Cleavage-stage embryo transfer: we’ll never let it go

Improved modern embryo culture techniques such as the use of triple gas incubators and commercially available culture media have helped increase the frequency of culture to the blastocyst stage, use of preimplantation genetic testing for aneuploidy, and single embryo transfer. One could argue that cleavage-stage embryo transfer is unnecessary in modern practice. In some older patients with poor prognosis, cleavage-stage embryo transfer could even be considered futile. Results from one study indicate that the live birth rate for a single cleavage-stage embryo from a 45-year-old woman at retrieval is less than 1% (1).