Assisted Hatching

What is Assisted Hatching?

Assisted Hatching (AH) is a specialized micromanipulation technique performed in the in vitro fertilization (IVF) laboratory, aimed at improving the embryo’s ability to implant successfully in the uterus. During the first days of its development, the embryo is surrounded by a transparent protective membrane known as the zona pellucida, which remains around the embryo until the hatching stage. For implantation to occur, the embryo must break through this membrane in order to attach to the endometrium.

The assisted hatching procedure involves creating a small opening or thinning the zona pellucida through extremely precise and controlled micromanipulation. Today, this technique is usually performed using advanced technologies such as laser systems, which help facilitate the embryo’s exit from the zona pellucida and consequently increase the likelihood of successful implantation.

There are cases in which the natural hatching process becomes more difficult. This is often observed in embryos with a thicker or harder zona pellucida, a condition that occurs more frequently in women of advanced reproductive age. In such situations, the zona pellucida may act as a mechanical barrier that prevents the embryo from exiting the membrane and reduces the chances of successful implantation.

Through the assisted hatching technique, the embryo’s task becomes easier. The partial thinning or opening of the zona pellucida reduces mechanical obstacles and increases the probability that the embryo will successfully complete the critical stage of implantation. Assisted hatching is applied only when it is considered medically necessary, based on specific characteristics of the embryo and the woman’s medical history. Proper case-by-case evaluation and personalized treatment planning are essential to achieving optimal outcomes in IVF.

When is Assisted Hatching Indicated?

Assisted Hatching is not a standard procedure for every IVF cycle. Rather, it is used selectively in cases where clinical and embryological evidence suggests the embryo may have difficulty hatching from its shell, thereby lowering implantation chances.

Below are the main indications for its use:

Poor-Quality Embryos

Embryos with high fragmentation or slow cell division rates are classified as poor quality. Although they can still be transferred and may lead to pregnancy, they often struggle to naturally hatch from their shell. Assisted hatching aims to overcome this barrier, creating a more favorable environment for implantation.

Embryos with a Thick or Hard Zona Pellucida

In some embryos, an abnormally thick or hardened outer shell may be observed. This can be the result of genetic or hormonal factors and may act as a mechanical barrier that prevents the embryo from successfully hatching. The technique of thinning or creating a small opening in the zona pellucida aims to eliminate this barrier and facilitate the embryo’s natural progression toward implantation.

Repeated IVF Failures

Couples who have undergone one or more unsuccessful IVF cycles without achieving pregnancy may benefit from adding assisted hatching in the next cycle. Used as a supportive intervention, it can enhance implantation chances—especially when there’s no clear reason for previous failures. In practice, assisted hatching is seen as an additional tool in personalized care that may provide a valuable boost toward pregnancy.

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Stabilization of the Embryo Using a Holding Pipette

The procedure begins with the stabilization of the embryo using a specialized holding micropipette. This instrument allows the embryologist to keep the embryo completely stable during the procedure, ensuring precise handling. Stabilization is essential for the success of the technique and helps protect the embryo during the manipulation process.

Creating a Microscopic Opening Using Laser Technology

The embryologist then uses a specialized laser system that delivers micro-pulses directed precisely at the zona pellucida of the embryo. With minimal thermal energy and strict control over the intensity and duration of the pulses, a microscopic opening or controlled thinning is created in the outer shell. The process is monitored continuously through high-resolution microscopic imaging, ensuring that the intervention is performed with maximum precision and without affecting the embryo’s cells.

Verification of the Procedure and Embryo Integrity

Once the opening or thinning of the zona pellucida has been created, the embryologist carefully examines the embryo to confirm that the procedure has been completed successfully. The intervention is extremely small and is designed to assist the embryo in naturally hatching during the following stages of its development.

Return to Culture Conditions

After the procedure is completed, the embryo is returned to its culture medium and placed back into the incubator of the IVF laboratory. There it remains under strictly controlled conditions of temperature, humidity, and gas composition so that it can safely continue its development.

Embryo Transfer and Implantation Preparation

The process concludes with the embryo transfer, which is performed at the appropriate developmental stage of the embryo. During embryo transfer, the embryo is placed inside the uterus through a painless and non-invasive procedure. If implantation occurs successfully within the endometrium, the embryo can continue developing into a normal pregnancy.

How Is Assisted Hatching Performed?

Assisted Hatching is a specialized and highly precise step within the in vitro fertilization (IVF) cycle. It is performed by experienced embryologists in a carefully controlled laboratory environment with the aim of facilitating the embryo’s natural hatching from its protective outer shell, known as the zona pellucida.

In modern clinical practice, the procedure is most commonly performed using high-precision laser technology, which allows the embryologist to create a microscopic opening or controlled thinning of the zona pellucida. This method offers greater accuracy, safety, and control compared to older techniques.

Success Rates & Scientific Evidence

Assisted hatching has been associated with improved implantation and pregnancy rates in IVF cycles, particularly when applied to couples who meet specific clinical criteria. According to published scientific studies, the use of this technique may improve treatment outcomes in cases involving reduced embryo quality or a history of repeated failed IVF attempts. The procedure facilitates the embryo’s natural release from the zona pellucida, thereby increasing the likelihood of successful attachment to the endometrium.

In the embryology laboratory with which our medical team collaborates, clinical data also confirm the positive impact of assisted hatching on pregnancy rates when the technique is applied based on appropriate indications. Our experience shows that the individualized evaluation of each case and the strict adherence to quality protocols are decisive factors for achieving optimal outcomes. For this reason, the technique is not applied indiscriminately, but selectively, allowing us to maximize its benefits without unnecessarily exposing embryos to additional manipulation.

Despite the documented benefits, it is important to emphasize that assisted hatching is not a universal solution and does not guarantee success in every IVF cycle. The procedure must be performed exclusively by specially trained and experienced embryologists, as any incorrect or premature manipulation may negatively affect embryo viability and reduce implantation potential. Final pregnancy rates are influenced by multiple factors, including the assisted hatching technique used, the quality of the embryology laboratory, the experience of the clinical team, and the precision of the embryo transfer procedure. When these factors are combined appropriately, assisted hatching can offer a meaningful advantage in the effort to achieve pregnancy.

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Frequently asked questions about Assisted Hatching

Is the Assisted Hatching procedure painful?

No. The procedure is performed entirely in the embryology lab before embryo transfer and does not involve any intervention in the woman’s body. It causes no pain or discomfort.

How long does the hatching procedure take?

The lab procedure takes just a few minutes per embryo, but it is part of a broader process involving preparation, culture, and evaluation. The overall timeline is adapted to each IVF cycle’s needs.

Is it safe for embryos?

When performed by experienced embryologists using modern equipment and approved laboratory protocols, Assisted Hatching is considered a safe procedure. The embryology laboratory collaborating with our clinic carries out the procedure with the utmost respect for embryo integrity and safety.

Can it be used for frozen embryos (FET)?

Yes, the hatching technique is often applied to frozen-thawed embryos before embryo transfer, as these may have a thicker zona pellucida.

Does it affect the embryo’s sex or quality?

No. Hatching only alters the embryo’s outer shell and does not affect its genetic material, quality, or sex.

Our Doctors

In an era where fertility requires knowledge, care, and substantial guidance, FertUlity is not an impersonal clinic. It is two people who look you in the eye and accompany you step by step on the journey you dream of.

Dr. Chrysostomos (Makis) Papadopoulos Obstetrician – Gynecologist, MD, PhDc, MIC I

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Dr. Chrysostomos Papadopoulos - Specialist in Infertility, Endocrinology & Menopause in Athens

Dr. Maria Oikonomou Obstetrician – Gynecologist

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FertulityThrough the Words of our Parents

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      EXCELLENT  
   Based on 12 reviews 
    
 
 
 
   
 
 
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   Μαρια 
 26 days ago
 
 
  The word "thank you" to Dr. Makis Papadopoulos is too small to describe the gratitude we feel for this man. I am pregnant after IVF, having succeeded on the first attempt, and we owe this exclusively to our doctor. First Contact & Communication: From the very first contact, he won us over with his kindness, enthusiasm and willingness to dedicate as much time as we needed. Willing to explain everything in every detail, he solved every question we had in depth — not even a professor to students would analyze them with such patience and contagiousness! Scientific Training: He is an excellent scientist, with deep knowledge of the subject, a perfectionist and focused professional who leaves absolutely nothing to chance. He designed the right treatment for us, solving every problem down to the last detail, making us feel that whatever problem arises, it is certain that it will be solved. HUMANITY & SUPPORT: The most important thing, however, is his humanity. Communication with him was Immediate and he always had as much time as you needed on the phone to solve every question. He showed a deep, real interest, embracing us not just as a doctor, but as if he were our brother. We highly recommend him to every couple starting this journey. He deserves blind trust! We thank you from the bottom of our hearts for the greatest miracle of our lives!

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   Alexandra 
 52 days ago
 
 
  I don't often write reviews, but I feel that Mr. Makis truly deserves it. From the very first moment, he made me feel safe and confident. He listened carefully to what was on my mind, answered every question I had, and explained everything in a simple way, always based on scientific data. Many times, he even sent me relevant scientific studies so that I could better understand why he was suggesting a particular approach. But what stood out to me the most was that he didn't stop at the appointment. He followed up, was genuinely interested in my progress, and was available when I needed him. This is something you rarely encounter. Fortunately, he returned to Greece. He is one of the few doctors who, beyond their knowledge, remain above all human beings. He makes you feel like he sees you as a person and not as just another incident.

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   Matina 
 69 days ago
 
 
  A big thank you to Dr. Makis Papadopoulos who supported us from day one, who checked every little detail, who explained to us every move-step, every test, every medication for the reason we were doing it and what we would achieve. With incredible experience, knowledge, a lot of patience (because we had two other failed attempts with another doctor) and trust, within 8 months he adapted the protocols for our case and we achieved the positive result and we hold in our arms a priceless diamond. Above all, a rare person, calm and always available to listen to our concerns and reassure us. I highly recommend him!

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   Eva 
 93 days ago
 
 
  Thanks to Dr Makis Papadopoulos, I am now holding my two beautiful babies in my arms! He is a true expert. Professional with a human centric approach, friendly and empathetic, always available to answer our (many many) questions. I trust Dr Makis blindly and, honestly, I cannot recommend him enough!
  
 
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   Ivy 
 100 days ago
 
 
  My experience with Dr. Makis took me from a clinical stagnation to an incredible breakthrough, highly recommend Dr. Makis! Navigating the exhausting world of IVF, you know how devastating it is to watch your protocol dosages go up while your results go down. After three intense, high-dosage cycles with a previous clinic, I was left feeling incredibly discouraged. Despite escalating medications and growth hormones, my blastocyst yield was dwindling, culminating in a heartbreaking round with zero blastocysts. I knew I needed a doctor who didn't just follow a standard script, but who truly understood the nuances of egg quality and customized protocols. That is when I found Dr. Makis. Dr. Makis completely revolutionized my treatment plan. Instead of just pushing maximum dosages, he took a highly strategic, tailored approach. The result? Quality over pure protocol size. While my previous doctors kept increasing the medication dosages (which yielded fewer or zero blastocysts), Dr. Makis completely changed the strategy. He lowered the heavy stimulation, introduced smart egg-quality support (like melatonin), changed the protocol style entirely, and achieved a 700% increase in blastocysts compared to my best previous rounds. Beyond the incredible results, Dr. Makis brings a level of expertise, precision, and reassuring care that is rare to find. He looks at you as an individual, not a statistic, and knows exactly how to pivot when traditional routes fail. If you are looking for a specialist who can turn a difficult prognosis into an overwhelming success, look no further than Dr. Makis. I am incredibly grateful for his care.
  
 
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   Olga 
 111 days ago
 
 
  Dr. Makis Papadopoulos was excellent, professional, and very reassuring throughout the entire process. Thanks to his expertise and guidance, we were able to identify the issue early and take the appropriate steps from the beginning. He took the time to explain everything clearly, answered all our questions with patience, and made us feel comfortable and confident throughout our journey. We truly appreciated his caring approach, professionalism, and dedication. Highly recommended!
  
 
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   Euaggelia 
 122 days ago
 
 
  Dr. Makis Papadopoulos is an excellent scientist and above all a rare person! He is an approachable and smiling doctor, with excellent medical knowledge, who from the first moment I met him made me feel comfortable and trust him completely, answering every question I had with patience and documenting every answer with scientific studies and articles! The most important thing, however, is that Dr. Makis Papadopoulos is always there on the other end of the line to listen to you and reassure you without a trace of haste, a doctor who truly cares and makes you feel like he is your own person! Makis, thank you very much for everything!!! I am very lucky to have met you!

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   Anastasia 
 129 days ago
 
 
  Dr. Makis Papadopoulos is an excellent scientist with a human-centered interest. Our collaboration was excellent from the very beginning and he made me feel confident and secure by explaining every step of the process in great detail. I highly recommend him!

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   Fay 
 131 days ago
 
 
  Dr Makis Papadopoulos is very professional, caring and attentive. Very thorough in explaining the whole process throughout every step. Thank you! Highly recommended!!
  
 
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   Christina 
 134 days ago
 
 
  I would like to share my experience with Dr. Makis Papadopoulos, an outstanding gynecologist and scientist. We first connected in the summer of 2024, while he was based in Germany, through a mutual acquaintance, following a particularly challenging period for us. Prior to meeting him, we had gone through repeated unsuccessful attempts of stimulation and fertilization with other gynecologists. Unfortunately, those approaches relied largely on standardized protocols, without sufficient personalization to address the specific needs of my case. From the very beginning, Dr. Makis stood out for his human-centered approach and his willingness to dedicate time to truly understand our situation in depth. With strong, up-to-date scientific knowledge, he approaches every case holistically, focusing on individualized treatment and adapting protocols to the patient's unique needs. Throughout our collaboration, which now spans approximately two years (with a few breaks on our side), he has consistently been available, supportive, and clear in his guidance. He inspired confidence and helped us stay positive even during difficult phases of the journey. Beyond his scientific expertise, what truly sets him apart is his genuine care for the person behind each case: his empathy, honesty, and continuous effort to achieve the best possible outcome. My husband and I are deeply grateful for his support and guidance, and we now feel ready and optimistic to move forward to the next final stage. We highly recommend him to anyone seeking a gynecologist with true expertise, professionalism, and compassion. I would like to share my experience with Dr. Makis Papadopoulos, an excellent gynecologist and scientist. We met in the summer of 2024, when he was in Germany, through a mutual acquaintance, after a particularly demanding period for us. Before meeting him, we had gone through repeated failed attempts at stimulation and fertilization with other gynecologists. Unfortunately, the approaches that had been followed were mainly based on standardized protocols, without the necessary individualization to the specifics of my case. From the beginning, Dr. Makis stood out for his human approach and his willingness to spend time to understand our case in depth. With modern knowledge and scientific training, he approaches each issue multidimensionally, emphasizing the individualization of treatment and adapting the protocols to the real needs of the patient. During our collaboration, which now spans about two years (with short breaks on our part), he was always available, supportive and clear in his guidance. He inspired confidence in us and helped us remain optimistic even in difficult phases. In addition to his scientific competence, what sets him apart is his genuine interest in the person behind each case: his empathy, his honesty and his constant effort to achieve the best possible outcome. My husband and I thank him warmly for his support and guidance and we now feel ready and optimistic to move on to the next final stage. We highly recommend him to anyone looking for a gynecologist with real knowledge, professionalism and humanity.

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   Faidra 
 135 days ago
 
 
  Dr. Makis Papadopoulos is an excellent gynecologist and above all an excellent person! I truly thank him for his support and care during the egg freezing process. Although my case was particularly demanding, he stood by me with patience, knowledge, great experience and real interest. Our communication was direct and human, while his availability at the many appointments made me feel safe at every step. The protocols were designed specifically for me, aiming for the best possible result, while also taking into account the cost of the medications. I recommend him with all my heart to every woman who wants to trust someone for something so important and sensitive for her.

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   Iliana 
 137 days ago
 
 
  I highly recommend Dr. Makis, he is an incredible specialist. My journey was far from easy, encountering several challenges that  made the process feel overwhelming at times. What sets him apart is his willingness to go beyond standard procedures. He developed a specialized, custom protocol, tailored to my situation, which ultimately made all the difference. Beyond his technical expertise, his calm and clear communication kept me grounded throughout the process. I am so grateful for his persistence and high level of care!

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Because every fertility journey deserves the right support. At FertUlity, we provide science-based fertility care with a human approach. We support every path, from fertility assessment and preservation to modern assisted reproduction.

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