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It has been well documented that the implantation rate with blastocystsis better than with Day 3 embryos.

This is common sense , because a day 3 embryo needs to become a blastocyst before it can implant , and this is why its better to grow it in the IVF lab and wait till it becomes a blastocyst before transferring it in the uterus .

The problem with doing a day 3 embryo is it's impossible to predict which Day 3 embryo is going to become a blastocyst, as a result of which a lot of doctors will transfer many day 3 embryos at one time, to maximize the chances of achieving a pregnancy. The problem is that this strategy increases the risk of having a multiple pregnancy . As a result, the neonatal complication rate is much higher , because of the chances of premature labour increase considerably.

Its much better to allow the embryos to compete amongst themselves , by culturing them in vitro to day 5 in the lab , so that the embryologist can select the best quality blastocyst, and then transfer only this single blastocyst, and freeze the rest .

Not only does this increase the success rates in the fresh cycle , it also increases the pregnancy rates for the future , because we can then transfer the frozen blastocysts, one at a time.

Blastocyst transfer is now completely routine in all good IVF clinics, because the technology is so well-established and proven.

This is why it upsets me that doctors continued to do Day 3 transfers.

They take advantage of the patients ignorance, and exploit this.

This is either because the doctor knows their lab is not good enough to be able to grow embryos to Day 5, and they want to take shortcuts, so they can then blame the IVF failure to failed implantation, rather than a poor-quality lab !

Please insist on a Day 5 transfer, even if you have only 2-3 eggs. Doctors are worried whether they will be able to culture these eggs to Day 5, and will bulldoze the patient into transferring it earlier , but if the doctor is not confident that the lab that is capable of growing a good embryo into a good blastocyst, then perhaps he shouldn't be doing IVF in the first place .

This is why you should not allow doctors to take you for a ride . Please ask questions proactively, and demand answers, so you dont get cheated by unscrupulous doctors.

Source : https://blog.drmalpani.com/2021/02/why-dont-all-ivf-clinics-do-only.html
Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.
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