AimThis study aimed to assess the efficacy of the endometrial receptivity array (ERA) as a diagnostic tool and the impact of personalized embryo transfer (pET) for the treatment of patients with recurrent implantation failure (RIF) in Japan.MethodsFifty patients with a history of RIF with frozen‐thawed blastocyst transfers were recruited from July, 2015 to April, 2016. Endometrial sampling for the ERA and histological dating and a pET according to the ERA were performed. The receptive (R) or non‐receptive (NR) status of the endometrium as a result of the first ERA, endometrial dating, and pregnancy rates after the pET were analyzed.ResultsOf the patients with RIF, 12 (24%) were NR. Among them, eight (66.7%) were prereceptive. A clinical follow‐up was possible in 44 patients who underwent the pET. The pregnancy rates were 58.8% per patient and 35.3% per first pET in the R patients and 50.0% per patient and 50.0% per first pET in the NR patients. Discrepancies between the ERA results and histological dating were seen more in the NR patients than in the R patients.ConclusionsFor patients with unexplained RIF, there is a significance in searching for their personal window of implantation (WOI) using the ERA, considering the percentage of those who were NR and the pregnancy rates that resulted from the pET. By transferring euploid embryos in a personal WOI, much better pregnancy rates are expected.

This report describes six successful pregnancies (five healthy children from four deliveries and two miscarriages) with SrC1(2) oocyte activation using spermatozoa from nine patients with repeated fertilization failure. Oocytes were artificially activated by SrC1(2) 30 min after intracytoplasmic sperm injection (ICSI). Oocytes were placed in 10 mmol/l of SrC1(2) medium for 1 h, rinsed several times, and then cultured in Universal IVF medium. Developmental characteristics of five resulting children until 1 year old were assessed according to the maternal and children health hand book issued by Mothers' and Children's Health Organization in Japan. Mean fertilization rate, mean frequency of good cleaved embryos, pregnancy rate, and implantation rate after artificial activation in nine couples were increased from 21.7 to 64.5% (P < 0.001), from 0 to 15.4%, from 0 to 40.0% and from 0 to 25.0% respectively. Five healthy children were born following ICSI and artificial activation between February 2005 and March 2006. Physical and mental development of the children from birth to 12 months was normal. These suggest the utility and safety of SrCl(2) for patients with repeated failed fertilizations following ICSI and artificial activation.

Purpose To examine the impact on development of derived embryos from smooth endoplasmic reticulum clusters (SERC) in human metaphase II (MII) oocytes. Methods Retrospective analysis at Kyono ART Clinic. Comparison of embryological development, pregnancy, live birth and fetal malformation between oocytes with SERC (the SERC(+) group) and those without (the SERC(−) group) in 2,158 patients (3,758 cycles) after ICSI. Results Fertilization and implantation rate were significantly lower in SERC(+) MII oocytes than in SERC(−) MII oocytes. After the transfer of fresh and vitrified embryos derived from SERC(+) oocytes, 14 pregnancies resulted in 14 healthy babies, including 2 from fresh embryo transfer (ET) and 12 from vitrified-warmed ET, with no malformations. Conclusion(s) The presence of SERC in MII oocytes was associated with significantly lower fertilization rates and implantation rates than seen in SERC(−) MII oocytes within SERC (+) cycles. However, SERC had no impact on postimplantation development as well as neonatal outcome.Capsule To evaluate the impact of smooth endoplasmic reticulum clusters (SERCs) in human metaphase II (MII) oocytes on embryo development, clinical pregnancy rate and miscarriage rate.

Purpose: The aim of this study was to investigate the feasibility of using frozen-thawed testicular sperm as well as the timing of testicular sperm extraction (TESE) in patients with non-mosaic Klinefelter syndrome.Methods: Intracytoplasmic sperm injection (ICSI) was performed in six of 17 (35%) patients whose sperm was recovered by TESE. Multiple biopsies of both testes were performed on the day of oocyte retrieval in all but one of the six patients.Results: Seven pregnancies and deliveries were achieved in five couples, and one couple was unsuccessful. Five pregnancies were achieved using fresh motile sperm, and two were achieved using frozen-thawed sperm. Sperm cryopreservation was not possible in one of the five couples because of the small number of recovered sperm, and possible in four other couples for subsequent ICSI. One woman whose husband had TESE performed prior to ovarian stimulation did not become pregnant. This may be due to the attainment Conclusion: The outcome of ICSI using fresh or frozenthawed testicular sperm in patients with non-mosaic Klinefelter syndrome was identical; however, TESE should be performed on the day of oocyte retrieval until such time as a procedure with a higher sperm yield from TESE is available. Moreover, an improved recovery procedure after cryopreservation-thawing of a single spermatozoon must be developed.

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