from Section 6 - Embryo Assessment: Morphology and Beyond
Published online by Cambridge University Press: 07 August 2023
Embryo quality assessment and grading are major procedures in in vitro fertilization (IVF) laboratories and determining factors for clinical outcome success. Transferring in vitro cultured embryos at the blastocyst stage (generally day 5 to 6 after insemination), including elective single-embryo transfer (eSET), allows better embryo selection and has been associated with higher implantation rates and better clinical outcomes. Blastocyst transfer has become the preferred choice, replacing cleavage-stage (days 2 to 4) embryo transfer, among IVF laboratories worldwide. Recent advancements in embryo culture media, culture conditions and equipment, trophectoderm (TE) biopsy for pre- implantation genetic testing (PGT) and the concept of selecting only a few high-implantation-potential embryos for cryopreservation have contributed to more clinics practicing extended embryo culture to the blastocyst stage. Therefore, blastocyst quality assessment has become an essential and important protocol. This chapter discusses essential steps for blastocyst assessment as a quick guideline and lists blastocyst grading criteria based on three commonly used scoring systems in the reference protocol.
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