OBJECTIVE: The decision to use in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), or split insemination (IVF-ICSI) in the first cycle is based on the number of motile sperm. Hence, total fertilization failure (TFF) often occurs during IVF cycles, despite normozoospermia. To investigate whether the cumulative motile swim-up spermatozoa percentage at 22 hours post-insemination (MSPPI) is an indicator for ICSI, we analyzed TFF, fertilization, blastocyst development, chemical pregnancy, clinical pregnancy, and live birth rates. METHODS: This prospective study was performed using data obtained from 260 IVF cycles. At 22 hours after insemination, the remaining swim-up spermatozoa were observed and divided into six groups according to MSPPI (<10%, 10% to <30%, 30% to <50%, 50% to <70%, 70% to <90%, and 90% to 100%). RESULTS: Regardless of the ejaculated motile sperm concentration (0.6–280×106/mL motile spermatozoa), the incidence of TFF significantly increased when MSPPI was <10%, and the fertilization rate significantly decreased when MSPPI was <30%. We found that cumulative MSPPI correlated with the cumulative fertilization rate (Spearman correlation, 0.508, p<0.001). Regarding embryo development, we observed no significant differences in the rates of blastocyst development, chemical pregnancy, clinical pregnancy, or live birth among all groups. CONCLUSION: Our findings suggest that MSPPI is a viable indicator for split IVF-ICSI and ICSI. Taken together, by employing the MSPPI test in advance before IVF, ICSI, or split IVF-ICSI cycles, unnecessary split IVF-ICSI and ICSI may be avoided.
Blastocyst ; Embryonic Development ; Female ; Fertilization ; Fertilization in Vitro ; Incidence ; Insemination ; Live Birth ; Pregnancy ; Prospective Studies ; Sperm Injections, Intracytoplasmic* ; Spermatozoa*

Team-based learning (TBL) is an educational method developed to cultivate the ability to solve problems by learning and applying knowledge on one's own, as well as the ability to make decisions, take responsibility, and collaborate by working on issues in small groups. TBL in Kampo medicine was held as a special program : active learning at the 71st Annual Meeting of the Japan Society for Oriental Medicine. A total of 57 students participated in the TBL session. The theme of the session was the common cold with the theory of yin and yang. According to the results of a questionnaire survey, the students answered that they were able to understand the flow of diagnosis in Kampo medicine, which was the goal of the course. As a bridge from classroom lectures to clinical practice, TBL in Kampo medicine was considered to be useful in Kampo medical education.