Patient: Dr. Malpani, I keep hearing about day 3 and day 5 embryo transfers. Why do some IVF doctors still do day 3 transfers when the success rates seem to be better with day 5 transfers?
Dr. Malpani: That's an excellent question. It's universally accepted that the pregnancy rate is higher with a day 5 embryo, also known as a blastocyst, compared to a day 3 embryo. The blastocyst stage is when the embryo naturally enters the uterus, so transferring at this stage mimics the natural process more closely./p>
Patient: So, why would any doctor choose a day 3 transfer when the day 5 transfer is more effective?
Dr. Malpani: Ideally, they shouldn't. A day 3 embryo isn't at the right stage for the uterus; it should still be in the fallopian tube. Putting a day 3 embryo in the uterus can actually reduce the chances of success. Unfortunately, some doctors push for day 3 transfers because they're not confident in their IVF lab's ability to grow embryos to day 5. They might say it's better to put the embryo back inside the body rather than keep it in the incubator, but this usually points to poor lab quality or lack of expertise.
Patient: So they're just taking a shortcut, right?
Dr. Malpani: Exactly. They often do this because they have a bad IVF lab, poor-quality incubators, or lack confidence in their embryologist's skills. By doing a day 3 transfer, they try to avoid the risk of the embryo not making it to day 5 in their lab. They might say, "Look, we made embryos and put them back for you. If the cycle fails, it's not our fault." They'll come up with excuses like bad luck, stress, or the uterine lining not being good.
Patient: That sounds like a red flag to me.
Dr. Malpani: It absolutely is. If a doctor insists on day 3 transfers, it's a sign they lack confidence in their lab and clinical competence. You should insist on a day 5 transfer, and if they can't provide that, it's a good reason to look for a different clinic.
Patient: This is really enlightening. What should I do if I need more guidance?
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