During the IVF programme, on the second or the third day the embryos are transferred following the egg retrieval at the four to eight cell stages. For two or three more days, the IVF embryos must continue to grow so that it reaches the blastocyst transfer stage (50-150 cells) before they are ready for the implantation into the endometrium or the uterine wall. Recent advances in IVF laboratory treatments have allowed for the successful culture of embryos to the blastocyst stage.
What is Blastocyst Transfer ?
Blastocysts are an advanced embryo which is developed for about five to six days after the fertilization. There are two different types of cells and central cavity in the blastocysts. Healthy blastocysts should begin hatching from the outer shell known as the zona pellucid by end of the sixth day. It will be implanted into the lining of the mother’s uterus within 24 hours of hatching.
Blastocysts may have a better potential to implant into the uterine wall than earlier stage embryos. At the four-eight cell stage, many embryos stop their growth and it might be because of some inherent problem. Therefore, fewer embryos will have the ability to grow to the blastocyst stage. Those embryos that successfully reach the blastocycst stage tend to more developmentally competent that the earlier stage embryos. Also, at their stage of development when replaces into the uterus is very similar to what it would be in a natural conception cycle.
Benefits and drawbacks of Blastocysts
Once of the advantage of Blastocysts stage is that it helps in selecting the better embryo which is then replaced in the mother’s uterus. The embryo can be grown outside the mother’s uterus until a more natural time at the Blastocysts stage before it is transferred to the uterus. Blastocyst is just associated with the higher chance of pregnancy of around 50-60% and as we transfer fewer embryos, it is possible to reduce the chances of multiple pregnancy.
One of the disadvantages of the blastocysts stage is that, fewer embryos will survive at this stage, probably 30-50% embryos. There is also a possibility that none of the embryo will reach the blastocyst transfer stage. Thus, no embryo will be available for transfer.
Who is eligible for Blastocyst Embryo Transfer ?
Couples who have had unsuccessful prior attempts with IVF or IVF/ICSI despite having many good quality eggs retrieved are being offered blastocyst culture as an alternative treatment. The ability to select the most viable embryos for transfer & implantation should improve their chance of achieving a pregnancy.
In the IVF laboratory, the embryos are cultured for 5 days after the egg retrieval. At least 5 good quality embryos (six to eight cells) should be available on the 3rd day after the egg retrieval so as to maximize the chances of obtaining a blastocyst.
The couple can talk to the doctor regarding this option, whether it will benefit them or not.
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