by: Bunpei Ishizuka, M.D., St. Marianna University School of Medicine, Kawasaki, Japan
The first IVF baby was born in Japan in 1983. The number of infants born as a result of assisted reproductive technology (ART) has increased every year ever since. In 2007, the total number of infants born as a result of ART was reported to be 19,595, close to 2% of all births.
Japan is unusual in having a large number of registered ART facilities, 606 in total. Among these, only five facilities perform more than 700 cycles of both IVF-ET and ICSI per year. Only a few facilities, all of which are private clinics, perform more than 3,000 cycles of ART per year.
In Japan, the practice of ART is not governed by legislation. It is voluntarily regulated by physicians, mainly according to the bulletins of the Japan Society of Obstetrics and Gynecology and the Society of Reproductive Medicine. This regulation has had some degree of success. For example, the multiple pregnancy rate fell to 10.7% in 2007 after the Society of Obstetrics and Gynecology recommended single ET for women under the age of 35 undergoing their first ET. It was also recommended to transfer a maximum of three embryos, even for women who have undergone two or more ETs or for those over age 40.
On the other hand, since 1998, there have been cases in which members of the societies have performed IVF using oocytes donated by siblings or third parties, against regulations. Further, there have been some cases in which sisters have acted as gestational surrogates. Many couples go abroad to receive donated oocytes. In 2008, one couple traveled to India to obtain a gestational surrogate, but divorced before the infant was born. According to Japanese law, the child did not qualify for Japanese nationality, and so has no nationality.
Thus, assisted reproduction has been prevalent and has contributed to Japanese society. However, legislation has not caught up with the advances and prevalence of this technology.
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