And-receptor pairs known to play autocrine/paracrine functions in animal embryos. We also demonstrated that culturing these abnormally fertilized embryos in serum-free Fexinidazole culture media supplemented with growth BI 78D3 cost factors substantially promoted their development by more than 2-fold. The improvement of sequential culture systems for human IVF during the last decades has allowed extended culture of human early embryos to the blastocyst stage. Blastocyst transfer facilitates the selection of the best embryos with high implantation potential and therefore reduces the number of transferred embryos to avoid multiple pregnancies. However, the current human embryo culture system is still suboptimal and many embryos cannot develop to the blastocyst stage. Our results using normally fertilized day 3 embryos suggest that key autocrine/paracrine growth factors are beneficial to human embryonic development in vitro. These growth factors 1326631 not only increase the rate of blastocyst formation, but also the quality of blastocysts. Indeed, culturing good-quality day 3 embryos in culture medium supplemented with these growth factors resulted in a 3.3-fold increase in the blastocyst formation rate and a 7.6-fold increase in the proportion of high quality blastocysts as compared to controls. These findings are consistent with the hypothesis that autocrine/ paracrine factors secreted by early embryos are diluted during culture and growth factor supplementation is necessary to promote optimal blastocyst formation. Selective single blastocyst transfer in patients with good prognosis has been shown to be effective in reducing multiple pregnancies without compromising the pregnancy rate [25]. Because most of the commercially available, chemically-defined media for human embryo cultures in IVF-ET do not contain growth factors, the present supplementation of widely used culture media with autocrine/paracrine growth factors has practical value in future IVF-ET procedures. Different from previously published reports showing small stimulatory effects of individual growth factors on human embryo development, our combined treatment with several autocrine/ paracrine factors showed a robust stimulation of normally fertilized day 3 embryos likely due to additive effects of differentTable 1. Development of SCNT embryos cultured in media with or without growth factor supplementation.Without growth factors Vitrified oocytes Oocytes surviving the thawing Oocytes used for enucleation No. of successful enucleation No. of successful fibroblast injection No. of activated oocytes No. of cleaved embryos Embryos with 4-cells on day 3 Embryos with .8-cells 34 31 29 21 14 6 5 1With growth factors 29 25 24 22 15 12 8 6* 1(16-cell)Failed-to-be-fertilized oocytes were vitrified and then thawed before evaluation for morphology and SCNT using serum-starved fibroblasts arrested at the G0/G1 stage. After 
SCNT, reconstituted oocytes were activated using using 5 mM calcium ionophone for 10 min,followed by incubation for 4 h with 2.5 mM 6-dimethylaminopurine, and cultured in media with or without growth factors. Numbers of oocytes/embryos at each experimental stage are shown. *P = 0.187. doi:10.1371/journal.pone.0049328.tHuman Embryo Culturegrowth factors in the promotion of early embryonic development. Inclusion of IGF-I [14] or GM-CSF [17] increased the proportion of embryos developing to the blastocyst stage by 1.51-fold and 2.53-fold, respectively. In our study, treatment embryos 
with the growth fac.And-receptor pairs known to play autocrine/paracrine functions in animal embryos. We also demonstrated that culturing these abnormally fertilized embryos in serum-free culture media supplemented with growth factors substantially promoted their development by more than 2-fold. The improvement of sequential culture systems for human IVF during the last decades has allowed extended culture of human early embryos to the blastocyst stage. Blastocyst transfer facilitates the selection of the best embryos with high implantation potential and therefore reduces the number of transferred embryos to avoid multiple pregnancies. However, the current human embryo culture system is still suboptimal and many embryos cannot develop to the blastocyst stage. Our results using normally fertilized day 3 embryos suggest that key autocrine/paracrine growth factors are beneficial to human embryonic development in vitro. These growth factors 1326631 not only increase the rate of blastocyst formation, but also the quality of blastocysts. Indeed, culturing good-quality day 3 embryos in culture medium supplemented with these growth factors resulted in a 3.3-fold increase in the blastocyst formation rate and a 7.6-fold increase in the proportion of high quality blastocysts as compared to controls. These findings are consistent with the hypothesis that autocrine/ paracrine factors secreted by early embryos are diluted during culture and growth factor supplementation is necessary to promote optimal blastocyst formation. Selective single blastocyst transfer in patients with good prognosis has been shown to be effective in reducing multiple pregnancies without compromising the pregnancy rate [25]. Because most of the commercially available, chemically-defined media for human embryo cultures in IVF-ET do not contain growth factors, the present supplementation of widely used culture media with autocrine/paracrine growth factors has practical value in future IVF-ET procedures. Different from previously published reports showing small stimulatory effects of individual growth factors on human embryo development, our combined treatment with several autocrine/ paracrine factors showed a robust stimulation of normally fertilized day 3 embryos likely due to additive effects of differentTable 1. Development of SCNT embryos cultured in media with or without growth factor supplementation.Without growth factors Vitrified oocytes Oocytes surviving the thawing Oocytes used for enucleation No. of successful enucleation No. of successful fibroblast injection No. of activated oocytes No. of cleaved embryos Embryos with 4-cells on day 3 Embryos with .8-cells 34 31 29 21 14 6 5 1With growth factors 29 25 24 22 15 12 8 6* 1(16-cell)Failed-to-be-fertilized oocytes were vitrified and then thawed before evaluation for morphology and SCNT using serum-starved fibroblasts arrested at the G0/G1 stage. After SCNT, reconstituted oocytes were activated using using 5 mM calcium ionophone for 10 min,followed by incubation for 4 h with 2.5 mM 6-dimethylaminopurine, and cultured in media with or without growth factors. Numbers of oocytes/embryos at each experimental stage are shown. *P = 0.187. doi:10.1371/journal.pone.0049328.tHuman Embryo Culturegrowth factors in the promotion of early embryonic development. Inclusion of IGF-I [14] or GM-CSF [17] increased the proportion of embryos developing to the blastocyst stage by 1.51-fold and 2.53-fold, respectively. In our study, treatment embryos with the growth fac.