With the introduction of stage specific media many IVF labs have set their goals on moving towards blastocyst transfers in the near future. The reason for the quick growth and acceptance of extended culture is the many advantages that they possess. Blastocyst transfers have been used to treat patients with poor quality embryos, low number of embryos and oocytes, or with multiple IVF failure (9). In these situations extended embryo culture has been associated with an increase in IVF success.
One reason why blastocyst transfers have been more successful is because they avoid exposing early-stage embryos to the uterine environment, especially ones that have been subjected to super ovulation and high levels of estrogen. In vivo, embryos do not reach the uterus before the morula (16-cell compacted) stage, which is at least day 4 of vitro culture. Naturally, they reside in the fallopian tubes until the morula stage. Also, the uterus provides a different nutritional environment from the oviduct, this can cause stress on the embryo resulting in reduced implantation. Therefore it is beneficial in extended culture to wait to transfer the embryos, and minimize the exposure to the hyper stimulated environment.
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