The Complete Guide to Embryo Grading

Wondering whether your embryo has a good grade and what it means?

What is a good blastocyst grade? Is a 4AA embryo good? What is a grade 5 embryo?

In this video, we learn from embryologist, Jessica Manns, all about understanding embryo grades, from the criteria embryologists use to grade an embryo, what is a good embryo grade, what is a poor embryo grade, and how embryo grades affect IVF success rates.

What is embryo grading?

During an IVF cycle, embryos are graded by embryologists in order to help your fertility doctor assess which embryos are developing normally. 

This information can assist in selecting an embryo to transfer that is most likely to lead to a successful pregnancy.

"Embryo grading is a way to describe the way an embryo looks based on certain characteristics", embryologist, Jessica Manns, explains. The way an embryo looks is often referred to as embryo morphology.

Grading embryos based on their morphology helps embryologists understand whether your embryo is developing normally and at the expected speed.

This can give you and your fertility doctor some insight into which embryos may be better quality than others and which are most likely to result in success and lead to a baby. 

Embryo grading is important for: 
* predicting IVF success
* identifying which embryos are suitable for:
* embryo biopsy (PGT/genetic testing) 
* embryo freezing
* embryo transfer
* choosing the best embryo for a frozen embryo transfer (FET) cycle

If the embryo looks how it should on a certain day of development, then it is more likely to be viable compared to embryos that may be developing slower or have poor morphology.

Embryos are graded usually on Day 3 and on Day 5 of development.

On Day 3 embryos are graded based on:
-number of cells
-equal sizing of cells
-cell fragmentation

An ideal Day 3 embryo grade would be an embryo that has 8 cells that are all equal in size and no sign of fragmentation.

On Day 5, an embryo should be at the blastocyst stage. This is where embryo grading becomes more complicated. This is the time when most patients start to pay attention to embryo grading. Once embryos have reached the blastocyst stage, embryos are graded on a scale known as the Gardner Scale.

Blastocyst stage embryos are graded on the quality of their:
-development/expansion
-inner cell mass
-trophectoderm

The quality of the embryo's development is graded on a scale of 1-5 with 5 being the best. The inner cell mass is graded on s scale of A-C with A being the best. Finally, the trophectoderm is graded on a scale of A-C with A being the best.

The best embryo grade you can have is 5AA.

Day 5 blastocyst embryo grading scale:
Good (Any embryo grade that has all A's)
Fair (Any embryo grade that has a B)
Poor (Any embryo grade that has a C)

In this video, we cover:
- what is embryo grading
- how are embryos graded
- embryo development timeline
- embryo grading chart
- comparing blastocyst grades
- best embryo grade?
- worst embryo grade?
- how embryo grades affect IVF success
- can the embryo grade tell you an embryo's gender?
- embryo grade follower Q&A

TIMESTAMPS
0:00 Meet the embryologist!
0:19 What is embryo grading?
0:57 Embryo Development Timeline
2:50 Day 3 Embryo Grading
5:36 Day 5 Embryo Grading | Blastocyst Stage
9:05 Best Embryo Grade on Day 5
9:39 4AB vs 4BA embryo grade
10:09 4AA vs 5AA embryo grade
10:30 Day 5 vs Day 6 blastocyst
11:07 Embryo Grading and IVF Success
11:31 Follower Questions on Embryo Grading
11:35 Is a hatched blastocyst good or bad?
13:37 3BB Embryo - what does 3 mean?
14:12 Can a frozen embryo grade change?
14:45 What does fair mean in embryo grading?
15:43 Can embryo grade tell me the gender?
16:01 Embryo Grading vs PGT
16:29 4BB embryo success rate?

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