Yukihiro Shibui

Regulating assisted reproductive technologies in Japan.

Japan’s first in vitro fertilization preembryo transfer (IVF-ET) baby was born in 1983 some 5 years behind Louise Brown, the world’s first IVF-ET child (1). Subsequent technological advances have been remarkable, and assisted reproductive technology (ART) has now become firmly established in the treatment of infertility. In 1999, 69,019 cycles of IVF-ET had been performed in Japan, with 11,929 babies born as a result; this equates to 1 in 100 live births. The number of facilities performing IVF-ET has increased annually, reaching 423 in 1999 (2). There are few large-scale IVF facilities in Japan handling in excess of 200 cases a year; instead the country is characterized by its numerous small clinics. To date, however, no legal regulations covering ART have been promulgated in Japan. Since the Japan Society of Obstetrics and Gynecology (JSOG) issued its “Announcements on IVF-ET” in 1983, new statements and revisions have been made in line with the emergence of new technologies. Nevertheless, it is necessary to point out that the development of practical legal regulations has moved slowly in this country. For example, although artificial insemination by donor (AID) was first performed in 1949, for some reason, this date is cited as 1996 in JSOG statements (3). Some couples now travel to countries where IVF is unregulated in order to reap the benefits of ART, including preimplantation genetic diagnosis (PGD),

Epigenetics in assisted reproductive technology

It has been reported that the rates of epigenetic disorders such as Angelman syndrome (AS) and Beckwith-Wiedemann syndrome (BWS) are high in offspring conceived by assisted reproductive technology (ART). Angelman Syndrome is characterized by intellectual disability and BWS is known as large offspring syndrome (LOS). Weight abnormalities have also been reported in cloned animals. Possible factors underlying these findings include inherent gamete characteristics, influence of in vitro culture and peculiarity of ART methods. It is important to conclusively determine whether such epigenetic abnormalities are present in children conceived by ART, so as to consider the health of next generations.

Effect of oocyte transportation time on the clinical results of transport in vitro fertilization/intracytoplasmic sperm injection-embryo transfer

Background and AimsIn transport assisted reproductive technology (ART), the time taken to transport oocytes to the main center differs greatly among the satellite facilities and may influence the clinical results.MethodsFor the conventional in vitro fertilization (IVF) groups in which oocytes were collected at the satellite facilities and transported to the main ART center for insemination and embryo transfer, there were 29 cycles in 27 patients with a transportation time within 60 min (short time transport IVF (ST-IVF)), 78 cycles in 62 patients with a time between 60 and 120 min (long time transport IVF (LT-IVF)), and there were 141 cycles in 110 patients at the main ART center (center IVF (C-IVF)). For the intracytoplasmic sperm injection (ICSI) group, there were 65 ST-ICSI cycles in 42 patients, 146 LT-ICSI cycles in 97 patients, and 326 cycles in 238 patients at the main ART center (C-ICSI).ResultsThe morphologically favorable embryo rate was lower in the ST-ICSI group (33.8%, P < 0.05) than in the C-ICSI group (38.1%), and the morphologically poor embryo rate in the LT-IVF group (38.6%, P < 0.0001) was higher than in the C-IVF group (26.7%). The rate of embryo transfers resulting in pregnancies was 16.7% in the ST-ICSI group (P < 0.01) and 17.3% in the LT-ICSI group (P < 0.001), both less than that of 35.2% for the C-ICSI group.ConclusionsTo improve both the morphologically favorable embryo rate and the pregnancy rate in transport ART, it is essential to improve the total quality control at the satellite facilities.