Earticle

초록

영어

All of ART treatments in Japan are under control of Japan Society of Obstetrics and Gynecology (JSOG). JSOG covers all fields of obstetrics and gynecology in Japan. ART can be performed only in JSOG-certified centers to which at least one ART specialist (M.D.) must belong. ART specialist is certified by Japan Society of Reproductive Medicine (JSRM) which cover the field of reproductive medicine together with JSOG. Each ART center must submit the reports of all of ART treatment cycles every year and the accumulated data is open to public. From the latest data, number of ART treatment cycles in Japan is the largest in the countries registration system is functioned. (Actually, the largest and the second largest countries are China and India, respectively.) However, delivery rate per treatment cycles in Japan is the worst because percentage of cycles with aged women over 40 years old is increasing in recent years. In addition, neither egg donation nor preimplantation genetic screening (PGS) of embryos is permitted from ethical point of view. All of clinical research must be registered to JSOG and get permission in advance. At the end of the research, the report must be submitted. The major characteristics of Japan ART are minimum stimulation and “all freeze”, though these are not working range of embryologist. Needless to describe, minimum stimulation is performed in order to avoid ovarian hyper stimulation syndrome (OHSS). “All freeze” is the strategy to get higher implantation rate by complete synchronization of endometrium cycle and embryo development. In relation to ART laboratory works, very expensive machines (Time-lapse cinematography- equipped dry incubators, automatic vitrification machine, etc.) are developed in recent years. TLC-equipped dry incubator is gradually introduced in many ART centers. Accordingly, single step blastocyst culture medium is also going to be popular in order to reduce laboratory work. As the result of author’s investigation, osmolality of blastocyst medium is significantly increased during 5 days culture in dry incubator when compared with humidified condition (p<0.05) in spite that culture medium is covered by mineral oil. No significant difference in blastulation rate though slightly decreased in dry condition. Rescue ICSI (rICSI), double insemination (rescue conventional insemination: rcIVF), rescue artificial oocyte activation (rAOA) are widely performed in many centers in order to improve fertilization rate. The major unsolved problems in the field of ART are thin endometrial layer cases, aged women and azoospermia. In vitro proliferation of endometrial-derived stem cells, being performed by Prof. S. Kato’s group in Kyushu University, and in vitro germ cells production from iPS cells by two groups, M. Saito in Kyoto University and K. Hayashi in Kyushu University, may be able to solve these problems in the future.

저자

• Osamu Okitsu [ Center for Reproductive Medicine, Miyake Clinic ]

참고문헌

발행기관

간행물

표지보기 관심저널 등록

• 간행물명

  발생공학 국제심포지엄 및 학술대회 [International Symposium on Developmental Biotechnology]

• 간기

  연간

• 수록기간

  2004~2018

• 십진분류

  KDC 527 DDC 636