Embryo transfer on Day 3 or Day 5?

One of the common questions that patients ask about IVF is the difference between doing an embryo transfer on Day 3 or Day 5 following egg pick up. To answer this, we should know a little about the reproduction physiology. When a woman conceives naturally, fertilization occurs in her fallopian tubes. It takes about 3 to 4 days for the fertilized egg to travel through the fallopian tube to the endometrial cavity of the uterus ( mother’s womb). During the transit of the fertilized egg (called a zygote at that stage), the zygote divides into an embryo (by day 2-3) and then further divides to a morula (by day 4) prior to arriving/implanting in the uterus. So, by the time the pregnancy implants in the uterus, it's at a stage of development called a blastocyst on day 5.

Investigations on this field show that blastocyst transfer (day 5) during IVF treatments results in a significantly higher chance of pregnancy compared to an embryo transfer on day 3.

We have routinely been performing blastocyst culture and transfer for many years and observe significantly higher implantation and pregnancy rates as compared to what we see with day 3 embryos. First of all, it could be that longer incubation of embryos in the laboratory allows healthier embryos to grow, while those that are not healthy generally stop growing. This would increase the likelihood that better quality embryos would be chosen and transferred into the patient’s uterus, potentially increasing the chance for pregnancy. Another possible reason is that it more physiologically mimics that which occurs in nature during a spontaneous pregnancy. IVF labs which have poorer techniques and personnel, tend to favour day 3 transfers, as they may not be able to nurture the growing embryos for 5 days. However, if a very limited number of embryos are available on day 3 and no embryo selection is required, then the benefit of a day-5embryo transfer may be limited to the improved synchronization between embryo and endometrium. Because it is obvious that the best conditioned place for the embryos is the mother’s womb itself.

Finally, a clinic’s success with embryo cryopreservation following extended culture should also be carefully considered. We believe that extended culture to day 5 must go hand in hand with an excellent cryopreservation program in order to maximize patient success.

http://turkey-ivf.com/day-3-day-5-ivf-icsi.html

Egg Freezing

Egg freezing, as the name suggests, is the process of freezing and storing human eggs for use in in vitro fertilization (IVF). As part of an IVF cycle, the patient is given certain hormonal drugs for stimulating the ovaries to produce eggs. The eggs develop within the follicles, which are monitored until they grow large enough. This usually takes around two weeks. The follicles are then emptied carefully and the embryos are identified and separated. The egg retrieval process takes place as the patient under general anesthetic or sedation. At this point, the eggs are either fertilized and prepared for implantation or placed in liquid nitrogen for storage.

Egg freezing and embryo freezing

Embryo freezing has been done for many years now, and thousands of babies around the world have been born from frozen embryos. However, egg freezing is still a rather new technique. The number of babies born from frozen eggs amount to around 900, and the procedure is considered experimental by some clinics.

Why opt for egg freezing and storage?

Egg freezing and storage is done so that it can be used for fertility treatment in the future. It is especially recommended for patients undergoing some forms of cancer treatment or medical treatment that could affect fertility. It is also recommended for patients who are concerned about declining fertility over time, but are not ready to have a child at present.

The procedure for egg freezing

The egg freezing procedure is conducted in six steps given below:

1. Your doctor will first explain the entire egg freezing procedure and the risks involved before you agree to it. Some clinics may also have a specialist counselor who you can consult to know more about the process and whether you should go ahead with it.

2. If you agree to the egg freezing procedure, you will first undergo screening tests to ensure that you do not have infectious diseases like hepatitis B or C or a HIV infection.

3. Once you complete the screening, you need to give written consent for storing your eggs

4. A standard IVF cycle is started and the eggs are collected using the conventional procedure.

5. The eggs are added to a cryoprotectant or freezing solution so that they are protected while they are in a frozen state.

6. The eggs are frozen either by vitrification, which is a fast freezing process, or by cooling them slowly. Once frozen, they are stored in liquid nitrogen storage tanks.

What does the consent form specify?

The consent form that you sign before the egg freezing process gives you certain control over what will happen to your eggs. The specifics of the form may vary with each clinic, but they usually let you specify the following:

• Your consent to the eggs being stored and used later for your IVF treatment
• The period of storage for your eggs, with the usual period being 10 years
• What should be done with the stored eggs in the event of your death or if you are no longer able to make decisions for yourself
• If your eggs may be used for your treatment alone or for training/research or donated for others' treatment