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Incubation and Fertilization: Fertilization and Embryo Formation takes place in incubator where they are nourished until they are ready for transfer (3-5 days). The IVF incubator is a highly controlled environment that maintains precise temperatures, gas concentrations, and uses highly filtered purified air. Fertilization is apparent in 24 hours, but complete embryo formation takes little longer. After a period of 16-20 hours, the eggs are examined and checked for the first signs of fertilization. At this time, the embryologist can observe under the microscope "two pronuclei".

The fertilized egg essentially looks like a "round ball with two eyes" and they represent the genetic material from the husband and wife. After two to three days, if the embryos are growing normally, they are ready for the IVF embryo transfer. We then observe the embryos for 3-6 days. At the present time, embryos can be transferred either 3 or six days following retrieval. A 3 day embryo is usually at the 6-8 cell stage. After 3 days blastocyst is transferred this improves implantation and pregnancy rates.

Assisted Hatching (AZH ): Zona Pellucida (ZP) is acellular matrix forming the outer layer of oocyte. Sperms are lined to ZP receptors. ZP prevents polyspermic fertilization. After fertilization, it protects embryo and maintains its integrity during migration from fallopian tube to uterus. Getting out of ZP is called hatching.

After fertilization and embryonic cleavage, the embryo must hatch out of ZP and attach to the uterine wall for continued development of the pregnancy. Loss of ZP is the result of embryonic & uterine functions. In uterus blastocyst gets out of the zona so that tropho-ectoderm cells interact with endometrial cells and the Zona free embryo implants into the uterus. If Zona free compact embryo implants in fallopian tube it results in tubal pregnancy. The embryo's ability to hatch may be inhibited when:

  • There is advanced maternal age (> 38 years old):
  • Embryo has thicker zona pellucid, has increased fragmentation or abnormally dividing cells.
  • Embryos are developing slowly; and/or have undergone micromanipulation.
  • Embryos that present extensive fragmentation after freezing and thawing.
  • There may be other undetermined factors including previous failed embryo transfers.
   
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