Noninvasive assessment of human embryo nutrient consumption as a measure of developmental potential.

OBJECTIVE: To determine the relationship between blastocyst development and morphology and embryo metabolism.
DESIGN: Noninvasive assessment of carbohydrate uptake and ammonium production by individual embryos.
SETTING: Private assisted reproductive technology unit. PATIENT(S): Patients donated, with consent, cryopreserved pronucleate embryos and noncryopreserved blastocysts. INTERVENTION(S): Culture of 60 thawed pronucleate embryos in sequential media to the blastocyst stage with concomitant noninvasive analysis of embryo metabolism and analysis of 13 blastocysts from noncryopreserved embryos. MAIN OUTCOME MEASURE(S): Pyruvate and glucose consumption as well as blastocyst formation and quality. RESULT(S): Pyruvate and glucose uptakes on day 4 were significantly higher by embryos that went on to form blastocysts than by embryos that failed to develop to the blastocyst stage. Glucose uptakes were greatest in those blastocysts of highest grade, whereas pyruvate uptakes were similar irrespective of blastocyst grade, indicating that glucose is the more important nutrient for the human blastocyst. Among blastocysts of the same grade from the same patient, there was considerable spread of glucose consumption, indicating that glucose consumption may be of use in identifying blastocysts for transfer. Ammonium production by individual embryos was also measured, reflecting amino acid transamination and use by the human embryo. CONCLUSION(S): The ability to identify in culture the embryo with the highest developmental potential will facilitate the move to single-embryo transfers.