| The end point of an IVF
treatment cycle is an embryo; and an IVF lab will successfully
create many embryos in the lab for most of their patients.
Good IVF labs routinely show patients their embryos; but
unfortunately many labs don't, which means most patients
are clueless about how good the quality of their embryos
is. However, this is vitally important information, so
you can assess your chances of conceiving, and modify
the next treatment cycle accordingly.
Here's a visual guide to embryos, so you can appreciate
what your embryos are meant to look like.
1. This is a 2-cell embryo on
Day 2. The zona ( shell) is normal and uniform; each
of the cells ( called blastomeres) is equal in size
with a clear cytoplasm. You can also see a single central
nucleus clearly in the right hand cell. There are a
few fragments as well, which appear like bubbles, but
since these are less than 10%, this would be considered
to a Grade A embryo.
2. This is a 4-cell embryo on Day 2. The cells are clear
and equal; and there is less than 10% fragmentation,
which makes this a Grade A embryo. This is better than
a 2-cell embryo, because it is dividing more rapidly,
and has a better chance of becoming a baby !
3. This is a Grade A 5-cell embryo on Day 2. The reason
I have included this image is to emphasise that not
all the cells in an embryo divide at the same time,
so it's perfectly normal to see embryos which have an
odd number of cells ! You can clearly see the central
nucleus in the top cell.
4. This is a 8-cell embryo on Day 3. The cells are clear
and equal; and there is no fragmentation, which makes
this a Grade A embryo.This is the sort of embryo which
delights an embryologist's heart !
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5. This is a 10-cell compacting
embryo on Day 3. The edges between the cells are getting
blurred, so it's becoming harder to count the number
of cells.
6. This is a morula on Day 4.
The cells borders have become indistinct and are said
to be compacting.
7. This a hatched expanded blastocyst on Day 6. This
is a perfect embryo - every embryologist's dream ! You
can see that the blastocyst has escaped from the zona
( which means it has hatched); and that the blastocyst
is now much larger from the zona ( which means it has
expanded). Such an embryo has no business not becoming
a baby when transferred into the uterus, but the implantation
rate even with such a beautiful embryo is only 40%.
You can see some more pictures of embryos
on the next page.
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