Advanced Age and Going to Blastocyst for ET
A common concern that we often hear from patients is that they cannot go to Blastocyst because they only have a few eggs. They think that advanced maternal age and a corresponding low number of embryos means that maturing to Blast for the embryo transfer is not an option.
The above photo shows a Day 6 embryo that matured from a 41 year old with one egg.
A lot of the hesitation from clinics (and patients) to go to Blast is due to concern that they may not get even a single blastocyst - that the embryo may arrest or be slow. This is a fair concern. Growing to Blastocyst does not guarantee a Blastocyst. It's also important to note however that transferring an embryo on Day 3 also does not guarantee a Blastocyst.
Because we do a lot of preimplantation genetic screening, we culture a lot of patients to the Blast stage and we see many patients of advanced age making Blasts (although these embryos are not always genetically normal). The good news is that patients get a nice indicator of the potential of the embryo. Reaching Blastocyst is a great milestone to set in achieving a successful pregnancy given how many embryos can arrest past Day 3.