Blastocyst transfers greatly differ from early cleavage transfer with the quality of embryo that is available. In contrast to early cleavage transfer, with blastocysts you are fully able to see the quality of the embryos. Only the most viable embryos are expected to develop into blastocysts; this is the result of self-selection.
A large proportion of embryos that are morphologically normal on day 3 are actually chromosomally abnormal. This is part of the reason there is a 80-90% implantation rate failure that is seen in cleavage stage transfers. Although transfers on day 5 cannot guarantee the absence of chromosomally abnormal embryos, they can reduce the chance. There is a significantly lower chance of chromosomally abnormal embryos surviving to day five than with day 2 or 3. Extended culture provides a better chance for selection of viable and genetically normal embryos. Only the most competent embryos will be capable of developing to blast stage and beyond (12).
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