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  • Embryo transfer on Day 3 or Day 5? Which is better for a successful pregnancy ?

    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.



  • Preparation of the program

    Preparation of the program

    Doctor Consultation

    After you decide to attend the IVF program, your doctor will examine you and will finish all the processes necessary to start the program. During the examination, the ovaries, the uterus, the length of uterus and cervix will be observed. Also, tests such as hormone levels, hysterosalphingogram (HSG), spermiogram and serology will be completed. All of these tests are done in one menstrual cycle. After this meeting, the patient has to start taking folic acid. Folic acid is found protective against abnormalities of the bone structure and complications in the nervous system of the baby, when used in a regular basis before the pregnancy and during the first 3 months.

    Meeting With The IVF Coordinator

    The IVF coordinator will first check and make sure that your file is completed. Also he/she will give you information about general course of the program such as the arrival time and the place for ultrasound and blood analysis, use of the drugs, phone number you can reach anytime and financial issues. Before this meeting, please note all the questions you might have. In our experience, most of the questions which are not written can be forgotten during the meeting.

    The second part of the meeting is the description of the drugs and their doses, start of the medication and control dates. All of this information is given in written forms. Please feel free to ask anything. Any mistake you make in the usage of your medication would harm you financially and more importantly would cause loss of your precious time.



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