Paper Title
Quarter Laser Assisted Hatching and Intra-Cytoplasmic Sperm Injection Outcome

Abstract
In an attempt to increase pregnancy rates after Intra-Cytoplasmic Sperm Injection procedures (ICSI) Assisted Hatching (AH) technique was originally created. A lot of AH techniques emerged including mechanical, chemical and Laser AH. However, Laser Assisted Hatching (LAH) was proven to be superior to other techniques due its easy integration in existing injection systems, its safety on the embryos, and the general ease of usage. LAH is hypothesised to enhance the pregnancy rates for patients undergoing ICSI cycles because it was previously found that ZonaPellucida (ZP) gets harder and firmer after ICSI, thus the growing embryo fails to hatch, due to ZP hardening, and consequently it never implants itself into the endometrium. Many meta-analyses could not conclude if AH is beneficial due to the mixed results from researches. So, there is still uncertainty. Our study was carried out to evaluate the impact of quarter LAH on the reproductive outcome of ICSI cycles in patients with poor prognosis. Quarter LAH is the process of thinning quarter the circumference of ZP. Controlled ovarian stimulation was done for the cases, oocytes were collected and denudated. ICSI was done for those oocytes, fertilization was checked, and good quality embryos were isolated for the quarter LAH process before being transferred back into the uterus on day three. Chemical pregnancy and clinical pregnancy rate were estimated for both experiment and control groups and our study revealed that quarter LAH could significantly improve both chemical and clinical pregnancy rate of ICSI cycles for patients with poor prognosis. Keywords - In Vitro Fertilization, ICSI, LAH, Pregnancy rates