左 勝則

ABSTRACT Purpose To summarize assisted reproductive technology (ART) data for 2023 collected through the Japan Society of Obstetrics and Gynecology registry. Methods and Results 625 out of 638 registered ART facilities took part in the study, documenting 561 664 treatment cycles and 85 048 newborns (+3.3% and +10.2% increases from 2022). The average age of women undergoing treatment was 37.3 years (standard deviation: 4.8); 205 986 cycles (36.7%) involved women aged ≥ 40 years. Among fresh cycles, oocyte retrieval was performed in 281 665 cycles, including 168 343 freeze‐all cycles (59.8%). A total of 2329 pregnancies and 3375 newborns resulted from in vitro fertilization and intracytoplasmic sperm injection cycles, yielding 1772 and 2502 newborns, respectively. The overall rates for single embryo transfer (SET) and singleton delivery were 80.5% and 96.5%. Frozen–thawed embryo transfer accounted for 271 361 cycles, resulting in 109 850 pregnancies and 80 774 newborns, with a SET rate of 84.7% and a singleton delivery rate of 96.3%. Conclusions In 2023, the second year of insurance coverage, the registry recorded the highest numbers of treatment cycles and newborns. Effective registry systems planned for 2026 will enable comprehensive evaluation of emerging trends in Japanese ART practice.

ABSTRACT Aim To describe how decreased fetal movement (DFM) was managed in patients with fetomaternal hemorrhage (FMH) and to evaluate the diagnostic limitations of this condition in real‐world settings. Methods This retrospective cohort study included individuals who developed FMH with cerebral palsy from the Japanese nationwide cerebral palsy registry between 2009 and 2022. We investigated whether patients experienced DFM or were prenatally diagnosed with FMH. Furthermore, we assessed how DFM was managed. Results This study included 57 patients who developed FMH with cerebral palsy, and none were prenatally diagnosed with FMH. DFM was present in 43/57 (75.4%) patients. A sinusoidal pattern was observed in 29/57 (50.9%) patients, and elevated middle cerebral artery peak systolic velocity (MCA‐PSV) was detected in 6/10 (60.0%) patients who underwent this test. Of the 43 patients with DFM, 42 (97.7%) sought medical care for this symptom; however, only 12 (27.9%) underwent examinations on the same day as the onset of DFM, and 9 (20.9%) were admitted on that same day. Furthermore, 6/43 (14.0%) were instructed to stay home after telephone consultation or medical examination for this symptom. In five of the 43 patients (11.6%) who experienced DFM, the initial non‐stress test was reactive. However, all these patients eventually developed either a non‐reactive or non‐reassuring fetal status. Conclusions DFM was prevalent among pregnancies complicated by FMH; however, it was often inadequately managed, resulting in diagnostic delays. Furthermore, fetal heart rate monitoring and MCA‐PSV evaluations had diagnostic limitations. To facilitate early treatment, clinicians need to promptly assess preceding DFM while recognizing the limitations of existing tests.

Abstract Since 2005, the Reproductive Endocrinology Committee of the Japan Society of Obstetrics and Gynecology has conducted research and provided recommendations for reproductive medicine and endocrinology. This report summarizes the activities of eight subcommittees over 2 years, from 2023 to 2024. These subcommittees addressed various topics, including the review of medical and social indications for oocyte cryopreservation, the current status and challenges of embryo cryopreservation and disposal, the investigation of ovulatory disorders through the HyPO‐P classification and a nationwide survey of young women with suspected polycystic ovary syndrome, the revision of polycystic ovary syndrome diagnostic criteria and the development of updated treatment guidelines, the survey of adoption rates of in vitro fertilization add‐on treatments following insurance coverage, the national survey on the diagnosis and management of diffuse uterine leiomyomatosis and hereditary leiomyomatosis and renal cell carcinoma, the establishment of a clinical registry system for adenomyomectomy cases, the management of subclinical hypothyroidism in patients with infertility, and the promotion of effective utilization of assisted reproductive technology registry data in Japan. Each subcommittee provides valuable insights into the current status of reproductive medicine in Japan, identifies key challenges, and proposes recommendations to support clinical practice and guideline development. This report will serve as a foundation for advancing reproductive medicine and ensuring high‐quality patient care in Japan.