Blastocyst Culture and Transfer

What is Blastocyst Culture and Transfer?

IVF’s advanced approach, blastocyst culture and transfer, involves growing embryos in controlled conditions before implanting them in the mother’s uterus. In vitro fertilisation (IVF) involves transferring embryos to the uterus following egg collection and insemination, while a blastocyst is an embryo that has matured in the laboratory for 5-6 days after insemination. For infertile couples, this treatment has been shown to increase their odds of having a healthy baby.

The Stages of Blastocyst Culture

Following is a rundown of each stage of growth in Blastocyst IVF:

  • Day 0 is the initial day of collecting eggs (IVF/ICSI is performed the next day).
  • Day 1 is the pronuclear stage (the embryologist examines to see the number of eggs fertilised).
  • Day 2 is the two to four-cell stage.
  • Day 3, is the eight-cell stage
  • Day 4 is the morula stage
  • Day 5 or 6 is the blastocyst implantation stage

When is Blastocyst Culture Recommended?

In general, blastocyst culture is advised when –

  • Despite retrieving several healthy eggs, many couples have failed to conceive with IVF or ICSI. This is where Blastocyst culture may benefit them because it has a higher success rate than Day 3 Embryo Transfer. In this case, the doctor can use blastocyst culture to look for any problems with the embryo’s growth between days three and six.
  • Compared to the more typical Day 3 Embryo Implantation for a single embryo, Blastocyst Transfer on Day 5 is helpful for couples pursuing Elective Single Embryo Transfer (eSET) since it enhances the chance of pregnancy.
  • Preimplantation genetic diagnosis (PGD) is a cutting-edge medical treatment that reduces the likelihood that a genetic disorder will be passed down from a parent to a child during pregnancy. During PGD, a small number of cells from an embryo are removed for genetic examination in a process called embryo biopsy. After that, only the viable embryos are put back into the uterus.
  • Blastocyst IVF is also suggested for couples who have many viable embryos on day three. During this long culture, the embryologist can see which frozen embryos are most likely to implant by seeing how they change into blastocysts. As a result of the screening technique, fewer embryos will be transferred on day 5, reducing the risk of multiple pregnancies.

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What Are the Advantages of Blastocyst Culture?

Allowing embryos to develop in a laboratory until they get to the blastocyst stage enables the selection of the most viable embryo/s for embryo transfer. Only the embryos with the best growth potential become blastocysts.

In a normal pregnancy, the embryo travels to the uterus about five days after fertilisation and implants there. The uterine lining is more responsive on this day. Thus, it is more biological to perform a blastocyst transfer.

Pre-implantation genetic screening (PGS) and pre-implantation genetic diagnosis (PGD) are procedures that may be necessary for some couples. Embryo biopsy is advised to be performed on blastocysts rather than Day 2/3 embryos, hence they need to be cultured in a special way called a blastocyst culture.

Up to 60% of blastocysts that are fertilised can implant. With the option to transfer a single blastocyst with a high implantation rate, expectant mothers have a better shot of carrying a healthy singleton pregnancy and fewer chances of dealing with the complications of having multiple.

Who Can Benefit from Blastocyst Culture?

Not everyone can benefit from a blastocyst transfer. The optimal embryo is chosen by a selection procedure performed in a lab. Blastocyst culturing is recommended:

  • In Cases of Recurrent IVF Failure: If a patient has a poor pregnancy rate after IVF treatment with day 2/3 embryo transfer, a blastocyst culture may provide useful information about the embryos’ development.
  • To Prevent Multiple Pregnancies: The risk of having more than one child can be decreased by using blastocyst culture to select and transfer just the healthiest embryo.

What are the Risks of Blastocyst Culture?

Some embryos may not survive the blastocyst transfer because they cannot be cultured in a petri dish for five days. This means fewer embryos will be available for freezing and transplantation. After day 3, embryos stop growing and treatment is discontinued without the chance of an IVF embryo transfer for all but 5% of couples. The disorder is called embryonic block and may be the underlying cause of infertility.

How Is Blastocyst Transfer Done?

The process of a blastocyst transfer is quite similar to that of In Vitro Fertilisation (IVF). The only distinction between a blastocyst transfer or blastocyst IVF and a regular IVF cycle is the age of the embryo upon implantation. The blastocyst transfer process entails the following steps:

  • The first step is to collect the eggs. It’s an easy, quick, and painless procedure that won’t take more than 30 minutes of your time. Eggs are removed from mature follicles using a scanning probe during the procedure.
  • After collecting the eggs, they are fertilised with sperm from the male spouse or a donor.
  • After fertilisation, the embryos are housed in a lab incubator until they develop into blastocysts. After six days in an incubator, these embryos have a better chance of surviving and thriving in the uterine environment. Only the healthiest blastocysts are implanted into the uterus; the rest are cryopreserved for potential future use.
  • At the six-day point, an embryo is considered a blastocyst. The blastocyst is at the optimal time for implantation when it reaches this stage. When a blastocyst has developed sufficiently to survive in the uterine environment, an embryologist places only the healthiest of them inside the woman’s uterus.
  • About two weeks after your blastocyst IVF procedure, you will be asked to take a pregnancy test to see if the blastocyst transfer was successful. You will have an ultrasound if your pregnancy is at least six weeks along.
  • Maintain constant communication with your doctors. If the blastocyst transfer goes well, keeping up with the monitoring is important. Having checkups routinely might ward off potential issues. Sometimes, even for the most optimistic parents, the emotional toll of a surgery gone wrong can be too much to bear.

Why is Blastocyst Culture So Successful?

Blastocyst IVF is like normal conception, in which the embryo moves down the fallopian tube and into the uterus five days after being fertilised. This helps the embryo and the uterine lining develop simultaneously, improving the likelihood of implantation.

Only the healthiest and strongest of a batch of embryos will make it past the early stages of development in blastocyst culture. The likelihood of transferring a genetically healthy embryo with a high implantation capability is increased with blastocyst culture because of the selective exclusion of delayed and arrested embryos from transfer. A healthy pregnancy is more likely to result from doing this.

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