Nutrient consumption can identify highest quality IVF embryos for transfer

By Michelle Beaulieu Cooke

NEW YORK (Reuters Health) – A simple, noninvasive measurement of nutrient consumption may help identify embryos resulting from in vitro fertilization that have the greatest developmental potential, and therefore the greatest chance of implantation success.

"We are rapidly moving closer to single blastocyst transfers by being able to identify the healthiest embryo in the cohort for transfer," study director, Dr. David K. Gardner told Reuters Health. "The benefits of transferring a single embryo are enormous, as there is always some potential problem to the mother and/or baby with multiple gestations, especially with triplets or higher."

Dr. Gardner and colleagues, at the Colorado Center for Reproductive Medicine in Englewood, studied the association between carbohydrate uptake and ammonium production by individual donated embryos and their developmental potential. They examined 60 cryopreserved pronucleate embryos, thawed and cultured to the blastocyst stage, and 13 blastocysts from noncryopreserved embryos.

Embryos that developed to the blastocyst stage had significantly higher pyruvate and glucose uptake on day 4 than those that failed to develop to this stage, the investigators report in the December issue of Fertility and Sterility. Moreover, of the embryos that went on to form blastocysts, those of the highest grade had significantly higher glucose consumption on days 5 and 6 than blastocysts of lesser quality.

"Of perhaps greatest significance," the authors say, "is the finding that among the 13 blastocysts that had the same score for their inner cell mass and trophectoderm development and were from the same patient, there was a wide spread of nutrient consumption."

In other words, the findings suggest that nutrient consumption, particularly of glucose, could be a useful means of identifying individual blastocysts from a single patient that have the greatest transfer potential.

Dr. Gardner told Reuters Health that he and his associates are currently conducting a randomized clinical trial to prospectively measure the association between nutrient consumption and implantation outcome.

"The ability to select a single embryo for transfer, together with better methods of cryopreservation, means that patients have a high chance of conceiving with a singleton while being able to have further attempts with their cryopreserved embryos later," he concluded.

Fertil Steril 2001;76:1175-1180.

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