菅沼 信彦

Abstract Uterus transplantation (UTx) has emerged as a revolutionary treatment for absolute uterine factor infertility, made possible by extensive preclinical research. Animal studies have played a pivotal role in advancing UTx to clinical practice. We highlight Japan's contribution, including non‐human primate research and regulatory progress, leading to its anticipated clinical implementation. The expansion of UTx in the Asia‐Oceania region underscores its global impact. Further refinements in surgical techniques, optimization of immunosuppressive regimens, and establishment of clear patient eligibility criteria will be crucial for ensuring the long‐term success and sustainability of UTx programs worldwide. This letter acknowledges the Swedish team's foundational efforts in establishing UTx as a viable reproductive technology.

Purpose: To analyze the usefulness of intravaginal insemination (IVI) for the infertility treatment in couples with sexual dysfunction before applying assisted reproductive technology (ART). Methods: Among 208 couples who presented sexual dysfunction, 144 couples underwent IVI procedures. The profiles of pregnant and non-pregnant patients were compared. Results: Of 144 patients, 58 women conceived successfully (40.3% pregnancy rate). Between the pregnant and non-pregnant cases, the husband's age and infertility period were significantly higher (P = .0104) and longer (P = .0027) in the unsuccessful cases than the successful ones. The husbands who could not impregnate had a significantly higher ratio of sperm abnormalities (P = .0048). Among the 57 successful cases who underwent IVI treatment, 38 (66.7%) patients became pregnant within 3 times of the procedure, while 48 (84.2%) patients conceived within 6 times. Conclusion: The authors can propose the following inclusion IVI criteria for couples with sexual dysfunction: (a) younger husband (36 years old or less) which may be most important, (b) infertility duration of 3 years or less, (c) normal sperm condition, and (d) IVI trial for 3 times (maximum of 6 times). Since IVI appears to be a simple, noninvasive, and inexpensive way for couples with sexual dysfunction, it can be attempted before ART application.