Blastocyst culture: myth or magic?
The development of sequential serum-free culture medium has led to a reported increase in implantation rate after transfer of embryos on days 5-6 (approximately 40%) compared with those achieved after transfer on days 2-3 (approximately 20%). However, there are numerous uncertainties surrounding extended culture that need to be considered. This article examines some of the problems and questions considered in relation to the following areas: the developmental capacity of the embryo in vitro; the uterine environment after embryo transfer; the clinical indications surrounding blastocyst transfer including a reduction in multiple pregnancy rate and relevance in preimplantation genetic diagnosis (PGD); and the introduction of blastocyst culture into the embryology laboratory.
Butterworth
S
S
Reproductive Medicine Unit, Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS, UK.
D001755:Blastocyst / Q000502:physiology*; D046149:Embryo Culture Techniques; D004624:Embryo Transfer / Q000379:methods; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D008297:Male; D011247:Pregnancy; D013997:Time Factors; D016896:Treatment Outcome