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 Головна  Контакти  Карта сайту |
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Day 3 or Day 5? Advantages and Disadvantages IVF center Intersono, Lviv, Ukraine OBJECTIVE: During the last decade, the extension of embryo culture to day 5 has gained popularity in IVF practice (Wilson et al., 2002). There are few scientific reasons to compare cleavage-stage and blastocyst-stage embryo transfers. The first: an embryo does not implant before day 5, better synchronization with an endometrium already affected by an IVF stimulated cycle, blastocysts have better correlation between morphology and euploidy status . On the other hand, blastocysts have certain drawbacks, such as the lack of one day co-culture with endometrial cells (an embryo descends into the uterine cavity on day 4); the increased possibility for some embryos not to develope into blastocysts in vitro. It has been reported that Y-bearing preembryos (males) develop at faster rates than X-bearing ones (females). If this theory is proved accurate, one may expect a skew in sex ratios after day 5 transfer, as the most advanced blastocysts are almost always replaced preferentially. The aim of this study is to compare clinical pregnancy rate, implantation rate, multiply gestation rate and male/female sex ratio after blastocyst and cleavage-stage transfers. DESIGN: Retrospective (randomized) analysis MATERIALS and METHODS: Analysis and comparison of 336 fresh and cryocycles with day 5 embryo transfer (ET) and 296 fresh and cryocycles with day 3 ET performed in Medical Center Intersono between April, 17 2007 and June, 24 2008.
CONCLUSIONS: Both cleavage-stage and blastocyst-stage embryo transfer policies have advantages and drawbacks. Our data presented in this study has shown better outcomes using 5 day ET. Not always extended culture will turn enough retrieved eggs into a blastocyst. Our data support the observation of an altered sex ratio imbalance favoring male offspring with blastocyst transfer. However further studies and researches are needed in group of day 3 ET.
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