[Ten-year outcome of semen cryopreservation for patients with malignant disease and preservation system at Kansai Medical University].

Sperm cryopreservation allows patients with threatened fertility to preserve their reproductive potential. A total of 41 patients who had their semen cryopreserved at Kansai Medical University Hospital from January 2000 to March 2010 were enrolled in this study. For the first five years (2000-2005), cryopreservation was performed free of charge,while in the last five years (2006-2010),patients were charged for services and required to update their registration every 2 years. In addition,over the last five years, subjects were limited to patients treated for their original disease at our institution. The mean age of the patients was 27.7 years. The type of disease varied,and included testicular tumors (44%),hemotopoietic organ tumors (44%),and other carcinomas (12%). All specimens cryopreserved during the first five years continued to be cryopreserved without any prognostic investigation,except for one patient who had died. For those patients required to update their registration,prognostic investigation was possible in all cases,and one of the 6 patients updated their cryopreservation. In the case of the other five patients,abandonment was due to recovery of spermatogenesis in 2 cases,death from original disease in 2 cases,and 1 case of voluntary termination for reasons unknown. A paid and updated cryopreservation system may be useful for the cryopreservation of sperm as a means of prognostic investigation.

[Acquired male hypogonadotropic hypogonadism (MHH) in a patient with empty sella: a case report].

A 40-year-old unmarried male was referred to our hospital with anejaculation. His secondary sex characteristics, sexual function and ejaculation were previously normal but for the last 5 years he found it impossible to ejaculate even though he could achieve an erection. His genital stage was Tanner V, and pubic hair stage was Tanner III. There were no varicoceles or chromosomal aberrations. His testis volume was 10 ml on the right side and 12 ml on the left. His hormonal data were luleinizing hormone (LH) 0.3 mIU/ml (normal: 2.2-8.4 mIU/ml), fillicle stimulating hormone (FSH) 1.5 mIU/ ml (1.8-12 mIU/ml), testosterone 0.05 ng/ml (2.01-7.5 ng/ml). A gonadtropin releasing hormone (GnRH) test and human chorionic gonadotropin (hCG) stimulation test revealed low responses of LH, FSH and a normal response of testosterone. Magnetic resonance imaging of the head revealed slight depression of the diaphragma sellae, indicating an "empty sella". We diagnosed acquired hypogonadtropic-hypogonadism related empty sella. An hCG replacement therapy was introduced and after 3 months the patient's capacity to ejaculate was restored and testis volume was 14 ml on both sides. Six months after hormone replacement therapy, semen analysis revealed azoospermia. Then we added r-hFSH to his treatment and expect his sperm to reappear.