The Effect of a Newly Designed Needle on the Pain and Bleeding of Patients During Oocyte Retrieval of a Single Follicle.

Background: The purpose of this study was to evaluate the effect of needle type on pain and bleeding during oocyte pick-up (OPU).

Methods: From May through November 2013, patients undergoing OPU from a single follicle without any analgesic treatment were including this study. Eligible patients (n=75) were randomized 1:1 to undergo the procedure with either a reduced needle (17 gauge body, 20 gauge tip; RN group) or a standard needle (19 gauge; SN group).

Perinatal outcomes of patients who achieved pregnancy with a morphologically poor embryo via assisted reproductive technology.

Purpose: To learn more about the perinatal outcomes of conception via the use of low-grade embryos, we evaluated the relationship between the status of transferred embryos and the resultant perinatal outcomes.

Methods: A total of 340 patients who achieved pregnancy via ART treatment and consequently delivered in our clinic between April 2009 and March 2014 were recruited for this study. Patients were divided into two groups according to a morphological assessment of the transferred embryos, which relegated 79 patients into a poor-embryo group with the remainders (n = 261) placed into a good-embryo group.

Clomiphene citrate affects the receptivity of the uterine endometrium.

Purpose: To investigate whether clomiphene citrate (CC) affects uterine receptivity or not, we evaluated pregnancy rates (PR) during the hormone replacement cycle (HRC) according to the period between the last day of CC administration and the day of embryo transfer (ET).

Methods: From March 2008 through March 2010, a total of 378 treatment cycles among 378 patients who received CC and had to avoid fresh ET due to a thin uterine endometrium were recruited. All patients underwent thawed ET using HRC.

Advanced scheduling for zygote intrafallopian transfer is possible via the use of a hormone replacement cycle for patients who have experienced repeated implantation failures.

Purpose: Zygote intrafallopian transfer (ZIFT) is an effective option for patients who have experienced repeated implantation failures (RIF) in assisted reproductive technology (ART) treatment. However, advance planning for the day of the operation can be problematic. Using a hormone replacement cycle (HRC) makes it possible to plan for the day of ZIFT.

Prostaglandin therapy during the proliferative phase improves pregnancy rates following frozen embryo transfer in a hormone replacement cycle.

Aim: To determine the efficacy of prostaglandin administration during the proliferative phase in order to improve pregnancy rates following frozen embryo transfer during a hormone replacement cycle (HRC).

Methods: From September 2010 through March 2012, patients (n = 135) were recruited who had undergone oocyte retrieval during a stimulation cycle with clomiphene and had deferred fresh embryo transfer (ET) due to a thin uterine endometrium. All patients were less than 40 years of age and underwent thawed ET following all embryo cryopreservation, and were randomly divided into two groups for thawed ET using a conventional hormone replacement cycle with or without prostaglandin derivatives (prostaglandin or conventional group).

Using a mild stimulation protocol combined with clomiphene citrate and recombinant follicle-stimulating hormone to determine the optimal number of oocytes needed to achieve pregnancy and reduce the concerns of patients.

Purpose: The purpose of this study was to investigate how many oocytes are needed to achieve an adequate pregnancy rate per 1 oocyte retrieval cycle in mild ovarian stimulation.

Methods: This protocol consisted of clomiphene citrate and recombinant-follicle-stimulating hormone injection without a gonadotropin-releasing hormone-antagonist. From January 2009 through December 2010, there were 1,227 women who underwent assisted reproductive technologies treatment with mild stimulation at the Sugiyama Clinic.

Role of salpingoscopy in assessing the inner fallopian tubes of infertility patients with ovarian endometriomas.

Aim: The aim of this study was to observe the insides of the fallopian tubes of patients with unilateral or bilateral endometriomas by using salpingoscopy and evaluate the inner cavity of the fallopian tubes according to our original scoring system.

Material And Methods: From April 2008 through December 2010, patients with unilateral or bilateral endometriomas were recruited (n = 157, endometrioma group). All patients underwent laparoscopic ovarian cystectomy and salpingoscopy.

Hyaluronan-enriched transfer medium improves outcome in patients with multiple embryo transfer failures.

Purpose: To ascertain whether the use of hyaluronan-enriched transfer medium (HETM) improves pregnancy and implantation rates among embryo transfer patients with a history of multiple implantation failures.

Methods: Patients (n = 314) under the age of 40 and with a history of multiple unsuccessful embryo transfers were enrolled. There were three groups of patients: those undergoing fresh embryo transfer (fresh ET [n = 111]), those undergoing vitrified-warmed ET in the natural cycle (WET-N [n = 101]) and those undergoing WET in a hormone replacement cycle (WET-H [n = 102]).

A programmed schedule of oocyte retrieval using mild ovarian stimulation (clomiphene citrate and recombinant follicle-stimulating hormone).

Purpose: The purpose was to establish a mild ovarian stimulation protocol that would help assisted reproductive technology (ART) units to avoid scheduling on weekends.

Methods: This protocol directed patients to take 50 mg/day of clomiphene citrate between days 3 and 7 of the menstrual cycle: 225 IU of recombinant follicle-stimulating hormone (rec-FSH) were administered on days 3, 5 and 7; human chorionic gonadotropin (hCG) was administered on day 9; and, oocyte pick-up (OPU) was planned for day 11. From October 2008 through October 2009, 514 women underwent ART treatment with mild stimulation at the Sugiyama Clinic, and we evaluated whether OPU was accomplished on the planned day.

Elective single cleavage-stage embryo transfer need not result in lower pregnancy rates compared to double cleavage-stage embryo transfer.

Aim: To confirm whether women who choose to have one fresh embryo transferred and one frozen-and-thawed embryo when needed can dramatically reduce the possibility of a multifetal pregnancy while giving themselves a better chance of achieving pregnancy.

Methods: We enrolled 685 patients who were undergoing assisted reproductive technology (ART) treatment at our clinic between January 2005 and December 2008. None of the patients had a history of ART treatment, and they received either a double-embryo transfer (DET) or single-embryo transfer (SET) during this period.

A new evaluation score that uses salpingoscopy to reflect fallopian tube function in infertile women.

Objective: To build an evaluation scoring system using the results of salpingoscopy, and to evaluate the relationship between this scoring system and the outcome of pregnancy.

Design: Retrospective study.

Setting: Sugiyama Clinic.

A study of the effect of an extremely low oxygen concentration on the development of human embryos in assisted reproductive technology.

Purpose: To determine whether embryos cultured with a low oxygen level (2%) brought about beneficial effects on the outcome of ART.

Methods: This is a sequential case-control embryo-culture study. Embryos were cultured either with a gas mixture containing 2% O, 5% CO, and 93% N (low-oxygen group) or 5% O, 5% CO, and 90% N (conventional group).

Clinical outcomes resulting from the transfer of vitrified human embryos using a new device for cryopreservation (plastic blade).

Purpose: We attempted clinical application of a plastic blade, which is a novel cryopreservation device, for vitrification of human embryos and blastocysts.

Methods: Between February 2003 and December 2007, a total of 4,430 Day 3 embryos from 898 patients (Day 3 group) and 55 blastocysts from 29 patients (blastocyst group) were vitrified and cryopreserved with a plastic device, and subsequently thawed for embryo transfer. Clinical outcomes after thawing and transfer of vitrified embryos and blastocysts were evaluated.

Effect of sera on the adhesion of natural killer cells to the endothelium in severe pre-eclampsia.

Objective: To investigate the effect of serum on the interaction between natural killer (NK) cells and endothelial cells in pre-eclampsia.

Methods: Seven severely pre-eclamptic patients, five normal pregnant women, and four normal non-pregnant women were included in this study. Freshly isolated NK cells labeled with Chromium-51 were incubated on an endothelial cell monolayer in the presence of patient serum.

Gasless laparoscopic surgery using a new intra-abdominal fan retractor system: an experience of 500 cases.

Aim: The aim of this study is to report the feasibility of a newly developed intra-abdominal fan retractor system for use in gynecologic laparoscopic surgery.

Methods: Five hundred women undergoing gasless laparoscopic surgery using the abdominal wall lifting device were included in the study. The intraoperative and postoperative courses, and complications were examined.

Change of the mitochondrial distribution in mouse ooplasm during in vitro maturation.

Mitochondria (mt) have been reported to be closely related to the maturation of mammalian oocytes, but their function in oocyte maturation has not been elucidated. In this study, we examined the kinetics of mt and chromatin configuration during in vitro maturation of mouse oocytes to clarify the relationship between oocyte maturation and mitochondrial distribution morphologically. Oocytes were recovered from 6-to 8-wk-old ICR strain female mice.