{"id":6645,"date":"2015-01-07T17:38:00","date_gmt":"2015-01-07T14:38:00","guid":{"rendered":"https:\/\/serkanoral.com\/tup-bebekte-embriyo-kalitesi\/"},"modified":"2025-09-06T22:06:23","modified_gmt":"2025-09-06T19:06:23","slug":"embryo-quality-in-ivf","status":"publish","type":"post","link":"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/","title":{"rendered":"Embryo Quality in IVF"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_82_2 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">\u0130\u00e7indekiler<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/#embryo-quality-in-ivf\" >Embryo Quality in IVF<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/#embryo-selection-criteria\" >Embryo selection criteria<\/a><ul class='ez-toc-list-level-4' ><li class='ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/#first-day-evaluation\" >First day evaluation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/#evaluation-of-the-division-phase-on-day-2-and-3\" >Evaluation of the division phase on day 2 and 3<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/#day-5-and-6-blastocyst-stage-evaluation\" >Day 5 and 6 blastocyst stage evaluation<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/#day-one-review\" >Day One Review<\/a><ul class='ez-toc-list-level-4' ><li class='ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/#core-position-and-volume\" >Core position and volume<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/#number-shape-and-distribution-of-nucleoli\" >Number, shape and distribution of nucleoli<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/#location-of-polar-body\" >Location of polar body<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/#2nd-and-3rd-day-division-phase-examination\" >2nd and 3rd day division phase examination<\/a><ul class='ez-toc-list-level-4' ><li class='ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/#early-division\" >Early Division<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/#division-speed\" >Division Speed<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/#blastomere-cell-size\" >Blastomere (cell) size<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/#fragmentation-degree\" >Fragmentation degree<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/#structural-features-of-blastomeres\" >Structural features of blastomeres<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/#cytoplasmic-view\" >Cytoplasmic View<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/serkanoral.com\/en\/embryo-quality-in-ivf\/#perivitelline-area-and-zona-pellucida-features\" >Perivitelline area and zona pellucida features<\/a><\/li><\/ul><\/li><\/ul><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n\n<p>The quality of the embryos is evaluated according to various morphological parameters after fertilization. Apart from various other factors, the quality of the transferred embryo significantly determines the chances of pregnancy. It is important to keep in mind that the woman&#8217;s age and some other factors are as important for pregnancy as embryo quality. Each embryo is examined under a microscope to determine embryo quality. Each embryo is evaluated according to three parameters:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Number of cells;<\/li>\n\n\n\n<li>Whether the cells are of equal size or not;<\/li>\n\n\n\n<li>Presence of \u201cfragmentation\u201d and its proportional percentage relative to embryo size.<\/li>\n<\/ul>\n\n\n\n<p id=\"viewer-9t76617828\">The number of cells in each embryo is between 1-12. It is thought that the more cells there are in the embryo, the faster the embryo divides, and therefore the highest chance of pregnancy. On the 3rd day after <a href=\"https:\/\/serkanoral.com\/en\/who-can-get-egg-freezing\/\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>egg<\/strong><\/a> collection, a cell count of 6 or more indicates a good quality embryo. Pregnancy can also be achieved with embryo transfers of 4 or fewer cells, albeit with <a href=\"https:\/\/serkanoral.com\/en\/what-to-do-after-miscarriages\/\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>lower<\/strong><\/a> chances. In a perfect quality embryo, the cells are of similar size and there is no fragmentation. The structure we call fragmentation is non-living cell residues. As fragmentation increases, the embryo quality (grade) decreases and the chance of pregnancy decreases.<\/p>\n\n\n\n<p id=\"viewer-6a79117708\">It is also important to know that embryo quality is a very rough indicator of pregnancy success. A good quality embryo may not always provide the ideal <a href=\"https:\/\/serkanoral.com\/en\/genetic-diagnosis-of-male-infertility\/\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>genetic<\/strong><\/a> and biochemical content for a healthy baby. Embryo quality can change within hours. For this reason, it is recommended that people do not focus on embryo quality more than necessary. The point to keep in mind is that the most important indicator of embryo quality is to obtain a healthy baby.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"viewer-so9zu17712\"><span class=\"ez-toc-section\" id=\"embryo-selection-criteria\"><\/span>Embryo selection criteria<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p id=\"viewer-q13ud17714\">Embryos are examined with special microscopes, classified and scored. The higher the embryo score, the higher its potential to attach and cause pregnancy. The embryo\/embryos with the highest score on the day of transfer are preferred for transfer. Many parameters of the embryo are used in scoring.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"viewer-ilxa717716\"><span class=\"ez-toc-section\" id=\"first-day-evaluation\"><\/span>First day evaluation<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Core position and volume<\/li>\n\n\n\n<li>Number, shape and distribution of nucleoli<\/li>\n\n\n\n<li>Location of polar body<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"viewer-3qt9v18146\"><span class=\"ez-toc-section\" id=\"evaluation-of-the-division-phase-on-day-2-and-3\"><\/span>Evaluation of the division phase on day 2 and 3<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Early division<\/li>\n\n\n\n<li>The momentum of division<\/li>\n\n\n\n<li>Blastomere volume<\/li>\n\n\n\n<li>Fragmentation degree<\/li>\n\n\n\n<li>Blastomere multinucleation (more than one nucleus)<\/li>\n\n\n\n<li>Cytoplasmic image<\/li>\n\n\n\n<li>Features of perivitelline area (extracytoplasmic area) and zona pellucida (outer shell)<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"viewer-2e5r018215\"><span class=\"ez-toc-section\" id=\"day-5-and-6-blastocyst-stage-evaluation\"><\/span>Day 5 and 6 blastocyst stage evaluation<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Blastocele (central cavity) size<\/li>\n\n\n\n<li>Inner cell mass<\/li>\n\n\n\n<li>Outer cell mass (Trophectoderm)<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"viewer-9dt2l17764\"><span class=\"ez-toc-section\" id=\"day-one-review\"><\/span>Day One Review<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"viewer-b8tsm17766\"><span class=\"ez-toc-section\" id=\"core-position-and-volume\"><\/span>Core position and volume<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<p id=\"viewer-xhsxs17768\">16-18 hours after the microinjection application, 2 nuclei carrying chromosomes from the mother and father begin to form in the middle of the egg. The female pronucleus progresses until it gets very close to the male pronucleus and they merge. Observing 2 nuclei in the middle of the egg means that the oocyte is fertilized.<\/p>\n\n\n\n<p id=\"viewer-9gqap17770\">Research and studies have shown that for pronuclear oocytes to be considered morphologically normal, both PNs must be in a central position in the cytoplasm, close to each other and of the same size.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"viewer-o66of18345\"><span class=\"ez-toc-section\" id=\"number-shape-and-distribution-of-nucleoli\"><\/span>Number, shape and distribution of nucleoli<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<p id=\"viewer-cv6b817774\">Nucleoli are tiny, numerous and scattered within the nuclei. Over time, they fuse with each other, decrease in number, grow larger and line up tightly next to each other. Studies show that the same number and order of nucleoli in both nuclei is an indication of higher retention potential.<\/p>\n\n\n\n<p id=\"viewer-mo99617776\">According to the Tesarik and Greco scoring system, P0 has the highest holding potential and P5 has the lowest holding potential.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"viewer-q260y17780\"><span class=\"ez-toc-section\" id=\"location-of-polar-body\"><\/span>Location of polar body<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<p id=\"viewer-1lgq117782\">The polar body is a structure located in the perivitelline space and formed during meiosis. The appearance of the polar body means that the egg is mature. The small angle between the nuclei and the polar body indicates that the embryo&#8217;s retention potential is high.<\/p>\n\n\n\n<p id=\"viewer-7k5l417784\">The cytoplasmic halo is the region of low density seen around the egg. Its presence is an indication that the embryo has a high retention potential.<\/p>\n\n\n\n<p id=\"viewer-2gv9417786\">Day 1 fertilized egg: Two nuclei can be seen, one carrying chromosomes from the mother and the other from the father.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"viewer-fw29717788\"><span class=\"ez-toc-section\" id=\"2nd-and-3rd-day-division-phase-examination\"><\/span>2nd and 3rd day division phase examination<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p id=\"viewer-3dnev17790\">In embryo scoring systems, the cleavage stage should also be evaluated to distinguish embryos with high implantation potential.<\/p>\n\n\n\n<p id=\"viewer-5sl8817792\">The presence of early cleavage at the cleavage stage, cleavage acceleration, blastomere volume, fragmentation rate, nuclear status of blastomeres, cytoplasmic image, perivitelline area and zona pellucida features are examined. Many different cleavage stage embryo scoring systems have been identified in the literature. After providing information on the parameters evaluated in these scoring systems, an example &#8216;cleavage stage embryo scoring system&#8217; will be given.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"viewer-eh27v18599\"><span class=\"ez-toc-section\" id=\"early-division\"><\/span><strong>Early<\/strong> Division<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<p id=\"viewer-ruz9u17796\">The fertilized egg begins to divide after an average of 20 hours and forms a 2-cell embryo. At the twenty-fifth hour, an average of 20% of fertilized eggs are in the 2-cell stage. Studies have shown that embryos that divide early (20-26 hours after <a href=\"https:\/\/serkanoral.com\/en\/what-is-microinjection-icsi\/\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>microinjection<\/strong><\/a>) have a higher pregnancy and implantation potential. Based on this information, the time of first cell division of fertilized eggs is examined as an important criterion used when choosing an embryo.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"viewer-c3mhb18664\"><span class=\"ez-toc-section\" id=\"division-speed\"><\/span>Division Speed<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<p id=\"viewer-m4eya17802\">A good quality embryo should have 4-5 blastomeres on day 2 (hour 42-44) and at least 7 cells on day 3 (hour 66-68). Studies have shown that embryo development that is too slow or too fast negatively affects embryo implantation rates.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"viewer-n49pm18727\"><span class=\"ez-toc-section\" id=\"blastomere-cell-size\"><\/span>Blastomere (cell) size<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<p id=\"viewer-9er2y17806\">Cell division that is not of the same size is considered a parameter that provides information about embryo quality and embryo development potential. Studies have shown that pregnancy and implantation rates are negatively affected by the transfer of embryos that are not divided equally.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"viewer-xlzd118790\"><span class=\"ez-toc-section\" id=\"fragmentation-degree\"><\/span>Fragmentation degree<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<p id=\"viewer-0ddcf17810\">The structures within the embryo that are not cells are called fragments. The number of fragments without a nucleus and the ratio of their amount to the embryo volume should be examined when determining embryo quality. The cause of cell fragmentation and its effect on embryo development are not fully known and are specific to both the embryo and the patient.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"viewer-ywhhu18853\"><span class=\"ez-toc-section\" id=\"structural-features-of-blastomeres\"><\/span>Structural features of blastomeres<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<p id=\"viewer-pf7vj17814\">Another morphological parameter used for embryo scoring is the presence of more than one nucleus in a cell (multinucleation). This is an undesirable situation and embryos with this condition should not be transferred.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"viewer-zvo8x18916\"><span class=\"ez-toc-section\" id=\"cytoplasmic-view\"><\/span>Cytoplasmic View<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<p id=\"viewer-psnh117818\">If the cytoplasm is light colored, transparent or slightly granulated (spongy structure), it is considered normal.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"viewer-yhyqr17820\"><span class=\"ez-toc-section\" id=\"perivitelline-area-and-zona-pellucida-features\"><\/span>Perivitelline area and zona pellucida features<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<p>When scoring embryos, width, narrowness and inclusions in the perivitelline region (extra-cytoplasmic area) should be evaluated, and the structure and thickness of the zona pellucida (outer shell) are also examined.<\/p>\n\n    <div class=\"xs_social_share_widget xs_share_url after_content \t\tmain_content  wslu-style-1 wslu-share-box-shaped wslu-fill-colored wslu-none wslu-share-horizontal wslu-theme-font-no wslu-main_content\">\n\n\t\t\n        <ul>\n\t\t\t        <\/ul>\n    <\/div> \n","protected":false},"excerpt":{"rendered":"<p>The quality of the embryos is evaluated according to various morphological parameters after fertilization. Apart from various other factors, the quality of the transferred embryo significantly determines the chances of pregnancy. It is important to keep in mind that the woman&#8217;s age and some other factors are as important for pregnancy as embryo quality. Each [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":1105,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[28],"tags":[],"class_list":["post-6645","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ivf","has-post-video"],"_links":{"self":[{"href":"https:\/\/serkanoral.com\/en\/wp-json\/wp\/v2\/posts\/6645","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/serkanoral.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/serkanoral.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/serkanoral.com\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/serkanoral.com\/en\/wp-json\/wp\/v2\/comments?post=6645"}],"version-history":[{"count":0,"href":"https:\/\/serkanoral.com\/en\/wp-json\/wp\/v2\/posts\/6645\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/serkanoral.com\/en\/wp-json\/wp\/v2\/media\/1105"}],"wp:attachment":[{"href":"https:\/\/serkanoral.com\/en\/wp-json\/wp\/v2\/media?parent=6645"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/serkanoral.com\/en\/wp-json\/wp\/v2\/categories?post=6645"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/serkanoral.com\/en\/wp-json\/wp\/v2\/tags?post=6645"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}