Skip to main content
SpringerLink
Log in

Embryo blastulation and quality between days 5 and 6 of extended embryo culture

  • Embryo Biology
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

This study aims to know what proportion of culture day 5 pre-blastocyst-stage embryos develop into blastocysts by culture day 6 and what patient and cycle characteristics are associated with delayed blastocyst formation.

Methods

A retrospective observational cohort analysis was performed including a total of 9886 embryos from 1008 IVF cycles in 835 patients, who underwent treatment between January 1, 2016, and December 31, 2018. Autologous fresh in vitro fertilization (IVF) cycles at a single academic center were included in the analysis. Embryos were group-cultured using single-step culture media. Blastulation was defined as the presence of a new blastocyst. Usable blastulation was defined as the presence of a new good or excellent quality, expanded, hatching, or hatched blastocysts.

Results

The mean blastulation rate between days 5 and 6 of extended embryo culture was 30.9%. The mean percentage of embryos developing into usable blastocyst-stage embryos was 19.8%. The factors associated with blastulation on day 6 included the total number of embryos and the number of pre-blastocysts on day 5, as well as the use of ICSI. Age, the number of total embryos, those remained in culture and pre-blastocysts, as well as the blastulation rate on day 5 were associated with usable blastulation.

Conclusion

It is important to know the usable blastocyst development rate between culture days 5 and 6 in order to adequately counsel patients debating whether to proceed with fresh ET on day 5 or forego ET with the expectation that embryos will be biopsied for PGT and/or cryopreserved on culture day 6. Our findings provide evidence to help guide patients in this difficult decision.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Scott RT, Upham KM, Forman EJ, Zhao T, Treff NR. Cleavage-stage biopsy significantly impairs human embryonic implantation potential while blastocyst biopsy does not: a randomized and paired clinical trial. Fertil Steril. 2013;100(3):624–30.

    Article  Google Scholar 

  2. Desai N, Ploskonka S, Goodman L, Attaran M, Goldberg JM, Austin C, et al. Delayed blastulation, multinucleation, and expansion grade are independently associated with live-birth rates in frozen blastocyst transfer cycles. Fertil Steril. 2016;106(6):1370–8.

    Article  Google Scholar 

  3. Gardner DK, Schoolcraft WB. In vitro culture of human blastocyst. In: Jansen R, Mortmer D, editors. Towards reproductive certainty: infertility and genetics beyond. Carnforth: Parthenon Press; 1999. p. 377–88.

    Google Scholar 

  4. Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source Code Biol Med. 2008;3:1–8.

    Article  Google Scholar 

  5. Zhang JQ, Li XL, Peng Y, Guo X, Heng BC, Tong GQ. Reduction in exposure of human embryos outside the incubator enhances embryo quality and blastulation rate. Reprod BioMed Online. 2010;20(4):510–5.

    Article  Google Scholar 

  6. Sauerbrun-Cutler MT, Huber WJ 3rd, Has P, Shen C, Hackett R, Alvero R, et al. Is intracytoplasmic sperm (ICSI) better than traditional in vitro fertilization (IVF): confirmation of higher blastocyst rates per oocyte using a split insemination design. J Assist Reprod Genet. 2020;37(7):1661–7.

    Article  Google Scholar 

  7. Sfontouris IA, Martins WP, Nastri CO, Viana IG, Navarro PA, Raine-Fenning N, et al. Blastocyst culture using single versus sequential media in clinical IVF: a systematic review and meta-analysis of randomized controlled trials. J Assist Reprod Genet. 2016;33(10):1261–72.

    Article  Google Scholar 

  8. Kort JD, Lathi RB, Brookfield K, Baker VL, Zhao Q, Behr BR. Aneuploidy rates and blastocyst formation after biopsy of morulae and early blastocysts on day 5. J Assist Reprod Genet. 2015;32(6):925–30.

    Article  Google Scholar 

  9. Haas J, Meriano J, Bassil R, Barzilay E, Zilberberg E, Casper RF. Development potential of slow-developing embryos: day-5 morulae compared with day-5 cavitating morulae. Fertil Steril. 2019;111(1):105–11.

    Article  Google Scholar 

  10. Cimadomo D, Scarica C, Maggiulli R, Orlando G, Soscia D, Albricci L, et al. Continuous embryo culture elicits higher blastulation but similar cumulative delivery rates than sequential: a large prospective study. J Assist Reprod Genet. 2018;35(7):1329–38.

    Article  Google Scholar 

  11. Hershko Klement A, Ovadia M, Wiser A, Berkovitz A, Shavit T, Nemerovsky L, et al. What we learned from extended culture of “rejected” day-3 cleavage stage embryos: a prospective cohort study. J Ovarian Res. 2017;10(1):1–5.

    Article  Google Scholar 

  12. Wu DH, Reynolds K, Maxwell R, Lindheim SR, Aubuchon M, Thomas MA. Age does not influence the effect of embryo fragmentation on successful blastocyst development. Fertil Steril. 2011;95(8):2778–80.

    Article  Google Scholar 

  13. Lehner A, Kaszas Z, Murber A, Rigo J Jr, Urbancsek J, Fancsovits P. Embryo density may affect embryo quality during in vitro culture in a microwell group culture dish. Arch Gynecol Obstet. 2017;296(2):345–53.

    Article  Google Scholar 

  14. Dai SJ, Xu CL, Wang J, Sun YP, Chian RC. Effect of culture medium volume and embryo density on early mouse embryonic development: tracking the development of the individual embryo. J Assist Reprod Genet. 2012;29(7):617–23.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Iowa Hospitals and Clinics, Iowa City, IA, 52242, USA

    E. B. Nguyen, E. A. Jacobs, K. M. Summers, A. E. Sparks, B. J. Van Voorhis, V. E. Klenov & E. H. Duran

  2. Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, 98195, USA

    E. B. Nguyen

  3. Department of Obstetrics and Gynecology, 200 Hawkins Drive, 31322 PFP, Iowa City, IA, 52242, USA

    E. H. Duran

Authors
  1. E. B. Nguyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. A. Jacobs
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. M. Summers
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. E. Sparks
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B. J. Van Voorhis
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. V. E. Klenov
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. E. H. Duran
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

NEB and JEA equivalently contributed to the drafting of the article; KVE contributed to the conception of the study question and provided intellectual input; SAE contributed to data acquisition, drafting, and critical review of the manuscript; SKM performed statistical analyses and contributed to drafting and critical review of the manuscript; VVBJ provided intellectual input and critical review of the manuscript; and DEH participated in the conception of the study question, statistical analysis, interpretation of the results, drafting, and critical review of the manuscript.

Corresponding author

Correspondence to E. H. Duran.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

E. B. Nguyen and E. A. Jacobs should be regarded as joint First Authors

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nguyen, E.B., Jacobs, E.A., Summers, K.M. et al. Embryo blastulation and quality between days 5 and 6 of extended embryo culture. J Assist Reprod Genet 38, 2193–2198 (2021). https://doi.org/10.1007/s10815-021-02156-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-021-02156-7

Keywords

Search

Navigation