Friday, November 06, 2009

Will this embryo become a baby ?

Embryo transfer is often the high point of an IVF cycle. It represents the outcome of all the hard work the clinic does - and many doctors are quite proud of the embryos they create for you.
Good clinics will routinely give you a photo of your embryos for your records, as this documents that you have received high quality care.

Seeing your embryos is a very emotional moment for patients as well, many of whom start thinking of these as their "babies" ( and call them embies affectionately).

Here's what a beautiful Day 5 embryo ( called a blastocyst) looks like.

While the embryologist is likely to be very happy with this embryo, and give it a top grade ( Grade 4AA according to the Gardner rating system for blastocysts), what the patient wants to know is - Will this embryo become a baby ?

The honest truth is that we simply do not know !

While this is a gorgeous embryo, which will gladden an embryologist's heart, we still don't know if it will implant after it is transferred into the uterus.

Why is this so ? Remember that implantation is a complex biological process which we cannot really influence. Human reproduction is an inefficient enterprise - whether it's being attempted in the bedroom or in the IVF lab, and there are still limits to what the technology can do.

After all, we are inserting a microscopic ball of cells into the uterus. How can we possibly track its fate or monitor its health ?

Even a superb blastocyst can have genetic problems which we cannot diagnose with today's technology . In fact, we do know that more than 50% of excellent blastocysts will have a genetic problem.

At the end of the day, all we can say is that implantation is affected by multiple factors - and no matter how beautiful your embryos , how healthy your uterus and how good the IVF lab , you still need a little bit of luck !

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