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Embryo / Blastocyst Culture And Transfer

After egg retrieval, sperm are added to the eggs and fertilization takes place. Not all eggs fertilize. The resultant embryos are then kept in culture for 3-6 days. Transfers can take place on days 2-6 after retrieval. Typically we utilize a day 3 (multicell) or day 5 (blastocyst) transfer. We were the first program in NE Florida to offer Blastocyst culture and transfer. We have had a great experience with this method.

Blastocyst, or day 5 culture, allows for more embryo selection in cases of large embryo number where choosing the best embryo may be difficult. Typically, many of the embryos will make it to day 3 at the 8-cell stage. This is the point where the egg genes turn off and the embryo genes take over. As a result, many embryos go to day 3 and then fail to develop further. This is a problem when there are more 8-cell embryos present than the desired transfer number. The next milestone of development for the embryo is Blastocyst formation on day 5. This then can be used to remove the bad embryos and increase the odds of picking a successful embryo. Therefore, in cases with more than three 8-cell embryos on day three, we will often recommend going out to day 5 to allow for better selection.

Large programs often don’t offer Blastocyst culture due to the added manpower and equipment necessary to house embryos for another 2-3 days. In many cases, an extra embryo is transferred on day 3 to compensate for the decreased ability to choose the best embryos at the 8-cell stage; thereby, incurring an increased risk of triplets or higher order multiples.

At JCRM we have placed a great emphasis on the transfer of the embryos since this is such a vital part of a successful cycle. We utilize ultrasound guidance and have been doing so for years. This allows for a much more controlled embryo transfer which clearly translates into a better chance for success. In some cases, we may even recommend IV sedation for the transfer to allow some smooth muscle relaxation to open the cervix slightly.