TIMING OF EMBRYO TRANSFER

AND EMBRYO GRADING

LEEPIKA PATNAIK
EMBRYOLOGIST
FEMELIFE FERTILITY FOUNDATION PVT LTD
NATURE AND NURTURERS
 Nature is simply
magical.
 Nature chooses to
implant one embryo
for intended
pregnancy
SIMILARLY
THE ULTIMATE GOAL OF ART PROGRAM IS THE
BIRTH OF HEALTHY LIVE BABY

With advances in ART , best oocytes, best

sperms and best embryos are selected
EMBRYO TRANSFER

ET technique is a very much

skill based technique
POOR ET TECHNIQUE ACCOUNTS FOR 30%
IVF FAILURE

 Successful outcome depends on the proper

intrauterine insemination and a soothingTransfer.

 Theskill varies widely from individual to

individual even within the same IVF unit.
TWO FACTS

Other than expert skills of ET two factor affect success

rate

 Timing of ET
 Grading Of Embryos
TIMING OF EMBRYOS TRANSFER
ET has been carried out by

 Day 2:i.e about 48 hours of oocyte retrieved

 Day 3:i.e about 72 hours of oocyte retrieved

 Day 5:i.e blastocyst Transfer

DAY 2 TRANSFER

Day 2 transfer is done in majority (50-70%) cases in most

ivf centers
DAY 3 TRANSFER
 It shows similar
pregnancy rates as in day
2 transfer

 The benefit is selection of

better embryos thus better
development of embryos
DAY 5 BLASTOCYST TRANSFER

 With Day 5 or Blastocyst

Transfer, Pregnancy Rate
is 50-60% but as many as
30% patient may fail to
develop to blastocyst
Stage
DEVELOPMENT OF EMBRYO
SELECTION
OF GOOD
EMBRYO IS
BASED ON THE
FOLLOWING
CRITERIA
MORPHOLOGICAL GRADING OF DAY 2 DAY3
AND DAY5 EMBRYO

This can be done manually by

visualizing the embryos under
stereo zoom microscope or
inverted microscope
GRADING OF EMBRYOS
 Grade 1: Equal size of blastomeres with no
fragmentation seen
 Grade 2: Equal or irregular blastomere with not more
than 10% fragmentation
 Grade3: More than 10-50% of fragmentation with
unequal blastomeres
 Grade 4: Fragmentation or loss of more than 50%
blastomeres but with at least one viable blastomere.
MORPHOLOGICAL ASSESSMENT OF
EMBRYOS
MORPHOLOGICAL ASSESSMENT OF
EMBRYOS
SUCCESS RATE OF IVF AND GRADING OF
EMBRYO

Normally ET of grade 1 and grade 2

embryos result similar as compared to
poor pregnancy rates with grade 3
and grade 4 embryos
MORPHOLOGICAL ASSESSMENT OF
BLASTOCYST
MORPHOLOGICAL ASSESSMENT OF
BLASTOCYST
PREG. RATE AND BLASTOCYST TRANSFER
Using this grading system, it is shown that
clinical pregnancy rates in excess of 60%
can be attained by the transfer of atleast
one high scoring blastocyst
 GOLDEN RULE IS
If the embryos are not of good
quality or grade on day 2, it is
best to transfer them back on the
same day , in stead of waiting for
day 3 or day 5 transfer
By selecting good quality embryos with
proper timing