A systematic review and meta-analysis came to the result that assisted zona hatching is related to increased rates of clinical pregnancy and multiple pregnancy in women with previous repeated failure or frozen-thawed embryos. However, it is unlikely to increase clinical pregnancy rates when performed in fresh embryos transferred to unselected women, to those without poor prognosis or to women of advanced maternal age. Also, overall, there no evidence of a significant difference in live birth rate following assisted hatching compared with no assisted hatching.[needs update]
^ abMartins, W. P.; Rocha, I. A.; Ferriani, R. A.; Nastri, C. O. (2011). "Assisted hatching of human embryos: A systematic review and meta-analysis of randomized controlled trials". Human Reproduction Update. doi:10.1093/humupd/dmr012.
^Farquhar, C.; Rishworth, J. R.; Brown, J.; Nelen, W. L. M.; Marjoribanks, J. (2013). Brown, Julie, ed. "Assisted reproductive technology: an overview of Cochrane Reviews". The Cochrane Library8: CD010537. doi:10.1002/14651858.CD010537.pub2. PMID23970457.