Outcomes of Embryo Transfer Following Laser-assisted Hatching in Patients with Recurrent Implantation Failure: A Systematic Review and Meta-analysis of Randomized Controlled Trials
In brief
Laser-assisted hatching raised live births across nine trials in recurrent implantation failure
In nine randomized trials involving 2,481 women with recurrent implantation failure, laser-assisted hatching was linked to higher live birth rates and fewer miscarriages than embryo transfer without hatching. The analysis found no significant improvement in implantation rates, and evidence for several outcomes was uncertain or varied across studies, so larger, higher-quality trials are needed to confirm the benefit.
- Journal
- Reproductive sciences (Thousand Oaks, Calif.) (Q1)
- Published
- 28 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Mohammadamin Parsaei, Elaheh Karimi, Parsa Seifi, Masoumeh Dehghan Tarzjani, Azadeh Tarafdari
- PMID
- 42803876
- DOI
- 10.1007/s43032-026-02219-z
Why clinicians should know about it
- Picked for Obstetrics and Gynecology (top studies of the week, 4 October 2026): Laser‑assisted hatching meta‑analysis in RIF patients
Abstract
Recurrent implantation failure (RIF) affects approximately 10% of women undergoing embryo transfer. While laser-assisted hatching (LAH) has been proposed to improve outcomes, its efficacy remains uncertain in RIF patients. This study evaluated whether LAH improves outcomes for women with RIF. A systematic review was conducted in PubMed, Web of Science, Scopus, and Embase on January 22, 2025, for randomized controlled trials comparing embryo transfer outcomes following LAH versus controls in RIF. Random-effects meta-analyses generated log odds ratios (LOR), with evidence certainty graded using the Grading of Recommendations Assessment, Development and Evaluation tool. Nine studies involving 2,481 women with RIF were included. Meta-analysis revealed significantly higher rates in the LAH group compared to controls for clinical pregnancy (LOR = 0.643 [0.267, 1.019]; I2 = 70.62%, very low certainty), ongoing pregnancy (LOR = 0.811 [0.076, 1.546]; I2 = 63.54%, very low certainty), and live birth rate (LOR = 0.519 [0.127, 0.911]; I2 = 15.21%, moderate certainty). Additionally, the LAH group had a significantly lower miscarriage rate (LOR = -0.632 [-1.136, -0.127]; I2 = 0.00%, moderate certainty). No significant differences were observed for implantation rates (LOR = 0.691 [-0.036, 1.417]; I2 = 87.14%, very low certainty) or multiple pregnancy rates per clinical pregnancy (LOR = 0.166 [-0.269, 0.600]; I2 = 0.00%, moderate certainty). Our findings suggest that LAH before embryo transfer may improve pregnancy and live birth rates following embryo transfer in women with RIF; however, no significant effect was observed on implantation. Due to observed heterogeneity and the low quality of available studies, high-quality, large-scale randomized controlled trials are needed to confirm these results.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.