研究者業績
基本情報
- 所属
- 藤田医科大学 医学部 医学科 産婦人科学 講師
- 学位
- 博士(医学)(2013年3月)
- J-GLOBAL ID
- 201501004478802341
- researchmap会員ID
- 7000012956
日本産科婦人科学会・専門医・指導医
日本周産期新生児医学会・周産期(母体・胎児)専門医・指導医
日本人類遺伝学会・臨床遺伝専門医
日本生殖医学会・生殖医療専門医・指導医
日本がん治療認定医機構がん治療認定医
日本産科婦人科内視鏡学会・技術認定医
日本内視鏡外科学会・技術認定医
母体保護法指定医
日本医師会認定産業医
研究分野
1論文
56-
Cureus 17(3) e81185 2025年3月BACKGROUND: When using assisted reproductive technology, there are cases where, despite the transfer of a good embryo, sometimes pregnancy may not be the case. Thus, during hormone replacement cycle implantation, it is important to synchronize the number of days of progesterone administration with the degree of embryo maturity. This study aimed to compare the outcomes of the administration of oral dydrogesterone for the duration of progestin use during the hormone replacement cycle for frozen-thawed blastocyst transfer. MATERIAL AND METHODS: The primary outcome of this study was the clinical pregnancy rate. We performed a retrospective cohort study of patients who underwent frozen-thawed blastocyst transfers between January 2017 and December 2024. According to our standard protocol, a vitrified-warmed blastocyst transfer was performed using dydrogesterone, which was administered orally at our center. A total of 554 cases were included in the study. Using the Gardner classification to evaluate the quality of blastocysts, grade AA was classified as the best quality, the AB/BA group as good quality, and the BB group as fair quality. We classified the 554 cases into 317 AA, 163 AB/BA, and 74 BB cases using the Gardner classification. Based on the duration of progestin administration, patients were divided into four groups: 120 hours (120 h), 132 hours (132 h), 144 hours (144 h), and 156 hours (156 h). We used the Shapiro-Wilk method and the Steel-Dwass test to determine whether there were differences in patients' background age and BMI among the four groups (120 h, 132 h, 144 h, and 156 h). We used Fisher's exact test and the Bonferroni method to determine whether there were differences in the final outcome of pregnancy rate between the four groups of 120 h, 132 h, 144 h, and 156 h. RESULTS: In the analysis of all embryos, the pregnancy rate at each timepoint of the primary evaluation was significantly higher in the 144-h group than in the 132-h group. Next, on analyzing the results by embryo grade, there was no difference in the pregnancy rate at each timepoint in the AA group. In the AB/BA group, the pregnancy rate was higher in the 144-h group than in the 132-h group. In the BB group, the pregnancy rate was higher in the 144-h group than in the 132-h group. CONCLUSION: This study clarified two aspects. First, the pregnancy rate in the 144-h group was significantly higher than that in the 132-h group in the analysis of all embryos. Second, the window of implantation may be more important for poor-quality embryos. This study showed that the oral administration of dydrogesterone requires a window of implantation of at least 144 hours.
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Asian journal of endoscopic surgery 17(2) e13298 2024年4月INTRODUCTION: The da Vinci SP surgical system is a surgical platform capable of implementing robotic-assisted surgery through a single port and was first introduced in Japan at our hospital. In this paper, we describe our experience of the initial introduction of the da Vinci SP surgical system and its surgical outcomes. This is the first report on the surgical outcomes of using da Vinci SP, and its comparison with the conventional system in Japan. METHODS: After developing an application for a highly difficult new medical technology in-house, we compared the surgical outcomes (median values) of 15 patients who had undergone total hysterectomy at our hospital using the da Vinci SP (1-port) system (SP group) for uterine myoma after March 2023 and of 154 patients who underwent total hysterectomy using the conventional da Vinci Xi (four ports) system (Xi group) for uteri weighing <500 g. RESULTS: The results of the comparison of the characteristics between 15 patients in the SP group and 154 patients in the Xi group were as follows: uterus weight (g): 230 (90-500) versus 222 (55-496) (p = .35); surgical time (minutes): 199 (171-251) versus 198 (88-387) (p = .63); intraoperative blood loss (mL): 13 (5-82) versus 20 (2-384) (p = .17); and rate of surgical complication (%): 0.0 versus 1.3 (p = .66). The data indicated a comparable weight of the resected uterus, surgical time, intraoperative blood loss, and rate of surgical complications between the two groups. CONCLUSION: Robotic-assisted total hysterectomy using the da Vinci SP surgical system allowed clinicians to safely perform surgeries according to the conventional systems.
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In vivo (Athens, Greece) 38(5) 2374-2382 2024年BACKGROUND/AIM: The frequency rate of injection site reactions (ISR) due to fosaprepitant meglumine (Fos APR) has been shown to vary depending on the types of combined anticancer drug. This study aimed to elucidate the impact of Fos APR on ISR in patients receiving paclitaxel and carboplatin, with and without bevacizumab therapy (TC±Bev). PATIENTS AND METHODS: This study focused on patients with gynecologic cancer (n=93) who received TC±Bev administration at Fujita Health University Hospital from March 2016 to February 2020, and monitored up to six cycles. The patients were randomly assigned to the Fos APR group (n=47) and the Aprepitant (APR) group (n=46). Using Visual Infusion Phlebitis (VIP) scores, ISR was evaluated by comparing the VIP scores of all cycles using a linear mixed model. The risk factors that contribute to the occurrence of vascular pain throughout all cycles were also examined. RESULTS: The VIP scores of all cycles showed a near significant intergroup difference (p=0.071). Factors that affected the development of vascular pain included Fos APR and age (p=0.027 and 0.049, respectively). Regarding age, patients aged <65 years had a higher risk. Four patients underwent a switch from the originally assigned neurokinin-1 receptor antagonist; in all of these cases, Fos APR was changed to APR for vascular pain. CONCLUSION: Fos APR may increase the risk for ISR associated with TC±Bev therapy for gynecological cancer.
MISC
27書籍等出版物
4講演・口頭発表等
198-
日本産科婦人科学会雑誌 2020年3月 (公社)日本産科婦人科学会
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東海産婦人科内視鏡手術研究会雑誌 2019年10月 東海産婦人科内視鏡手術研究会
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東海産婦人科内視鏡手術研究会雑誌 2019年10月 東海産婦人科内視鏡手術研究会
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日本産科婦人科内視鏡学会雑誌 2019年8月 (一社)日本産科婦人科内視鏡学会
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日本インターベンショナルラジオロジー学会雑誌 2019年5月 (一社)日本インターベンショナルラジオロジー学会
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日本受精着床学会雑誌 2019年3月 日本受精着床学会第一分割異常胚の違いがその後の胚発生に影響を及ぼすかについて比較検討した。採卵し胚盤胞培養を行った胚のうち、タイムラプスモニタリングシステムでの観察により、第一分割で3割球以上となり、第一分割終了時のフラグメントが10%以下であった1135個の胚を対象とした。また、第一分割において正常分割が確認された9428個の胚を対照群とした。3核群は524個(46.2%)、2核群は611個(53.8%)であった。3核群、2核群の良好胚盤胞発生率はそれぞれ5.2%、26.0%となり、2核群が有意に高率であった。対照群の良好胚盤胞発生率は44.7%となり、3核群、2核群はともに対照群と比較すると有意に低率であった。凍結融解単一胚盤胞移植妊娠率はそれぞれ40.0%、46.9%であり、有意差を認めなかった。また、生産率はそれぞれ65.8%、83.3%であり、両群間で有意差を認めなかった。対照群の凍結融解単一胚盤胞移植妊娠率は47.2%、生産率は68.3%であり、いずれも有意差を認めなかった。
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日本受精着床学会雑誌 2017年3月 日本受精着床学会ピエゾICSIにおいて卵細胞膜が早期に破膜したため再穿刺を行った場合の卵子生存率、胚発生、移植を行った場合の妊娠率について検討した。その結果、穿刺1回のみで正常破膜が得られた群、穿刺1回目に異常破膜を生じ再穿刺で正常破膜が得られた群、2回以上穿刺を行っても異常破膜しか得られなかった群とした場合の卵子変性率は、それぞれ1.8%、11.6%、29.2%で、各群間に有意差を認めた。穿刺1回群と2回以上の穿刺を行った群の良好胚盤胞発生率はそれぞれ33.6%、36.8%、胚盤胞移植妊娠率は46.7%、58.8%で、いずれも両群間で有意差を認めなかった。複数回穿刺は胚発生能および妊孕能に影響しないことから、異常破膜がみられた場合は卵子の別の部位から再穿刺を行うことが望ましいと考えられた。