If you’ve already gone through at least one cycle of in vitro fertilization (IVF) and haven’t become pregnant, you want to do everything you can to increase your chances during the next round. One factor that influences the chances of IVF is the quality of the embryos themselves. Fragmented embryos are less likely to implant and develop into fetuses.
Only a handful fertility centers throughout the United States offer a state-of-the-art procedure called Embryoplasty™. This technically challenging procedure requires skill, experience, and customized microsurgery instruments to remove fragments from embryos before implantation.
At Noble Fertility Center in Manhattan’s Murray Hill neighborhood in New York City, our founder Peter L. Chang, MD, is skilled at improving viability in embryos with Embryoplasty. If your embryos have fragmented in previous IVF attempts, here’s what you should know about Embryoplasty.
1. Embryo fragmentation is common
If you’re a candidate for IVF, you’ve probably struggled with infertility for some time. That’s why every unsuccessful cycle of IVF is especially difficult to bear; you’ve already endured a lot of disappointment.
One of the reasons you had trouble getting pregnant in the first place and why your IVF may fail is that your embryos could contain fragments that secrete harmful substances that affect the health of surrounding cells. Embryo fragmentation is fairly common in IVF patients.
Factors that increase your risk for fragmentation include:
- Increased maternal age
- Poor quality eggs or sperm
- Chromosomal abnormalities in embryo
- Abnormal cell cycles
- Apoptosis (programmed cell death)
- Oxidative stress
Fragments adversely affect the implantation rate. If a fragmented embryo does implant, it’s more likely to be miscarried.
2. Embryo fragmentation reduces IVF success
Studies have shown that fragmented embryos are less likely to implant and become fetuses. The larger the fragments and the more of them that reside in the embryo, the less viable the embryo is.
Fertility centers grade the quality of embryos based on the presence and size of fragments. Also important is the appearance and size of the blastomeres (individual cells) in the embryo.
- Grade I: no fragmentation; blastomeres are the same size
- Grade II: less than 10% fragmentation with equal-sized blastomeres or no fragmentation with unequal-sized blastomeres
- Grade III: 10% to less than 25% fragmentation
- Grade IV: 25% to less than 50% fragmentation
- Grade V: 50% or more fragmentation
Embryoplasty removes the microscopic fragments so higher-graded embryos have the same chance of implantation and pregnancy as lower graded embryos. However, Grade IV and Grade V embryos may be too fragmented for Embryoplasty.
3. Embryoplasty should be done early
Because the fragments in the embryo secrete substances that can damage the blastomeres, we recommend performing Embryoplasty early, usually by Day 2 of the IVF-embryo transfer cycle. On Day 2, the blastomeres are smaller and there’s more space between them, which makes removing the fragments easier.
4. We check for fragmentation before implantation
When we fertilize your or donor eggs in our laboratory, we analyze the health of the resulting embryos using a variety of criteria. We look for chromosome damage but also for fragmentation. We don’t recommend implanting Grade III or higher embryos that haven’t undergone Embryoplasty, due to their high failure rate.
5. Embryoplasty increases chance of pregnancy
When we recommend that you undergo IVF, we want to give you the best possible chance for pregnancy possible. Embryoplasty significantly increases that chance. In one study comparing fragmented embryos with and without Embryoplasty, the results were dramatic:
- Clinical pregnancy: 43.7% vs. 28.8%
- Ongoing pregnancy: 36.8% vs. 22.1%
- Implantation: 25.8% vs. 14%
If you’ve dealt with failed IVF before, call us today for a consultation to find out if Embryoplasty is the step you need to take to make your dreams of a new baby come true. Contact us today at 925-230-9471, or click the “Book online” button to request a consultation.