Thursday, February 06, 2020

Should you do a Day 3 or a Day 5 transfer if you only have a single embryo ?

Should you do a Day 3 or a Day 5 transfer if you only have a single embryo ?

 If you have lots of embryos, then it makes sense to grow them up to Day 5 ( blastocyst stage) because the embryologist can then select the ones which are growing the best , and transfer these, to maximise your chances of implantation.

Suppose you only have a single embryo on Day 3? Should you transfer on Day 3 ? Or should be willing to wait till day five? Now, this is a dilemma, because if you wait till Day 5 and it arrests in the lab, you'll have no embryos to transfer.  Many patients - and doctors - will say, "A bird in the hand is worth two in the bush," so we might as well put it back inside the uterus , even though the uterus may not be the best place for a Day 3 embryo. After all, why take a chance? And if it's going to implant, it may very well do that.

This is especially true for poor quality IVF clinics, which aren't very sure about their laboratory conditions, and don't want to take a risk . They want to transfer the embryo back into the uterus as quickly as possible , because this way they can tell the patient, "Well, we transferred an embryo , which means we did our best. And if it didn't implant, that's your bad luck."

However , if you have the courage, you should be willing to wait till Day 5. If it develops to a blastocyst in vitro, it has a better chance of implanting. And if it is going to arrest, I feel it's better it does so in the lab for the following reasons.
1. This spares you the agonising 2 week wait , and you don't have to live in unnecessary suspense and uncertainty. False hope can be cruel !
2. While this option causes short term pain, it helps you make more intelligent decisions about what to do in your future IVF cycles . Thus, it's easier to come to terms with the fact that you maybe better off using donor eggs, rather than trying IVF again and again with your own eggs.

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