Blastocyst transfers (BT), may benefit chromosomal translocation-carrier couples who suffer multiple miscarriages or are unable to achieve pregnancy following classical ART techniques. In vitro culture applies an additional selection pressure, so that those embryos which achieve blastocyst formation have higher survival probability as healthy balanced translocation carriers or unaffected embryos. Sixteen IVF cycles were performed in 11 patients. When blastocyst are obtained, implantation rate per blastocyst and delivery rates (7/11 cycles, eight healthy babies born) are high. However, the overall blastocyst formation rate is low (20%), and as a consequence in nearly half of the cycles, no blastocyst can be obtained. We propose that this strategy may be used initially as an alternative or a complement to preimplantation genetic diagnosis, and to apply the forces of natural selection in vitro.