorously evaluated using the Risk of Bias In Non-randomized Studies-of Interventions (ROBINS-I) tool with a Weighted Cohen’s kappa coefficient (κ). Summative data, subgroup analyses, and evaluation of heterogeneity were analyzed via Stata 15.</p> Results <p>47 eligible studies were included, covering 24,876 couples. When comparing the effectiveness of LAH to other methods or no intervention, the results revealed enhancements in implantation and clinical pregnancy rates. For implantation rates, the pooled effect size showed an OR of 1.22 (95% CI 1.09–1.36), indicating a modest improvement with LAH. As for clinical pregnancy rates, LAH was associated with an OR of 1.12 (95% CI 1.03–1.22), demonstrating its positive impact. However, term delivery rates showed a modest but statistically detectable improvement, with an OR of 1.07 (95% CI 1.01–1.14), and sensitivity analysis revealed this effect to be study-dependent. The abortion rate remained statistically unchanged with LAH, OR 0.95 (95% CI 0.85–1.06; <i>P</i> = 0.34; I<sup>2</sup>: 0%). Subgroup analyses, particularly focusing on age and embryo status (fresh vs. frozen), elucidated some of the observed heterogeneity, offering a deeper understanding of LAH's varying impacts across different patient demographics and treatment specifics.</p> Conclusion <p>LAH represents a valuable adjunct in ART, particularly beneficial for specific patient groups. It modestly improves implantation and clinical pregnancy rates without compromising safety. However, its effect on term delivery is small, sensitive to individual studies, and uncertain overall.</p> Graphical Abstract <p></p>

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What is the role of laser-assisted hatching in enhancing ART success rates: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月2日

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  • Yang Ma,
  • Yiyang Ying,
  • Zanche Huang,
  • Qin Zhang,
  • Ning Ren

摘要

Background

Laser-assisted hatching (LAH) has been reported to improve implantation and pregnancy rates, yet its efficacy and safety profile require rigorous evaluation. To assess the impact of LAH on pregnancy-related outcomes and safety metrics within Assisted Reproductive Technologies (ART) procedures, we conducted a systematic review and meta-analysis.

Methods

Electronic databases were searched from inception to November 30, 2023. Studies, comparing LAH with other hatching methods or no intervention within ART frameworks, were included. The quality of the included studies was rigorously evaluated using the Risk of Bias In Non-randomized Studies-of Interventions (ROBINS-I) tool with a Weighted Cohen’s kappa coefficient (κ). Summative data, subgroup analyses, and evaluation of heterogeneity were analyzed via Stata 15.

Results

47 eligible studies were included, covering 24,876 couples. When comparing the effectiveness of LAH to other methods or no intervention, the results revealed enhancements in implantation and clinical pregnancy rates. For implantation rates, the pooled effect size showed an OR of 1.22 (95% CI 1.09–1.36), indicating a modest improvement with LAH. As for clinical pregnancy rates, LAH was associated with an OR of 1.12 (95% CI 1.03–1.22), demonstrating its positive impact. However, term delivery rates showed a modest but statistically detectable improvement, with an OR of 1.07 (95% CI 1.01–1.14), and sensitivity analysis revealed this effect to be study-dependent. The abortion rate remained statistically unchanged with LAH, OR 0.95 (95% CI 0.85–1.06; P = 0.34; I2: 0%). Subgroup analyses, particularly focusing on age and embryo status (fresh vs. frozen), elucidated some of the observed heterogeneity, offering a deeper understanding of LAH's varying impacts across different patient demographics and treatment specifics.

Conclusion

LAH represents a valuable adjunct in ART, particularly beneficial for specific patient groups. It modestly improves implantation and clinical pregnancy rates without compromising safety. However, its effect on term delivery is small, sensitive to individual studies, and uncertain overall.

Graphical Abstract