[Present state and future in reproductive medicine].

It has been almost 21 years since the first birth of IVF baby and rapid advances in assisted reproductive technology (ART) have taken place. Today, several new technology have been developed such as microfertilization and cryopreservation of embryos and ART has become an important and popular tools for treatment of infertility patients with several causes. However, the take home baby rates have still been low around 15%. To improve the results in ART programs, the improvement of embryo viability and the solution of problems of implantation have been required. Recently, sequential culture media for production of high quality blastocysts have been developed and results have been as good as with co-culture. These culture media are now commercially available. Several authors reported that higher clinical pregnancy rate was achieved and high-order multiple pregnancy can be eliminated with blastocyst transfer. It has been expected that blastocyst transfer would become the means to solve the major problem that ART has faced such as the low take home baby rates and high-order multiple pregnancy.