🇩🇪 Deutsche Version: Carnegie-Stadien

The Carnegie Stages are the 23 internationally standardized stages of human embryonic development — from fertilization (CS 1, day 1) to the end of the embryonic period (CS 23, day 56). The convention goes back to George L. Streeter (1942—1951, Carnegie Institution of Washington), was revised by Ronan O’Rahilly and Fabiola Müller, and today serves as the standard reference (O’Rahilly & Müller, Cells Tissues Organs 192:73—84, 2010).

The stages are ordered not by days in the womb but by morphologically defined steps. They are thus the only internationally comparable point of reference for embryonic development — independent of individual variation in the speed of development.

Significance for personal ontology

The Carnegie Stages describe how the human person unfolds in the first dimension — they do not describe whether and when it comes to be. In terms of personal ontology, a person is present from CS 1 onward (cf. embryo, fertilization, beginning of human existence). The Carnegie convention supplies the morphological vocabulary by which the claims of personal ontology can be empirically anchored — it does not replace them.

Three reference points are especially relevant to the argument:

  • CS 1 (day 1) — zygote after syngamy. Beginning of the new organism with totipotency. The personal-ontological beginning.
  • CS 6 (day 17) — appearance of the primitive streak, beginning of gastrulation. End of the possibility of monozygotic twinning. Classical boundary of the ISSCR’s 14-day rule. Pivot point of the debate over individuation (Smith/Brogaard 2003 vs. Damschen/Schönecker 2006 vs. Condic 2020).
  • CS 23 (day 56) — end of the embryonic period. All organ primordia laid down. Transition to the fetal phase (week 9).

Complementary to the morphological Carnegie convention, the HuDeCA Cell Atlas has since 2019 supplied cellular resolution: which cell types exist at which stage, into which lineage trajectories they diverge, at which spatial positions they appear. Where Carnegie describes the what kind of form, HuDeCA describes the which cells within it.

Table of the 23 stages

CSDay(s) post fert.Defining eventDescription
1Day 1ZygoteFertilization, single-celled zygote after syngamy.
2Day 2—3Cleavage, morulaFirst cleavage divisions up to the morula (2—16 cells).
3Day 4—5Free blastocystFree blastocyst with blastocoel; ICM/trophoblast differentiation; hatching from the zona pellucida.
4Day 6Attaching blastocystApposition of the blastocyst to the endometrium.
5Day 7—12Implantation, bilaminar germ discImplantation, lacunar trophoblast, formation of the bilaminar germ disc.
6Day 17Primitive streak, onset of gastrulationAppearance of the primitive streak; onset of gastrulation; classical boundary of the 14-day rule.
7Day 19Notochordal processFormation of the notochordal process; gastrulation advances.
8Day 23Primitive pit, neural platePrimitive pit; neural plate appears.
9Day 25Neural folds, first somitesNeural folds; first 1—3 somites; cardiac primordium.
10Day 28Neural tube fusion, pharyngeal arches 1—2Onset of neural tube fusion; pharyngeal arches 1 and 2; first heartbeat.
11Day 29Rostral neuropore, optic vesicleClosure of the rostral neuropore; optic vesicle.
12Day 30Caudal neuropore, upper limb budClosure of the caudal neuropore; upper limb buds; arches 3—4.
13Day 32Lower limb budLower limb buds; lens placode; otocyst.
14Day 33Lens pit, ureteric budLens pit; ureteric bud.
15Day 36Lens vesicle, hand platesLens vesicle closed; hand plates.
16Day 39Foot plates, retinal pigmentFoot plates; retinal pigment visible.
17Day 41Finger raysFinger rays; nasolacrimal groove.
18Day 44Toe rays, eyelid primordiumToe rays; eyelid primordium; onset of ossification.
19Day 46Trunk elongationElongation of the trunk.
20Day 49Elbow flexionUpper limbs bent at the elbow.
21Day 51Free fingersHands and feet reach the midline; fingers free.
22Day 53Eyelids, external earEyelids and external ear well developed.
23Day 56End of embryonic periodEnd of the embryonic period; all organ primordia laid down; transition to the fetal phase (week 9).

Pluripotency hierarchy along the stages

The ISSCR Standards for Human Stem Cell Use in Research (2023) codify the cells’ scope of differentiation along the stages:

  • CS 1—2 (day 1—3) — totipotency: zygote and early blastomeres can form both embryonic and extra-embryonic tissue.
  • CS 3 (day 4—5) — naive pluripotency: inner cell mass (ICM) of the free blastocyst.
  • CS 5 (day 7—12) — primed pluripotency: post-implantation epiblast.
  • From CS 10 onward — gradual specification into multi- and unipotent lineages (e.g., hematopoietic stem cells, spermatogonia).

The pluripotency hierarchy is a statement about cells, not about the personhood of the organism to which they belong.

Fields of application

  • Bioethics of reproductive medicine (preimplantation genetic diagnosis, embryo transfer, synthetic embryo models) — most ART interventions take place between CS 1 and CS 5.
  • Research ethics — the ISSCR’s 14-day rule effectively sets the boundary at CS 6 (primitive streak).
  • Law and regulation — many jurisdictions date legal or clinical thresholds to Carnegie Stages (implantation, primitive streak).
  • Personal ontology — the stages supply the morphological vocabulary by which the argument of personal ontology is empirically anchored.

Sources: Generated by querying the Personhood ontology.

Further sources:

  • O’Rahilly, R. & Müller, F. (2010): Developmental Stages in Human Embryos: Revised and New Measurements. Cells Tissues Organs 192(2): 73—84. (Standard reference of the Carnegie convention.)
  • Streeter, G. L. (1942—1951): Developmental Horizons in Human Embryos. Carnegie Institution of Washington, Contributions to Embryology, vols. 30—34. (Classical first version.)
  • Sadler, T. W. (2023): Langman’s Medical Embryology. 15th ed. Wolters Kluwer.
  • Carlson, B. M. (2018): Human Embryology and Developmental Biology. 6th ed. Elsevier.
  • ISSCR (2023): Standards for Human Stem Cell Use in Research. International Society for Stem Cell Research.
  • Endowment for Human Development: Developmental Stages in Human Embryos (Carnegie Collection) — https://www.ehd.org/developmental-stages/stage0.php.
  • Mark Hill (UNSW): Embryology — Carnegie Stage Comparisonhttps://embryology.med.unsw.edu.au/embryology/index.php/Carnegie_Stage_Comparison.

See also