Is Day 5 Embryo Transfer Better than Day 3? Assembly Line IVF Vs. Personalized IVF
From Dr. Paul Gindoff of Chelsea Fertility NYC:
We all know what “statistically significant” means, and we respect the information.
However, it is only relevant in the context of the comparisons made in the study and may not be applied in a generic manner to all situations.
Evidence-based medicine is interpreting data with the use of statistics within the context of clinical importance and relevancy to patient care. In addition to its statistical power, it is also graded on its value to populations and methodology.
Blastocyst embryos are cultured for five days after egg fertilization.
The question of the decade is: Are you more likely to achieve a pregnancy having embryo transfer on day 5 than on day 2 or 3? As was done in the earlier days of in vitro fertilization (IVF).
There are no evidence-based studies to support this.
Trends in reproductive medicine include limiting the number of embryos to be transferred to reduce multiple births. However, older patients will have lower pregnancy rates if this is applied. Blastocyst transfer had once been thought to achieve better pregnancies in older patients regardless, but this is not the case.
There is no evidence-based studies to support this notion.
FLASH: If genetic studies (PGS) are done on the blastocyst and found to be normal; the pregnancies rates are higher at all ages: evidence based. Without PGS there is no evidence-based medicine support of superiority of day 3 vs. day 5 in prospective randomized large population studies.
Flexibility in IVF management is important especially in more challenging cases.
How do you know you are more challenging when standard screening blood tests of ovarian reserve in females and semen analysis in males cannot identify all these cases? Management that is rigid, i.e. all IVF patients in said clinic, have day 5 embryo transfer or no transfer at all is not evidence- based and functions simply as a mechanism to help work flow and logistics in that clinic.
Having a system that allows for day 3 or day 5 embryo transfer to serve the unique and personalized needs and requirements of the individual patients to optimize their care and outcome.
The notion that any embryo that does not survive to day 5 would never implant on day 3 is simply a theory. There are no evidence-based studies for this. Yet, hundreds of thousands of patients conceived and delivered with day 3 embryo transfer for decades before day 5 transfers were introduced. It’s important to ask your fertility doctor why a set management plan is instituted and the medical research and studies behind this recommendation; empower yourself.
Contact Chelsea Fertility NYC to learn more about embryo transfer during IVF.
