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日本辅助生殖技术实况调查。

Fact-finding survey on assisted reproductive technology in Japan.

机构信息

Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.

Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan.

出版信息

J Obstet Gynaecol Res. 2023 Nov;49(11):2593-2601. doi: 10.1111/jog.15780. Epub 2023 Aug 28.

Abstract

AIMS

In anticipation of the future development of assisted reproductive technology (ART) and to smoothly introduce new technology, it is necessary to understand the current staffing status of the medical system and the current state of treatment, as well as the status of in vitro fertilization add-ons, where the need for insurance coverage is currently a matter of debate.

METHODS

ART facilities in Japan were surveyed (437 valid responses, response rate: 71%). Current staffing status of the medical system, implementation rates of ART, add-on treatments, and medical supplies were investigated.

RESULTS

Despite the abundance of embryologists, nurses, and obstetricians and gynecologists in facilities, the majority of facilities lacked counselors, anesthesiologists, and other essential medical professionals. Conventional ovarian stimulation was widely adopted (median 120 [interquartile range 60-300] cycles), followed by mild ovarian simulation (60 [30-200]). Additionally, freeze-thaw embryo transfer cycles (300 [120-750]) were performed more frequently than fresh embryo transfer cycles (30 [30-60]). Among the add-ons, assisted hatching (85.1%), chronic endometritis examination (77.2%) and treatment (76.9%), artificial oocyte activation (67.3%), endometrial receptivity analysis (64.2%), and endometrial microbiome analysis (58.9%) were relatively widely employed.

CONCLUSIONS

The implementation of frozen-thawed embryo transfer cycles, freeze-all strategies, and add-on treatments have become popular and widely accepted despite the lack of robust evidence regarding their safety and efficacy.

摘要

目的

为了迎接辅助生殖技术(ART)的未来发展,并顺利引入新技术,有必要了解医疗系统的当前人员配置状况和治疗现状,以及体外受精附加治疗的情况,目前,保险覆盖范围的需求是一个有争议的问题。

方法

对日本的 ART 设施进行了调查(有效应答 437 份,应答率:71%)。调查了医疗系统的当前人员配置状况、ART 的实施率、附加治疗和医疗用品。

结果

尽管设施中胚胎学家、护士和妇产科医生人数众多,但大多数设施缺乏顾问、麻醉师和其他必要的医疗专业人员。常规卵巢刺激被广泛采用(中位数 120 [四分位距 60-300] 个周期),其次是轻度卵巢刺激(60 [30-200] 个周期)。此外,冻融胚胎移植周期(300 [120-750] 个周期)比新鲜胚胎移植周期(30 [30-60] 个周期)更为常见。在附加治疗中,辅助孵化(85.1%)、慢性子宫内膜炎检查(77.2%)和治疗(76.9%)、人工卵母细胞激活(67.3%)、子宫内膜容受性分析(64.2%)和子宫内膜微生物组分析(58.9%)相对广泛应用。

结论

尽管关于其安全性和有效性的证据尚不充分,但冷冻-解冻胚胎移植周期、全部冷冻策略和附加治疗的实施已变得流行并被广泛接受。

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