Association between urine and serum estradiol levels in in vitro fertilization cycles.

To study the correlation between urine and serum estradiol (E2) controlled ovarian hyperstimulation (COH). This is a cross-sectional analytical study that was conducted in a tertiary care hospital. Seventy-seven urine and blood samplings were collected from infertile women who were treated with COH. An electrochemiluminescent immunoassay was performed to evaluate E2 levels between urine and serum samples on the 6th day and the day of ovarian trigger. In addition, the correlations were evaluated between urine E2 level and number of follicles, retrieved, metaphase II oocytes, and fertilization rate. A sub-analysis was performed for age, responding status and BMI. Seventy-seven infertile women were recruited. The medians of serum and urine E2 level levels on the day 6th of ovarian stimulation were 833.20 pg/ml (IQR; 516.90-1371.00) and 3.67 (IQR; 2.84-4.81), respectively. On the day of ovarian trigger, the median of serum E2 level was 2113.00 pg/ml (IQR; 1382.00-3885.00) and urine E2 level (E2/creatinine) was 6.84 (IQR; 5.34-8.70). The correlation between serum and urine E2 level on day 6th was 0.53 and the day of ovarian trigger was 0.59, p < 0.001. Moreover, the correlations of urine E2 level on the day of ovarian trigger to number of follicles, number of oocytes retrieved, metaphase II oocytes and fertilization rate were 0.57, 0.58, 0.61, and 0.64 (p < 0.001). The urine E2 level was moderately correlated to serum E2, number of follicles growth, oocytes retrieved and fertilization rate.

A Cross-Sectional Study on the Quality of Life in Women with Endometrioma.

PURPOSE: To evaluate the quality of life (QoL) of women with endometrioma and explore the associated factors. PATIENTS AND METHODS: A cross-sectional study was conducted between August 2020 and March 2021. A total of 99 women diagnosed with ovarian endometrioma with at least one endometriosis-associated symptom completed the Endometriosis Health Profile 30 (EHP-30) questionnaire for their QoL score before treatment for ovarian endometrioma. The questionnaire comprises a central questionnaire (30 items) and a modular questionnaire (23 items divided into 6 sections). Demographics and QoL scores were analyzed using descriptive statistics and multivariable linear regression or median regression. RESULTS: The mean QoL score was 35.0±15.8 (range, 16.0±21.2 in the social support dimension to 45.1±24.4 in the control and powerlessness dimension). In the modular questionnaire, the highest score was in the infertility domain, while the lowest was in the relationship with the physician domain. The pain score and chronic pelvic pain (CPP) were independent correlation factors for a higher total EHP-30 score: the higher the total EHP-30, the poorer the QoL. CPP was positively correlated with the QoL score in the work domain. CONCLUSION: The present study revealed that CPP was the factor associated with a worse QoL and work performance in women with endometrioma based on a disease-specific, EHP-30 questionnaire.

Effect of sperm selection method by cumulus oophorus complexes and conventional sperm preparation method on sperm quality and DNA fragmentation for assisted reproduction techonology.

OBJECTIVES: To compare the effectiveness of sperm selection using cumulus oophorus complexes (COCs) and conventional sperm preparation methods on sperm quality and DNA fragmentation METHODS: Normal semen samples under the World Health Organization (WHO)'s 2010 eligibility criteria were collected and processed using conventional sperm preparation methods. The prepared sperm were divided into two groups. Spermatozoa in the study group were selected based on their ability to penetrate a layer of COCs. In the control group, spermatozoa were kept in culture medium under similar conditions. The selected-sperm were evaluated based on sperm quality and DNA fragmentation. RESULTS: Thirty normal semen samples were recruited. Spermatozoa that were able to passthrough the COCs had significantly higher sperm motility parameters than the control group (curvilinear velocity [VCL; 143.5 vs 122.2; P < 0.01], average path velocity [VAP; 83.6 vs 69.3; P < 0.01], straight-line velocity [VSL; 67.95 vs 60.45; P < 0.01]). The percentage of normal spermatozoa morphology in the COCs group was significantly higher than in the control group (21.70% vs 18.76%). In addition, there was significantly less DNA fragmentation in the COCs group than in the control group (18.83 vs 10.83). CONCLUSION: Spermatozoa selected using COCs were likely to be effective in terms of sperm quality and DNA fragmentation.

Combined vaginal administration of nystatin, diiodohydroxyquin, and benzalkonium chloride versus oral metronidazole for the treatment of bacterial vaginosis.

OBJECTIVE: To compare combined vaginal administration of nystatin, diiodohydroxyquin, and benzalkonium chloride versus oral metronidazole for the treatment of bacterial vaginosis (BV). METHODS: A randomized controlled trial was conducted among women diagnosed with BV using the Amsel criteria (n=90) at a university hospital in Khon Kaen, Thailand, between June 27, 2017, and April 30, 2018. The oral metronidazole group (n=44) received 400 mg of metronidazole, administered three times per day. The combined vaginal tablet group (n=46) received a vaginal suppository once daily, which comprised nystatin (100 000 U), diiodohydroxyquin (100 mg), and benzalkonium chloride (7 mg). Treatment was administered for 7 days in both groups. Follow-up visits at 14 and 42 days assessed treatment outcomes and adverse effects. RESULTS: Remission of BV occurred among 41 (93%) women in the oral metronidazole group and 39 (85%) women in the combined vaginal tablet group. The adjusted relative risk was 0.92 (95% confidence interval 0.80-1.06). The rate of nausea and/or vomiting was significantly higher in the oral metronidazole group than that in the combined vaginal tablet group. CONCLUSION: Treatment efficacy of the combined vaginal tablet versus oral metronidazole was equivalent. CLINICAL TRIAL REGISTRATION: TCTR20170627001 (www.clinicaltrials.in.th).

Contraceptive practices and pregnancy intendedness among pregnant adolescents.

BACKGROUND: Adolescent pregnancy is a major health problem in many developing countries. OBJECTIVE: To assess contraceptive practices and pregnancy intendedness in pregnant adolescents. MATERIALS AND METHODS: This study was prospectively conducted from September 2013 to June 2014. All consecutively pregnant women between 15 and 19 years old attending the Antenatal Clinic at Srinagarind Hospital and the Khon Kaen Branch of the Planned Parenthood Association of Thailand were invited for participation. Face-to-face interviews by trained interviewers using standardized questionnaires were carried out. Logistic regression was used to determine an adjusted odds ratio (aOR) and 95% confidence interval (CI) of independent predictors. RESULTS: Two hundred participants were enrolled. Mean age was 17.2 years. One hundred and eighteen (59.0%) were currently in school. Seventy-five (37.5%) participants had never used any contraceptive methods. Of the 125 participants who had ever used contraception, regular use of contraceptives was reported in only 21 participants (16.8%). Only two participants (1.0%) had ever used an intrauterine device or implant. Participants' age was a significant independent factor associated with non-use of contraceptives (aOR, 6.42; 95% CI, 2.94-14.04). Of the 200 participants, 132 (66.0%) declared that the pregnancy was unintended. Significant independent factors predicting unintended pregnancy were educational status (aOR, 6.17; 95% CI, 3.27-13.75) and participants' age (aOR, 5.76; 95% CI, 2.42-13.70). CONCLUSION: Non-use and use of contraceptive methods with high failure rates were major reasons leading to adolescent pregnancies. Participants' age was an independent factor predicting non-use of contraceptives. Educational status and age of the participants were significant factors predicting unintended pregnancy.