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56 - Blastocyst Transfer

from PART III - ASSISTED REPRODUCTION

Published online by Cambridge University Press:  04 August 2010

By
David K. Gardner
Edited by
Botros R. M. B. Rizk ,
Juan A. Garcia-Velasco ,
Hassan N. Sallam  and
Antonis Makrigiannakis
Botros R. M. B. Rizk
Affiliation:
University of South Alabama
Juan A. Garcia-Velasco
Affiliation:
Rey Juan Carlos University School of Medicine,
Hassan N. Sallam
Affiliation:
University of Alexandria School of Medicine
Antonis Makrigiannakis
Affiliation:
University of Crete
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Summary

INTRODUCTION

Over the past three decades basic research has culminated in many significant advances in human assisted conception (Edwards 2004). An example of this is the relatively recent development of more physiological culture conditions. By employing such conditions, it has become possible to culture the human embryo to the blastocyst stage as a matter of routine (Gardner and Lane 1997). Clinics now have more options regarding the day of embryo transfer, giving increased flexibility in scheduling. Subsequently, the question raised is, is there an optimal day for embryo transfer following IVF in the human? In this chapter, the probable advantages of blastocyst transfer are discussed and the clinical data reviewed.

There are numerous potential benefits of blastocyst transfer in human IVF, which are summarized in Table 56.1. Not all sperm or oocytes are destined to give rise to a viable embryo (Tesarik 1994). By culturing the human embryo past the cleavage stages, that is, past embryonic genome activation (Braude et al. 1988), it is feasible to study the embryo properly. A key factor in determining transfer outcome in animal models is the synchronization of the embryo with the female reproductive tract. In all mammalian species studied to date, including nonhuman primates (Marston et al. 1977), the transfer of embryos to the uterus prior to compaction (and, therefore, before the generation of the first transporting epithelium) results in greatly reduced pregnancy rates compared to the transfer of morulae or blastocysts.

Keywords

blastocyst transferembryo cultureembryo transferembryologyvitrification
Type
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Infertility and Assisted Reproduction , pp. 531 - 539
Publisher: Cambridge University Press
Print publication year: 2008

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