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

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. In Japan, the first IVF-ET birth was reported in 1983 by Prof. Masakuni Suzuki at Tohoku University School of Medicine. 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.

Figure 1.

In vitro fertilization and embryo transfer process. A: Induction of ovulation: After menstruation, ovulation is induced to produce multiple oocytes. B: Testing: 1. Follicular diameter is measured using ultrasound. 2. Blood estradiol (E₂) levels are measured. 3. Oocyte maturity is assessed with urinary Luteinizing Hormone (LH) measurements. C: Oocyte retrieval: Ultrasound-guided transvaginal follicle puncture is used to collect oocytes. D: Semen collection: Semen is collected from the husband. E: Sperm preparation: Semen is separated into multiple layers on a thickener effluent, and separated using a centrifuge. (400 × g, 30 min). F: Insemination: The semen and oocytes are placed together in a dish with culture media. G: Confirmation of fertilization: Fertilization is confirmed on the first day after oocyte retrieval. H: Embryo transfer: On the third or fifth day after oocyte retrieval, fertilized eggs are transferred to the uterus through a catheter.

Figure 2.

Number of registered ART institutions.

Figure 3.

Number of couples treated by ART methods annually.

Figure 4.

Number of children born via each ART method annually.