IVF Success Rates with 5 Day Blastocyst Transfers at the Advanced Fertility Center of Chicago

Page author Richard Sherbahn MD

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High quality day 5 blastocyst stage IVF embryo Blastocyst grading is 4AA

IVF success rates with blastocyst transfer

• 5 day blastocyst transfer success rates are potentially confusing
• Almost all clinics that do extended embryo culture and blastocyst transfer IVF are selective in choosing patients eligible for it.
• Therefore, we should expect success rates to be higher in this selected population as compared to the rates in "unselected" patients.

However, this does not necessarily mean that having a blastocyst transfer increases a couples chance for pregnancy. It means that if we select patients for blastocyst transfer that are often younger and have more embryos that look better under the microscope (better embryo "quality") - we should have higher success rates - because we already know that those patients are more likely to have success - regardless of whether we transfer their embryos on day 3 or 5.

• See a discussion of the impact of the number of eggs retrieved and IVF success

Risks for multiple pregnancy with blastocyst transfers

Perhaps the greatest benefit of blastocyst transfer is the potential to reduce the risk of multiple pregnancy by transferring fewer embryos of higher quality. We have had a very low percentage of triplet (or higher order) pregnancies from blastocyst transfer.

• The rate of triplets with blast transfers at our IVF center has been about 2% of pregnancies.
• These triplets have almost always been due to "identical twin" splitting of an embryo
  • 2 transferred and 3 implanted, after one of the embryos split into 2

Having said that, below are our live birth success rates for blastocyst transfer cases

We have done blastocyst culture and transfer since 1998. We see significantly higher blastocyst implantation rates as compared to the implantation rates of day 3 embryos.

Below are our in vitro fertilization live birth success rates for the past 7 years according to the day of the embryo transfer procedure and female age.

January 1, 2003 to December 31, 2009

Live birth rates per transfer procedure
Day 2 and 3 "cleavage stage" transfers vs. day 5 and 6 blastocyst transfers

This data represents a total of 1816 IVF embryo transfer procedures

64 patients had an egg retrieval but had no embryos for transfer (3.4% of retrievals)
These statistics are "per embryo transfer", patients without transfer are not represented

Graph shows the same data for day of transfer as in the tables
Blue columns show success rates for day 3 transfers
Yellow shows success rates for day 5 blast transfers
Pink shows our success rates for all transfers

See our overall pregnancy and live birth rates

Regarding day 6 blastocyst transfer statistics

In the early years of blastocyst transfer (1998 and 1999) we sometimes looked at embryos early on day 5 and had patients with slower embryo development come in on day 6 for their transfer. For example, patients with only morula stage embros and no true blastocysts yet.

• We thought it was better to let those slower embryos develop and expand more in the culture dish before choosing the best 1 or 2 for transfer.

However, success rate statistics for day 6 blastocyst transfers were somewhat lower than we were seeing for 5 day transfers. We believe this is because some of the embryos that are "slower" on day 5 are weaker, poor quality embryos.

• Of course, the "slow" embryos that had blastocyst formation by day 6 and went on to expand, hatch, implant and make babies were strong and healthy all along - just slower starters.
• Remember the story about the tortoise and the hare?

Comparing day 5 and day 6 blastocyst transfers, we saw better success rates with transfers done day 5. However, this is because patients with embryos developing at a more "normal" rate were getting embryo transfers done on the 5th day, not because transferring embryos day 6 is somehow bad for outcome.

IVF blastocyst picture shows hatching out from the shell - at lower right of photo
This blastocyst is grade 5AA
After hatching, the embryo can invade and begin implantation in the uterine lining
This picture was taken a few minutes prior to embryo transfer

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