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When is it better to do the embryo transfer on day 3 or day 5?
Embryo transfer is a crucial process during Assisted Reproduction treatments, where embryos developed in the laboratory are placed in the woman’s uterus to initiate a pregnancy. In this blog, we will explain, depending on the embryo’s development, when to perform the embryo transfer: on day 3 or day 5.
- 1. What is embryo transfer?
- 2. When is it better to do the embryo transfer on day 3 or day 5?
- 3. The importance of personalised treatment
- 4. FAQs about when to perform the embryo transfer – embryo transfer on day 3 or 5
- 4.1. What can be done after two negative transfers?
- 4.2. I have had recurrent miscarriages; what day is best for embryo transfer?
- 4.3. Is it better to transfer embryos on day 3 or day 5?
- 4.4. Can I have the embryo transfer on day 3 if my embryos are PGS-tested?
- 4.5. Is it advisable to transfer two high-quality embryos on day 3?
- 4.6. Can the embryo transfer be done on the fourth day?
- 4.7. Testimonials
What is embryo transfer?
Embryo transfer is the final stage of an IVF treatment, where the embryos obtained in the laboratory are transferred to the uterus. Although this process can be stressful for patients, it also brings relief as they get closer to achieving implantation.
Beatriz Lozano, Laboratory Director of Assisted Reproduction at Vida Fertility, explains when it is best to perform the embryo transfer.
When is it better to do the embryo transfer on day 3 or day 5?
Advantages of Day 3
- Lower risk of embryo loss: Less risk of embryos not reaching day 5, as the “embryo bottleneck” typically occurs between day 3 and day 5.
Disadvantages of transferring on day 3
- Less selection: Less time to evaluate the viability of the embryo.
- Implantation: The probability of implantation may be lower compared to day 5 blastocysts.
Advantages of transferring embryos on day 5
- High implantation: Higher implantation success rate due to the more advanced development of the embryo. Naturally, embryos reach the uterus at the blastocyst stage.
- Embryo selection: Better selection of viable embryos, as we have more information and the ability to see which embryos have stopped developing.
Disadvantages of Day 5
- Embryo loss: Some embryos do not develop into blastocysts or stop developing before forming one.
The importance of personalised treatment
Personalisation of the IVF treatment is crucial to increase the chances of success. Each patient is different and needs an approach tailored to their specific needs and conditions. At Vida Fertility, we conduct a thorough analysis to determine the best day for embryo transfer.
FAQs about when to perform the embryo transfer – embryo transfer on day 3 or 5
What can be done after two negative transfers?
Dr Beatriz Lozano answers:
It is essential to review the medical history and perform additional tests, such as those related to endometrial receptivity, double-strand sperm DNA fragmentation analysis, or aneuploidy screening (PGS) to identify any underlying causes.
I have had recurrent miscarriages; what day is best for embryo transfer?
Dr Beatriz Lozano answers:
It is more natural to perform the transfer on day +5, due to the advantages discussed earlier. In cases of recurrent miscarriages, it would be advisable to conduct some tests, such as PGS, immune or haematological tests. This way, we can maximise the embryo’s viability.
Is it better to transfer embryos on day 3 or day 5?
Dr Beatriz Lozano answers:
The choice depends on multiple factors.
Embryo development has improved with the scientific evolution of assisted reproduction and embryo culture.
This evolution has allowed us to obtain more information about the embryos to select them for transfer. Traditionally, when there was a low number of embryos, they tended to be transferred on day +3. However, today, we can continue development safely until day +5, maximising the chances by having more information, selection capacity, and establishing a more natural synchronisation with the endometrium.
Can I have the embryo transfer on day 3 if my embryos are PGS-tested?
Dr Beatriz Lozano answers:
At Vida Fertility Institute, PGS or PGT is performed at the blastocyst stage, which means it is carried out on day +5 or +6 depending on the embryos’ development. Therefore, we could not perform the transfer on day +3.
Is it advisable to transfer two high-quality embryos on day 3?
Dr Beatriz Lozano answers:
As we have previously discussed, at Vida Fertility Institute, we perform the transfer on day +5 of development, recommending the transfer of a single embryo.
Transferring a single embryo reduces the risk of multiple pregnancies and, therefore, the increase in complications associated with pregnancy.
Can the embryo transfer be done on the fourth day?
It is not common to perform the transfer on D4, as generally, one more day is expected to obtain final development information. This way, we can make a better selection of the embryo to be transferred.
In any case, the transfer of a high-quality morula (day+4 embryo) has results comparable to those of a blastocyst.
At Vida Fertility, we are committed to providing personalised and effective treatments to help our patients achieve their dream of having a child.
Bibliography
- Li RS, Hwu YM, Lee RK, Li SH, Lin MH. Day 4 good morula embryo transfer provided compatible live birth rate with day 5 blastocyst embryo in fresh IVF/ET cycles. Taiwan J Obstet Gynecol. 2018 Feb;57(1):52-57. doi: 10.1016/j.tjog.2017.12.008. PMID: 29458903.
- Wang N, Zhao X, Ma M, Zhu Q, Wang Y. Effect of Day 3 and Day 5/6 Embryo Quality on the Reproductive Outcomes in the Single Vitrified Embryo Transfer Cycles. Front Endocrinol (Lausanne). 2021 Apr 23;12:641623. doi: 10.3389/fendo.2021.641623. PMID: 34046010; PMCID: PMC8147686.
- Prapas Y, Ravanos K, Petousis S, Panagiotidis Y, Goudakou M, Pavlidou T, Goudis A, Margioula-Siarkou C, Chalkia-Prapa ME, Prapas N. Day-5 fresh embryo transfer is associated with superior clinical outcomes in oocyte donation cycles compared with day-3 embryo transfer. J Matern Fetal Neonatal Med. 2022 Dec;35(24):4723-4727. doi: 10.1080/14767058.2020.1863360. Epub 2020 Dec 15. PMID: 33323000.
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ℹ️ The information published on Vida Fertility is reviewed by our fertility specialists and medical team, following up-to-date scientific criteria and evidence-based medicine. Our team is a member at scientific societies such as SEF, ESHRE and SEGO.
