Answer from: Raúl Olivares, MD
Yes, they can implant. There is a very clear correlation between embryo quality and implantation rates. The better the embryo looks, the higher the rates. We know that there are embryos, which in terms of morphology are not really very pretty, but they can still be genetically normal. There is more than one study that has confirmed that if the embryo is genetically normal, the embryo morphology is not that relevant. The implantation rates of embryos graded as A could be as good as the embryos graded as C if the genetics are normal.
The idea is that we are always going to start transferring those embryos that look better but as long as the embryo is evolving, I think that it’s worth freezing them because we’ve all got cases in which poor embryos have implanted, while the ones that have been initially selected hadn’t.
Answer from: Andrea Sánchez Freire
Yes, the poor embryos can implant. Depends on the age of the patient, endometrium, the quality of embryo, if they are of Day 3 or Day 5. Sometimes poor quality blastocysts on Day 5 can result in a pregnancy, it depends on a lot of factors.
Answer from: Harry Karpouzis, MD, MRCOG, DIUE
Yes, poor embryos can implant. It is very important to understand that when we grade, it is subjective, it is not objective. The grading might be different from laboratory to laboratory. Also, we cannot be 100% sure what the thing we see under the microscope means and what gives a good predictive value, and what doesn’t. Yes, we know most of the things but we don’t know all of them. We need to understand that we grade the embryos morphologically. We don’t grade them chromosomally. We don’t know if a very good grading embryo, will be chromosomally normal. Yes, it will have changes to be chromosomally normal, rather than an embryo that is not morphologically good grade quality, but this is not 100% sure. We have seen many times a good grade embryo that didn’t implant because finally, it wasn’t chromosomally normal, and the worse quality embryo implanted because it was chromosomally normal and if we had left it for a bit longer the grade might have changed as well.
In cooperation with the Institute of Life, our main cooperation IVF laboratory, Pelargos IVF now offers artificial intelligence in the laboratory which means that we have a lot of data from many cases studied under the microscope. This data is being collected and also other elements are assessed, elements that cannot be assessed under the microscope. This gives you an understanding of the implantation chances of the embryos and especially the information on which embryos have lesser chances to implant. I think artificial intelligence will be the future in the laboratories so that we can increase the chances of success rather than the very subjective grading system of the laboratory.
