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.

Purpose In a previous study, a new method was described using the sperm immobilization test (SIT) with computer‐aided sperm analysis (CASA). However, obtaining high‐quality sperm as needed was a known issue. Here, we compared the results of using frozen‐thawed sperm and fresh sperm for the SIT using the CASA method. Methods For the frozen‐thawed preparation, 500 μL of condensed semen and 500 μL of Sperm Freeze were mixed in a cryovial and cryopreserved in liquid nitrogen. Density gradient centrifugation was used for the collection of motile sperm in both the fresh and frozen‐thawed sperm preparations. A total of 50 serum samples were prepared for both the fresh and frozen‐thawed sperm with each sample tested containing 10 μL of serum, 1 μL of either fresh or frozen motile sperm suspension, and 2 μL of complement. Sperm motilities were measured using CASA after a 1‐hour incubation period for both fresh and frozen‐thawed sperm. Results Both fresh and frozen‐thawed sperm reacted similarly when exposed to serum containing sperm‐immobilizing antibodies asserting the use of frozen‐thawed sperm for the diagnosis of immunological infertility. Conclusion These results suggest the possibility of using cryopreserved sperm for the SIT when fresh sperm is unavailable.

Objective: Cancer treatment for adolescent and young adult (AYA) patients with cancer can have lasting effects on their reproductive health by causing premature menopause. Fertility can be preserved by cryopreservation of oocytes, embryos, or ovarian tissue. Recently, many cases of pregnancy and delivery after ovarian tissue warming and transplantation have been reported. The number of ovarian tissue cryopreservation cases has been increasing in our hospital. Herein, we evaluated the current status of ovarian tissue cryopreservation among AYA patients.Method: Ovarian tissue cryopreservation was performed in nine cases at our hospital between February 2017 and March 2018. In 6 of the 9 patients, oocyte pick-up without controlled ovarian stimulation was performed for both ovaries during the removal of one ovary by laparoscopic surgery. We retrospectively collected data from the patients' medical records. Result:The patients ranged in age from 11 to 43 years, and all the patients were nulligravida. Among these patients, 3 had breast cancer; 2, leukemia; 1, Ewing sarcoma; 1, vulvar sarcoma; 1, mediastinal tumour; and 1, suprasellar germ cell tumour. Five of the 9 patients underwent ovarian tissue cryopreservation after chemotherapy. The mean anti-Müllerian hormone (AMH) level was 1.54 ng/ml. Twenty-six oocytes were collected from 6 patients. Ten oocytes matured in vitro could be cryopreserved. Conclusion:So far, there have been no cases of pregnancy by ovarian tissue warming and transplantation. Further accumulation of cases and consideration is needed to yield any findings on the usefulness of this technique.