Assisted Embryo Hatching

Assisted Hatching (AH) is the technique of thinning the shell or outer covering of an embryo. Assisted Hatching was developed from the observation that embryos with a thin zona pellucida (shell) had a higher rate of implantation during IVF. It was predicted that helping the embryo hatch out of its shell would allow for a better chance of implantation in the endometrium. The Assisted Hatching procedure is done in the lab. The embryos selected for transfer and for the AH are held gently in place by a glass holding pipette, while a small pipette containing an acid-type solution is used to thin or create a hole in the zona pellucida. The embryos are then rinsed to remove any excess acid solution and returned to the incubator prior to your embryo transfer procedure.

Before consenting for the Assisted Hatching procedure your physician will discuss whether this procedure is in your best interest. We have a list of criteria that determines if you are a good candidate for this procedure.

A hysterosalpingogram (HSG) is performed after the bleeding from a period has ended but before ovulation has occurred. for women with regular menstrual cycles, this is typically between day 5 and day 12 of their cycle. (Day 1 is considered the first day of full flow bleeding).

If you are having your hysterosalpingogram under anesthesia, then you should not have anything to eat or drink for 12 hours prior to you procedure. For example, if your hysterosalpingogram is scheduled for 10:00 a.m., you should fast from 10:00 p.m. the night before.

If you are not having anesthesia, then you may eat or drink normally.

In order to reduce cramping from the hysterosalpingogram, you may take any of the following medications one to two hours before the procedure: (DO NOT TAKE THESE MEDICATIONS IF YOU ARE HAVING ANESTHESIA)

ibuprofen (Motrin, Advil)
naproxen (Naprosyn)
ketorolac (Toradol)

Please arrive at the surgery center at least 30 minutes before your procedure. If you are having anesthesia, you should arrive at least 60 minutes before your procedure. Check in at the reception desk. Once you are checked in, you will be taken to the admit / recovery area and be greeted by our friendly nursing staff.

You will be asked to removal all of your clothing and change into a gown. Anesthesia patients will at this time have an intravenous line inserted into a vein on their arm. The anesthesiologist will interview you about your medical history and explain the type of anesthesia you will receive.

Non-anesthesia patients may walk into the surgical suite. Anesthesia patients will be taken into the surgical suite on a cart. In keeping with the spa like atmosphere of the American Fertility Center, the lights in the surgical suite will be dimmed.

After lying down on a comfortable surgical bed, your legs will be placed in stirrups. A speculum will be placed into the vagina. The cervix will be leaned with iodine on a soft gauze sponge. If you are not having anesthesia, a small injection of anesthetic will be administered into the cervix. A hysterosalpingogram catheter will be advanced into the uterus.

At this point, the x-ray machine will be moved into place over your pelvis. The doctor will use a syringe to advance the contrast (dye) through the catheter into the uterus while the x-ray machine takes continuous images. At the American Fertility Center, you will have a high definition monitor next to your surgical bed where you can watch the entire procedure being performed.

Once the procedure is completed, the doctor will review and explain the images to you immediately. Your questions will be answered. You will then be guided further according to the findings.

After the hysterosalpingogram

1. Expect some cramping and vaginal bleeding. The amount may be similar to what you experience during a period. On occasion, it may be heavier than a normal period.
2. Iodine is used to clean the cervix and vagina. You may notice brown colored discharge.
3. A fever is not normal. If you think you have a fever, take you temperature. Call the office if your temperature is higher than 100.4 degrees
4. You may take Tylenol, Ibuprofen or similar medication for cramps.
5. Some cramping is common. Call the office if you have severe pain above and beyond what you would consider normal and that is not relieved by medication.
6. You may shower tonight. You may bathe after the vaginal bleeding has stopped.
7. You may eat or drink whatever you like.
8. You may have intercourse once the vaginal bleeding has stopped. It is okay for you to attempt pregnancy if you desire.

Follow-up:

1. If you have additional diagnostic tests, complete them and then follow up in the office to discuss the results.
2. If you are not sure what the next step is, call the office. We will review your chart and give you appropriate instructions.

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