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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Reproduction
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1404601
This article is part of the Research Topic Advances in the Treatment of Sexual Precocity and Infertility View all 27 articles

Survey of In Vitro Fertilization Add-Ons in Japan (Izanami Project)

Provisionally accepted
Nagisa Shionoya Nagisa Shionoya 1Mitsutoshi Yamada Mitsutoshi Yamada 1*Sayaka Harada Sayaka Harada 1Hiromitsu Shirasawa Hiromitsu Shirasawa 2Seung C. Jwa Seung C. Jwa 3Keiji Kuroda Keiji Kuroda 4Miyuki Harada Miyuki Harada 5Yutaka Osuga Yutaka Osuga 5
  • 1 School of Medicine, Keio University, Tokyo, Japan
  • 2 Akita University, Akita, Akita, Japan
  • 3 Saitama Medical University Hospital, Saitama Medical University, Saitama, Saitama, Japan
  • 4 Sugiyama Clinic Marunouchi, Tokyo, Japan
  • 5 The University of Tokyo, Bunkyo, Tōkyō, Japan

The final, formatted version of the article will be published soon.

    Objective: To identify any correlations between evidence levels, adoption rates, and additional costs of in vitro fertilization (IVF) add-ons. Design: Online survey Subjects: The survey was conducted in 621 assisted reproductive technology-registered facilities that are members of the Japanese Society of Obstetrics and Gynecology from December 22, 2021, to February 13, 2022. Exposure: The survey included details regarding the specific add-on modalities employed and their associated costs; inquiries pertained to the fertility healthcare infrastructure in Japan before the implementation of the National Health Insurance scheme. Main Outcome Measures: The correlation between the adoption rate and cost of IVF add-ons and their evidence levels were analyzed. The evidence level of the add-on treatments was classified into Green, Amber, and Red categories based on the United Kingdom’s Human Fertilisation and Embryology Authority and Cochrane systematic reviews. Results: A total of 438 eligible responses were analyzed, with clinics constituting 70.9% of the respondents’ facilities. A total of 18 add-ons were assessed, and 96.5% (423/438) of facilities used at least one add-on. A positive correlation of the adoption rate and an inverse correlation of the cost with the evidence level of the IVF add-on treatment were observed (not significant). Outpatient clinics, defined as medical facilities with no beds, had a significantly higher adoption rate (Amber, 65.7%; Red, 52.0%) of add-ons than other facilities, regardless of the evidence rating, although the costs were similar across all site attributes. Conclusion: Accumulating evidence on the efficacy and safety of add-ons will lead to the development of medical care with a high-cost benefit, as an increase in the adoption rate and a decrease in cost are expected when limiting to medical care with a high level of evidence.

    Keywords: Adoption, cost, in vitro fertilization, Add-ons, Japan

    Received: 21 Mar 2024; Accepted: 23 Sep 2024.

    Copyright: © 2024 Shionoya, Yamada, Harada, Shirasawa, Jwa, Kuroda, Harada and Osuga. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Mitsutoshi Yamada, School of Medicine, Keio University, Tokyo, 108-8345, Japan

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