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Intrauterine insemination (IUI) is a simple first line treatment for infertile couples (1). This inexpensive treatment, in comparison with other assisted reproductive techniques (ART), has been widely used to treat infertile couples with a variety of indications such as male subfertility, unexplained fertility, cervical mucus hostility and endometriosisrelated infertility. (2-7) Pregnancy rates after IUI differ between studies according to patient selection criteria, the presence of various infertility factors, ovarian stimulation methods, number of cycles performed, different sperm parameters, and preparation %). There was no triple or higher order multiple pregnancies. At the end of the sixth cycle, 73 clinical pregnancies had been achieved (89.0% %). After diagnostic laparoscopy, the pregnancy rate per cycle for patients 35 years age was 18% %, which is significantly higher than that of patients 35 years of age. Pregnancies occurred up to the fifth cycle after laparoscopy. The pregnancy rate (PR) per cycle was significantly higher in cases of sperm movement rates more than 30% % (PR 9.3% %) and total motile sperm counts more than 10 10 6 /ml (PR 8.2% %). A study comparing the washed and unwashed cases did not reveal any differences. Conclusion : In male sub-fertility cases of sperm parameters as motility rates 30% % and motile sperm concentration 10 10 6 /ml, IUI could be a useful option for infertility treatment J. Med. Invest. 58 : 127-133, February, 2011 ORIGINAL Effect of semen characteristics on pregnancy rate following intrauterine insemination

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PurposeTo assess the kisspeptin concentrations in follicular fluid and their relationship with clinical outcomes during assisted reproductive technology.MethodsThirty‐nine patients who were aged 24‐40 years and underwent oocyte retrieval for in vitro fertilization/intracytoplasmic sperm injection participated in this study. In 65 follicular fluid samples that had been obtained from 30 patients and their blood samples, the kisspeptin levels were measured in order to investigate the correlations with their gonadal hormone levels. Venous blood samples were collected from 14 patients to investigate their plasma kisspeptin levels across different phases of assisted reproductive technology.ResultsThe follicular fluid kisspeptin level was significantly higher than that of the plasma level and was positively associated with the follicular fluid estradiol concentration and with the serum estradiol and number of mature oocytes. In the plasma, the maximum concentration of kisspeptin was observed on the day of ovum pick‐up and on the day of embryo transfer during ovarian stimulation for assisted reproductive technology.ConclusionKisspeptin was present in the follicular fluid and the plasma kisspeptin concentration was affected by ovarian stimulation. Kisspeptin appears to affect oocyte maturation and ovulation.

Background Although animal models of PCOS have been used in many studies, none of them can reproduce both the reproductive and metabolic phenotypes of PCOS. In addition, behavioral parameters have not been evaluated in PCOS animal models. Purpose We tried to produce an improved rat model of PCOS, and the reproductive, metabolic, and behavioral phenotypes of the model rats were evaluated. Methods Female rats were implanted with silicon tubes containing oil‐dissolved dihydrotestosterone (Oil‐DHT) as a new PCOS model. Their phenotypes were compared with those of conventional PCOS model rats (DHT), into which tubes containing crystalline DHT were implanted, and non‐DHT‐treated rats (control). Results Both the Oil‐DHT and DHT rats showed greater body weight gain, food intake, and fat depot weight than the control rats. Furthermore, these groups showed fewer estrous stages and increased numbers of cystic follicles. The DHT rats exhibited lower ovarian and uterine weights than the control rats, whereas no such changes were observed in the Oil‐DHT rats. The Oil‐DHT and DHT rats showed less locomotor activity in the light phase than the control rats. Conclusions Our proposed PCOS model reproduced both the reproductive and metabolic phenotypes of PCOS and may have potential for PCOS research.

HighlightsWe present a case of multiple mucinous metaplasia and neoplasia of cervix, endometrium, fallopian tube, ovary, and mesenterium with external urethral meatus neoplasm.Immunohistochemistry showed almost same pattern in each neoplasms.PCR-direct sequencing showed no existence of both KRAS and GNAS mutations.This report suggests a possibility of synchronous mucinous metaplasia and neoplasia “beyond” female genital tract.

Fulminant type 1 diabetes (FT1D) is a novel subtype of type 1 diabetes (T1D) and is characterized by a relatively low glycated hemoglobin (HbA 1c) level at onset, despite the abrupt occurrence of marked hyperglycemia with ketosis or ketoacidosis (1). Recent studies have shown that anti-programmed cell death (PD)-1/anti-PD-ligand 1 (PD-L1) therapy for malignancies leads to the development of T1D including FT1D (2-4). In typical FT1D, insulin secretion capacity is completely exhausted within ;7 days after the onset (1); in some cases, a rapid loss of insulin secretion was observed during 2 days prior to onset of diabetic ketoacidosis (DKA) (5). Meanwhile, the detailed time course of insulin secretion capacity in anti-PD-1 therapyinduced FT1D has not yet been reported. We present a case of an 82-year-old Japanese man with squamous cell cancer of the lung, who had received multiple courses of anti-PD-1 immunotherapy (pembrolizumab) every 3 weeks for ;12 months. Written informed consent was obtained from the participant. On the day of the 16th course of anti-PD-1 therapy, his casual plasma glucose and HbA 1c levels were 106 mg/dL and 5.8% (40 mmol/mol), respectively. However, a blood test performed on the scheduled day of the 17th course revealed his casual plasma glucose was 432 mg/dL; thus, he was immediately hospitalized without the planned course. His height was 158.5 cm; weight, 47.0 kg; and BMI, 18.7 kg/m 2. He had

Krebs von den Lungen-6 (KL-6), a mucinous sialylated sugar chain on human mucin-1 glycoprotein (MUC1), is a diagnostic marker for interstitial lung diseases. Furthermore, elevated serum KL-6 levels have been observed in certain malignant tumor types of epithelial origin. The expression of MUC1 has been observed in patients with epithelial ovarian cancer (EOC) and is considered a potential therapeutic target. In the present study, KL-6 serum levels were investigated in patients clinically suspected of having malignant ovarian tumors. A total of 219 patients were enrolled in the study, which analyzed their serum KL-6 levels in addition to tumor expression of MUC1 using immunohistochemistry. High serum KL-6 levels were predominantly observed in patients with EOC, and did not occur in patients with benign or borderline tumors. The level of serum KL-6 was highly correlated with tumor stage, grade and histological type, and demonstrated superior sensitivity for the detection of ovarian cancer compared with that of serum cancer antigen 125. High serum KL-6 was significantly associated with shorter progression-free survival. In addition, tumor MUC1 expression status was significantly correlated with serum KL-6 levels. These data suggest that serum KL-6 may be a useful, non-invasive biomarker surrogate for tumor MUC1 expression in future clinical trials of MUC1-targeted therapy.