Saturday, 29 March 2014

What are Grade A, B and C embryos?

IVF cycle can be an emotional rollercoaster journey for women, who hanker for motherhood in the world of technology. Embryo transfer is an important step of IVF cycle. The day of embryo transfer fills joy and anxiety in the IVF laboratories, where many women cry while many others nervous enough to evoke their tear gland. 

For doctors, it is an acid test to counsel women about grades of their embryos. Doctors and embryologists refer them as grade A, B or C embryos to determine the quality before transfer in a woman’s uterus during IVF cycle.

Observably, not all the embryos are Grade A, but women need to be upset if they find their embryos of Grade B or Grade C

They need to understand that Grade B or Grade C embryo does not mean that they would reproduce abnormal babies. Grades are just the medical reference and it does not determine the health of the baby.

An embryo is referred as Grade A when all the cells are equal and there are no fragments. A Grade B embryo is an embryo which has more than 10% fragments or has unequal cells and Grade C is the lowest quality embryo.

So, a Grade A embryo has a better chance of implanting and becoming a baby as compared to a Grade B embryo. In both cases, baby will be completely normal and the grades are given to determine the chances ofimplantation.

Technology comes with some limitation and it is impractical for the doctors to predict if the embryos would be implanted or not. Women with poor quality eggs should not lose hopes of conceiving as the embryos are living organisms and they have ability to self-correct.  It has been observed that embryos which were Grade B on Day 3 turn into blastocysts by Day 5.

Quality and complications related like miscarriage or abnormalities have no relation. Women, who are implanted Grade B embryos does not mean they increase the chances of miscarriage. Likewise, if a woman miscarries with Grade B embryo then it does not mean that the quality of embryo led to the miscarriage. 

A goof IVF doctor ensures the embryo transferred in woman’s womb is of good quality to grow and become a baby. Not all Grade A embryos become babies and many Grade B embryos become healthy babies.

It is important for a doctor to give pictorial description of embryos to the patient, even if it is Grade B embryo. Pictures can do a lot more than words. 

Embryos in pictures can be more assuring than the medical terminologies provided in reports. IVF patients are generally under the shadow of emotions, so, it is important for a good IVF doctor to provide pictures of embryos to patients to understand the practicality of process. 

It is the duty of both doctor and patient to establish a clear channel of communication.

Dr Neeraj Pahlajani

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