The test and examination of infertility


This method is used when fertilization in the body is considered to be difficult. Tubal factor infertility (when fallopian tube passage or pick-up problems are suspected), Fertilization problems (egg problems, sperm problems), male infertility, When natural intercourse or artificial insemination fails to result in pregnancy. Other indications include unexplained infertility, advanced age, endometriosis, severe ovulation disorders, and polycystic ovaries (PCO).


Ovulation Induction

From the 3rd day of menstruation to around the 10th day of menstruation


How can I grow a follicle?


There are different types of ovulation induction methods, such as "complete natural cycle", “Minimal stimulation", “Medium stimulation", and “High stimulation", which are used according to the ovarian reserve capacity. There is also a wide range of variations on the same method by changing the chemicals used, the unit dose, and the timing of administration. Basically, the doctor will make a decision based on the past hormone test results, but if the patient has a preference for ovulation induction, please consult with the doctor.


LH surge induction

From the 9th day of menstruation to the 13th day of menstruation


What is the LH surge induction?


The LH surge is necessary for the egg to mature and have the ability to fertilize during egg retrieval.
In our clinic, we use injections and nasal drops, and do this two days before egg retrieval.



From the 11th day of menstruation to around the 14th day of menstruation


Can I use anesthesia during egg retrieval?


You can choose "no anesthesia" or "intravenous anesthesia" if you wish. The cost of anesthesia is included in the egg retrieval fee.
(Anesthesia fee of ¥20,000 (tax not included) will be charged only in the case of a completely natural cycle.)



The day of Egg Retrieval


How is the egg fertilized by the sperm? How can I decide?


There are 4 methods of fertilization. Each has advantages and disadvantages, as well as different costs. The final decision on the method of fertilization will be made in consultation with the patient and the doctor after checking the eggs on the day of egg retrieval and the sperm findings to be used on the day.

The method of
Explanation Advantages Disadvantages
  • ・Natural fertilization
  • ・Fertilization in a more natural state (less stressful)
  • ・Reduced fertilization rate in case of fertilization disorders.
  • ・Morphological sperm sorting is impossible.
  • ・Multiple sperm fertilization occurs (about 5%)
  • ・Conventional IVF is chosen first, and only eggs that have not been fertilized naturally within a few hours are subjected to ICSI.
  • ・Eggs that could not be fertilized in Conventional IVF can be fertilized later.
  • ・Artificial multiple sperm fertilization may occur (about 2%)
  • ・Performed after Conventional IVF, which may slow down timeline and slightly delay development
  • ・Performed when fertilization failure is predicted in advance, or when TESE sperm and sperm findings are poor.
  • ・Fertilization is possible even with poor sperm findings.
  • ・Morphological sperm sorting is possible.
  • ・The stress of needle insertion on the egg.
Split ICSI
  • ・The retrieved eggs are divided into two groups (1) Conventional IVF and (2) ICSI, and fertilization is performed on the same day.
  • ・ICSI can be used to ensure fertilization and Conventional IVF can be tried.
  • ・If you don't have a large number of eggs retrieved, you may not be able to try both.



1 to 6 days after Egg retrieval


Is it possible to know the culture status of the embryos (fertilized eggs) after egg retrieval?


There are 4 ways to check the culture status of an embryo (fertilized egg).It might be duplicated.

(1) Receive an explanation from the doctor. … Please make an appointment for examination.

(2) Receive explanation from staff. … Please make an appointment for look back IVF consultation.

(3) Patients who wish may receive email updates on their culture status. Emails are sent three times: the day after egg retrieval, three days after egg retrieval, and six days after egg retrieval.

(4) Observing the embryonic development process on video using a time-lapse embryo monitoring system.

It can also be cultured using a culture medium containing GM-CSF, which is effective in cases where premature miscarriages are repeated two or more times.


Embryo transfer

2 to 5 days after Egg retrieval


How does the embryo transfer process work?


We will proceed with the following 7 choices.
If you have a preferred method, please consult your doctor in advance.

Option 1 Fresh embryo transfer? Or cryopreservation and freeze-thaw embryo transfer after the next cycle?
Option 2 Is the transferred embryo a 4 cell stage? 8 cell stage? Or blastocyst?
Option 3 How many embryos transfer? One? Two? Two stage transfer?
Option 4 Is the frozen thawed embryo transfer method a natural ovulation cycle transfer?
Minimum stimulating transfer?
Hormone regulated transfer?
Option 5 Is the SEET method implemented?
Option 6 Hyaluronic Acid Embryo Transfer Solution.
Option 7 Laser Assisted Hatching.


What is the difference between fresh embryo transfer and frozen-thawed embryo transfer in Option 1?


[Fresh embryo transfer] This is a method in which embryo transfer is performed during the egg retrieval cycle. It is not recommended due to the lower pregnancy rate compared to frozen and thawed embryo transfer, the risk of ovarian swelling, luteal dysfunction due to egg retrieval, and the risk of developing ovarian hyperstimulation syndrome (OHSS).[Frozen thawed embryo transfer]The fertilized egg (embryo) obtained from the egg retrieval is cultured and cryopreserved. This is a method in which the embryos are thawed on the scheduled day of embryo transfer and the thawed embryos are transferred. Because it can regulate the uterine environment, the pregnancy rate is high and the miscarriage rate is low.


What is laser assisted hatching in Option 7?


LAH(Laser Assiated Hatching) is a method of assisting the embryo(fertilized egg) to escape the shell called the zona pellucida.LAH is one out of several methods to help the embryo to hatch and attach to the uterus.

This is a method for assisting in the hatching of embryos. The reason why hatching needs to be assisted is that there have been reports that when embryos are cryopreserved, the part of the egg shell called the zona pellucida becomes hardened. It is also said that as women age, their clear zones become harder. When this happens, the embryo itself may not be able to break the zona pellucida with its own strength, and may not be able to implant because it cannot hatch. To prevent this from happening, laser assisted hatching is a method of using human hands to help with the hatching.


Pregnancy test

2 weeks after Egg retrieval


How do I know I’m pregnant?


A blood sample is taken about 11 to 12 days after the embryo transfer, and the results are determined by the hCG hormone level in the blood. If you would like to have the test done earlier, please ask our staff as it can be done from 7 days after the transplant.span[If positive]After you have been in our clinic until you are about 8 weeks pregnant, we will write you a letter of introduction to the delivery facility of your choice and you can move on to that facility. Please let our staff know if you would like to transfer to another hospital or clinic as soon as possible.[If negative]You can take your time to consult with us about this IVF and your future treatment. You can also visit the "Implantation Failure Outpatient" for consultations and tests related to implantation.

DirectorKaoru Miyazaki

Graduated from Keio University School of Medicine in 2004. In 2013 he completed the Graduate School of Medicine, Keio University. He was a physician as well as an assistant professor of obstetrics and gynecology at Tokyo Dental College Ichikawa General Hospital, and an assistant professor of obstetrics and gynecology at Keio University. He was a research assistant professor of obstetrics and gynecology at Northwestern University in Chicago from 2017-2018. In 2018, he started as a part-time doctor at Hara Medical Clinic, and since 2020 he has been director of the clinic. He is a board certified specialist and instructor with the Japan Society of Obstetrics and Gynecology, a reproductive medicine specialist, a regenerative medicine certified doctor, a board certified member of The Japan Society for Menopause and Women’s Health, and an endocrinologist with the Japan Endocrine Society.


We use cookies to enable the Haramedical Clinic service and to improve your experience with us. To learn more, check out our privacy policy. By clicking OK or continuing to use our site, you agree that we can place these cookies.