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The Truth about Embryo Quality: Blastocyst Grading Explained Simply
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- Published on Apr 17, 2026
- Understanding embryo grading in IVF and what embryo quality really means can be confusing and stressful for many fertility patients. If you are going through IVF, preparing for an embryo transfer, or trying to understand your blastocyst grade, this video is for you. In this episode, I explain how embryo grading works, what the numbers and letters mean, and how embryo quality relates to pregnancy success and genetic health.
In this video, you’ll learn:
• What embryo grading means in IVF and how blastocysts are evaluated
• How embryologists grade embryos using numbers and letters (1-6, A-C, A-C)
• What blastocyst expansion, inner cell mass, and trophectoderm grades represent
• The difference between high-grade and lower-grade embryos
• Why embryo grading is a “beauty contest” and not a genetic test
• Whether embryo quality predicts implantation and pregnancy success
• How embryo grading compares to PGT and genetic testing
• Why beautiful embryos can still be genetically abnormal
• How doctors use embryo grades to choose embryos for transfer
• What IVF patients should know before an embryo transfer
Understanding IVF embryo grading, blastocyst quality, and genetic testing can help you make informed decisions during fertility treatment and reduce unnecessary anxiety. Whether you are reviewing your embryo report, considering PGT testing, preparing for a frozen embryo transfer, or feeling worried about your embryo grades, this video will help you feel educated, empowered, and confident in your IVF journey.
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ABOUT : Lora Shahine, MD, is a double board certified reproductive endocrinologist and OBGYN currently practicing at Pacific NW Fertility in Seattle, WA. Originally from North Carolina, Dr. Shahine graduated with a Bachelor of Science in biology from Georgetown University in Washington, DC, and completed her training in medical school at Wake Forest University School of Medicine, residency in obstetrics and gynecology at the University of California at San Francisco, and fellowship in reproductive endocrinology and infertility at Stanford University.
As Clinical Assistant Professor at the University of Washington and Director of the Center of Recurrent Pregnancy Loss at Pacific NW Fertility, she is committed to providing excellence in patient care, teaching the next generation of women’s healthcare providers, and continuing research in the fields of fertility and recurrent miscarriage. She has published over 75 peer-reviewed research projects and is an active member of the American Society of Reproductive Medicine, Seattle Gynecology Society, and the Babyquest Fertility Grant organization. Dr. Shahine is an accomplished author including 'Planting the Seeds of Pregnancy: An Integrative Approach to Fertility Care' and best-selling book, 'Not Broken: An Approachable Guide to Miscarriage and Recurrent Pregnancy Loss.'
Whether through her research, books, lectures, or active social media presense Dr. Shahine is passionate about educating on reproductive health and supporting the feritlity community.
DISCLAIMER: The content contained herein is provided for informational and/or entertainment purposes only and not intended as a substitute for advice provided by a healthcare professional. Use the provided information at your own risk. If you have or suspect that you have a medical problem, please contact your health care provider.
#drlorashahine #ivf #embryograding
just got news from my embryologist that i got 5. 5AA 4AA 3AA 4BB 3BB..this vid is helpful
Currently pregnant with my 4BB embaby !
Yay! Transferring my 4BB in two weeks
Same here
did you do the genetic testing?
Great!❤ Did genetic testing and waiting for my 4BB transfer🤞
Congrats!
Im doing IVF right now, feel scared and worry all the time. But after I found your video, I watched some of it, and I can say it's taking away my anxiety.
Lost my euploid 6ba as biochemical pregnancy. Now only left with 3bc.without pgt .Prayers needed for miracle
I'm praying for you! May you be blessed and with child in Jesus name. Amen.
How to contact you
tutdumu sizde?
Im here to learn lets go!
I love your videos and I’ve been following you throughout my ivf journey,, every single video has been very informative. ❤❤❤
Thank you!! I am so glad to know they are helping you
Doctor 2Ab good or plz tell me
Doctor 3bb
I love your videos, I'm in the PNW and would love to make a trip up to see you soon. TTC with PCOS has been tough ❤ but everything will work out soon.
valuable information
Thank you so much for this video. It’s like you read my mind. We have our miracle baby who was 6AA but ended up SGA. We still have embryos of different grades so have really been thinking whether we’re at risk of getting more issues because of their lower grades. This was really helpful.
Currently going through my withdrawal bleed so I still have a month before my FET cycle, but I didn't receive the 3 digit grading - I was just told all 5 of my my embryos that made it to blastocyst are a grade C and this slightly lowers implantation success rates. Now I'm super worried but the embryologist said she isn't worried and I shouldn't be either. Eek
My 5AA turned out to be aneuploid. PGTA is a must!
Same here! 4AA and aneuploid.
Same, 4AA ended in chemical pregnancy. Currently pregnant with my 4BA embryo
Please talk about vacuole inside the eggs.
Great video
Thanks!
I had a failed transfer earlier this year it was a Euploid, Unaffected for PGT-M D5 3BA my husband and I weren’t sure if that was the best option to transfer but our Dr. Said the embryologist care more about the day, well it failed and was heartbreaking because I was sure it was gonna work. Now my next FET will be 3/31 with a D6 5AB. I’m really nervous and anxious about it. Hope it works this time🤞🏻
How successful 2AA EUPLOID can be ?
Should you have an old inverted mic that you not using. Thinking of arranging a budget lab for our people with low income
Is there anything you can do to improve odds if you are balanced translocation carrier? I had 11 eggs , 7 fertilized, 4 blastocysts and all 4 had unbalanced translocations. Feeling distraught. All information is welcome.
I got pregnant with my 4AA twins and just found out I lost one at 10 weeks and the other at 12 weeks. What should I ask my doctor next? What tests should I get done?
PGT A I think
So sorry for your loss. Try baby aspirin 😢
I had one embryo take 7 days to reach a 4BB grading. Should I be concerned about the length of time it took? Would the slower development potentially indicate a genetic issue?
Everything is possible, but the rate of it being abnormal is higher. I have two reached on day 7 and I'm terrified of the result
Hi Doc, I’ve been following you for quite some time and I’m currently undergoing IVF. My first fresh ET was unsuccessful, and my doctor mentioned it was a compact blast. They said all 6 embryos were good, and we have 5 frozen day-3 embryos now. We’re considering another egg retrieval with genetic testing before transfer, but I’m unsure whether it’s better to proceed with a frozen ET first or do retrieval followed by ET. Do day-3 embryos still have a good chance of implantation? Thanks!
Frozen is better than fresh from my experience although I lost mine at 20 weeks… I did 3 fresh and one frozen which was the positive one..
@RW2023JR Thanks for sharing your experience, and I’m truly sorry for your loss. I really appreciate the insight, and I’ll definitely keep the frozen transfer in mind. Wishing you all the best as well!
Qué horror la FIV. Deja de engañar a las personas. Estás orillándolas a matar embriones, que son sus hijos!!!!!
DEJA DE ENGAÑARLAS. Los embriones ya son personas. El óvulo y el espermatozoides sin fecundar son células, pero una vez fecundados, ya hay embrión, el embrión ya ES VIDA
ONLY ONE EMBRYO IN THE SECOND PULLING.
4BC
IS THIS MEAN ANYTHING FOR THE CHILD?