Purpose To provide information about the relationship between follow‐up period and follicular development in patients with infertility due to premature ovarian insufficiency (POI) who are undergoing hormone replacement therapy (HRT). It is necessary to detect follicle development for artificial insemination or in vitro fertilization. Methods This retrospective cohort study was conducted at a university hospital in Tokyo, Japan, from April 2014 to February 2019 in 20 patients [follicular development group, 11 women (55%); non‐follicular development group, 9 women (45%)] with POI; their follicular development was followed up weekly. Background characteristics, including age, follicle‐stimulating hormone (FSH) and anti‐Mullerian hormone levels (AMH), the period from the last spontaneous menstruation to hormone replacement therapy initiation, and follow‐up period during HRT were investigated. The period without follicular development was tabulated, and the subsequent cumulative follicular development detection rate was calculated. Results At least 1‐year follow‐up, the cumulative follicular development rate was 70%; follicular development was observed with a probability of 49.1% at 3 months, 33.4% at 6 months, and 8.3% at 12 months in the follow‐up period. Conclusions The results show that the longer the non‐follicle development period, the lower the probability of subsequent follicular development in patients with POI during HRT.

Purpose This study compared Gavi®, an automated system for the equilibration and dehydration steps of vitrification, and a manual vitrification procedure in terms of effects on clinical outcomes. Methods The authors retrospectively compared survival rate, and clinical and perinatal outcomes after vitrified‐thawed single blastocyst transfer between Gavi® (G method) in 398 cases and Cryotop® (C method) in 208 cases. Results With C and G methods, survival rates were 98.6% (208/211) and 99.3% (398/401), total pregnancy rates were 34.3% (72/208) and 33.4% (133/398), and total miscarriage rates were 22.2% (16/72) and 24.8% (33/133), respectively. Among women <35 years old, pregnancy rates were 41.1% (30/73) and 40.5% (62/153) and miscarriage rates were 13.3% (4/30) and 16.1% (10/62) with C and G methods, respectively. Among women ≥35 years old, pregnancy rates were 31.1% (42/135) and 29.0% (71/245) and miscarriage rates were 28.6% (12/42) and 32.4% (23/71) with C and G methods, respectively. C and G methods showed no significant differences in any trials, including gestational age, cesarean section rate, or birthweight (P > .05 each). Conclusions Gavi® showed comparable clinical outcomes to the manual vitrification method and can be considered an alternative vitrification procedure in assisted reproductive technology.

There are many previous reports on the effects of ethanol on physiological function, including reports of elevated blood estrogen levels in women who drank alcohol. However, the mechanism of ethanol's effects on ovarian functions, such as follicle development and hormone secretion, hasn’t been fully clarified. Therefore, in this study, we investigated the impacts of ethanol on these phenomena and their mechanisms using a primary culture system of rat ovarian granulosa cells. In the present experiment, groups were created in which FSH or ethanol was added alone or FSH and ethanol were co-added, and mRNA and protein expression in each group was measured for LH receptor (LHR) and sex steroid hormone synthase, as well as for estradiol production, cAMP accumulation, FSH receptor (FSHR) internalization rate. The addition of FSH induced mRNA expression of LHR and aromatase, which led to membrane LHR expression and estradiol production. The coexistence of ethanol enhanced all these responses. The action of FSH is exerted via cAMP, and the co-addition of ethanol enhanced this cAMP production. Ethanol alone didn’t induce cAMP production. The enhancing effect of ethanol was also observed for cAMP induced by cholera toxin. Ethanol had no significant effect on the internalization rate of FSHR. In conclusion, ethanol increased FSH-stimulated cAMP production by increasing the activity of adenylyl cyclase, which enhanced FSH actions in rat granulosa cells. Alcohol is an exacerbating factor in several female hormone-related diseases, and the mechanism of ethanol-induced increase in estrogen secretion may be involved in the pathogenesis of these diseases.

Purpose To create and evaluate a machine‐learning model for YOLOv3 that can simultaneously perform morphological evaluation and tracking in a short time, which can be adapted to video data under an inverted microscope. Methods Japanese patients who underwent intracytoplasmic sperm injection at the Jikei University School of Medicine and Keiai Reproductive and Endosurgical Clinic from January 2019 to March 2020 were included. An AI model that simultaneously performs morphological assessment and tracking was created and its performance was evaluated. Results For morphological assessment, the sensitivity and positive predictive value (PPV) of this model for abnormal sperm were 0.881 and 0.853, respectively. The sensitivity and PPV for normal sperm were 0.794 and 0.689, respectively. For tracking performance, among the 51 objects, 40 (78.4%) were mostly tracked, 11 (21.6%) were partially tracked, and 0 (0%) were mostly lost. Conclusions This study showed that evaluating sperm morphology while tracking in a single model is possible by training YOLO v3. This model could acquire time‐series data of one sperm, which will assist in acquiring and annotating sperm image data.

We present a case of spontaneous pregnancy after laparoscopic surgery for a broad ligament pregnancy. A 34-year-old nulliparous woman presented with 6 weeks of amenorrhea. Due to the presence of an empty uterus with a 10 mm right adnexal mass on transvaginal ultrasonography and elevated serum human chorionic gonadotropin (hCG), ectopic pregnancy was suspected. Upon diagnostic laparoscopy, the presence of a 2 cm broad ligament ectopic pregnancy was confirmed. Laparoscopic removal of the gestational tissues was performed. Six months after surgery, a spontaneous pregnancy was established. At the 40th week of gestation, a cesarean section was performed due to arrested labor, resulting in live birth. To the best of our knowledge, there have been no reports of a spontaneous pregnancy occurring after laparoscopic surgery for broad ligament pregnancy. Laparoscopic surgery as a treatment option for broad ligament pregnancy may be useful in early gestational age because it can be completed without complications.