Can Fragmented Day 3 Embryos Make it to Blastocyst?

Fragmentation is frustrating. As a field, we still have not identified exactly why it occurs, but because we see it more frequently in older patients, it is thought to be related to egg quality.

It's generally accepted that as fragmentation increases over Days 3 to 5, the blastocyst rate decreases.

The embryo is losing as much as it is gaining and it reaches a point where it cannot continue to mature due to lack of cells. However in some cases the fragmentation on day 3 can be high AND the embryo can make it to the blastocyst stage.

The embryo pictured above had over 50% fragmentation on Day 3 (it was noisy in there!). On Day 5, it looked like a cavity was forming but there were still fragments inside, so we were not optimistic. On Day 6, it hatched out (with assisted hatching for preimplantation genetic screening) and when the blastocyst was outside, with the fragments inside, we realized that it was actually a beautiful embryo. This supports that sometimes culturing embryos to their full Day 6 can be advantageous. We can't expect for this to happen with all embryos that display fragmentation, but it does demonstrate that some Day 3 embryos that look noisy inside may actually develop into good looking embryos once contents are separated at Day 5 or 6.