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Embryos are cultured in incubator up to five days, until they become blastocysts. At this stage it may be easier to select the best quality embryo(s). Not all embryos will develop to produce blastocysts in the laboratory. Embryos can stop developing at the four-cell stage (day two) and progress no further, then it would be advisable to proceed with day III transfer. As with normal embryo transfer, due to the risks of a multiple birth if more than one blastocyst is transferred, you may want to consider single blastocyst transfer.

What’s so special about blastocyst culture in an IVF setting?

  • Standard practice in IVF involves the replacement of embryos into the uterus after 3 days when the embryos are at the cleavage stage of development.
  • Blastocyst transfer however involves extending the period that the embryos are cultured in the laboratory to 5 or 6 days.

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Blastocyst Step-by-Step Guide

Initial Consultation with Neelima Fertility Specialist


Blood Tests

Treatment Plan

Start of Treatment

The Process



Medications are given for development of one or more mature follicles in a woman’s ovaries.


Egg Release

Ovulation induction cycles are followed by a HCG Injection to induce ovulation, the final maturation of the egg and loosening of the egg from the follicle wall.



Pelvic ultrasound scans are used to access the endometrium (lining of the womb) and to determine how the follicles are developing.


Timed Intercourse

The couple is advised to have intercourse as per the ovulation scan and days suggested by the doctor.

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A Quick Question

Who is blastocyst culture appropriate for?

Blastocyst culture is suggested for:
  • IVF has not worked for me before. Should I try blastocyst culture?
    The short answer is yes. If your IVF did not work despite the fact that you had embryos for replacement on day 2 or 3, blastocyst culture should help us determine whether in fact your embryos develop beyond day 3 at all (even very good quality day 3 embryos may not form blastocysts) and if so, which of those embryos would be the best ones to transfer.
  • Are there any benefits in younger patients in whom IVF is likely to work anyway?
    As blastocyst culture can help to determine which embryos have the best chance of being able to implant, we can potentially reduce the number of embryos that we replace into the uterus and thereby reduce the risk of a multiple pregnancy. In women under 35 (without female factor infertility) we can therefore offer single embryo transfer and significantly reduce the risk of both twins and higher order multiple pregnancy (triplets and quads).
  • Is there any benefit for patients over 37?
    Yes. We can avoid the need to transfer 3 embryos on day 3, by transferring 2 blastocysts on day 5. The small risk of triplets can be minimised without affecting the pregnancy rate.