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IVF, In Vitro Fertilization with Blastocyst Culture and Day 5 Transfer
Advanced Fertility Center of Chicago
Infertility and In Vitro Fertilization Specialist Clinic
Gurnee & Crystal Lake, Illinois
Our Overall IVF Success Rates
Our IVF Success Rates with Day 5 Blastocyst Transfers
One blastocyst embryo transferred on day 5
Nick arrived 9 months later
Related Pages
- More discussion of blastocyst day 5 embryo transfer issues
- Pictures of day 5 blastocyst embryos and blastocyst grading
- How can blastocyst transfer reduce multiple pregnancy risks
- In vitro fertilization
- IVF pricing plan details
The blastocyst culture and day 5 embryo transfer procedure for in vitro fertilization facilitates selection of the best quality embryos for transfer to the uterus of the mother. The concept of embryo quality is a very important one for couples experiencing infertility. With blastocyst embryo transfer, we can transfer fewer embryos - reducing risks for multiple pregnancy - while keeping overall pregnancy rates high.
Definition of a blastocyst - an embryo that has developed for five to seven days after fertilization and has developed 2 distinct cell types and a central cavity filled with fluid (blastocoel cavity). The cells in a blastocyst have just started to differentiate. The surface cells that surround the cavity (just under the outer shell) are called the trophectoderm and will later develop into the placenta. The more centrally located group of cells are called the inner cell mass and will become the fetus.
High quality 4AA blastocyst IVF embryo
This day 5 blastocyst embryo has a large fluid filled cavity - blastocyst expansion grade is a 4
An inner cell mass with many, tightly packed cells (seen in the middle of the embryo) - grade A
A trophectoderm component with many cells in a cohesive layer - grade A
The overall grade of this blastocyst is 4AA
The day 5 blastocyst embryo transfer resulted in a healthy pregnancy and delivery
See more day 5 blastocyst pictures and information about blastocyst grading
A healthy blastocyst should begin hatching from its outer shell, called the zona pellucida by the end of the sixth day after fertilization. Within 24 hours after hatching, embryo implantation after IVF (or in a "natural" pregnancy) begins as the embryo invades into the lining of the mother's uterus. The blastocyst releases HCG hormone (the pregnancy test hormone) which is picked up by the mother's blood circulation as the embryo implants in the uterine lining.
The ultimate goal of in vitro fertilization (IVF) and embryo culture is to provide high quality embryos which are capable of continued normal development and result in live births. However, under standard IVF culture conditions, only about 25-60% of human embryos will progress to the blastocyst stage after 5 days of culture. This low rate of embryo development is the result of a less than optimal culture environment for the embryos. For this reason, embryos have traditionally been transferred into the uterus after only 2 or 3 days of culture.
Advantages of blastocyst transfer for IVF
One problem with this is that 2 to 3-day-old embryos are normally found in the fallopian tubes, not in the uterus. The embryo first moves into the uterus at about 80 hours after ovulation. The embryo implantation process begins about 3 days later - after blastocyst formation and hatching out of the embryonic shell (called the zona pellucida) have occurred. Therefore, if in vitro culture conditions are maximized so that healthy blastocysts form at a high rate, then blastocyst embryo transfer can be done on day 5 - at a more "natural" time for the embryos to be in the uterus, and very shortly before actual invasion and embryo implantation. The uterine lining at day 5 blastocyst transfer should be ideal and receptive to the arriving embryo - this is the same timing as occurs in a "natural" pregnancy situation.
Transferring blastocysts following IVF also provides another potential benefit - reduction of the possibility of multiple pregnancy. Some 2 or 3-day-old embryos do not have the capacity to become high quality blastocysts and a viable pregnancy. However, on day two or three of culture we do not have reliable methods to determine which embryos will be viable long-term, and which ones will arrest their development within a day or 2. By culturing embryos out to the blastocyst stage we will find that some of them have not become blastocysts - allowing us an opportunity to choose the most competent embryos for transfer. We can then transfer fewer embryos and still obtain high pregnancy success rates - with little or no risk for high order (triplets or higher) multiple pregnancy.
In the past, it was very difficult to get good numbers of high quality blastocysts with in vitro culture systems - unless "feeder" cells were utilized - this technique is called coculture. However, since the late 1990's advanced culture media have been available that (when used properly) can yield high blastocyst formation rates. This makes day 5 blastocyst embryo transfer a viable IVF treatment option for many couples with infertility.
Disadvantages of blastocyst transfer
If the IVF clinic is proficient at blastocyst culture and has excellent quality control in the laboratory, there should really not be any disadvantages to day 5 blastocyst transfer. However, if the culture environment is suboptimal, delayed embryo development and even embryonic arrest will occur - at least in some cases. Therefore, if the culture system and quality control in an IVF lab are inconsistent - good results will not be obtained with extended culture to day 5. Such programs will do better with day 3 embryo transfers - putting back the embryos earlier, before they are "stressed" too much in the weak culture environment. Another possible disadvantage is that some IVF clinics charge an extra fee for day 5 culture and transfer.
Details about our IVF pricing
Our IVF success rates
