Why we should do only Day 5 transfers for poor ovarian responders

Lots of clinics do Day 5 ( blastocyst) transfers, but they usually reserve them for patients with a good ovarian response - patients who have good eggs and lots of embryos , because they're pretty confident that they will get Day 5 embryos. However, they will use double standards when they're treating patients with diminished ovarian result. These are patients who have few eggs and few embryos and they're very scared that they may not get any blastocysts. This is why they will usually transfer their embryos on Day 2 or Day 3. These justification for this is as follows - If we only have two embryos on Day 3, then why bother to grow them in vitro to Day 5? Let's go ahead and transfer them on Day 3 itself.Interestingly, these doctors agree transferring blastocysts is a better option. Blastocysts have a better implantation rate as compared to Day 2 or Day 3 embryos; and blastocyst culture allows the doctor to choose the best embryos to transfer.Their argument is that if you only have two embryos, then a blastocyst transfer offers no advantage as far as selection is concerned . The reality is that they don't want to risk taking the chance that the patient may not have a transfer at all, if her embryos arrest in the IVF lab between Day 3 and Day 5.I think this is very shortsighted. If an embryo is going to become a baby when you put it back in the uterus, it first has to form a blastocyst inside the uterus. If the IVF lab is decent, then if it's going to form a ...
Source: Dr.Malpani's Blog - Category: Reproduction Medicine Tags: Blastocyst day 5 transfer ivf IVF pregnancy IVF success rate oopause Poor ovarian reserve Source Type: blogs