Efficacy of oral micronized progesterone when applied via vaginal route.

The aim of the study was to compare the efficacy of oral micronized progesterone when applied by the vaginal route. The comparative study of serum progesterone levels between oral and vaginal micronized progesterone administration was conducted in sixty female volunteers. The subjects were equally divided into two groups to receive the drug either via the oral or vaginal route. The subjects' profiles showed that there was no significant difference in general characteristics between these two groups. The blood tests for estrogen and progesterone levels were performed on all volunteers before and after the drug administration. The data collected from the experiment revealed that the serum progesterone levels achieved by oral administration (5.06 +/- 2.95 ng/ml) differed significantly (p < 0.001) from those achieved by vaginal administration (8.26 +/- 4.09 ng/ml). The data also revealed that the serum progesterone levels of the oral administration group (4.23 +/- 2.68 ng/ml) did not differ significantly (p = 0.925) from the other group (4.15 +/- 3.40 ng/ml) when the serum estrogen level was less than 30 pg/ml. On the contrary, when the serum estrogen level was at least 30 pg/ml, there was a significant (p < 0.005) difference in the serum progesterone levels between these two groups (6.32 +/- 2.99 ng/ml for the oral route and 9.76 +/- 3.23 ng/ml for the vaginal route).

Hypoosmotic swelling test of sperm supplemented with pentoxifylline after preparation by two-layer percoll gradient method.

The aim of this study was to compare the percentage of sperm tail membrane swelling under hypoosmotic conditions with those with and without pentoxifylline supplements in sperm prepared by the two-layer Percoll gradient method. Twenty five normal semen samples were collected from male partners of infertile couples attending the Infretility Clinic at Siriraj Hospital. After the process of sperm preparation by the two-layer Percoll gradient method, the final samples were divided into 2 tubes, 0.5 ml was added into one tube and another tube was kept as control. The hypoosmotic swelling test was performed on both specimens. The percentage of swollen spermatozoa in the pentoxifylline supplement group was significantly higher than the control group (82.8 + 7.7 vs 70.8 + 12.7; p < 0.00). It was concluded that the addition of pentoxifylline to the sperm prepared by the two- layer Percoll gradient method can enhance the sperm membrane integrity, and it may be beneficial to add pentoxifylline to sperm preparation for use in IUI or IVF.

Effect of pentoxifylline on human sperm preparation.

The aim of the research was to study the effects of pentoxifylline on the sperm motility. Thirty samples of semen were studied. Each sample was divided into two sub-samples swim up technique. The other sub-samples were mixed with 3.3 mmol pentoxifylline solution for thirty minutes before entering the process of the sperm swim up preparation. The data regarding sperm concentration, motility, and morphology after 5 minutes of the swim up were recorded. The study showed that the samples that were mixed with 3.3 mmol pentoxifylline had a significantly higher sperm concentration (p< 0.001), greater sperm motility (p = 0.014), and a more normal sperm morphology (p < 0.001) than those samples prepared using the conventional method. It was concluded that pentoxifylline added in the process of sperm preparation could improve the sperm quality outcome.

Induction of acrosome reaction by calcium ionophore A23187 in sperm separated by two-layer percoll gradient method.

The aim of this study was to compare thepercentages of sperm with an acrosome reaction between those with and without calcium ionophore A23187 induction after two-layer Percoll gradient separation. Thirty normal semen samples were obtained from the male partners of infertile couples attending the Infertility Clinic at Siriraj Hospital. After the process of sperm separation by two-layer Percoll gradient technique, the final samples samples were divided into 2 portions. An aliquot of 10 ตM of calcium ionophore A23187 was added to one portion to induce an acrosome reaction, while the other portion was used as a control. Fluorescein isothiocyanate-conjugated Pisum sativam agglutinin (FITC-PSA) staining was performed on both specimens and the acrosome reated-sperm were evaluated. The percentage of acrosome-reated sperm in the calcium ionophore A23187 induced group was significantly higher than those of the control group (24.8+6.6vs 15.4+6.0;p < 0.001). It is concluded that calcium ionophore can significantly induce an acrosome reaction on sperm separated by two-layer Percoll gradient technique, and it may be beneficial to add calcium ionophore A23187 to sperm preparation for use in IUI or IVF.

Sperm motility and morphology after preparation using the percoll gradient method compared with the IxaPrep gradient method.

In order to compare the Percell gradient and IxaPrep gradient methods, the percentage of progressively motile sperm and the percentage of sperm with normal morphology were examined. Thirty five normal semen sample were collected from the male partners of infertile couples attending the Infertility Clinic. The samples were divided into two fractions of 1 ml each. Both fractions were processed using the Percoll gradient and IxaPrep gradient methods, and sperm motility and normal morphology were evaluated. The percentages of spermatozoa that showed progressive motility and normal morphology from the sperm preparation using the IxaPrep gradient method were significantly higher than those prepared by the Percoll gradient method (77.7 + 12.0 vs 73.7 + 12.3 and 64.4 + 15.1 vs 61.1 + 13.3 respectively ; p<0.05). It was concluded that sperm preparation using IxaPrep gradient method showed better sperm quality with respect to progressive motility and normal morphology than those using the Percoll gradient method, The IxaPrep gradient method can be considered as an alternative to the Percoll gradient for sperm preparation.

Effect of different exposure periods to the infrared 1.48 m diode laser on the inner cell mass and trophectoderm of blastocysts.

This study was carried out to determine the effect of the duration of exposure to an infrared 1.48 mm diode laser, on the number of cells in the inner cell mass and the trophectoderm of blastocysts following laser-assisted embryo biopsy. A total of 102 mouse embryos were used in the study. The embryos were randomly divided into three groups; group A (n = 22), group B (n = 47) and group C (n = 33). The embryos in group A were biopsied using the laser with an exposure of 600 ms, whereas those in group B were biopsied using the same laser with an exposure of 5 ms. The embryos in group C were incubated in culture without any procedures, as a control group. The blastocyst formation rates of group B (46/47, 97.8%) and group C (33/33, 100%) were significantly higher than that of group A (12/22, 54.5%). The number of cells in the inner cell mass, trophectoderm and the total number of cells in the blastocyst in group A (16.1 ฑ 5.1, 35.5 ฑ 10.9, 51.6 ฑ 12.9) were similar to those in group B (14.0 ฑ 5.6, 36.0 ฑ 12.7, 50.0 ฑ 18.3). The number of cells in the inner cell mass, trophectoderm and the total number of cells in the blastocysts in group C (19.1 ฑ 6.5, 45.8 ฑ 14.0, 65.0 ฑ 18.7) was significantly higher than those of the study groups. In conclusion, the longer duration of exposure to the infrared 1.48 mm diode laser might adversely affect blastocyst formation. However, it might not affect the quality of the blastocysts with regard to the number of cells in the inner cell mass and the trophectoderm.

Increasing trend of illicit drug abuse in Thai parturient at Siriraj Hospital.

OBJECTIVE: To report the magnitude of the problem and to evaluate the outcome of maternal illicit drug use in Thai parturients. DESIGN: Retrospective case-control study. SETTING: Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University. SUBJECT: The subjects were 44,640 parturients who had deliveries at Siriraj Hospital from January 1998 to December 2001 and were divided into two groups. The study group consisted of 66 parturients with a history of illicit drug use and the control group consisted of 44,574 parturients without a history of illicit drug use. INTERVENTION: Medical records of 66 parturients with a history of illicit drug use were reviewed. Obstetric statistics of the department were retrieved from the computerized database in the Division of Obstetric and Gynecologic Registry. The data were analyzed using descriptive statistics. MAIN OUTCOME MEASURE: Characteristics of parturients, pregnancy outcome, type and incidence of illicit drug. RESULTS: Within the study period, 66 cases of maternal illicit drug use were identifiable during the intrapartum period; 65 cases used amphetamine or derivatives and 1 case used an opioid derivative. The number had risen from 1 case in 1998 to 58 cases in 2001. Mean age of the patients was 23.30 +/- 6.04 years. Compared to the control group which included 44,574 parturients, the patients had a lower incidence of antenatal care (ANC rate = 21.21% vs 94.35%; RR = 0.23, 95% CI = 0.14-0.26), a higher incidence of HIV infection (10% vs 2%; RR = 6.09, 95% CI = 2.83-13.12), a higher incidence of birth before arrival (BBA rate = 9.09% vs 1.06%; RR = 8.59, 95% CI = 3.98-18.51), and a lower cesarean section rate (10.60% vs 26.36%; RR = 0.40, 95% CI = 0.20-0.81). There were no serious intrapartum, immediate postpartum and neonatal complication. Fetal outcome included a higher incidence of low birth weight infants (22.73% vs 10.23%; RR = 2.22, 95% CI = 1.42-3.46) and a smaller head circumference than the normal range of Thai fetal biometry (31.85 +/- 1.47 cm). CONCLUSION: There is an increasing trend of illicit drug use in Thai parturients. Although the present case series of drug abuse in Thai parturients cannot give the whole picture of maternal drug abuse in the Thai population, the dramatic increase in the identifiable cases during the past 4 years is very alarming. Currently, the outcome of pregnancy in case detected during intrapartum is not much different from that in the general population. However, there are potential risks for the patients and their babies. All medical staffs should be aware of this condition. Careful clinical data gathering and laboratory testing are suggested for prevention of complications and the potential hazards of this problem.