5 day biopsy

Hi Carole,

Would you recommend a 3 day or a 5 day biopsy? Can you tell me some of the pros and cons?

Dear Tiny Dancer,
I would go with the strengths of your IVF lab. If they have good outcome data (preg rates) for day 3 biopsy, the older technology, it should be fine to do that. Overall, I think the future will be day 5 culture, day 5 biopsy, embryo freezing and replacement in a future frozen cycle. What are the pros of day 5 biopsy? - biopsy is only done on proven embryos that are more likely to implant because they got to blast stage, more cells are sampled so genetic testing is arguably more reliable, embryos are replaced in a frozen cycle in which the uterus can be especially primed for implantation. What are the Cons of day 5 biopsy? Not all labs are proficient at day 5 biopsy which involves removing several cells from a blastocyst's trophectoderm layer. Labs doing day 5 biopsy also need to have excellent blast freezing/thawing outcomes because replacement must wait on the lab results which will take several days. Find out which biopsy method your IVF lab is best at and go with their expertise. Both biopsy methods work. For more information - look for past posts on my blog re: biopsy and day 3 vs day 5 culture. You can use the search box on the first page to search for past posts on topics of interest. Best wishes. Carole

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Thanks for the info Carole. I am 38 and wondering if I would be a good candidate for a 5 day biopsy. With my last cycle I had 11 embies sent to GSN and had 2 normals, 1 xx compacted morula and 1 xy hatching blast. I'm fearful of not having any embies reach the blast stage by the 5th day, should this be a concern? Or will it all look differently because the embies would have been left on their own to grow and not biopsied on the 3rd day?

Hi Tiny Dancer,
Sorry I missed your question until now. The number of normal embryos, 2 out of 11, is low, as you mention, but not unexpected considering your age. Leaving the embryos grow until day 5 of culture will not change the number of abnormals detected. Only if the biopsy technique was poor, possibly resulting in embryo damage, would I expect more embryos to be able to progress to day 5 if biopsy is delayed until day 5. But progression to day 5 does not mean more embryos will be normal. Abnormal embryos sometimes progress just fine and show no outward sign of genetic abnormality. Biopsy technique (day 3 vs day 5) won't change the number of embryos that have aneuploidy (abnormal genetic results). The biggest hurdle you are facing is a high number of abnormal embryos due to advanced maternal age and also of the normals, you only want to transfer one gender, which cuts the available embryos for transfer by half again. So , yes, it is possible that you might have no normal girls to transfer in future cycles, but day of biopsy isn't the reason for low or zero embryos available for transfer. I wish it could be as easy as delaying day of biopsy to increase number of normals! :) Carole

Thanks Carole. I thought of another question.....do the embryos have to reach the blast stage before they can be biopsied? What happens if they don't reach that stage? Can they do it at day 6?