cleavage?

[bows&ribbons]

What does it mean that there are embryos on day 5 that have cleavage? Is there still time for them to develop into blastocysts so that they can be biopsied and frozen?
Thanks!

[Carole]

Usually the word cleavage is used like this- "cleavage stage" embryo which means an embryo that stage-wise is more than a simple fertilized egg (it must have cleaved at least one time creating 2 cells, or multiple times creating 3-, 4-, 5-, 6-, ...12cell and so on) but having not yet reached the morular or blastocyst stage of development in which the division phase continues but other things start to happen as well--for instance the embryo compacts into a morula with cells that are not floating loose next to one another but have intimate channels between them or the blastocysts stage which has defined regions that will result in defined future fetal parts. If an embryo is still cleavage stage on day 5 that means it is behind in development and the prognosis is poor unless fertilization occurred much later than we think so that the developmental program started later. Typically, embryos are "cleavage stage' on days 1-3 of culture, are morulas on day 4 and become blastocysts on day 5 of culture. Hope this helps. Carole

[bows&ribbons]

Is there something that causes them not to evolve to the blastocyst stage. I did not get anywhere around 50% evolve to that stage by day 5. Does anyone do acgh on day 3. what is the disadvantage of that? acgh seems very accurate.

[Carole]

Dear bows&ribbons,
Embryos don't progress because they can't due either to something with the embryo or if the culture conditions don't support the embryo properly. Lots of things can go wrong. Abnormal chromosome number can also explain lack of progression. Women who are over 35 may have more issues with failure to progress because they are at greater risk for having eggs with aneuploidy (abnormal chromosome number). Here's one lab website http://reprogenetics.com/array-cgh-testing-and-embryo-prognosis/ that explains acgh and discuss that it can be performed on cells biopsied on either day 3 or 5. In some cases , embryos are frozen pending test results and replaced in a frozen embryo cycle the next month. Acgh is gaining in popularity but there is some controversy about the value of the test for every patient and also some labs have higher error rates than others. Not everyone is sold on acgh but the field is moving that way. I think it can be a great asset but like all medical/technical procedures, we are still figuring out which patient population will benefit the most and which technical approach is best (biopsy d3 vs.5, fresh vs frozen transfer).Also it adds several thousand more dollars in expense to the patient and I don't know if insurance coverage for acgh is likely.

[bows&ribbons]

thanks carole, is there a way that I can send you a private message?
Thanks for your help!

[Carole]

Yes, you can reach me at info@fertilitylabinsider.com. ,but please know that I am NOT a physician nor a genetic counselor so I can not give you specific medical advice for your condition. At most I will point you to websites or additional information that you can then discuss with your doctor. Thanks for understanding my expertise limitations. :) Carole