Akiyo Taneichi

Uterine compression suture against impending recurrence of uterine inversion immediately after laparotomy repositioning

Uterine compression suture to prevent impending recurrence of uterine inversion after laparotomy repositioning has not been reported previously. A 28‐year‐old primigravid woman demonstrated uterine inversion. Although Huntingtons procedure had successfully repositioned the uterus, acute recurrence of inversion with uterine atony appeared to be impending during the surgery. We applied modified uterine compression sutures, which prevented the recurrence of inversion and achieved complete hemostasis. Three years later, the patient became pregnant and vaginally delivered a term infant. Thereafter, uterine inversion recurred, and was repositioned manually. Uterine compression suture may be of use not only for hemostasis for postpartum hemorrhage, but also for prophylaxis against acute recurrence of uterine inversion.

Sperm Immobilizing Antibodies in the Sera of Infertile Women Cause Low Fertilization Rates and Poor Embryo Quality In Vitro

PROBLEM: The effects of sperm immobilizing antibodies in the sera of infertile women on fertilization and embryo quality in vitro were investigated.

Diversity of Antisperm Antibodies Bound to Sperm Surface in Male Immunological Infertility

PROBLEM: The presence of antisperm antibodies (ASA) in males can reduce fecundity, however, relationship between the two is disputed. This study was performed to investigate if there is diversity of ASA bound to sperm surface using immunobead test (IBT) combined with complement dependent sperm immobilization test (SIT).

Association of uterine wall thickness with pregnancy outcome following uterine‐sparing surgery for diffuse uterine adenomyosis

The risk of uterine rupture is a major concern for women who become pregnant after undergoing an adenomyomectomy.

Establishment and application of criteria for the elective transfer of two good-quality embryos to reduce high-order multiple pregnancies

AimThis study was carried out to establish criteria for the elective transfer of two good-quality embryos to reduce high-order multiple pregnancy rates. The pregnancy and multiple pregnancy rates per transfer were retrospectively analyzed in 128in vitro fertilization and embryo transfer (IVF-ET) cycles.ResultsThe analysis revealed that the pregnancy and multiple pregnancy rates were 26.6% (34 of 128) and 23.5% (eight of 34), respectively. Five twin and three triplet pregnancies were included. The pregnancy rates in women 29 years old and younger, 30–34 years, 35–39 years, and 40 years and older were 21.2 (seven of 33), 37.0 (17 of 46), 25.8 (eight of 31), and 11.1% (two of 18), respectively. There was a significant difference of the pregnancy rates between 30 and 34-year-old and 40-year-old and older women (P < 0.05). The multiple-pregnancy rate in women 40 years and older was 0%. Three triplet pregnancies were established only in the first attempt of IVF-ET. The pregnancy rates in women, to whom good-quality embryos (0–4) were transferred, were 0% (none of 12) for 0, 17.2% (five of 29) for one, 41.2% (seven of 17) for two, 30.8% (12 of 39) for three, and 32.3% (10 of 31) for four and more embryos, respectively. The multiple pregnancy rates in women who had good-quality embryos of one, two, three, and four and more transferred were 0% (none of five), 23.5% (four of seven), 16.7% (two of 12), and 20.0% (two of 10), respectively.ConclusionThe criteria for the elective transfer of two good-quality embryos were established as follows: age < 40 years, a first treatment cycle, and more than three good-quality embryos available for transfer. After the application of the established criteria, the overall pregnancy and multiple pregnancy rates were 30.4% (14 of 46) and 14.3% (two of 14), respectively, which was satisfactory as compared with those in the 128 IVF-ET cycles before application of the criteria. An elective transfer of two good-quality embryos can be highly recommended to avoid high-order multiple pregnancies in subjects with the established criteria.

Chemokine Bioactivity of RANTES is Elevated in the Sera of Infertile Women with Past Chlamydia trachomatis Infection

PROBLEM:  It has been shown that Chlamydia trachomatis infection in infertile women is highly associated with tubal pathology. Chlamydia trachomatis antibody testing is a simple screening test for tubal factor subfertility, however, it is based on the detection of previous infection. Recently, association between some inflammatory diseases and chemokines has been investigated. This study was performed to clarify the relationship between chemokines in the sera of infertile women and past C. trachomatis infection.

Effects of sera from infertile women with sperm immobilizing antibodies on fertilization and embryo development in vitro in mice

PROBLEM: This study was performed to investigate if patients’ sera with anti‐human sperm antibodies show inhibitory effects on in vitro fertilization (IVF) and embryo development in mice.

Radiation Therapy for Chemotherapy-Resistant Recurrent Epithelial Ovarian Cancer

Objectives: While radiation therapy is administered as a palliative treatment for recurrent ovarian cancer, it remains unclear whether it improves the prognosis. Methods: The effects and adverse events of radiation therapy for patients with recurrent epithelial ovarian cancer were investigated using medical records. Results: Herein, 46 subjects comprising 33 patients whose recurrent lesions were contained within the irradiation field (therapeutic radiation group; TRG) and 13 patients with some recurrent lesions outside the irradiation field (palliative radiation group; PRG) were included. The TRG achieved a response rate (RR) of 66%, a disease control rate (DCR) of 100%, a progression-free survival (PFS) of 10 months, and an overall survival (OS) of 20 months. The PFS after radiation therapy was significantly longer than that following chemotherapy received just before radiation therapy. The PFS of patients with recurrent intrapelvic lesions was longer than that of patients with some extrapelvic recurrence. There was no significant association between PFS after radiation therapy and the duration from the previous chemotherapy or histological type. The RR, DCR, PFS, and OS of the PRG were 30 and 90% and 2 and 6 months, respectively. Serious adverse events were rare. Conclusions: Radiation therapy is a potential option for chemotherapy-resistant, localized recurrent ovarian cancer.

Frequency and characteristics of endometrial carcinoma and atypical hyperplasia detected on routine infertility investigations in young women: a report of six cases

Infertility patients are known to be at increased risk of endometrial carcinoma (EC) and atypical hyperplasia (AH). However, the incidence and clinical features of EC and AH in these patients remain to be clarified. In this study, we examined the rate at which a routine infertility workup revealed EC/AH and investigated the clinicopathological features of EC/AH detected in this way. Among patients diagnosed with EC or AH at the Jichi Medical University Hospital between the 10-year period from 1997 to 2006, six patients were referred from Tochigi Central Clinic, a specialized infertility facility. We report the clinicopathological features of these patients and calculate the incidence of EC/AH in patients who underwent infertility investigations at Tochigi Central Clinic. All six patients were younger than 40 and had early stage disease (final diagnosis: EC stage IA: 3, EC stage IB: 1, AH: 2). A total of 19 826 patients underwent routine infertility investigations at Tochigi Central Clinic during the same period. The incidence of EC/AH detected from these investigations was 0.03% (6/19 826) and that of EC was 0.02% (4/19 826): 5-10 times higher than the overall incidence in Japanese women of the same age. Routine infertility investigations may provide an opportunity to examine the corpus uteri of young women in whom examination is otherwise limited, contributing to the early detection of EC/AH.

Dynamic changes of the immunoglobulins in patients with severe ovarian hyperstimulation syndrome: efficacy of a novel treatment using peritoneo-venous shunt.

PROBLEM: To evaluate the efficacy of continuous auto‐transfusion system of ascites (CATSA) for the treatment of patients with severe ovarian hyperstimulation syndrome (OHSS) at the risk of febrile morbidity, the dynamic changes of immunoglobulins in the sera and the peritoneal fluid from patients with severe OHSS treated by CATSA were estimated.