The failure of embryonic zona pellucida to hatch following blastocyst expansion has been considered as a contributing factor in implantation failure. Assisted hatching, a commonly performed micromanupulation of zona pellucida, aims to improve implantation and pregnancy rates in assisted reproduction by helping natural hatching process. The techniques used for assisted hatching, the indications of the procedure, the association of the procedure with monozygotic twinning, and the use of this method in combination with blastocyst transfer is clearly discussed in this review. The outcome of IVF with the use of this method in fresh and frozen thawed cycles is clarified. In our opinion, further research with prospective randomized studies is needed for this technique to be used in assisted reproduction.
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