Comparison of two-layer Percoll gradient and mini-Percoll methods for sperm preparation.

To compare the efficiency of sperm preparation between the two-layer Percoll gradient and mini-Percoll methods, 50 normal and 33 abnormal semen samples from male partners of infertile couples were studied. The number of recovered spermatozoa, percentage of motility, percentage of normal morphology, and their survival at 24 and 48 hours were assessed. Both Percoll gradient techniques resulted in a significantly higher percentage of motility and percentage of normal morphology compared with the original semen samples (p < 0.0001). The two-layer Percoll gradient showed a higher sperm recovery than the mini-Percoll method (p < 0.001), but the latter resulted in a higher percentage of motility (p > 0.001) and a higher sperm survival rate at 24 hours (p < 0.05) than the former, regarding normal semen samples. These differences did not appear with abnormal semen samples when analyzed as a group. Considering each of the abnormal parameters separately, sperm recovery was significantly higher after the two-layer Percoll gradient in the case of astheno- and teratozoospermia (p < 0.05), but sperm survival at 48 hours was higher after the mini-Percoll gradient in the case of teratozoospermia (p < 0.05). It is concluded that both the two-layer Percoll gradient and mini-Percoll method can be used effectively for sperm preparation. The former yields a higher sperm recovery, but the latter should be considered regarding teratozoospermic samples and semen samples of very low volume.

Primary amenorrhoea: a retrospective study at Siriraj Hospital.

To determine the incidence of etiologic factors responsible for primary amenorrhoea in Siriraj Hospital on the basis of clinical examination and laboratory investigations. A retrospective study was performed from the records of patients who attended the Reproductive endocrine Clinic at Siriraj Hospital from 1 September 1992 to 31 August 1995. During the 3 years of the study period, there were 110 cases of primary amenorrhoea. One hundred and one cases were analyzed: nine cases were excluded because the patients lost follow-up before the final diagnosis could be concluded. The two most common etiologic factors were mullerian agenesis (39.65%) and gonadal dysgenesis (32.69%). Mean age of the patients when they first consulted the physicians was 22.45 +/- 6.06 years. Karyotyping was done on 28 of 32 cases of gonadal dysgenesis; 46,XX karyotype was found in 50 per cent and 45,XO in 14.29 per cent of analyzed cases. Clinical examination gave wrong diagnosis of absent uterus in 4 cases who were in the hypoestrogenic stage with hypoplastic uterus; ultrasonography and laparoscopy gave the wrong diagnosis in 1 case each in our report. These patients successfully menstruated after hormonal replacement therapy. The incidence of etiologic causes and cytogenetic study of primary amenorrhoea in our study is different from earlier reports. Racial and environmental differences may play a role in these differences. The facilities of diagnostic tools may also play a part. However, both clinical examination and many laboratory investigations have to be completed before final diagnosis of etiologic causes of primary amenorrhoea are elucidated. Diagnosis based on inadequate data can be misleading.