A preimplantation embryo exists independent of blood supply, and relies on energy sources from its in vivo environment (e.g., oviduct and uterine fluid) to sustain its development. The embryos can survive in this aqueous environment because it contains amino acids, proteins, lactate, pyruvate, oxygen, glucose, antioxidants, ions, growth factors, hormones, and phospholipids-albeit the concentration of each component varies by species, stage of the estrous cycle, and anatomical location. The dynamic nature of this environment sustains early development from the one-cell zygote to blastocyst, and is reciprocally influenced by the embryo at each embryonic stage. Focusing on embryo metabolism allowed us to identify how the local environment was deliberately selected to meet the dynamic needs of the preimplantation embryo, and helped reveal approaches to improve the in vitro culture of human embryos for improved implantation rates and pregnancy outcome.
| INTRODUCTIONThe basic energy needs-for example, glucose, pyruvate, and lactateof mammalian early embryos were determined for their in vitro culture nearly half a century ago (Biggers & Stern, 1973;Biggers, Whittingham, & Donahue, 1967), with the impact of endogenous fuels, including lipids and amino acids, identified soon thereafter (Chatot, Tasca, & Ziomek, 1990;Hillman & Flynn, 1980;Lane & Gardner, 1998;Quinn & Whittingham, 1982). Considerable progress has been made since these first studies, specifically defining a relatively complete system that accounts for the embryo's changing metabolism, which allowed for better reproducibility of in vitro culture as well as non-invasive assessment of embryo quality (Gardner & Leese, 1986;Gardner & Wale, 2013;Prasad, Tiwari, Koch, & Chaube, 2015;Houghton et al., 2002;Leese, Conaghan, Martin, & Hardy, 1993;Smith & da Rocha, 2012;Thompson, Brown, & Sutton-McDowall, 2016;Vajta, Rienzi, Cobo, & Yovich, 2010). Unfortunately, much of the data on embryo metabolism has come from in vitro studies (AbsalonMedina, Butler, & Gilbert, 2014;Gardner and Harvey, 2015;Leese, 2012Leese, , 2015Menezo, Lichtblau, & Elder, 2013