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    Assisted hatching in IVF and embryo transfer cycles in women with tuberculosis
    (Oxford Academic, 1997) Orhon, E.; Pabuicu, R.; Buiuk, T.; Duru, N. K.; Cıncık, Mehmet
    Introduction: Since Cohen et al. reported the first pregnancy after mechanical partial zona dissection, this micromanipulation technique has been used routinely to enhance the chance of fertilizing the ovum in instances of poor sperm quality. Recently, micromanipulation has been performed to facilitate embryo hatching. Women with genital tuberculosis appear to represent a less favourable subset within other tubal factor patients when treated with IVF. Not only the tubal factor but also the lack of a recipient endometrium may cause disappointing results in this group of infertile women. Materials and methods: The study included 14 cases of tuberculosis, evaluated with hysteroscopy, endometrial biopsy and an acid-fast bacilli stain before treatment with IVF and embryo transfer. All had ovarian stimulation under pituitary desensitization with long protocol GnRHa. Following 2 or 3 days of incubation, all embryos underwent mechanically assisted hatching using a microinjection pipette at the 4- to 8- cell stage. Prior to embryo transfer they were incubated for a further 2 h. Luteal phase support was achieved with progesterone vaginal suppositories. Results: Of the 14 patients, 12 (85.7%) achieved pregnancy in the first cycle. Each woman had three or four hatched embryos transferred. The implantation rate per hatched embryo was 39.5%. Conclusion: Compared with unhatched embryo transfer results, the surprisingly high rate of pregnancy in our series suggests that women with tuberculosis are lacking not only a receptive endometrium but also possibly a factor that may physiologically induce hatching.