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Almost all clinics that do extended embryo culture and blastocyst transfer IVF are selective in choosing patients eligible for it. Therefore, we should expect success rates to be higher in this selected population as compared to the rates in "unselected" patients. Below are our in vitro fertilization live birth success rates with fresh embryos for the past 7 years according to the day of the embryo transfer procedure and female age.
60 patients had an egg retrieval but had no embryos for transfer (2.7% of retrieval procedures). Cases that had preimplantation genetic testing, PGS are not included here because all embryos are frozen with PGS. Some studies have shown that there is a higher percentage of chromosomal abnormalities in day 3 embryos than in day 5 embryos.
One of the greatest benefits of blastocyst transfer is the potential to reduce the risk of multiple pregnancy by transferring fewer embryos of higher quality.

The rate of triplets with blast transfers at our IVF center has been about 2% of pregnancies.
In the early years of blastocyst transfer (1998 and 1999) we sometimes looked at embryos early on day 5 and had patients with slower embryo development come in on day 6 for their transfer. We thought it was better to let those slower embryos develop and expand more in the culture dish before choosing the best 1 or 2 for transfer. However, success rate statistics for day 6 blastocyst transfers were somewhat lower than we were seeing for 5 day transfers. Of course, the "slow" embryos that had blastocyst formation by day 6 and went on to expand, hatch, implant and make babies were strong and healthy all along - just slower starters. Comparing day 5 and day 6 blastocyst transfers, we saw better success rates with transfers done day 5.
We see significantly higher blastocyst implantation and pregnancy rates as compared to what we see with day 3 embryos.

We have had a very low percentage of triplet (or higher order) pregnancies from blastocyst transfer at our clinic.
We believe this is because some of the embryos that are "slower" on day 5 are weaker, poor quality embryos.
However, this is mainly because patients with embryos developing at a more "normal" rate were getting embryo transfers done on the 5th day, not because transferring embryos on day 6 is bad for outcome.

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