Why embryologists need to grade your embryos in an IVF lab !

1. Some times a top quality Embryo and a Poor quality Embryo look similar
Dr Saiprasad Gundeti, Malpani Infertility Clinic
One can easily differentiate the quality of 2 different Embryos by looking at various parameters like No.of Cells,
Size of Cells, Presence of Fragments and percentage of fragmanetation. This is why embryologists grade
embryos in the IVF lab, so we can select the best to transfer.
You can see what embryos should look like at www.drmalpani.com/knowledge-center/ivf/embryos
But there are instances when a good and a bad embryo look similar. This usually happens on day 4 On day 4 the
Cells compact and that stage is called Morula stage. The problem is that sometimes a poor quality 8-cell Embryo
with fragmentaion and unequal cells looks similar to a morula, and this can fool the patient and the doctor !
TOP QUALITY MORULA ON DAY 4 POOR QUALITY 8-CELL GRADE C EMBRYO ON DAY 4
In the Above pictures, the Morula stage Embryo looks beautiful and the picture next to it looks identical. But the
fact is that it is a poor quality Embryo with 1 large Cell and some unequal cells and fragmentation in it.
The large cell and the fragments make the embryo look like compacting Embryos, but the compacting
appearance is due to the fact that the large cell which is surrounded by lots of fragments.
At Malpani Infertility Clinic Pvt. Ltd , we send our patients the pictures of their Embryos , and sometimes on Day
4 some patients get confused when we call one embryo as Top quality and other one as poor quality. They
often ask us "They both look similar to us. What is the difference ?
But the next day on day 5, they can see that the top quality Morula has progressed to become a Blastocyst ;
while the poor quality Embryo remains arrested at a Fragmented 8-cell Stage

2. Day 5. The morula has become a blastocyst The 8-Cell Grade C Embryo remains arrested
On day 5 the top quality morula develops further and becomes a Blastocyst while the poor quality 8-cell Embryo
remains arrested
Hence it is important to check the embryos every day and keep a track of the embryo growth, which helps us
identify good quality growing embryos, so we can select the best ones for transfer.