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      In vitro fertilization in Japan — Early days of in vitro fertilization and embryo transfer and future prospects for assisted reproductive technology —

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          Abstract

          Assisted reproductive technology (ART) such as in vitro fertilization (IVF) and embryo transfer (ET) has been essential in the treatment of infertility. The world’s first IVF-ET baby was born in 1978 based on the technique developed by Dr. Robert Edwards and Dr. Patrick Steptoe. 1) In Japan, the first IVF-ET birth was reported in 1983 by Prof. Masakuni Suzuki at Tohoku University School of Medicine. 2, 3)

          IVF-ET is a procedure used to achieve pregnancy that consists of extracting oocytes from an infertile woman, fertilizing them in vitro, and transferring fertilized eggs into the patient’s uterine cavity (Fig. 1). Since the first report of successful IVF-ET, numerous techniques related to ART, such as cryopreservation of oocytes and embryos, gamete intrafallopian transfer (GIFT), and microinsemination, have been developed and refined (Table 1).

          Herein we describe the history of basic research in IVF-ET that led to human applications, how the birth of the first IVF-ET baby was achieved in Japan, the current status of ART in Japan, issues related to ART, and future prospects for ART.

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          Most cited references48

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          Fertilizing capacity of spermatozoa deposited into the fallopian tubes.

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            Observations on the penetration of the sperm in the mammalian egg.

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              A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization.

              The effectiveness of blastocyst culture and transfer in human in-vitro fertilization (IVF) was evaluated in a prospective randomized trial in patients having a moderate to good response to gonadotrophin stimulation. Embryos were transferred either on day 3 after culture to around the 8-cell stage in Ham's F-10 medium supplemented with fetal cord serum, or on day 5 after culture to the blastocyst stage in the sequential serum-free media G 1.2 and G 2.2. The pregnancy rates after transfer on day 3 or day 5 were equivalent, 66 and 71% respectively; however, significantly more embryos were transferred on day 3 (3.7) than on day 5 (2.2). The number of blastocysts transferred did not affect the implantation rate, and pregnancy rates when either two or three blastocysts were transferred were 68 and 87% respectively. The implantation rate of the blastocysts (50.5% fetal heart beat) was significantly higher compared to the cleavage stage embryos transferred on day 3 (30.1%). The percentage of blastocyst development was not affected by the number of 2-pronuclear embryos, or by maternal age. Irrespective of the number of blastocysts formed, pregnancy rates were similar. Furthermore, the pregnancy rate following blastocyst transfer in patients with 10 or more follicles at the time of human chorionic gonadotrophin administration was not affected by patient age. More than 60% of patients having blastocyst culture and transfer had supernumerary embryos for cryopreservation. The establishment of a pregnancy following thaw and transfer confirmed the viability of cryopreserved blastocysts cultured in the absence of serum or co-culture. The ability to transfer just two blastocysts while maintaining high pregnancy rates will therefore help to eliminate high order multiple gestations and improve the overall efficiency of human IVF.
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                Author and article information

                Journal
                Proc Jpn Acad Ser B Phys Biol Sci
                Proc. Jpn. Acad., Ser. B, Phys. Biol. Sci
                PJAB
                Proceedings of the Japan Academy. Series B, Physical and Biological Sciences
                The Japan Academy (Tokyo, Japan )
                0386-2208
                1349-2896
                9 May 2014
                : 90
                : 5
                : 184-201
                Affiliations
                [*1 ]Emeritus Professor of Tohoku University, Miyagi, Japan.
                Author notes
                []Correspondence should be addressed: M. Suzuki, Suzuki Memorial Hospital, 3-5-5 Satonomori, Iwanuma, Miyagi 989-2481, Japan (e-mail: masakuni@ 123456suzukihp.or.jp ).

                (Communicated by Nobutaka HIROKAWA, M.J.A.)

                Article
                pjab-90-184
                10.2183/pjab.90.184
                4104513
                24814992
                016ce128-b049-4410-b3c6-716a6c408891
                © 2014 The Japan Academy

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 January 2014
                : 12 February 2014
                Categories
                Review

                Life sciences
                ivf in japan,first successful ivf in japan,early days of ivf
                Life sciences
                ivf in japan, first successful ivf in japan, early days of ivf

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