Asada Ladies Clinic

Chūō-ku, Japan

Asada Ladies Clinic

Chūō-ku, Japan
SEARCH FILTERS
Time filter
Source Type

Baba T.,Sapporo Medical University | Endo T.,Sapporo Medical University | Ikeda K.,Sapporo Medical University | Shimizu A.,Sapporo Medical University | And 9 more authors.
Journal of Sexual Medicine | Year: 2011

Introduction. The prevalence of transsexualism is thought to differ among socio-geographic backgrounds, and little is known about its prevalence in Japan. Polycystic ovary syndrome (PCOS), which is known to be associated with insulin resistance and metabolic syndrome, is often seen in female-to-male (FTM) transsexual patients. Consequently, detection of PCOS is an important part of health care for these individuals. Aim. The purpose of this study was to assess the prevalence of transsexuality in Japan, as well as the incidences of PCOS and insulin resistance among Japanese FTM transsexual patients. Methods. One hundred four male-to-female (MTF) and 238 FTM Japanese transsexual patients were studied. Medical histories, including histories of menstrual cycling and hormone treatment, were taken. To exclude other diseases, such as congenital adrenal hyperplasia and hormone-secreting tumors, thorough medical assessments, including transvaginal or transrectal ultrasonography and measurement of serum hormone levels and insulin resistance indexes, were performed. Main Outcome Measures. The diagnosis of PCOS was based on the Rotterdam 2003 criteria. Results. Based on demographic statistics, the prevalences of MTF and FTM transsexuality are about 3.97 and 8.20 per 100,000 people, respectively, making the MTF-to-FTM ratio about 1:2. Of the FTM transsexual patients studied, 128 had not taken hormones before their initial assessment (untreated group); the remaining 50 self-administered androgen. Among the untreated group, 32.0% were diagnosed with PCOS, 30.1% were insulin-resistant, and 31.1% showed hypoadiponectinemia. Conclusions. The sex ratio among Japanese transsexuals is different than among Caucasians. PCOS and insulin resistance are common findings in FTM transsexual patients at initial presentation. © 2011 International Society for Sexual Medicine.


Shimizu C.,National Cancer Center Hospital | Kato T.,National Cancer Center Hospital | Tamura N.,Toranomon Hospital | Bando H.,University of Tsukuba | And 4 more authors.
International Journal of Clinical Oncology | Year: 2014

Background Treatment-related infertility is one of the important quality-of-life issues in young breast cancer (YBC) patients. Although existing guidelines recommend supporting fertility preservation (FP) of YBC, the perceptions of reproductive specialists (RS) has not been evaluated. We investigated the perceptions and needs of RS with regard to FP of YBC patients. Methods A cross-sectional survey was sent to 423 certified RS registered to the Japan Society for Reproductive Medicine to self-evaluate their perceptions and needs regarding FP in YBC patients. Results Two hundred RS (47 %) responded to the survey. 99 % responded that RS should be engaged in FP of YBC patients. 88 % responded that they would like to treat YBC patients, while 46 % responded that cancer treatment is more important than childbirth, even when the patient is recurrence-free 5 years after primary treatment. Respondents affiliated to private clinics were more likely to accept both fertilized and unfertilized egg preservation than those affiliated with academic or general hospitals. 70 % responded that they were anxious about treating breast cancer patients: concerns regarding a greater or unknown risk of recurrence (66 %), insufficient knowledge about breast cancer (47 %), and lack of a patient's spouse/partner (24 %) were identified as major barriers in supporting FP for YBC patients. Conclusions RS recognize the need for FP in YBC patients and are willing to participate in their care. Affiliation of RS was related to a positive attitude to egg preservation. Various concerns regarding FP among RS indicate the need for evidence that supports the safety of FP, inter-disciplinary communication, and practice guidelines. © 2014 Japan Society of Clinical Oncology.


Honnma H.,Asada Ladies Clinic | Baba T.,Sapporo Medical University | Sasaki M.,Asada Ladies Clinic | Hashiba Y.,Asada Ladies Clinic | And 5 more authors.
Fertility and Sterility | Year: 2012

Objective: To determine which parameter of blastocyst morphology is the most important predictor of ongoing pregnancy or miscarriage. Design: Retrospective analysis. Setting: One in vitro fertilization (IVF) center. Patient(s): Women who underwent a total of 1,087 frozen-thawed single-blastocyst transfer cycles. Intervention(s): First IVF treatment with blastocysts after frozen-thawed cycle. Main Outcome Measure(s): Ongoing pregnancy and miscarriage rates as related to blastocyst morphology (blastocyst expansion, inner cell mass, and trophectoderm), and interaction tests in unadjusted logistic regression models to assess clinical factors affecting outcomes. Result(s): After adjustment for trophectoderm, inner cell mass, and age as confounders, trophectoderm was determined to be statistically significantly related to the rate of ongoing pregnancy. Trophectoderm was also statistically significantly related to the miscarriage rate. By contrast, neither inner cell mass nor blastocyst expansion was statistically significantly related. Conclusion(s): In frozen-thawed embryo transfer cycles, trophectoderm morphology is statistically significantly related to the rates of ongoing pregnancy and miscarriage after adjusting for confounders. Trophectoderm morphology may be the most important parameter when selecting a single blastocyst for transfer. Copyright © 2012 American Society for Reproductive Medicine, Published by Elsevier Inc.


Honnma H.,Asada Ladies Clinic | Baba T.,Sapporo Medical University | Sasaki M.,Asada Ladies Clinic | Hashiba Y.,Asada Ladies Clinic | And 4 more authors.
Journal of Assisted Reproduction and Genetics | Year: 2012

Background: Recently, serum anti-Müllerian hormone (AMH) has been used as a good marker of ovarian response during in vitro fertilization (IVF). However, in the clinical setting, we felt that ovarian response was clearly different by age with the same AMH level. Then in this study we evaluated the relationship between serum AMH, age and parameters related to ovarian response and compared these parameters in regard to age within serum AMH-matched group. Methods and results: The relationship of these parameters were evaluated retrospectively in patients undergoing their first IVF cycle under a GnRH agonist flare up protocol (n = 456) between October 2008 and October 2010 in our clinic. To understand the relations between variables described above, principal component analysis (PCA) was performed. PCA revealed patients' age was at the different dimension from serum AMH and other variables. Therefore at first we segregated all patients into Low, Normal and High responder groups by their serum AMH using cut-off value of receiver operator characteristics curve analysis. Secondary, we divided each responder group into four subgroups according to patients' age. The high aged subgroups required a significantly higher dose of gonadotropin and a longer duration of stimulation; however, they had significantly lower peak E2 and a smaller number of total oocytes as well as M2 oocytes compared to the low aged subgroups. Conclusions: The influence of aging on the ovarian response was clearly seen in all groups; the ovarian response tended to decrease as patients' age increased with the same AMH level. Therefore serum AMH in combination with age is a better indicator than AMH alone. © 2011 Springer Science+Business Media, LLC.


Honnma H.,Asada Ladies Clinic | Baba T.,Sapporo Medical University | Sasaki M.,Asada Ladies Clinic | Hashiba Y.,Asada Ladies Clinic | And 4 more authors.
Reproductive Sciences | Year: 2013

We used logistic regression analysis to investigate the relationship between serum anti-Mullerian hormone (AMH) levels and the rate of ongoing pregnancy. Retrospective data were collected from 1043 women who had undergone their first cycle of in vitro fertilization (IVF), including 540 cycles of fresh embryo transfer and 503 cycles of frozen-thawed embryo transfer. The patients were divided into 4 groups based on the cutoff values from a receiver-operating characteristic curve: 0.0 to 12.4, 12.5 to 25.5, 25.6 to 44.1, and >44.2 pmol/L. After adjustment for multiple confounders, the serum AMH group was found to be significantly related to the rate of ongoing pregnancy in total cycles (0.0-12.4 vs 12.5-25.5 pmol/L; P =.0088, odds ratio, 1.909: vs 25.6-44.1 pmol/L; P =.0281, odds ratio, 2.109: vs >44.2 pmol/L; P =.0008, odds ratio, 2.840). In conclusion, there appears to be a significant relationship between serum AMH levels and the ongoing pregnancy rate in first IVF treatment cycles after adjustment for multiple confounders. © 2013 The Author(s).


Honnma H.,Kamiya Ladies Clinic | Asada Y.,Asada Ladies Clinic | Baba T.,Sapporo Medical University | Endo T.,Sapporo Medical University
Gynecological Endocrinology | Year: 2014

At present, there are no proven therapies to improve ovarian function in women with premature ovarian insufficiency (POI) or in those with extremely low ovarian reserve (LOR). We report successful IVF outcomes achieved with continuous high-dose estrogen supplementation in patients with LOR. Patients were 33- and 42-year-old nulligravidae with high-serum FSH (over 30IU/L) and undetectable serum AMH (under 0.1ng/mL) levels; however, neither patient fulfilled the diagnostic criteria for POI. After cycle cancellation and unsuccessful IVF treatment, both patients received conjugated estrogen (CE) supplementation (2.5-3.75mg/day) from day 2 of their menstrual cycle to the day of HCG administration in their IVF treatment cycles. Following continuous high-dose estrogen supplementation, oocytes were successfully retrieved from both patients and fertilized. Both patients also achieved ongoing pregnancy through frozen-thawed embryo transfer cycles. In conclusion, high-dose estrogen supplementation down-regulated serum FSH and LH within their physiological ranges, which led to functional follicle growth and prevented early luteinization. Further studies will be needed to confirm the effect of this treatment on POI patients and to establish a new and individualized protocol for LOR patients. © 2014 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted.


Asada Y.,Asada Ladies Clinic
Journal of Mammalian Ova Research | Year: 2010

In recent years, assisted reproductive technology (ART) has undergone marked development and has come to play a central role in reproductive medicine. Although controlled ovarian stimulation (COS) has also improved, assessment of the ovarian reserve has become important for further improving stimulation. Existing methods of ovarian reserve assessment are inadequate, and antiMllerian hormone (AMH) has recently garnered attention as a marker for ovarian reserve. AMH is not influenced by the menstrual cycle, can be measured at any time by collecting blood, and correlates very strongly with the number of eggs collected during in vitro fertilization. Whereas basal FSH (a conventional marker) changes after actual decreases in ovarian reserve, AMH enables quantitative prediction of ovarian reserve and is important for determining strategies for fertility treatment. Many infertile patients have AMH levels close to zero and are potential cases of premature ovarian failure. As the number of elderly infertile patients is increasing rapidly and fertility treatment is shifting from the reproductive stage to the non-reproductive stage, markers that are unstable during menopause, such as basal FSH and E2, are becoming unreliable. AMH is expected to play an increasingly important role and may become a routine test in fertility treatment.


Asada Y.,Asada Ladies Clinic
Journal of assisted reproduction and genetics | Year: 2013

In the present study we investigated the cause of GnRHa's failure to trigger oocyte maturation and present an effective rescue protocol for use when failure occurs. Case reports. One in vitro fertilization (IVF) center. Eight cases of failure of GnRH agonist (GnRHa)-triggered oocyte maturation and one case of GnRHa successfully triggered oocyte maturation, despite a weak response in the LH-RH test. All cases were successfully rescued by re-triggering maturation using HCG, with seven of the eight patients achieving ongoing pregnancy and successful delivery. In three patients the cause of the oocyte maturation failure was likely temporal or continuous severe down-regulation of the hypothalamus-pituitary-axis, the cause was unknown in the other five patients. In cases where GnRHa fails to trigger oocyte maturation, a rescue protocol entailing re-triggering with HCG can produce successful outcomes.


PubMed | Asada Ladies Clinic
Type: Case Reports | Journal: Journal of assisted reproduction and genetics | Year: 2013

In the present study we investigated the cause of GnRHas failure to trigger oocyte maturation and present an effective rescue protocol for use when failure occurs.Case reports.One in vitro fertilization (IVF) center.Eight cases of failure of GnRH agonist (GnRHa)-triggered oocyte maturation and one case of GnRHa successfully triggered oocyte maturation, despite a weak response in the LH-RH test.All cases were successfully rescued by re-triggering maturation using HCG, with seven of the eight patients achieving ongoing pregnancy and successful delivery.In three patients the cause of the oocyte maturation failure was likely temporal or continuous severe down-regulation of the hypothalamus-pituitary-axis, the cause was unknown in the other five patients.In cases where GnRHa fails to trigger oocyte maturation, a rescue protocol entailing re-triggering with HCG can produce successful outcomes.


PubMed | Asada Ladies Clinic
Type: Journal Article | Journal: Journal of assisted reproduction and genetics | Year: 2012

Recently, serum anti-Mllerian hormone (AMH) has been used as a good marker of ovarian response during in vitro fertilization (IVF). However, in the clinical setting, we felt that ovarian response was clearly different by age with the same AMH level. Then in this study we evaluated the relationship between serum AMH, age and parameters related to ovarian response and compared these parameters in regard to age within serum AMH-matched group.The relationship of these parameters were evaluated retrospectively in patients undergoing their first IVF cycle under a GnRH agonist flare up protocol (n=456) between October 2008 and October 2010 in our clinic. To understand the relations between variables described above, principal component analysis (PCA) was performed. PCA revealed patients age was at the different dimension from serum AMH and other variables. Therefore at first we segregated all patients into Low, Normal and High responder groups by their serum AMH using cut-off value of receiver operator characteristics curve analysis. Secondary, we divided each responder group into four subgroups according to patients age. The high aged subgroups required a significantly higher dose of gonadotropin and a longer duration of stimulation; however, they had significantly lower peak E2 and a smaller number of total oocytes as well as M2 oocytes compared to the low aged subgroups.The influence of aging on the ovarian response was clearly seen in all groups; the ovarian response tended to decrease as patients age increased with the same AMH level. Therefore serum AMH in combination with age is a better indicator than AMH alone.

Loading Asada Ladies Clinic collaborators
Loading Asada Ladies Clinic collaborators