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Fig 6. A beautiful 8-cell embryo on Day 3. This is a Grade A embryo, with regular, equally sized, clear blastomeres; and no fragments.
There is quite a lot of suspense and anxiety till you find out from the lab how many embryos have fertilized. This is a biologic variable, which we still cannot control. Sometimes, even though the eggs and sperm may look excellent, there may be a total failure of fertilization. This can be a major blow, because it means that there are no embryos to transfer. Poor fertilization rates may be because of poor lab conditions, a sperm problem, or an egg problem. If only one patient has poor fertilization on a particular day, in a good lab, then it's usually the sperm that are held to be responsible.
The normally fertilized embryos are left in culture, where they continue to divide, and their quality graded after another 24 hours. Good quality embryos divide rapidly; and healthy embryos have 2-4 cells, of equal size, with clear cytoplasm and few fragments. The IVF lab is the heart of the IVF clinic today, and an IVF clinic is only as good as its lab! Unfortunately, most patients have no idea of what happens in the lab, and they rarely get a chance to talk with the embryologist, the skilled biologist who works in the IVF lab. The embryologist is the unsung hero of IVF treatment who does all the important work behind the scenes. The dramatic improvements in pregnancy rates with IVF today are because of the important contributions embryologists have made to finding the best ways of growing and culturing embryos in vitro.
Many patients are worried that their eggs, sperm or embryos may get mixed up with someone else's. While this can happen, the probability of it happening in a well-run laboratory is very low, because good labs have quality control mechanisms to prevent such mix-ups from occurring.
After 48 - 72 hours, when embryos usually consist of two to eight cells each, they are ready to be placed into the woman's uterus. This procedure is known as embryo transfer.
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
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