Wednesday, March 9, 2011

Grading Of Embryos At Blastocyst: How Does It Reflect Implantation Rates?


My husband and I recently went through our first IVF. We have been trying for 2.5 years to get pregnant and have done 6 failed IUIs. We have stage 2 endometriosis that was cleared out by a laparoscopy last Fall. Aside from that we are unexplained infertility. We retrieved 10 eggs and 9 fertilized naturally. We transferred 2 blastocysts on Day 5 that were graded 2BB and 3BB at transfer. We had 5 others that made it to freeze on day 6.

I have been a little stressed out about the quality of the blastocysts. I know that 4AA is the highest. Will our blastocyst quality impact implantation rates? R. from the U.S.


Hello R. from the U.S.,

The answer to your question is yes and no. It is ambiguous because grading does not necessarily predict whether implantation, pregnancy or a successful delivery will take place. I have often been surprised when I get a pregnancy from embryos that are "graded" as poor quality. I have also seen cases where when we do genetic testing called PGS (preimplantation genetic screening) the test results reveal that the good quality embryos are abnormal and the real bad one is normal! So I don't think you can say that the way your blastocyst are graded will necessarily have any impact on their ability to implant.

At this point in time, we do not have the technology to evaluate embryos fully to know which ones will implant and which ones won't. As far as I'm concerned, all embryos have the potential to implant and lead to a successful pregnancy. In my opinion, only God knows for sure. It is a good sign that you had embryos to transfer and freeze...Good luck with your transfer results!

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
Monterey, California, U.S.A.

1 comment:

  1. Dr Ramirez
    I found your reply to R from the U.S. about blastocyst grading and the chance of success. Thank you very much for that concise and thoughtful answer. I wanted to know the exact same thing myself after 3 miscarriages, perforated uterus leading to infertility, 4 failed IUI's and 2 failed fresh IVF cycles which each yielded only 1 blastocyst (good ones) with none to freeze. Today I have completed my third fresh IVF cycle and had only 1 poor blastocyst with none to freeze. I had almost given up hope for this one...but you've eased my mind. Thank you and my fingers are firmly crossed. Anne



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