ABSTRACT
Saline infusion sonohysterography (SIS) is a widely used procedure for intrauterine lesion diagnosis. It has few side effects and complications. The authors present a case report of a middle-aged Thai woman who presented with metrorrhagia. Malignancy had been ruled out with fractional curettage. Despite hormonal treatment, she had persistent metrorrhagia. SIS was performed and a tubo-ovarian abscess developed. Exploratory laparotomy with TAH and BSO were carried out for treatment.
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Objective: To compare the efficiency of two cryopreservations between conventional slow freezing and vitrification of mouse blastocysts using cryo-E. Methods: ICR female mice (8 weeks) were superovulated with 5 IU/ml of pregnant mare serum gonadotrophin (PMSG), the successfulness of mating with males was verified by the presence of a vaginal plug. Blastocysts were obtained between 3.5 and 4.5 days per p.c. or 96-108 hours after hCG administration by flushing the uterus. Randomly selected blastocysts were simultaneously frozen by slow-rate freezing and a vitrification method. One month later, the embryos were thawed and cultured in the blastocyst medium (COOK; Sydney IVF, Australia). Results: Based on 250 slow freezing and 310 vitrified mouse blastocysts, vitrification resulted in a slightly higher survival and hatching rates than the slow-freezing method (83.9% VS 82.0%, and 68.8% VS 66.8%, respectively). Conclusion: Both slow freezing and vitrification of mouse blastocysts are useful methods for cryopreservation. These results showed that vitrification is better than slow freezing in terms of simplicity, duration, and cost-effectiveness.
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Objective: Preimplantation genetic diagnosis (PGD) is technique for detecting genetic diseases. Preimplantation genetic diagnosis for aneuploidy screening (PGD-AS) using fluorescent in situ hybridization (FISH) has been used worldwide including at Siriraj Hospital. The objective of this study was to comparethe pregnancy rate between a PGD-AS group with standard assisted reproductive techniques (ARTs) in Siriraj Hospital. Methods: Couples who requested PGD-AS underwent a standard ARTs process followed with blastomere biopsy for FISH analysis. The pregnancy rate was compared among the PGD-AS group and the control group. The control group was divided into 2 subgroups – all patients required ARTs subgroup and age ≥ 35 yrs. subgroup. Results: 6 stimulated cycles from 4 patients were performed in the PGD-AS group. The pregnancy rate per stimulated cycle in the PGD-AS group, control group and age ≥ 35 yrs group were 33.33%, 16.20% and 12.05% respectively. Moreover, the pregnancy rate per transferred cycles in the PGD-AS group, control group and age ≥ 35 yrs group were 40.00%, 21.02% and 13.17% respectively. Conclusion: PGD is an advanced method for detecting genetic defects. PGA-AS might increase the pregnancy rate.
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Objective: To study the correlation between the percentages of HA-unbound sperm and DNA fragmented sperm by TUNEL assay. Methods: The semen residue from semen analysis was tested by HBA and TUNEL assay. Results: The mean age of patients included in the study was 34.8 years (± 3.7 years). The proportion of HA-unbound sperm ranged from 11.3% to 24.2%, with a mean of 17.08% (± 3.24%). The range of TUNEL positive in semen samples was 2% to 11.75%, with a mean of 5.78% (± 2.28%). Pearson’s correlation between two tests was 0.848 (p<0.01). Intraobserver variation of the results of HBA ranged from 3.3% to 7.6%, with a mean of 6.23% (± 1.11%). Intraobserver variation of the results of TUNEL assay ranged from 0% to 6.9%, with a mean of 1.54% (± 2.7%). Agreement measuring of each test was determined by using intraclass correlation. The intraclass correlation coefficient of HBA and TUNEL assay were 0.970 (P<0.001) and 0.997 (P<0.001) respectively. Conclusion: As several studies have found, the binding capacity of sperm to HA is correlated with several sperm parameters. In this study, the strong correlation between the percentages of HA-unbound sperm and TUNEL positive sperm implies, furthermore, that the HA-bound sperm percentage correlates with low levels of DNA fragmentation.
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Objective: To evaluate the efficacy, cycle control of menstruation, side effects, and acceptability of the contraceptive patch in Thai women. Methods: In this noncomparative study, 60 healthy Thai women were treated with contraceptive patches. Assessments of the efficacy, cycle control, side effects, and acceptability were performed at baseline, cycles 1, 3 and 6. Results: The Mean age of the participants was 25.8 years. A total of 50 women completed 6 cycles providing 300 woman-months of use, with the women who withdrew from the study providing a further 5 woman-months of use for a total of 305 woman-months. There were no pregnancies during the study, neither method nor participant failures. Withdrawal bleeding was regular and predictable, with a low incidence of unscheduled bleeding. The most frequent adverse event was breast tenderness, headache, skin irritation, hair loss, nausea, and acne. Most of the users were satisfied with the contraceptive patch. Conclusion: The contraceptive patch provided effective contraception with excellent cycle control, and was well tolerated with good compliance. This convenient approach to contraception appears highly acceptable in Thai women.
ABSTRACT
A 34 year-old Thai female woman who had a previous history of recurrent pelvic inflammatory disease or recurrent pelvic inflammatory disease (PID), presented with recurrent pelvic pain and high grade fever. She was admitted and a diagnosis of tubo ovarian abscess was made. Physical examination and ultrasonographic examination demonstrated high grade fever, adnexal tenderness and a right mixed solid cystic mass compatible with tubo ovarian abscess. Despite prescription of combined parenteral antibiotic, her symptoms did not improve. An exploratory laparotomy showed a left ovarian abscess with a kinked fallopian tube behind the uterus. A left salpingectomy with partial oophorectomy was performed. Cultured pus was identified as group B streptococci. Antibiotics therapy was continued until clinical improvment and she was discharged on the seventh post operative day. Tubo ovarian abscess or tubo ovarian abscess (TOA) is a serious consequence of PID. The streptococcus group B infection is a rare cause of TOA. There is a discussion about diagnosis, medical treatment and surgical treatment. Although medical treatment with broad-spectrum antibiotics has allowed patients to avoid operations, some of them who failed medical treatment required surgical treatment. Especially in women who need childbearing potential in future, conservative surgery has become the initial approach as well as this case report.
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The aim of the study was to evaluate the cryodamage effects on human sperm characteristics, especially on sperm DNA integrity, after 6 months of freezing comparing between liquid nitrogen vapour (LNV) and computerized program freezer (CPF). Forty normal semen samples were collected for semen analysis. Each sample was mixed with cryoprotective media and devided into 2 straws. The first straw was frozen with LNV and the second one with CPF. After 6 months of cryostorage, semen samples were thawed, and sperm chromatin integrity as well as sperm motility, morphology, vitality and cryosurvival rate were determined. Percentages of DNA damage were higher (p<0.01) following freezing with LNV than with CPF. Sperm vitality was greater (p<0.05) after CPF than after LNV, as well as cryosurvival rate (p<0.001). Post-thawed sperm motility was greater after CPF than after LNV, either in grade A (p<0.001) or in grade B (p<0.05). No significant difference was observed in the percentage of normal sperm morphology comparing the two freezing methods. The current study demonstrated post-thawed decrease in sperm DNA integrity as well as other sperm characteristics after freezing in both methods. The CPF significantly provided superior results in post-thawed sperm DNA integrity, sperm motility and vitality than LNV did. In case of 6 months of cryostorage, therefore, we recommend the computerized program freezer as a preference for sperm cryopreservation.
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OBJECTIVE: To compare the percentage of sperm tail membrane swelling under hypo-osmotic conditions between sperm treated with pentoxifylline and 2-deoxyadenosine. DESIGN: Experimental in vitro study. MATERIAL AND METHOD: Thirty normal semen samples from male partners of infertile couples were collected. After sperm preparation by two-layer Percoll gradient method, each sperm sample was divided into three specimens. Pentoxifylline and 2-deoxyadenosine were separately added into two specimens, while the third specimen was used as a control. Hypo-osmotic swelling test was performed in all specimens. Percentage of swollen spermatozoa in each specimen was evaluated. RESULTS: The mean percentage of swollen spermatozoa in the semen samples supplemented with pentoxifylline and 2-deoxyadenosine were both significantly higher than those in the control (82.8 +/- 7.7 and 83.0 +/- 9.5 vs 70.8 +/- 12.7; p < 0.001). There was no significant differences of swollen spermatozoa between pentoxifylline and 2-deoxyadenosine (p = 0.898). CONCLUSION: Addition of pentoxifylline and 2-deoxyadenosine to the sperm prepared by the two-layer Percoll gradient method can almost equally enhance the sperm membrane integrity. Therefore, it may be beneficial to add these compounds to sperm preparation for use in assisted reproduction.