Table 4. Istanbul Consensus Scoring System for Blastocysts
  Grade Rating Description
Stage of development 1   Early
2 Blastocyst
3 Expanded
4 Hatched/hatching
ICM 1 Good Prominent, easily discernible, with many cells that are compacted and tightly adhered together
2 Fair Easily discernible, with many cells that are loosely grouped together
3 Poor Difficult to discern, with few cells
TE 1 Good Many cells forming a cohesive epithelium
2 Fair Few cells forming a loose epithelium
3 Poor Very few cells
(Alpha Scientists in Reproductive Medicine & ESHRE Special Interest Group of Embryology, 2011).