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Background and objective: Intrauterine insemination (IUI) after ovarian stimulation with clomiphene citrate has been a mainstay of therapy for couples suffering from non-tubal infertility because IUI is a simple, non-invasive, and cost-effective technique. Pregnancy rates after IUI were 8% to 15% on the average. Although the number of available follicles was increased by ovarian stimulation, the results are still not very promise. Because the clinical pregnancy rate of IUI in Srinagarind Hospital was 3.08%. The new insemination method for improving the clinical pregnancy rate was considered to be an alternative way technique which could be reduced cost and duration of treatment and avoid complication of the assisted reproductive technology. A preliminary RCT compared the clinical pregnancy rate of IUTPI and IUI was the main objective of the study.Methods: The study was conducted from April 1, 2007 to March 31, 2008 at Infertility clinic, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University. The volunteers were women with non-tubal infertility who met the inclusion criteria (unexplained infertility, minimal-mild endometriosis, mild oligozoospermia) and undergoing first treatment cycle were randomized to the study. Twenty eight women were randomized to the study and allocation to group A (IUTPI) or group B (IUI) on the day of insemination followed the ovarian stimulation with clomiphene citate (CC). On the day of 36-40 hours after hCG administration, IUTPI was performed by using a pediatric Foley's catheter size 8 F inseminating with 10 mL of sperm suspension and IUI was performed with 0.5 mL of sperm suspension by using the household IUI catheter.Results: A total of 28 cycles was completed treatment and followed up (16 IUTPI cycles and 12 IUI cycles).The clinical pregnancy rate per cycle was 6.3%(1/16) for IUTPI and 0%(0/12) for IUI, p=1.00. The ongoing pregnancy rate per cycle was 6.3%(1/16) for IUTPI and 0%(0/12) for IUI, p=1.00. No multiple pregnancy, ectopic pregnancy, ovarian hyperstimulation syndrome and infection were occurred.Conclusion: This preliminary result of IUTPI after ovarian stimulation with clomiphene citrate might not be advantage over the standard IUI for couples with non-tubal infertility on pregnancy rate.Keywords: Intrauterine tuboperitoneal insemination, intrauterine insemination, clinical pregnancy rate, ongoing pregnancy rate
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Backgrounds and Objectives: Cancer of the cervix is the most common cancer in Thai women with an estimated 16.4% of all cancer in females. It has been proposed that cigarette smoking among HPV positive women is one of the co-factors which likely influence the risk of cervical cancer progression. The association between cervical cancer development and the duration or the dose of cigarette smoking of the family members, however, was still unclear. This study is determined to evaluate the association between passive smoking as well as other factors such as HPV infection and cervical cancer in Northeastern Thai women.Methods: A case–control study was undertaken with 55 cases of SCCA and 55 age-matched healthy controls. HPV DNA was analyzed in cervical specimens with the GP5+/6+ primers. The information regarding sexual behaviors, reproductive history, contraceptive use, and history of smoking were collected from all subjects. This study was approved by the Ethics Committee of Khon Kaen University No. HE 450333.Results: HPV infection, prolong oral contraceptive pills use, age at first delivery, number of sexual partners and smoking status of partners revealed statistical different increase risk for cervical cancer with the odds ratio of 38.74, 12.72, 11.10 and 4.92-fold respectively with p
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Background : The prenatal diagnosis of duodenal obstruction enables clinicians to plan proper obstetric management and early postnatal surgical correction.Objective: To present an case report.Results: We report the case of a 38-year-old woman obstetric ultrasound examination at 31 weeks’ gestation because of the large size of her uterus. The examination revealed a single live fetus left whose size was consistent with 31 weeks’ gestation. The fetus had polyhydramnios and the double-bubble sit in its abdomen. Cordocentesis was performed. Chromosomal examination of the fetal blood revealed trisomy 21. Preterm delivery occurred at 34 weeks’ gestation and a baby girl weighing 2,460 grams was delivered vaginally. Surgical correction of the duodenal obstruction was carried out. The cause of the obstruction was an annular pancreas. The baby died on the fifth postoperative day because of sepsis.Conclusion: Ultrasound was show to be a useful diagnostic toll for the prenatal diagnosis of duodenal obstruction. It enabled further management to be properly planed.
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Nuclear transfer is the process involving the introduction of genetic material (in form of an individual cell nucleus removed from either an embryonic, a fetal or an adult cell) into the cytoplasm of an unfertilised egg or embryo, whose own genetic material (nucleus) has been removed. The nuclear genes of clones produced by this technique would be identical, although the mitochondrial DNA of such clones would be different. However, unlike the embryonic splitting technique, nuclear replacement has the potential to create a clone of an adult organism, as well as the potential to produce many more clones.
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Objectives: To investigate the effects of preimplatation exposure of (F1×F1) strain mouse embryos to different dosages (0.3 VS 0.6mM) of ammonium chloride.Study Method: Total of 267, one-cell stage mouse embryos were randomly allocated to culture in either M16 medium (control), or the other two experimental groups which are M16+0.3 mM ammonium chloride or M16-0.6 mM ammonium chloride. Embryos were left in culture for 3 days before being transferred to 2.5 day pseudopregnant recipients. Embryo morphology was assessed after 1, 2 and 3 day of culture. The number of implantation site, fetuses, moles and any gross abnormality found were noted.Results: There was no significant difference in the number of embryos achieved morula or more advanced stage after three days of culture between the two treatment groups. Implantation rate was significantly higher in the group of embryos exposed to 0.3 mM ammonium chloride compared to those exposed to 0.6 mM ammonium chloride (Fisher Exact test, P
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Progress in reproductive technologies provided opportunity for scientists to be able to grow human embryos in vitro for more than two decades. Skills and knowledge derived from in vitro fertilization and in vitro culture of mammalian embryos opened the chance for scientists to develop the strategies to derive embryonic stem cell lines from mammalian and human embryos. This achievement has initiated a new era in the fields of biotechnology, pharmacology, basic scientific research and cell-based medicine. To date, scientists have made some progress in optimizing regimens in deriving ES cell lines from human embryos but much more research and development are still required especially in the aspect of directing stem cells into the specific cells of potential clinical use. Collaboration among clinicians and scientists from diverse fields, together with the public awareness of how useful this technology could offer to modern medicine, will result in the accumulation of knowledge in this field and ultimately a progress in cell-based therapy in the future.
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Introduction Hysterectomy is one of the most common major gynaecological operations, and the vast majority of this procedure is performed for benign disease. This operation disrupts the intimate anatomical relationship between the uterus, bowel, bladder and vagina, and inevitably the local nerve supply. It is, therefore, conceivable that hysterectomy may alter the function of these organs. The procedure may be total, when both the body of the uterus and the cervix are removed, or subtotal, when the cervix is conserved. In the UK, subtotal hysterectomy is an unpopular procedure, accounting for only 1.47% of the hysterectomics in 1994-1995.(1) This is apparently largely due o a perceived risk of cervical stump carcinoma. However, there are a number of compelling reasons why gynaecologist might review his/her views: the incidence of cervical cancer is falling due to more effective screening; the increased risk of ureteric and bladder damage associated with total, but minimised by subtotal, hysterectomy might persuade some to consider whether the former operation is always necessary; and, finally, the conflicting report from Scandinavia in the early and late 1980, where the issue was whether one or the other operation conferred benefit in terms of urinary, bowel and sexual function, have brought the whole controversy into the public domain.
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Objective: To assess the success rate and factors influencing the success rate of sterilization reversal in Srinagarind hospitalDesign: A descriptive studySetting: Srinagarind hospital, Khon Kaen UniversitySubject: 206 patients who underwent microsurgical sterilization reversal in Srinagarind hospital between January 1, 1984 to June 30, 1993.Result: Mean age of the patients was 32.0 years, most of them were government officers and farmers. The reasons for reversal were remarriage (68.0 percent) and death of their children (17.5 percent). Most of the patients had postpartum tubal reanastomosis was performed in 83.0 percent of the patients. Ampulla to ampulla was the most common type of reanastomosis. The mean duration of the operation was 135.8 minutes. Success rate of the operation as determined by delivery of the liveborn was 58.7 percent while abortion rate and ectopic pregnancy rate were 8.3 and 6.6 percent, respectively. Most of the pregnancies occurred in the first two years after the operation with the mean interval between the operation and the commencement of pregnancy of 21.6 months. Factors that influence the success rate of sterilization reversal were age of the patients, time interval after sterilization, type of sterilization and part of the uterine tubes being reanastomosed. This study revealed that the patients with age under 35 years, operation performed within 5 years after sterilization, interval type of sterilization, and isthmic-isthmic reanastomosis were the factors that resulted in the better success rate.Conclusion: sterilization reversal in Srinagarind hospital had a good success rate and factors that influenced the success were age of the patients, time interval after sterilization, type of sterilization, and part of the uterine tubes being reanastomosed
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IntroductionImplantation is the process of which the blastocyst attaches to the uterine epithelium. Generally there are two factors which determine the success of implantation. These include (1) the production of the hatched blastocyst capable of implanting and (2) the development of an endometrium that is receptive to the embryo. Overall responsibilities for the coordination of these two processes lies with ovarian hormones, estrogen and progesterone. However, it is now clear that under their influence, locally acting soluble factors secreted by the endometrium can act on the embryo to influence its development. Developing embryos, in turn, have been shown to produce soluble factors, cytokines and growth factors, that can act in an autocrine manner, or on the endometrium to influence receptivity (1, 2) . This article will review new data indicating a critical role for cytokines and growth factors, both in preimplantation embryo development and endometrial receptivity.