Advanced Fertility Center of Chicago ivf

IVF, In Vitro Fertilization with Blastocyst Culture and Day 5 Transfer

  • Blastocyst culture and day 5 embryo transfer for in vitro fertilization allows selection of the best quality embryos for transfer
  • Embryo quality is important with infertility
  • With blastocyst transfer, we transfer fewer embryos - reducing multiple pregnancy risks, and maintain high IVF success rates

Definition of a blastocyst

  • An embryo that has developed for five to seven days after fertilization and has 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
  • A more centrally located group of cells - the inner cell mass, will become the fetus
single blastocyst transfer
Single blastocyst transferred day 5
single blast baby
Nick arrived 9 months later
4aa balstocyst
High quality 4AA blastocyst IVF embryo

There is a large fluid filled cavity - blastocyst expansion grade is 4 Inner cell mass is grade A - with many, tightly packed cells Trophectoderm is grade A - many cells in a cohesive layer Embryo transfer resulted in healthy pregnancy Day 5 blastocyst pictures, information on blastocyst grading

Blastocyst development

The most commonly used indications for assisted hatching with an in vitro fertilization case are:

  • The blastocyst usually forms on day 5 as fluid builds within the compacted morula
  • A healthy blastocyst often begins hatching from its outer shell, called the zona pellucida between day 5 to day 7 after fertilization
  • Within 24 hours after hatching, embryo implantation after IVF (or a "natural" pregnancy) begins as the embryo invades into the uterine lining
  • The blastocyst releases HCG hormone (the pregnancy test hormone) which leaks into the mother's blood as the embryo implants

Blastocyst formation rate

  • The goal of in vitro fertilization and embryo culture is to provide high quality embryos which are capable of continued development and result in live births
  • However, under standard IVF culture conditions, only about 25 to 60% of human embryos progress to the blastocyst stage after 5 days of culture
  • The low rate of embryo development has 2 main causes:
    • A less than optimal culture environment in the lab dish
    • The inherent "weakness" of human embryos
  • Therefore, in the past embryos were transferred to the uterus after 2 or 3 days

Advantages of blastocyst transfer for IVF

  • One problem with this is that 2 to 3-day-old embryos are normally n the fallopian tubes, not in the uterus. The embryo gets to the uterus about 80 hours after ovulation.
  • Embryo implantation process begins about 3 days later - after blastocyst formation and hatching out of the embryonic shell have occurred.
  • Therefore, if in vitro culture conditions are maximized so healthy blastocysts form at a high rate, then day 5 blastocyst embryo transfer can be done.
    • The uterine lining on day 5 should be receptive to the arriving embryo - this a more "natural" time for the embryos to be in the uterus. It is the same timing as with a natural pregnancy.
    • The transfer is done shortly before the time for actual invasion and implantation

Pregnancy rates and reduce risks for multiples

  • Transferring blastocysts following IVF also provides another potential benefit - reducing possibility for multiple pregnancy
  • Many 2 or 3-day-old embryos do not have the capacity to become high quality blastocysts and make a viable pregnancy. However, on day two or three of culture we don't have methods to determine which embryos will be viable long-term, and which will soon arrest their development.
  • By culturing embryos to day 5 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 very little risk for having high order (triplets or higher) multiple pregnancies.

Extended in-vitro culture systems

  • In the past, it was difficult to get high quality blastocysts with in vitro culture systems - unless "feeder" cells were utilized - called coculture.
  • However, since 1998 more advanced culture media have been commercially available that (if used properly) can yield high blastocyst formation rates.
  • Now blastocyst embryo transfer is a viable IVF treatment option for many couples

Disadvantages of blastocyst transfer

  • If the IVF clinic is proficient at blastocyst culture and has excellent quality control in the laboratory, there is potentially no disadvantage to day 5 blastocyst transfer.
  • However, if the culture environment is suboptimal, delayed embryo development and even embryonic arrest will occur in some cases.
  • Therefore, if the culture system and laboratory quality control are inconsistent - good results will not be obtained with extended culture to day 5.
  • Such programs will do better with day 3 transfers - putting back embryos earlier, before they are "stressed" excessively by the weak culture environment.
  • Another possible disadvantage - some clinics charge more for day 5 transfer

Details about IVF costs

Our IVF success rates

4920 N. Central Ave
Suite 2C

Chicago, IL 60630

Phone: (773) 794-1818
Fax: (773) 794-1819

30 Tower Court
Suite F
Gurnee, IL 60031

Phone: (847) 662-1818
Fax: (847) 662-3001

820 E. Terra Cotta Ave (Rte 176)
Suite 118
Crystal Lake, IL 60014

Phone: (815) 356-1818
Fax: (815) 356-1866



I am so grateful for Advanced Fertility Center. I just had my son Leland. I want to thank Dr. Catenacci and all of the nurses that helped us. Especially Ashley in the Crystal Lake office. You made this process easier by being supportive and positive. Thank you very much!


Dr. Sherban and his staff are the most amazing, compassionate, and supportive people. After almost 5 years of trying to conceive, going through numerous tests and meeting with another clinic closer to home, who told me my chances even with IVF were still very low, a good friend recommended advanced fertility center of Chicago. Best decision we ever made! We now have 2 amazing children who are now 5 and 3 years old! I cannot stress enough how amazing this staff is, they make you feel like family!


Our experience was amazing with Dr. Cantanucci and all of the nurses (especially Ashley). After ttc for 4 years and at 41 years of age, we became pregnant after 1 round of IVF, and had our beautiful boy this past October. Can't thank them enough!


2/7/15 our son was born all thanks to the assistance of Dr. Sherbahn and his staff. Everyone was so helpful and here for all our questions, worries, etc. They want this for you just as much as you want this for you! Handled with pure professionalism and care from the very start! Thank you advanced fertility!