For instance, a large number of embryos in extended culture have exhibited cleavage arrest or cleavage abnormalities such as high cell fragmentation. The high numbers of cleavage arrest and abnormalities can lead to the patient having no viable embryos for transfer, and therefore a canceled transfer.
The study of transfers on day 4 have not been looked at until fairly recently, and still remain an unpopular day of transfer. Some of the advantages of day four transfers are: facilitating assisted hatching, decreasing the risk of multiple pregnancies, better selection of embryos, and preimplantation genetic diagnosis analysis prior to implantation.
There is evidence that day 4 transfers most accurately reflect the natural process. In the human body between early cleavage and blast stages compacting embryos become morulas and enter the uterine cavity 4-5 days after ovulation takes place. It is uncertain why this stage has been neglected in the IVF laboratory.
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