Evidence map›Paper›PMID 41372265›Full record

ArticleScientific reports2025

Effect of assisted hatching on pregnancy outcomes following 1,678,872 single embryo transfers based on the Japan Assisted Reproductive Technology Registry.

A Kusamoto, M Harada, T Kawahara, H Koike, C Kunitomi, Y Fukui, Y Sanada, N Takahashi, M Matsuo, T Makabe and 6 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. The effect of laser-assisted incubation on bovineFrontiers in veterinary science · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

A KusamotoDepartment of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan.
M HaradaDepartment of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan. haradam-tky@umin.ac.jp.
T KawaharaClinical Research Promotion Center, The University of Tokyo Hospital, Tokyo, Japan.
H KoikeDepartment of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan.
C KunitomiDepartment of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan.
Y FukuiDepartment of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan.
Y SanadaDepartment of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan.
N TakahashiDepartment of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan.
M MatsuoDepartment of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan.
T MakabeDepartment of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan.
Y UrataDepartment of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan.
G IzumiDepartment of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan.
N OoiDepartment of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan.
O HiraikeDepartment of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan.
Y OsugaDepartment of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan.
Y HirotaDepartment of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan.

Funding

Children and Families Agency 23DB0101Japan Society for the Promotion of Science 22K09614Japan Society for the Promotion of Science 23K08816Japan Society for the Promotion of Science 23K19667Japan Society for the Promotion of Science 24K23506National Center for Child Health and Development 2025B-10
6 · The paper itself

Abstract

Assisted hatching (AH) is a reproductive technique that artificially thins or breaches the zona pellucida to facilitate hatching. Despite its widespread use, there is insufficient evidence to conclude that AH improves pregnancy outcomes, particularly when performed selectively. Here we conducted a retrospective study using the Japan Assisted Reproductive Technology Registry from January 2010 to December 2019. AH was performed in 55.0% of 1,678,872 single embryo transfers (SETs), with higher frequency in advanced age women, frozen-thawed ET cycles, blastocyst transfer cycles, and hormonal replacement cycles. After adjusting for these covariates, the propensity-weighted clinical pregnancy rate (29.6% vs. 31.3%) and live birth rate (21.2% vs. 22.4%) were marginally but significantly lower in the AH group compared to the without-AH group. Moreover, AH increased risks of miscarriage (0.82% increase), multiple pregnancy (0.23% increase), and placenta accreta spectrum (0.12% increase). Subgroup analysis indicated that AH was effective for frozen-thawed blastocyst ET cycles in women under 35 years but worsened pregnancy outcomes in many groups, especially those with fresh or cleavage-stage embryos and women older than 40 years. These findings suggest that the impact of AH on pregnancy outcomes varies based on the characteristics of patients and ET cycles, prompting further discussion of its indications.

Indexed as

Pregnancy OutcomeReproductive Techniques, AssistedSingle Embryo TransferAdultEmbryo TransferFemaleHumansJapanLive BirthPregnancyPregnancy RateRegistriesRetrospective StudiesAnd zona pellucidaAssisted hatching (AH)Assisted reproductive technology (ART)Propensity score-weighted analysisSingle embryo transfer (SET)Subgroup analysis

Identifiers

PMID41372265
PMCPMC12696074

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.