Deciding Which Embryo To Transfer for In Vitro Fertilization (IVF)

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When it comes to In Vitro Fertilization (IVF) success, people often wonder how the best embryo is chosen. According to the American Society for Reproductive Medicine, choosing the best quality embryo to transfer is determined in large part by the laboratory as it grades every embryo depending on how it looks. Taken into consideration are the number (and size) of the cells and their level of development.

Clinics typically rely on several indicators to assess which embryo is a) best and b) whether it should be transferred first:

-The speed at which the embryo is dividing and reaches each specific stage, such as the blastocyst on day 5 or cleavage stage (the period after fertilization, when a 1-cell embryo begins to develop into a multicellular organism).

-The blastocyst expansion and hatching stage, size and compactness of the inner cell mass (ICM), cohesiveness as well as the amount of cells of the trophectoderm (TE) are assessed criteria in morphological grading.

-Genetic testing can tell us whether the embryo has the correct number of chromosomes.

What To Expect With IVF

When undergoing IVF, a single cycle of IVF may take around 2-3 weeks and you may need more than one cycle. You will undergo:

  1. Ovarian stimulation
  2. Egg retrieval
  3. Sperm retrieval
  4. Fertilization
  5. Embryo transfer

Medications can help get your uterus lining prepared. When you are ready for the egg retrieval process or at the time of embryo transfer, you may be given progesterone supplements to help your uterus lining be more receptive to implantation. Sometimes other treatments may be sought before attempting an embryo transfer:

Assisted Hatching

Within five to six days after fertilization takes place, the embryo will hatch from the membrane surrounding it. When this happens, it can then implant into the uterus lining. Assisted hatching may be recommended for women who are older or after having had several IVF endeavors failed to take hold.

Preimplantation Genetic Testing

In this scenario, your embryos will be growing in the incubator until they get to the stage where a tiny sample can be extracted followed by testing for certain genetic issues or whether there are the right number of chromosomes. Healthy embryos can then be placed into your uterus.

Embryo Transfer

This transfer is typically done five days post egg retrieval. You will be made comfortable although the treatment is typically painless. Your physician will place a catheter (a long, thin, flexible tube) into your vagina where it will be inserted into your uterus via your cervix. The syringe with your chosen embryo will be released via the media into your uterus.

The goal is to have an embryo implant in the lining of your uterus anywhere from six to 10 days after egg retrieval that will eventually lead to a healthy pregnancy!

Healthy Birth

After IVF, there are factors which impact your success of giving birth to a healthy baby:

-Your age: During IVF, younger women tend to be most successful for becoming pregnant and giving birth when using their own eggs. If you are 41 or older, using donor eggs during IVF can boost your odds of success.

-Embryo status: Embryo quality and grading does not correlate to pregnancy rates directly.  Embryos that are healthy enough to transfer or freeze have a decent chance of leading to pregnancy.

-Prior births: If you have already borne a child, you are more likely to achieve pregnancy with IVF than someone who hasn’t.

-Infertility factor: If you have a normal egg supply, you are more likely to become pregnant with IVF. Conversely, having severe endometriosis decreases the odds of achieving pregnancy with the help of IVF.

-Lifestyle features: Smoking decreases your egg retrieval rates with IVF and increases your odds of miscarrying. In fact, smoking reduces your odds of success with IVF by 50%. Being obese also lowers your pregnancy and birth success rate. When trying to conceive with IVF, it is strongly advised to avoid the use of recreational drugs and consuming too much caffeine.

Our Utah Fertility Center specialists and team look forward to assisting you on your fertility journey with IVF. We invite you to call us at one of our locations nearest you.

Read In-Depth Articles:
Embryo Grading
Which Embryo To Transfer