Best Blastocyst Culture Treatment in Delhi

What is Blastocyst Culture?

Blastocyst is the name given to the embryo when it has reached 5 or 6 days of age. At this stage, it develops a cavity filled with fluid within itself, dividing itself into two parts - an outer ‘trophectoderm’, which is a line of cells that eventually forms the placenta, and the ‘inner cell mass’, which is a clump of cells destined to become the future baby.

Blastocyst culture means culturing the embryos into a specialised medium that contains nutrients specifically meant for this stage of growing embryo. Rather than just 2 or 3 days, the embryos are thereby cultured for until 5 or 6 days inside the laboratory incubator. The culture conditions are adjusted to perfection such that the embryo “feels” it is inside the mother’s womb, meaning, the lab environment is kept as similar to the human body as possible.

So why do Blastocyst Culture?

Not all embryos that are formed after fertilisation through IVF or ICSI progress survive till day 5. In other words, not all embryos are normal or viable. Providing the best Blastocyst culture treatment in Delhi , we understand that the challenge of any good embryologist is to figure out the best embryos that are normal and discard the ones that are not likely to implant or survive inside the uterus. If we go for blastocyst culture, some embryos might not progress till day 5 because they were never fit to begin with. Therefore, we can successfully select the best ones on day 5 stage (blastocysts) and discard the ones that get arrested before that.

Moreover, if you see natural process, the human embryo gets implanted in the endometrium on day 5/6 only. On day 2 or 3, it is inside the fallopian tube, developing itself while travelling toward the uterus. Culturing embryos till day 5 and transferring at blastocyst stage might be more natural than day 2 or 3 transfer. Again, the uterus is more ‘quiescent’ so that the uterine contractions that sometimes expel the embryo out of the body is less likely to happen on day 5, or blastocyst transfer.

Surplus blastocysts leftover after embryo transfer are frozen with vitrification technique. Frozen blastocysts have excellent survival and pregnancy rates after thawing and putting them inside the uterus.

What are all Advantages of Blastocyst Transfer (day 5/6) Versus Cleavage Stage (day 2/3) Transfer?

(A). Perhaps the biggest advantage, as already mentioned, is helping us to select the best possible embryo(s) out of the whole number of fertilised eggs. If an embryo develops into a good grade (Grading is done by the best Ivf doctor in Delhi, our in-house Embryologist Dr. Akanksha Mishra, according to Gardner and Schoolcraft criteria) blastocyst, it is much more likely to develop into a successful pregnancy as compared to a single day 2 or day 3 embryo. This is like ‘deselecting’ the unfit ones out. (B). As uterus is more relaxed on day 5/6 there is a better chance of the embryo retained inside. (C). If we go for blastocyst transfer, the biggest advantage is to do away from putting too many embryos inside. Since we are confident, we have the fittest embryos (blastocyst) with us, we can put just one or maximum two embryos, thereby avoiding multiple pregnancy. (D). Blastocyst transfer reduces the “Time taken to pregnancy” because we are putting the strongest embryos inside. This is a blessing to those couples who are frustrated with extended waiting periods and do not have the patience to accept a negative cycle outcome. (E). Last but not the least, one can expect a very high success rate (close to 80%) after transferring a good quality blastocyst.

Are there any Disadvantages of doing a Blastocyst Transfer?

(A). Not a disadvantage per se, but the decision to proceed for blastocyst transfer involves accepting a risk that some embryos will not progress till that stage. Also, there is a very small chance that all the embryos might get arrested before day 5 and we don’t have any embryos left to transfer. Providing the best female infertility treatment in Delhi, the chances of that happening are very less, especially in a hi-tech laboratory environment with best lab equipment / highly skilled professionals present in Janini IVF. (B). Blastocyst culturing is just a “selection” tool. It doesn’t make the embryo any better than it already was. In other words, if the embryo was unfit or unhealthy due to any reason, it would not become better just because it has progressed to blastocyst stage. But again, if an embryo has indeed progressed till day 5 stage, it is much more likely to be healthy and much more likely to give a successful outcome.

Is Blastocyst Transfer for me?

Generally blastocyst transfer is meant for couples who have good quality multiple embryos on day 2 or 3. Blastocyst transfer is a blessing to those couples who have suffered from previous IVF or ICSI attempt failures, as there is a higher chance of conceiving after blastocyst transfer. It is also beneficial to those couples who want only a single embryo transferred inside the uterus to avoid twins or higher order births.

Dr. Rutvij Dalal, the best IVF specialist in Delhi, believes in the fact that the couple should take an active, informed decision after talking to the clinician. He believes in providing all the relevant information to the couple so that not only they are informed about the whole process but also better equipped to decide what is best for them. Eventually, we will take a joint decision in picking the best option for you.

What is Sequential Transfer?

Now that you have understood what is cleavage stage transfer (transfer on day 2/3) and blastocyst transfer (transfer on day 5/6), let us now see what sequential transfer is. Sequential transfer basically means transferring 1 or 2 embryos on day 3 and again 1 embryo on day 5. So, out of the 3 embryos transferred, one will be a blastocyst and 1 or 2 will be day 3 embryos.

Why do Sequential Transfer? What are the Advantages?

Sequential transfer practice gives us the advantage of higher pregnancy rates at the same time keeping multiple pregnancies low. It is a kind of “best of both worlds” or a middle-ground that gives us a win-win situation. This is particularly true in patients who’ve had previous failed attempts to IVF/ICSI at other centres.

At Janini IVF, the best ivf treatment center in Delhi, our “Faith reborn” campaign specifically addresses the compassionate and targeted treatment of those couples who have failed IVF cycle(s) elsewhere. One of the essential ingredients of treating previous failed patients is Sequential transfer. In many years of our practice, we have found phenomenal results with sequential transfer compared to only cleavage transfer, or only blastocyst transfer. Of course, blastocyst transfer is the best thing if you DO have blastocysts formed. But one of the risks of proceeding for blastocysts is that sometimes, all the embryos suffer arrest and we have to cancel the cycle because we don’t have a single blastocyst remaining. By transferring one or two embryos on day 3 itself, we are insuring ourselves against that risk.

Dr. Dalal at Janini IVF and Dr. Akanksha Mishra (embryologist) stand as one of the most learned and accomplished IVF professionals in the fraternity. A gold medalist and recipient of several awards, Dr. Dalal has done significant work on studying the realm of Blastocysts, in general and sequential transfer, in particular. During his illustrious career, he has even published a highly appreciated manuscript about his randomised, prospective trial on “sequential transfer”. This paper was published in an International Journal of repute and Dr. Dalal also received numerous awards on this paper.

Here is the link to that publication :-

http://www.ivflite.org/article.asp?issn=2348-2907;year=2015;volume=2;issue=1;spage=30;epage=36;aulast=Dalal