Details of a Researcher - BABA Tsuyoshi

Papers - BABA Tsuyoshi

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Association of prenatal passive smoking and metabolic gene polymorphisms with child growth from birth to 3 years of age in the Hokkaido Birth Cohort Study on Environment and Children's Health

Titilola Serifat Braimoh, Sumitaka Kobayashi, Fumihiro Sata, Seiko Sasaki, Houman Goudarzi, Thamar Ayo Yila, Atsuko Araki, Chihiro Miyashita, Hisanori Minakami, Tsuyoshi Baba, Kazuo Sengoku, Reiko Kishi

SCIENCE OF THE TOTAL ENVIRONMENT ( ELSEVIER SCIENCE BV ) 605 995 - 1002 2017.12 [Refereed] [International journal]

Although the effects of prenatal passive smoking on birth weight have been reported, the effects of metabolic gene polymorphisms on passive smoking have not been studied. Therefore, we investigated the effects of maternal passive smoking and metabolic gene polymorphisms on child growth up to 3 years of age using cotinine as a biomarker. We included 1356 Japanese participants in a prospective cohort between 2003 and 2007 (cotinine levels at the third trimester <= 0.21 ng/mL and 0.22 to 11.48 ng/mL for non-passive and passive smokers, respectively), and measured child outcomes such as weight, length, head circumference, and Kaup index. Additionally, we analyzed cytochrome P450 1A1 (CYP1A1), epoxide hydrolase 1 (EPHX1), and two N-acetyltransferase 2 (NAT2) genotypes using real-time polymerase chain reaction methods. Associations were investigated using multiple regression models. Kaup index gain from birth up to 3 years of age was significantly smaller in children born to passive smokers than in those born to non-passive smokers (-0.34 kg/m(2); 95% confidence interval: -0.67, -0.01). Maternal CYP1A1 genotype was not associated with prenatal passive smoking and Kaup index gain, but was significantly associated with prenatal passive smoking and head circumference gain from birth up to 3 years of age (-0.75 cm; 95% confidence interval:-1.39, -0.12). Thus, this study suggests that prenatal passive smoking may have potent effects on postnatal growth frombirth up to 3 years of age. Moreover, children with maternal CYP1A1 genotype may be more susceptible to the effects of prenatal passive smoking. (C) 2017 Elsevier B.V. All rights reserved.

DOI PubMed

当院における死戦期帝王切開を念頭においた産科救急システムの構築

水内将人, 藤部佑哉, 嶋田浩志, 馬場剛, 石岡伸一, 斎藤豪

日本周産期・新生児医学会雑誌 ( (一社)日本周産期・新生児医学会 ) 53 ( 2 ) 727 - 727 2017.06

Possibility of less radical treatment for patients with early invasive uterine cervical cancer

Miseon Kim, Shinichi Ishioka, Toshiaki Endo, Tsuyoshi Baba, Masahito Mizuuchi, Sakura Takada, Tsuyoshi Saito

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH ( WILEY-BLACKWELL ) 42 ( 7 ) 876 - 882 2016.07 [Refereed] [International journal]

AimRadical trachelectomy (RT) with lymphadenectomy has become a standard treatment modality for patients with early invasive uterine cervical cancer who hope to preserve fertility. However, pregnancy after RT has high risks of preterm birth. The possibility of more conservative RT and the application of RT for patients with higher clinical stages were studied. MethodsThe medical charts and specimens of 42 patients who underwent RT and 64 patients who underwent radical hysterectomy were retrospectively studied. Tumor size, distance between the margin of the cancer and the internal orifice of the uterus (os), parametrial invasion, lymph node metastasis and prognoses were investigated. ResultsThe average distances between the inner margin of the cancer and the internal os were 37 mm, 29 mm, 18.7 mm and 14 mm for patients with stage 1 A2, 1B1 ( 2 cm), 1B1 (> 2 cm) and 1B2, respectively. When amputation was performed 10 mm below the internal os, all 10 patients with 1 A2, 57 with 1B1 ( 2 cm), 19 with 1B1 (> 2 cm), and one with 1B2 had a cancer-free margin > 10 mm. Patients with stage 1 A2 had a cancer-free margin > 10 mm even if we amputated the cervix 20 mm below the internal os. Parametrial invasion was detected in two patients with stage 1B1. ConclusionsA simple trachelectomy 20 mm below the internal os with pelvic lymphadenectomy might be possible for stage 1 A2 patients. The present method is best for stage 1B1 patients ( 2 cm). RT for stage 1B1 (>2 cm) or higher stages should be contraindicated.

DOI PubMed

Obstetrical prognosis of patients with cervical intraepithelial neoplasia (CIN) after "coin-shaped" conization.

Miseon Kim, Shinichi Ishioka, Toshiaki Endo, Tsuyoshi Baba, Tsuyoshi Saito

Archives of gynecology and obstetrics 293 ( 3 ) 651 - 7 2016.03 [International journal]

PURPOSE: Uterine cervical conization is related to adverse pregnancy outcomes in subsequent pregnancies. To deal with this problem, we started conservative coin-shaped conization for reproductive-aged patients with cervical intraepithelial neoplasia (CIN). Here we report both the obstetrical and oncological impacts of this operation in comparison with the standard cone-shaped resection. METHODS: A total of 401 women 44 years old or younger were treated in our hospital by CO2 laser conization between 2003 and 2012, and subsequently 50 patients became pregnant. The patients were divided into two groups, a standard cone-shaped conization group (until 2008) and a shallow coin-shaped conization group (beginning in 2008). The pregnancy courses and oncological prognoses of these two groups were studied. RESULTS: Cone height reduction of about 3 mm was done. However, there were no significant differences between the two groups with regard to the occurrence of oncological complications. In the standard conization group, 18 of the 25 patients delivered at term. In the coin-shaped conization group, 20 of the 25 patients delivered at term. There were no significant differences between the two groups with regard to the occurrence of various obstetrical complications. However, the reduction rate of cervical length over the pregnancy was smaller in the coin-shaped group and the number of patients with a short cervix length of 2 cm or less was smaller in the coin-shaped group. CONCLUSIONS: Although conservative coin-shaped conization did not markedly improve the obstetrical prognosis, this operative procedure improved the reduction rate of uterine cervical length over the pregnancy without any increase in oncological complications.

DOI PubMed

BMI66.5kg/m2の高度肥満妊婦における帝王切開の経験

森下美幸, 嶋田浩志, 馬場剛, 石岡伸一, 遠藤俊明, 齋藤豪

産科と婦人科 ( (株)診断と治療社 ) 83 ( 2 ) 226 - 231 2016.02

Successful delivery after transabdominal cerclage of uterine cervix for cervical incompetence after radical trachelectomy.

Shinichi Ishioka, Toshiaki Endo, Tsuyoshi Baba, Yushi Akashi, Miyuki Morishita, Asuka Sugio, Naohiro Kanayama, Tsuyoshi Saito

The journal of obstetrics and gynaecology research 41 ( 8 ) 1295 - 9 2015.08 [International journal]

Pregnancy after radical trachelectomy (RT) has a high risk of prematurity and complications such as preterm premature rupture of the membrane and chorioamnionitis. Placing a cervical cerclage at the time of RT plays an important role in preventing such obstetrical complications. In patients who have trouble with the cervical cerclage, miscarriage during the second trimester seems to be inevitable. We have therefore started preconception transabdominal cerclage (TAC) for these patients. A 36-year-old Japanese woman who had a history of miscarriage due to trouble with the nylon thread used for cerclage, successfully delivered after TAC. TAC is a useful treatment modality to prevent miscarriage for patients who have trouble with cerclage after RT.

DOI PubMed

治療方針に苦慮した急性Stanford A型大動脈解離合併妊娠

嶋田浩志, 遠藤俊明, 山本雅恵, 杉尾明香, 清水亜由美, 森下美幸, 明石祐史, 馬場剛, 石岡伸一, 齋藤豪

北海道産科婦人科学会会誌 ( 北海道産科婦人科学会 ) 59 ( 1 ) 22 - 26 2015.03

周産期の大動脈解離の発症は非常に稀であるが、40歳未満の大動脈解離の発症の半数は妊娠に合併するといわれている。急性のStanford A型大動脈解離は手術治療が原則であるが、妊娠に合併した場合の治療方針は明確に定まっていない。今回我々は帝王切開術と子宮摘出術の決断に苦慮した急性Stanford A型大動脈解離の一例を経験したので報告する。症例は31歳女性。未経妊未経産。妊娠31週に制御不能な胸痛および背部痛を自覚し、前医を受診した。造影CTで急性Stanford A型大動脈解離と診断され、当院に手術目的に緊急搬送された。治療方針に苦慮したが帝王切開を先行させ、胎児を娩出後に人工血管置換術を一期的に行った。人工血管置換術中の産科的出血を予防するために子宮全摘術を実施した。術後経過は良好で合併症もなく、母子ともに術後24日目に退院した。帝王切開術の施行時期と子宮摘出術の選択に議論の余地はあるが、人工血管置換術時の体外循環による胎児への影響と大動脈解離の死亡率を考慮した場合、妥当な選択だったと考えられる。(著者抄録)

Importance of uterine cervical cerclage to maintain a successful pregnancy for patients who undergo vaginal radical trachelectomy

Miseon Kim, Shin-ichi Ishioka, Toshiaki Endo, Tsuyoshi Baba, Yushi Akashi, Miyuki Morishita, Hidefumi Adachi, Tsuyoshi Saito

INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY ( SPRINGER JAPAN KK ) 19 ( 5 ) 906 - 911 2014.10 [Refereed] [Domestic journal]

We have performed 36 vaginal radical trachelectomies (RTs) for patients with early invasive uterine cervical cancer and experienced 10 deliveries. Pregnancy after RT has far higher risks of prematurity and complications such as preterm premature rupture of the membrane (pPROM) and chorioamnionitis. We report the significance of transabdominal cerclage in the follow-up of pregnancy after vaginal RT. Our operative procedure is based on that of Dargent et al. We amputated the cervix approximately 10 mm below the isthmus. For the removal of the parametrium, we cut at the level of type II hysterectomy. A nylon suture is also placed around the residual cervix. Pregnancy courses after vaginal RT were studied in 9 patients (10 pregnancies) with respect to cervical length and several infectious signs. Obstetric prognosis after RT was improved with our follow-up modality. Four patients who were followed up with this modality were able to continue their pregnancies until late in the third trimester. However, it was not effective for four patients who showed cervical incompetence due to slack cerclage. They suffered from pPROM without any infectious signs and uterine contraction. Though we performed transabdominal uterine cervical cerclage for one patient in her 19th week of pregnancy, it was unsuccessful. Cervical cerclage placed at the time of RT played an important role in preventing dilatation of the uterine cervix and the subsequent occurrence of pPROM. Transabdominal cervical cerclage should be performed earlier in pregnancy or before pregnancy in patients who have experienced problems with cervical cerclage.

DOI PubMed

Common hypothetical etiology of excess androgen exposure in female-to-male transsexualism and polycystic ovary syndrome

Tsuyoshi Baba, Toshiaki Endo, Keiko Ikeda, Tsuyoshi Saito

Gender Identity: Disorders, Developmental Perspectives and Social Implications ( Nova Science Publishers, Inc. ) 253 - 270 2014.07

Gender identity disorder is recognized as a rare disease. The prevalence of this disorder is different among regions and races. In Japan, the prevalence of female-to-male transsexual (FTM-TS) patients is estimated to be 1 in 12,500 women, which is approximately twice as many as male-to-female transsexual patients. There are two interesting facts in association with FTM-TS: 1) the complication rate of polycystic ovary syndrome (PCOS) is high among FTM-TS patients and 2) natal female patients with congenital adrenal hyperplasia (CAH) tend to have gender identity problems more often than the normal population. PCOS is a common disease and it affects 5-10% of women of reproductive age. PCOS is characterized by ovulation disorder, hyperandrogenism, and polycystic ovarian morphology. Additionally, PCOS is correlated with insulin resistance, and predisposes to type 2 diabetes mellitus, atherosclerosis, and metabolic syndrome. The etiology of PCOS is still obscure, but excess androgen exposure during the fetal period is considered to be a dominant hypothesis. CAH is an autosomal recessive disorder impairing adrenal steroid metabolism, which causes excess androgenemia from the fetal period. A review on 250 natal female cases with CAH showed that 13 (5.2%) of the patients had serious gender identity problems. Surprisingly, the occurrence of FTM-TS in CAH is extremely high. The pathogenesis of FTM-TS is still uncertain. However, excess androgen exposure may be related to FTM-TS according to the above-mentioned findings. In humans, experimental androgen administration to women is impossible. However, cross-sex hormone administration to FTM-TS patients is not associated with any problems because it is a standard tactic for treatment. If excess androgen exposure is a cause of PCOS, androgen-treated FTM-TS patients may be a disease model of PCOS. Assessment of the effects of androgen administration on metabolic parameters is informative because FTM-TS patients with PCOS may have potent insulin resistance. In this chapter, we discuss endocrinological aspects of FTM-TS, the effect of crosssex hormones, and the hypothetical etiology in FTM and PCOS.

Continuous high-dose estrogen controls serum FSH and LH levels: new treatment strategy for extremely low ovarian reserve patients, two case reports.

Hiroyuki Honnma, Yoshimasa Asada, Tsuyoshi Baba, Toshiaki Endo

Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology 30 ( 5 ) 341 - 4 2014.05 [International journal]

At present, there are no proven therapies to improve ovarian function in women with premature ovarian insufficiency (POI) or in those with extremely low ovarian reserve (LOR). We report successful IVF outcomes achieved with continuous high-dose estrogen supplementation in patients with LOR. Patients were 33- and 42-year-old nulligravidae with high-serum FSH (over 30 IU/L) and undetectable serum AMH (under 0.1 ng/mL) levels; however, neither patient fulfilled the diagnostic criteria for POI. After cycle cancellation and unsuccessful IVF treatment, both patients received conjugated estrogen (CE) supplementation (2.5-3.75 mg/day) from day 2 of their menstrual cycle to the day of HCG administration in their IVF treatment cycles. Following continuous high-dose estrogen supplementation, oocytes were successfully retrieved from both patients and fertilized. Both patients also achieved ongoing pregnancy through frozen-thawed embryo transfer cycles. In conclusion, high-dose estrogen supplementation down-regulated serum FSH and LH within their physiological ranges, which led to functional follicle growth and prevented early luteinization. Further studies will be needed to confirm the effect of this treatment on POI patients and to establish a new and individualized protocol for LOR patients.

DOI PubMed

Long-term treatment with dehydroepiandrosterone may lead to follicular atresia through interaction with anti-Mullerian hormone

Keiko Ikeda, Tsuyoshi Baba, Miyuki Morishita, Hiroyuki Honnma, Toshiaki Endo, Tamotsu Kiya, Tsuyoshi Saito

JOURNAL OF OVARIAN RESEARCH ( BIOMED CENTRAL LTD ) 7 46 - 46 2014.04 [Refereed] [International journal]

Background: Hyperandrogenism is the primary manifestation of polycystic ovary syndrome (PCOS), which appears to be caused by excess exposure to androgen. As such, androgenized animal models have been developed and investigated to study the etiology of PCOS. Anti-Mullerian hormone (AMH) is known to be associated with follicle growth, and its levels are two to three times higher in women with PCOS than in those with normal ovaries. We studied how duration of androgen administration affects folliculogenesis and AMH expression. Methods: We divided 30 immature (3-week-old) Sprague Dawley rats into six groups. Three groups were injected each evening with dehydroepiandrosterone (DHEA) (6 mg/100 g body weight/0.2 ml sesame oil) for 7, 15 or 30 days, respectively. The three control groups were injected with 0.2 ml of sesame oil for the corresponding lengths of time. Resected ovaries were sectioned and examined to determine follicle numbers at each developmental stage, and immunostained to assess AMH expression. Results: On day 7, follicle numbers and AMH expression levels at each developmental stage of follicle growth were similar in the respective control and DHEA groups. On day 15, the total follicle number (P = 0.041), the percentage of primordial follicles (P = 0.039) and AMH expression were significantly greater in the DHEA than the control group. On day 30, the percentages of primordial (P = 0.005), primary (P = 0.0002) and atretic (P = 0.03) follicles were significantly greater in the DHEA group, whereas the percentage of intermediary follicles (early pre-antral, late preantral, and early antral follicles) was significantly lower in the DHEA group (P = < 0.0001). AMH expression in DHEA-treated rats on day 30 was seen exclusively in the primordial (P = 0.0413) and late antral follicles (p = 0.028). Conclusions: Androgen administration increases AMH production in a process that regulates the growth of primordial follicles. That is, androgen-induced AMH expression provides local negative feedback to folliculogenesis augmented by androgen.

DOI PubMed

Excessive androgen exposure as an etiological factor of polycystic ovary syndrome

Tsuyoshi Baba, Toshiaki Endo, Sayaka Adachi, Keiko Ikeda, Ayumi Shimizu, Miyuki Morishita, Yoshika Kuno, Hiroyuki Honnma, Tamotsu Kiya, Tsuyoshi Saito

Journal of Mammalian Ova Research ( Japanese Society of Mammalian Ova Research ) 31 ( 1 ) 23 - 30 2014

Polycystic ovary syndrome (PCOS) is a heterogeneous group of disorders characterized by ovulation disorder, hyperandrogenism, and polycystic ovarian morphology (PCOM). Several diagnostic criteria suggest that hyperandrogenism is a core symptom of PCOS. Androgens are believed to cause preantral follicle growth and arrest the growth of antral follicles. This results in accumulation of small antral follicles in the ovaries, thus forming PCOM. Observational studies of patients with female-to-male transsexualism or congenital adrenal hyperplasia indicate that androgen administration to these patients does not produce typical PCOS-like features. However, endogenous androgen exposure in early life may lead to some traits of PCOS in adulthood. To reveal the association between the timing of excess androgen exposure and reproductive function, various animal models have been investigated using androgen administration. Rhesus monkeys exposed to excess androgen during the early fetal period show a PCOS-like phenotype, including metabolic and hypothalamic- pituitary characteristics. This finding implies that exposure to excess androgen during this critical period programs the hypothalamic-pituitary-ovary axis and metabolic organs. Although findings obtained in animal studies will not necessarily be replicated in humans, prenatal androgen excess is the dominant PCOS hypothesis. ©2014 Japan Society for Ova Research.

DOI

Difficulty in the management of pregnancy after vaginal radical trachelectomy.

Sakura Takada, Shin-Ichi Ishioka, Toshiaki Endo, Tsuyoshi Baba, Miyuki Morishita, Yushi Akashi, Masahito Mizuuchi, Hidefumi Adachi, Miseon Kim, Tsuyoshi Saito

International journal of clinical oncology 18 ( 6 ) 1085 - 90 2013.12 [Domestic journal]

BACKGROUND: We have performed 26 vaginal radical trachelectomies (RTs) for patients with early invasive uterine cervical cancer since 2003 and, to date, have experienced 8 deliveries. The procedure has a high risk for preterm labor and the subsequent occurrence of preterm premature rupture of membranes (pPROM). We report the present situation and the limits of follow-up of pregnancy after vaginal RT. METHODS: Our operative procedure is based on that of Dargent et al. We usually amputate the cervix approximately 10 mm below the isthmus. To remove the parametrium, we cut at the level of type II hysterectomy. Pregnancy courses after vaginal RT were studied in 8 patients with respect to symptoms, cervical length, and several infectious signs. RESULTS: We recommended that patients enter hospital early in their second trimester, and prophylactic daily vaginal disinfection with povidone-iodine and an ulinastatin vaginal suppository were administered. Careful checking for vaginal infectious signs, as well as cervical length and abdominal tension of patients was also performed. Four patients followed up with this modality were able to continue their pregnancies until late in the third trimester. However, this follow-up modality was not effective for patients who showed cervical incompetence due to slack cervical cerclage. They suffered from pPROM at 26 and 19 weeks of gestation. CONCLUSION: We need a new approach for the management of pregnant patients after vaginal RT with cervical incompetence due to slack cervical cerclage to prevent cervical infection.

DOI PubMed

Assisted reproductive technique increases the risk of placental polyp

Tsuyoshi Baba, Toshiaki Endo, Keiko Ikeda, Ayumi Shimizu, Miyuki Morishita, Yoshika Kuno, Hiroyuki Honnma, Tamotsu Kiya, Shin-Ichi Ishioka, Tsuyoshi Saito

Gynecological Endocrinology ( 6 ) 29 ( 6 ) 611 - 614 2013.06 [Refereed] [International journal]

The purpose of this study was to clarify the risk factors and outcomes of placental polyp. This retrospective study was conducted on 1645 patients delivered or aborted in Sapporo Medical University from 2007 through 2011. Transvaginal color Doppler ultrasonography, hysteroscopy, contrast-enhanced MRI or 3D-CT angiography were performed. There were 1532 deliveries and 113 abortions. Seventy-one (4.3%) were ART-conceived and the remaining 1574 (95.7%) were non-ART pregnancies. Fifteen (0.91%) cases were confirmed as having placental polyp. Nine cases of placental polyp were identified among the 1574 (0.57%) as non-ART-related pregnancies, and 6 were identified among the 71 (8.5%) as ART-related pregnancies. Thus, pregnancies achieved through ART showed 20x greater incidence of complicating placental polyp than pregnancies achieved through without ART (p=9.02×10-6 odds ratio, 19.59 95% confidence interval, 5.27-72.84, logistic regression analysis). Evaluation of blood flow within the polyp showed that in five of seven patients with low blood flow, the polyps spontaneously dropped off 79-115 days postpartum. Thus, ART-related pregnancies may be a risk factor of placental polyp, and spontaneous drop-off of the polyp is often observed in cases with low blood flow within the mass. © 2013 Informa UK Ltd.

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Failure of GnRH agonist-triggered oocyte maturation: its cause and management.

Yoshimasa Asada, Fumiaki Itoi, Hiroyuki Honnma, Shuji Takiguchi, Noritaka Fukunaga, Yoshiki Hashiba, Tsuyoshi Baba, Toshiaki Endo

Journal of assisted reproduction and genetics 30 ( 4 ) 581 - 5 2013.04 [International journal]

OBJECTIVE: In the present study we investigated the cause of GnRHa's failure to trigger oocyte maturation and present an effective rescue protocol for use when failure occurs. DESIGN: Case reports. SETTING: One in vitro fertilization (IVF) center. PATIENT(S): Eight cases of failure of GnRH agonist (GnRHa)-triggered oocyte maturation and one case of GnRHa successfully triggered oocyte maturation, despite a weak response in the LH-RH test. MAIN OUTCOME MEASURE(S): All cases were successfully rescued by re-triggering maturation using HCG, with seven of the eight patients achieving ongoing pregnancy and successful delivery. RESULT(S): In three patients the cause of the oocyte maturation failure was likely temporal or continuous severe down-regulation of the hypothalamus-pituitary-axis, the cause was unknown in the other five patients. CONCLUSION(S): In cases where GnRHa fails to trigger oocyte maturation, a rescue protocol entailing re-triggering with HCG can produce successful outcomes.

DOI PubMed

Excessive androgen exposure in female-to-male transsexual persons of reproductive age induces hyperplasia of the ovarian cortex and stroma but not polycystic ovary morphology

Keiko Ikeda, Tsuyoshi Baba, Hiroko Noguchi, Kunihiko Nagasawa, Toshiaki Endo, Tamotsu Kiya, Tsuyoshi Saito

HUMAN REPRODUCTION ( OXFORD UNIV PRESS ) 28 ( 2 ) 453 - 461 2013.02 [Refereed] [International journal]

Does administration of androgen to female-to-male transsexual persons (FTMs) of reproductive age induce polycystic ovary (PCO) morphology? Administration of high-dose androgen to women causes pathognomonic changes to the ovarian cortex and stroma that resemble SteinLeventhal syndrome but it does not induce PCO morphology. Androgen is thought to play a key role in follicular development and to be involved in the pathophysiology of polycystic ovary syndrome (PCOS). In several experimental models, animals given high-dose androgen show ovarian changes similar to those in women with PCOS. In previous human studies, the ovaries of FTMs who received androgen for long periods also exhibited PCO morphology. We conducted a retrospective casecontrol study of women, all without PCOS, undergoing salpingo-oophorectomy. The case group consisted of 11 FTMs taking testosterone (duration range: 17 months to 14 years), while the control group consisted of 10 patients with gynaecologic malignancies who did not receive testosterone. Resected ovaries from both groups were compared histologically with respect to changes in the cortex and stroma, and the number of follicles at each maturation stage. Compared with controls, the FTM group had a thicker ovarian cortex (P 0.0001), and more hyperplastic collagen (P 0.001), ovarian stromal hyperplasia (P 0.003) and stromal luteinization, i.e. luteinized stromal cells with a small dark central nucleus surrounded by clear cytoplasm (P 0.004). Isolated clusters of such stromal luteinized cells were found only in the testosterone-treated ovaries of FTMs. The number of primordial follicles was similar in the two groups (P 0.22). The numbers of early stage (primary, pre-antral and early antral) follicles, which are dependent on androgen, were also similar (P 0.81), as were the numbers of antral follicles (P 0.97). In contrast, significantly greater numbers of atretic follicles were seen in the FTM than that in the control group (P 0.01). In addition to the low numbers in the study groups, the histological changes in FTMs were investigated after testosterone administration, therefore it is possible that some of the observed changes were already present, before androgen administration. Our results are at variance with those of earlier studies and suggest that excessive androgen exposure in women of reproductive age may not be a factor in the pathogenesis of PCOS. None.

DOI PubMed

Serum anti-Mullerian hormone levels affect the rate of ongoing pregnancy after in vitro fertilization.

Hiroyuki Honnma, Tsuyoshi Baba, Masahiro Sasaki, Yoshiki Hashiba, Hisanori Oguri, Takanori Fukunaga, Toshiaki Endo, Yoshimasa Asada

Reproductive sciences (Thousand Oaks, Calif.) 20 ( 1 ) 51 - 9 2013.01 [International journal]

We used logistic regression analysis to investigate the relationship between serum anti-Mullerian hormone (AMH) levels and the rate of ongoing pregnancy. Retrospective data were collected from 1043 women who had undergone their first cycle of in vitro fertilization (IVF), including 540 cycles of fresh embryo transfer and 503 cycles of frozen-thawed embryo transfer. The patients were divided into 4 groups based on the cutoff values from a receiver-operating characteristic curve: 0.0 to 12.4, 12.5 to 25.5, 25.6 to 44.1, and >44.2 pmol/L. After adjustment for multiple confounders, the serum AMH group was found to be significantly related to the rate of ongoing pregnancy in total cycles (0.0-12.4 vs 12.5-25.5 pmol/L; P = .0088, odds ratio, 1.909: vs 25.6-44.1 pmol/L; P = .0281, odds ratio, 2.109: vs >44.2 pmol/L; P = .0008, odds ratio, 2.840). In conclusion, there appears to be a significant relationship between serum AMH levels and the ongoing pregnancy rate in first IVF treatment cycles after adjustment for multiple confounders.

DOI PubMed

A myotonic dystrophy 1 patient complicated with placental adherence after miscarriage of one dichorionic diamniotic twin following her tenth in vitro fertilization and embryo transfer

Toshiaki Endo, Tsuyoshi Baba, Asuka Sugio, Miyuki Morishita, Madoka Takahashi, Yushi Akashi, Shinichi Ishioka, Nobutada Tachi, Tomihiro Imai, Mitsuharu Tamakawa, Tsuyoshi Saito

ARCHIVES OF GYNECOLOGY AND OBSTETRICS ( SPRINGER HEIDELBERG ) 286 ( 6 ) 1605 - 1608 2012.12 [Refereed] [International journal]

DOI PubMed

Weight reduction and pioglitazone ameliorate polycystic ovary syndrome after removal of a Sertoli-stromal cell tumor

Tsuyoshi Baba, Toshiaki Endo, Keiko Ikeda, Ayumi Shimizu, Miyuki Morishita, Yoshika Kuno, Hiroyuki Honnma, Tamotsu Kiya, Shin-Ichi Ishioka, Tsuyoshi Saito

International Journal of Women's Health 4 ( 1 ) 607 - 611 2012.11 [Refereed] [International journal]

This report presents an unusual case of Sertoli-stromal cell tumor and polycystic ovary syndrome successfully treated with weight reduction and an insulin-sensitizing agent. A 22-year-old woman, gravida 0, para 0, visited our hospital for the first time with a 12-year history of secondary amenorrhea and hypertrichosis. Transvaginal ultrasonography revealed a solid tumor in the right ovary. Right salpingo-oophorectomy was performed and pathological examination confirmed a Sertoli-stromal cell tumor. The patient's serum androgen levels declined postoperatively, but remained above normal. Pioglitazone treatment for 6 months also significantly reduced serum androgen levels, but they still remained above normal. However, after losing 12 kg of body weight, the patient's serum androgen levels declined to normal, and spontaneous menstruation became regular. Weight reduction with pioglitazone is an effective means of treating hyperandrogenism. © 2012 Baba et al, publisher and licensee Dove Medical Press Ltd.

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160kg高度肥満妊婦に対する帝王切開の経験

中嶋千紗, 馬場剛, 森下美幸, 金美善, 足立英文, 明石祐史, 浅野拓也, 嶋田浩志, 杉尾明香, 石岡伸一, 遠藤俊明, 齋藤豪

北日本産科婦人科学会総会・学術講演会プログラム・抄録集 ( 東北連合産科婦人科学会・北日本産科婦人科学会 ) 60回 87 - 87 2012.09

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