PurposeSperm cryopreservation is the gold standard for maintaining fertility in male survivors of cancer. In order to help increase the future success of fertility preservation in these patients, the present state of sperm cryopreservation was examined at the current institution and its challenges were discussed.MethodsBetween January, 2004 and February, 2017, 31 male patients with cancer were introduced to the center for fertility preservation. The ages and semen characteristics of these patients were examined and compared between those whose sperm were cryopreserved before (the pretreatment group) and after (the post‐treatment group) cancer treatment.ResultsThe mean sperm concentration of the pretreatment group was significantly higher than that of the post‐treatment group. Normozoospermia was found in eight and three patients in the pretreatment and the post‐treatment groups, respectively, albeit this difference was not significant. In contrast, the prevalence of azoospermia was higher in the post‐treatment group (five patients) than in the pretreatment group (one patient).ConclusionAs many patients possibly suffer from infertility following chemotherapy, it is necessary to provide fertility preservation opportunities to young male patients with cancer prior to the commencement of cancer treatment.
Endometriosis is a chronic disease that commonly affects women in their reproductive age. It has been reported that the infertility due to endometriosis is largely caused by pelvic adhesion, oocyte damage, and so on. There are several causes of endometriosis including bacterial infections, immunological abnormalities, epigenetics, and aberrant DNA methylation. The natural killer (NK) cells present in the peritoneal fluid express CD16 and CD56. They also express NK cell inhibitory receptors and activating receptors and usually work to eliminate endometrial cells in the retrograde menstruation. However, in women with endometriosis, the changes in these receptors and production of cytokines by NK cells cause the onset and progression of endometriosis. In this review, we have focused on the role of NK cells in pelvic endometriosis and presented the immunological abnormalities in endometriosis including the possibility of future treatment.
HighlightsMultiple bone metastases following cervical cancer was completed resolved.Metastatic lesions were present within a previously irradiated zone of primary external radiation.Concurrent chemotherapy and bisphosphonate administration is promising.
The high toxicity of chemotherapy can damage a patient's gonadal function, leading to premature ovarian insufficiency (POI). Here, we report the case of a patient suffering from POI after chemotherapy for breast cancer, who 3 years later ovulated spontaneously and became pregnant. The patient, a 31-year-old infertile women, nulligravida, was diagnosed with breast cancer. The Anti-Müllerian Hormone (AMH) level in her serum was 1.85 ng/mL before multimodal treatment for cancer. She later visited our hospital for amenorrhea and 2 years after cancer treatment, she was diagnosed with POI. Her AMH level at that point was less than 0.1 ng/mL. One year after the diagnosis of POI, the patient's AMH level increased slightly to 0.14 ng/mL and she ovulated spontaneously. The patient later became pregnant using Assisted Reproductive Technology on the fourth attempt.During the course of treatment for infertility at our hospital, the AMH levels in her serum changed along with the recovery of ovarian function. These findings suggest the possibility that ovulation and pregnancy could be predicted by the chronological changes of the AMH levels in the patient's serum.
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