Friday, May 08, 2015

Do Grade A Embryos Guarantee a Pregnancy?

As an IVF specialist one of the most common questions I hear from patients is- “If I have Grade A embryos, does this mean that I will get pregnant ?” The answer to this simple question , like the answer to so many other questions in IVF is a resounding " Maybe" . I tell my patients that only a fortune teller can predict whether a particular embryo will become a baby !

At Malpani Infertility Clinic, we grade embryos to improve the chances of pregnancy  for our patients, because this allows us to select the best embryos for transfer. You should understand how we grade, and what this means with reference  to the potential of your embryo’s development.

The Subjective Aspect

The fact is that regardless of which embryo grading system is used, it is subjective. It’s possible for our embryologist , Dr Sai, to grade embryos accurately, because of his extensive experience and expertise. We also provide you with photos of your embryos, so you can understand how we grade them. The grade allows us to make educated guesses about the potential of an embryo implanting, but the ambiguity in my answer stems from the fact that some embryos with poor grades sometimes end up becoming babies, while those with perfect grades may fail to do so.  This is because regardless of the grading system used, the embryo grade does not reflect what is occurring genetically inside the embryo.

How does the Embryologist Make His Decision?

An Embryologist uses his training and experience to effectively assess your embryos , so he can select the ones that are most likely to implant in your womb. The criteria used for grading early-stage embryos are:

•    The number of cells present
•    The speed at which these cells are dividing
•    Whether their division is even
•    Whether any fragments of cells are present (this indicates that some of the cells have degenerated)

Different grading systems are utilized for embryos that reach the blastocyst stage (Day 5 of development). Once the embryos have been graded, the suitable ones are then selected for transfer and proper storage. Every clinic uses slightly different embryo grading systems, but all of them produce similar results.

Along, with the grade of the embryo, a complete description should also include the number of cells the embryo has, along with its photo. You can see what embryos should look like at

When is an Embryo Transferred?

An embryo can be transferred into your womb at different stages of its development.
The grading system helps us determine which of your embryos should be transferred; and whether we can freeze the rest. At our clinic, embryo transfer occurs 3-5 days post retrieval.  Since embryos differ developmentally on these particular days, the grading systems used for Day-3 (cleavage stage) embryos and Day-5 (blastocyst stage) embryos also differ.

Choosing the Best

To maximize your chances of getting pregnant, our embryologist chooses the best quality embryos for transfer. This is especially important when only a single embryo is transferred at a time.

What Happens to all the Remaining Embryos?

Post the embryo transfer our embryologist will very carefully assess the quality of the remaining embryos. The best quality ones will then be frozen and stored , and will be used in the follow-on IVF treatment cycle. In case the first transfer is unsuccessful, you can come back for the frozen transfer in the next cycle itself, if you so desire. If you do get pregnant, you can use your frozen embryos for your next baby – even after many years. Frozen embryos do not have a shelf life !  Embryo grading allows us to select which embryos to freeze. We freeze only Grade A embryos, as these have a nearly 100% chances of surviving the freezing and thawing process.

Need more information? Please send me your medical details by filling in the form at so that I can guide you better!

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