Stage 4 (6 days)

Stage 4 is reserved for the attaching blastocyst that is adhering to the endometrial lining
of the uterus. The attaching process is called adplantation and heralds the onset of
implantation. Stage 4 embryos have an estimated postfertilization age of approximately
6 days.

The process of attachment and implantation initiates the at first localised transformation
of the uterine endometrium into the decidua (maternal decidua). This process is
described as decidualization (decidualisation) that eventually spreads throughout the
entire uterine lining.

Summary

 Week 1-2, size 0.1 - 0.2 mm

 Adplantation and implantation commences, increase in hCG

Stage 5 (7-12 days)

 Stage 5a specimens have a postfertilization age of 7 to 8 days and are
characterized by a trophoblast that is still mainly solid. The greatest diameter of
the conceptus is less than 0.5 mm. The blastocystic cavity is flattened probably
because of its collapse during implantation. Mesoblast formation begins along
the inner side of the trophoblast. The embryonic disc is approximately 0.1 mm in
diameter and is composed of two layers, a thick layer called the epiblast and a
thin layer called the hypoblast. The amniotic cavity is apparent for the first time
and is formed by the curved epiblast of the embryonic disc.

The amniotic sac, also called the bag of waters or the membranes, is the sac in
which the embryo and later fetus develops in amniotes. It is a thin but tough
transparent pair of membranes that hold a developing embryo (and later fetus)
until shortly before birth. The inner of these membranes, the amnion, encloses
the amniotic cavity, containing the amniotic fluid and the embryo. The outer
membrane, the chorion, contains the amnion and is part of the placenta. On the
outer side, the amniotic sac is connected to the yolk sac, the allantois, and via
the umbilical cord, the placenta. The amniotic sac and its filling provide a liquid
that surrounds and cushions the fetus. It is a site of exchange of essential
substances, such as oxygen, between the umbilical cord and the fetus. It allows
the fetus to move freely within the walls of the uterus.

 Stage 5b specimens have an estimated postfertilization age of 9 days with a

conceptus diameter of approximately 0.1 mm. The distinguishing characteristic at
 this substage is the presence of numerous irregular, slit like lacunae within the
cytoplasm of the syncytiotrophoblast. Most of the lacunae communicate with
each other and with the endometrial sinusoids but they contain relatively little
maternal blood.
 Stage 5c specimens have an estimated postfertilization age of 11 to 12 days and
a conceptus diameter of approximately 0.15 to 0.2 mm. The rostral and caudal
ends of the embryonic disc can be identified for the first time as well as the right
and left sides.

Stage 6 (day 16- 21)

Stage 6 embryos are in the presomite period and have an estimated postfertilization
age of 16 to 21 days and a greatest length of approximately 0.3 mm. When the
gastrulation (primitive) streak is present in the caudal part of the specimen it is
sometimes classified as Stage 6b. Similar specimens without a gastrulation streak are
then classified as Stage 6a. Chorionic villi and the amniotic cavity and secondary
umbilical vesicle (yolk sac) are evident. Embryonic endoderm is present for the first
time.
-The three extra embryonic spaces (amniotic, primitive yolk sac and chorionic) are
present.

-The large chorionic cavity is surrounded by the cell layers extending to form chorionic
villi. These villi are the beginning of the functional units of the placenta.

-Outside of these villi, and extending from their tips, trophoblasts invade the maternal
decidua forming maternal blood-filled lacunae (lakes). Emptying into these maternal
lacuna are both uterine glands and spiral arteries held open by trophoblast cells.

-The maternal uterine wall continues to undergo expanding decidualization in response

to the implantation process.