Matchuporn Sukprasert

Comparison of desogestrel/ethinyl estradiol plus spironolactone versus cyproterone acetate/ethinyl estradiol in the treatment of polycystic ovary syndrome: A randomized controlled trial

To compare the effects of ethinyl estradiol (EE) 30 mcg/desogestrel 150 mcg plus spironolactone 25 mg/day (group A) versus EE 35 mcg/cyproterone acetate 2 mg (group B) on hyperandrogenism and metabolism in PCOS.

Glucose metabolism in obese and lean adolescents with polycystic ovary syndrome.

Abstract Data on glucose metabolism in Asian adolescents with polycystic ovary syndrome (PCOS) are limited. Glucose metabolism assessment using an oral glucose tolerance test (OGTT) in obese and lean Thai adolescents with PCOS, and a comparison between the two groups were done. Thirty-one patients (19 obese, 12 lean) were enrolled. Their median (range) age was 14.9 (11.0–21.0) years. Eighteen patients had abnormal glucose metabolism (13 hyperinsulinemia, 4 impaired glucose tolerance, and 1 diabetes). Compared between obese [median (range) BMI Z-score, 1.6 (1.2–2.6)] and lean [median (range) BMI Z-score, 0.1 (–1.4 to 0.6)] patients, the frequencies of each abnormal OGTT category, areas under the curves of glucose and insulin levels, and insulinogenic index were not different; however, insulin resistance was greater in the obese group. In conclusion, a high proportion of our adolescents with PCOS had abnormal glucose metabolism. Therefore, OGTT should be performed in adolescents with PCOS for the early detection of abnormal glucose metabolism.

The Effects of Short Abstinence Time on Sperm Motility, Morphology and DNA mDamage

This was an experimental study to determine the influence of short abstinence time on sperm motility, morphology and DNA damage performed at the Assisted Reproductive Technology (ART) unit, Ramathibodi Hospital. Fifty-seven semen samples with normal semen analysis according to World Health Organization (WHO) 1999 and Kruger strict criteria were obtained. Volunteers were instructed to abstain for 3-5 days, 18-30 hours and 4 days for the 1st, 2nd and 3rd semen collection Total motile sperm count (TMSC) was determined using computer-assisted semen analysis (CASA); sperm morphology was determined using eosin-methylene blue staining and DNA damage was assessed by TUNEL assay. The results showed that TMSC was not significantly different between the 1st (3-5 days abstinence time) and 2nd semen collection (18-30 hours abstinence time after the 1st collection) (p value=0.289). The percentage of DNA damage (4.6% vs. 9.8%, p value<0.001) and normal morphological sperm (14.9% vs. 17.2%, p value<0.001) in the 2nd semen collection were significantly lower than the 1st collection, although the value was still in the normal range. Semen parameters of the 3rd collection (4 days abstinence time after the 2nd collection) correlate with those of the 1st collection. We conclude that in normal semen, with an abstinence time of only one day, TMSC was not significantly different between 3-5 days abstinence time and 18-30 hours abstinence time. The result of DNA damage and the percentage of normal morphological sperm were significantly lower in 18-30 hours abstinence time.

Breast reconstruction in pregnancy: a case report of multidisciplinary team approach in immediate autologous flap reconstruction for pregnancy‐associated breast cancer

This report presents the results of immediate breast reconstruction with autologous flap in Pregnancy‐associated breast cancer (PABC). There was no obstetrics and surgical complications in our report. Immediate breast reconstruction can be performed in PABC after a careful selection. Multidisciplinary team approach is the key in managing these groups of patients.

Sperm motility and DNA integrity affected by different g-forces in the preparation of sperm in urine specimens

Retrograde ejaculation, a common type of anejaculation, is attributable to many causes, some of which can be treated with medication and some of which cannot. For infertility treatment, sperm must be collected from the urine of the patients. Our study attempts to ascertain the effects of different g‐forces on sperm motility, morphology and DNA integrity in sperm preparation by the Sil‐Select™ density gradient method of isolating sperm from urine specimens. Forty‐seven semen samples with normal semen analyses according to World Health Organisation (WHO) 1999 criteria were included in this study. Semen samples of 1 ml were mixed with 20 ml alkalinised normal urine and then divided equally into tubes A and B. The two samples were prepared by the Sil‐Select™ density gradient centrifugation method at 350 g (tube A) and at 700 g (tube B). Total motile sperm after centrifugation at 700 g was significantly higher than after centrifugation at 350 g [6.7 (0.4–23.0) million versus 3.1 (0.1–13.7) million] (P < 0.001). There was no significant difference between the either the percentage of sperm with normal morphology or with DNA damage between centrifugation at 350 g and 700 g (P > 0.05), although centrifugation at 700 g achieves a higher number of total motile sperm compared with Sil‐Select™ sperm preparation at 350 g centrifugation.