The Present Status of Management for Infertility in Miyagi Prefecture, Japan

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Abstract
To summarize the current management of infertility in Japan, a questionnaire survey was administered. A mail-survey method was used, and surveys were sent to 126 obstetrical and/or gynecological medical facilities in Miyagi Prefecture. The respondents included 86 facilities (68.3%). The majority of participants employed routine assessments, and their records included basal body temperature (98.8%), semen analysis (88.8%), and tubal patency tests (78.8%). Laparoscopic diagnosis, however, was uncommon (15.8%). With respect to treatment, surgical procedures, especially endoscopic procedures, were not generally carried out in addition to medicinal treatment. Sixty-one percent of the respondents performed intrauterine insemination, however assisted reproductive technology (ART) was provided by a few participants, for example, in vitro fertilization-embryo transfer was available at 11.3% of facilities. In self-assessment, the median pregnancy rates for the group undergoing laparoscopy and that not were significant different (30% and 20%, respectively), and those of the group undergoing ART provided and that not were significant different (35% and 20%, respectively). In conclusion, there are various differentials in the methods of diagnosis and treatment of infertility in the medical facilities today, and the outcomes are not always satisfactory. For appropriate management of infertile couples, it will be necessary to more closely manage cooperation between primary care doctors and reproductive specialists.