目的:展望辅助生殖技术(ART)的未来发展,顺利引进新技术,有必要了解医疗系统的人员配备现状和治疗现状,以及体外受精附件的状况,目前,对保险的需求是一个争论的问题。
方法:对日本的ART设施进行了调查(437份有效回复,反应率:71%)。医疗系统目前的人员配备状况,ART的实施率,附加治疗,并对医疗用品进行了调查。
结果:尽管有丰富的胚胎学家,护士,以及设施中的产科医生和妇科医生,大多数设施缺乏辅导员,麻醉师,和其他基本的医疗专业人员。常规卵巢刺激被广泛采用(中位数120[四分位距60-300]个周期),其次是轻度卵巢模拟(60[30-200])。此外,冻融胚胎移植周期(300[120-750])比新鲜胚胎移植周期(30[30-60])更频繁。在附加组件中,辅助孵化(85.1%),慢性子宫内膜炎检查(77.2%)和治疗(76.9%),人工卵母细胞活化(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%)应用相对广泛。
结论:实施冻融胚胎移植周期,冻结所有策略,尽管缺乏关于其安全性和有效性的有力证据,但附加治疗已变得流行并被广泛接受.
OBJECTIVE: 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.