which is better for the pregnancy outcome?

1. ET : DAY 3 VS DAY 5
kasr al ainy school of Medicine
Cairo University
ِ ‫ه‬
‫اَّلل‬ ِ‫م‬ْ‫س‬ِ‫ب‬
ِ‫ن‬ َٰ‫م‬ْ‫ح‬‫ه‬‫الر‬
ِ‫يم‬ ِ‫ح‬‫ه‬‫الر‬

2. WHAT IS THE PROBLEM?
 Culture media have improved to allow for Day 5
transfer
 Should it be routine?

3. WHAT IS THE PROBLEM? CONT.
 Is there a real value?
 Is it practical?

4. QUESTIONS TO BE ANSWERED
 Are there any adverse effects ?
 Is it suitable for all women?

5. IS IT SUITABLE FOR ALL WOMEN?
 Women with less than 8 embryos on day 1 have a
chance to reach day 5 with no embryos
 So day 5 should not be offered for any woman with
limited number of oocytes

6. ARE THERE ANY ADVERSE EFFECTS ?
 Increased incidence of Autism has been reported
with Day 5 embryos

7. PGS: routine or not
ASRM/ESHRE 2015
? Neonatal and maternal outcome
after blastocyst transfer: a
population based registery study
Ernestad et al, Am J Obstet
Gynecol, March 2016
 In Sweeden from 2002 to 2013, compare
delivieries after blastocyst versus cleavage
versus spontaneous 4819 blastocyst, 25747
cleavage, 1,196,394 spont.
 No increase in birth defects. Preterm birth was
higher with blastocyst. PP and placental
abruption higher with BET

8. IS IT PRACTICAL?
 IVF center should have large number of incubators
to allow for Day 5 transfer
 If keeping quality control standards
 Not suitable at all for busy center

9. IS IT REALLY OF VALUE?
 For single embryo transfer : Yes
 If DET or TET : No

10. CONCLUSION
 Day 5 ET should only be offered for highly selected
cases

11. THANK YOU
Dr. Hesham Al-Inany MD, PhD
e-mail : kaainih@yahoo.com