ArticleFrontiers in endocrinology2026
Association between laser-assisted hatching and subsequent blastocyst development in fresh day 3 cleavage-stage embryos: a retrospective cohort study using propensity score matching, generalized estimating equations, and time-sensitivity analyses.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: To investigate the association between laser-assisted hatching (LAH) and blastocyst developmental outcomes of day 3 (D3) cleavage-stage embryos in fresh IVF cycles, using Propensity Score Matching (PSM), Generalized Estimating Equation (GEE) analysis, and Time-sensitivity analyses. Methods: The clinical data of 4365 couples who received Results: After propensity score matching, LAH was associated with a higher transferable blastocyst formation rate, especially in grade II-IV embryos (P < 0.001). GEE analysis confirmed this association, whereas no significant improvement in high-quality blastocyst formation was observed. Sensitivity analyses using ±6-, ± 12-, and ±24-month windows showed no significant difference in overall blastocyst formation. For transferable blastocyst formation, no association was found in the ±6-month model, while positive associations were observed in the ±12-month model (adjusted rate difference: 4.62%, 95% CI: 1.30%-7.95%, P = 0.006) and ±24-month model (6.69%, 95% CI: 4.46%-8.92%, P < 0.001). However, after adjustment for calendar time, this association became non-significant (P = 0.573), suggesting possible time-related confounding. Conclusion: LAH may improve transferable blastocyst formation in low-grade day 3 cleavage-stage embryos under specific analytical conditions, but the findings were heterogeneous across sensitivity analyses. Because implantation, pregnancy, live birth, neonatal safety, and long-term offspring outcomes were not assessed, these results should be considered hypothesis-generating and require confirmation in multicenter prospective randomized trials.
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