The sperms, eggs and embryos are handled in the ART Embryology Lab. All reproductive cells/tissue are identified, isolated, processed and evaluated under a sterile environment. After Egg Retrieval, the egg will be initially identified, then, it will be placed into an incubator for 4 hours before the insemination or ICSI. On the egg retrieval day, embryologists will inform you of the number of retrieved eggs. The embryologists also will inquire about the embryo culture plan with you.
Your eggs are retrieved by the physician and handled over the embryologist in the procedure room. Once the embryologist receives the eggs (oocytes), he/she will examine them under a microscope to determine number of eggs (oocytes) retrieved. We will be able to determine the maturation stage 4-6 hours after retrieval. See below for the stages of egg (oocyte) maturation.
*You will see these indications of maturation development in your embryo update on Day 1 of your embryo development.
If your egg (oocyte) is mature, our embryologist will fertilize your eggs with ICSI (Intra-Cytoplasmic Sperm Injection) or by conventional fertilization per patient's request. Our center recommends patients to consider ICSI for fertilization because by doing so, you reduce the risk of your eggs being unfertilized when compared to conventional insemination.
On day 1, an email update will be sent to you showing you the overall progress of your eggs (oocytes) up until then. This includes whether your eggs were fertilized or not. If they are, their culture plan will commonly be to continue culturing until day 5, to see if they will develop into blastocysts. If your egg remained at an immature state (MI or GV), this means that it is unable to develop into a mature egg and it will be discarded.
If your egg retrieval was on a Saturday, your day 1 update will be postponed and sent to you on the following Monday.
Some patients may receive an update on day 2 because their egg retrieval was on a Saturday and just so happens that on Monday we have a day 2 update to provide. Normally, we do not provide these updates. In the event that you do receive it, below is the explanation for what the three numbers mean. In general on day 2, your embryos will have developed into more than one cell and the numbers describe the embryo's appearance.
1st number = number of cells of the embryo
2nd number = degree of fragmentation of the cells
3rd number = symmetry of the cells
During this period, our embryologist will not be checking for development progress to prevent any disturbances in their growth.
It's the big day! Typically, 40-50% of embryos will have developed into blastocysts. Why is it so important for your embryos to be able to grow into blastocysts? By growing into blastocysts, the chances of a successful pregnancy increases. However, do not be discouraged if your embryos are not at this stage yet. Not everyone's embryo will grow at the same rate so do not worry if yours has not achieved the blastocyst stage yet. Some may be growing slower, while others may be growing faster. If your embryo is lagging behind, our embryologist will continue to culture so long as there is development. If it is in an arrested state (stopped growing), then unfortunately we must discard this embryo as it is no longer usable for transfer. Please see below for the grading scale of the blastocysts.
Compacting – Describes the normal growth stage of day 3.5
Morula – Describes the growth stage of day 4.5
Cavitating – Describes the growth stage of day 4.5
1st number = 3=expanding, 4=fully expanded, 5=hatching, 6= fully hatched Describes development of blastocysts
2nd Letter = Describes the grading of the embryo (inner cell mass) (Ex. A, B, or C)
3rd Letter = Describes the grading of the placenta component (Trophectoderm) (Ex. A, B, or C)
For most culture plans directed by the doctor and embryologist, your embryos will be frozen once they have reached blastocysts stage. Certainly, there are exceptions to this but in general, they are frozen at this stage.