The Story of Assisted Reproductive Technology

The Story of Assisted Reproductive Technology

For many, having a child is part of the life that they want. Though there are some that are fortunate enough to be able to have a family and children, not everyone gets this opportunity. Some individuals and couples have a difficult time conceiving children even if they want to. 

This is a struggle that Doctor Osamu Kato was familiar with, especially as someone whose expertise was in reproductive medicine. In November 1990, he began his work with his first IVF clinic, Towako Maternity Clinic of Komatsu. He moved to Tokyo in October 1993 and opened the Kato Ladies Clinic. 

It was here that Dr. Kato started to make innovative contributions to the rapidly growing field of reproductive medicine. He spearheaded new approaches in the treatment of clomiphene citrate ovarian stimulation and natural cycle IVF.  His protocols evolved into a more natural and physiologic approach in follicular stimulation. 

Alongside this, his IVF laboratory developed advances in culturing, cryopreservation and transfer procedures. The marriage of a natural approach and advanced technology has made Kato Ladies Clinic a leader in Assisted Reproductive Technology in Japan. 

Kato Repro Biotech Center’s tried and tested approach has now been made available in the Philippines. After 20 years, Dr. Kato established IVF clinics for natural cycle and minimal stimulation IVF, seven of which were established in Japan and four abroad; in Shanghai, New York, Irvine California, and Manila. 

In Vitro Fertilization

IVF was Dr. Kato’s focus, and it is important to know its types and processes. In Vitro Fertilization (IVF) is a set of complex procedures that help improve one’s fertility and assist in the conception of a child. The process of IVF happens like this: mature eggs are collected from a woman’s ovaries. These are then fertilized by a sperm in a lab. The now fertilized eggs are then transferred to the uterus. One full cycle of IVF takes three weeks. This, however, is on average. The process can take longer depending on the steps taken. Though these steps may sound simple, IVF is a delicate process that must be done with extreme care.  

There are two types of IVF treatments that Kato offers. The first is the Natural Cycle IVF. This procedure entails no medication or injections to the patient. Instead, close monitoring of follicular development and hormonal levels through an ultrasound is done to time the administration of a trigger to start the final oocyte maturation and ovulation. This is a simple treatment, yet a very delicate one as well. It also has the least interference with the oocyte’s natural development.

The second type is the Minimal Stimulation IVF. This is when follicular development is stimulated and spontaneous ovulation is suppressed using clomiphene citrate. A follicle-stimulating hormone (FSH) is also used at a low dose to facilitate the growth of dominant follicles.  Once there’s sufficient follicular growth, a trigger is administered to induce final oocyte maturation. 

For older women, another treatment method was developed in Kato’s clinic. The treatments starts clomiphene citrate on the third day of menstruation, then followed by the addition of a very low dose of human menopausal gonadotropin (HMG) to stimulate follicular development.

Carefully selected types of drugs are used at low doses to make sure that IVF is body-friendly, while maximizing the natural principles of oocyte development.

IVF Treatment is the most effective form of Assisted Reproductive Technology (ART), but this does not mean that it is the only one. Below are other ART procedures that Kato Repro Biotech Center offers:

Kaufmann Therapy

Occasionally, there are women who have a hard time with their oocyte collection because of the excessive use of ovulation inducing agents from previous treatments that have affected their menstrual cycle. The disturbed cycles are repaired and restored to normal ones by our unique technique employing the Kaufmann therapy. With this method, we attempt to collect a good oocyte for IVF over the span of 50 days. 

Egg Collection

Kato began efforts for developing a unique needle for egg collection in 1999. At present, an egg collection needle gauge 21 or 22, about half the global standard thickness (gauge 17), is used at their clinic. The blade at the needle tip has been processed with a special technique to minimize tissue damage.

 At present, over 20,000 eggs are collected annually at the Kato Clinic. As a result of the modifications and improvements they have made, the clinic has had no record of accidents involving bleeding during egg collection.

This very fine needle causes minimal pain and bleeding, thus not requiring general anesthesia, which is usually used for egg collection in other fertility clinics. With this needle, egg collection can usually be completed in several minutes, without causing physical stress; this allows the patient to return home after about 15 minutes.

Sperm collection 

Sperm collection is done for men whose semen does not contain sperm. A needle is used to aspirate semen from the epididymis. If no sperm is acquired from the epididymis, testicular sperm extraction (TESE) is performed. In Vitro Fertilization with intracytoplasmic sperm injection (IVF-ICSI) under a microscope is possible as long as at least one sperm is available.

Intracytoplasmic sperm injection (ICSI)

This method is used when the fertilization rate is low due to problems involving the sperm, such as sperm count or shape. For this procedure, a sperm is directly injected into the egg to aid the process of fertilization. Today, techniques have been developed to ensure that the injection is gentle.

Blastocyst culture

Once an egg is fertilized, it becomes a blastocyst. The blastocyst then enters the uterus about five days after fertilization, and is implanted in the innermost lining of the uterus a day or two after. This will then result into a pregnancy. Blastocyst transfer is a technique by which the embryo grown to this level in vitro is transferred into the uterus. This is commonly done to prevent multiple pregnancy.

At Kato, it is also done for women with bilateral oviduct obstruction, hydrosalpinx, and a history of extrauterine pregnancy. Blastocyst transfer is also considered in cases where a woman doesn’t get pregnant after numerous attempts of transferring the fertilized egg after 2 or 3 days. 

Assisted hatching 

Assisted hatching is the removal of the clear zone around the blastocyst at the time of its transfer to the uterus. This improves the success rate of implantation, especially in cases where there are oviduct-associated abnormalities, embryonic growth is slow, and where the embryo transfer is done under hormonal adjustment. 

Embryo transfer and cryopreservation

The fertilized egg cultured in vitro is eventually returned into the uterus. Usually, a small tube called a “catheter” is used to transfer the fertilized egg under the guidance of an ultrasound. If the innermost lining of the uterus cannot readily accept the fertilized egg, the egg is cryopreserved and transferred at a later and more appropriate point of time. A fine, soft, size 2 catheter made of silicone is used to transfer the embryo into the uterus. 

Single Embryo transfer

Kato has been attempting to reduce multiple pregnancies for many years now. At present, only one embryo is returned into the uterus at a time in 100% of their cases. The importance of single embryo transfer is highlighted in this clinic because of the physical risks that come with a multiple pregnancy, such as elevating the incidence of premature labor or causing maternal complications, and because the simultaneous transfer of multiple embryos does not increase a woman’s pregnancy rate.

All of these services are offered at the Kato Repro Biotech Center. Their evidence based protocols and techniques, as well as their roster of doctors and special advisers equipped with the proper knowledge and skills when it comes to Assisted Reproductive Technology, makes it the ideal clinic for these procedures. 

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