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Biomedical subjects

N Sukcharoen

Publications and source records attributed to N Sukcharoen.

At least 19 recordsLinked to original sources
PubMed2001

Comparison of the outcome of intracytoplasmic sperm injection using fresh and frozen-thawed epididymal spermatozoa obtained by percutaneous epididymal sperm aspiration.

The study was conducted to compare the outcome of intracytoplasmic sperm injection (ICSI) between fresh and frozen-thawed epididymal spermatozoa retrieved by percutaneous epididymal sperm aspiration (PESA) from obstructive azoospermic men. Overall, 53 PESA procedures were performed in 42 obstructive azoospermic men, followed by ICSI procedures with either fresh (n = 40) or frozen-thawed (n = 13) epididymal spermatozoa. Comparing all ICSI cycles with fresh and frozen-thawed epididymal spermatozoa, the fertilization rates (77.4 vs 86.8%) and the cleavage rate (91.3 vs 95.1%) were not statistically different. A total of 64 embryo transfers were performed: 48 embryo transfers after the use of fresh epididymal spermatozoa and 16 embryo transfers after the use of frozen-thawed spermatozoa. The overall pregnancy rate per embryo transfer was also similar between both groups (40.8 vs 40%). The implantation rate per embryo (18.2 vs 12.7%), clinical pregnancy per embryo transfer (36.7 vs 33.3%) and delivery/ongoing pregnancy rate (36.7 vs 33.3%) were not statistically different. In conclusion, there were no significant differences of the outcome of intracytoplasmic sperm injection using fresh and frozen-thawed epididymal spermatozoa obtained by PESA.

Adult↗
PubMed2001

The outcome of sperm retrieval and intracytoplasmic sperm injection for obstructive azoospermia.

OBJECTIVES: To study the outcome of sperm retrieval and intracytoplasmic sperm injection (ICSI) from obstructive azoospermic men. METHOD: Overall, 50 sperm retrieval procedures were performed in 45 obstructive azoospermic men, followed by 57 ICSI procedures with fresh epididymal spermatozoa (n=40), fresh testicular spermatozoa (n=4) or frozen-thawed epididymal spermatozoa (n=13). RESULTS: Sperm retrieval was accomplished via percutaneous epididymal sperm aspiration (PESA) in 42 cases, testicular sperm aspiration (TESA) in 1 case and testicular sperm extraction (TESE) in 2 cases. TESA and TESE were only applied when PESA failed to produce enough spermatozoa for simultaneous ICSI. PESA was successful in 92 per cent of cases. Fertilization rate after ICSI was 79.6 per cent of the metaphase II oocytes. Seventy one embryo transfers were performed using both fresh and frozen thawed embryos resulting in clinical pregnancy in 39.4 per cent. Ongoing pregnancy was achieved in 35.2 per cent. CONCLUSION: ICSI has been shown to give a high fertilization and pregnancy rate with epididymal and testicular spermatozoa retrieved from obstructive azoospermic men. PESA is a noninvasive and simple technique for retrieving spermatozoa from obstructive azoospermic men. Therefore, it is suitable as the primary sperm recovery technique in patients with obstructive azoospermia.

Embryo Transfer↗
PubMed1999

Telomerase activity in complete hydatidiform mole.

OBJECTIVE: To investigate whether telomerase is activated in complete hydatidiform mole and whether it could predict the development of persistent gestational trophoblastic tumors (GTTs). STUDY DESIGN: For this prospective study, 21 patients with complete hydatidiform mole were recruited. Molar tissue was obtained for telomerase activity measurement using the telomeric repeat amplification protocol assay. Patients' clinical characteristics, telomerase activity and subsequent clinical outcome were analyzed. RESULTS: Telomerase activity was detected in 12 cases (57.1%) with varied intensity. Two of four patients who had telomerase activity, uterine size larger than expected and preevacuation serum beta-human chorionic gonadotropin (beta-hCG) levels > 10(6) mIU/mL developed persistent GTT. CONCLUSION: Telomerase activity is detectable in some complete hydatidiform moles and might be useful for predicting persistent GTT when combined with uterine size and preevacuation serum beta-hCG level.

Adolescent↗
PubMed1999

Infected ovarian cyst in a homozygous beta-thalassemic patient.

An infected ovarian cyst in a thalassemic patient is rarely reported. We describe the case of a 22-year old woman with splenectomized homozygous beta-thalassemia who developed high fever and was diagnosed as having an infected ovarian cyst. The mechanisms which beta-thalassemia might predispose to infection and considered to be immunocompromized are discussed. She was given an intravenous antibiotic regimen and the infected ovarian cyst was removed. The difficulties in the diagnosis of an infected ovarian cyst is because of its rarity and the paucity of information on it in the literature. Therefore, the triad of ovarian cyst, immunocompromized host, and signs of infection with failure to identify any other source of infection should raise the suspicion of an infected ovarian cyst.

Adult↗
PubMed1998

Sperm morphology evaluated by computer (IVOS) cannot predict the fertilization rate in vitro after intracytoplasmic sperm injection.

OBJECTIVE: To evaluate sperm morphology assessment using the IVOS (Hamilton-Thorne Research Version 3 Dimension Program, Beverly, MA) system in prediction of fertilization rate in vitro after intracytoplasmic sperm injection (ICSI). DESIGN: A prospective clinical study. SETTING: Diagnostic andrology laboratory and assisted conception service. PATIENT(S): Thirty-five patients from the ICSI program were evaluated. Semen samples were analyzed using a computerized system for conventional semen parameters, sperm movement characteristics, and sperm morphology. Only patients with three or more metaphase II (MII) oocytes available were studied. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Fertilization rates in vitro after ICSI were compared according to the sperm morphology obtained from the IVOS system. RESULT(S): Linear regression analysis of fertilization rates against the sperm parameters assessed by computer (IVOS), which included conventional semen parameters, sperm movement characteristics, percentage of normal sperm morphology, and percentage of each specific abnormal sperm morphology, did not reveal any significant correlations. The mean (+/- SEM) fertilization rates in the healthy prognosis group (normal sperm morphology > or = 4%) and poor prognosis group (normal sperm morphology < or = 4%) were 82.4 +/- 4.0% and 75.0 +/- 3.8%, respectively. There was no statistically significant difference in the mean fertilization rate between both groups. Moreover, no statistically significant difference was found in overall fertilization rates in vitro between the two prognosis categories (79.6% versus 78.0%). CONCLUSION(S): Sperm morphology obtained from the IVOS system is not related to the outcome of ICSI and cannot be used for prediction of fertilization rate in vitro after ICSI.

Adult↗
PubMed1998

Comparison of the fertilization rate after intracytoplasmic sperm injection (ICSI) using ejaculated sperms, epididymal sperms and testicular sperms.

Intracytoplasmic sperm injection (ICSI) has been successfully used to achieve fertilization and pregnancies for patients with extreme oligoastheno-zoospermia using ejaculated sperms or patients with azoospermia using epididymal or testicular sperms. The aim of this study was to compare the fertilization rate after ICSI using ejaculated, epididymal and testicular sperms. Between January and September 1997, 10 azoospermic men underwent percutaneous epididymal sperm aspiration (PESA) or testicular sperm extraction (TESE) to recover sperm for ICSI. A total of 5 PESA cases and 5 TESE cases were performed at the Center for Assisted Reproduction & Embryology. Thirty-one patients performed ICSI using ejaculated sperms during the same period of time were used as a control group. ICSI using ejaculated sperms, epididymal sperms from PESA and testicular sperms from TESE was a highly successful technique, achieving fertilization rates of 78.5 per cent, 83.3 per cent and 80.8 per cent, respectively. Good fertilization rates were achieved without significant differences among the various sperm sources.

Cytoplasm↗
PubMed1996

Prediction of the in-vitro fertilization (IVF) potential of human spermatozoa using sperm function tests: the effect of the delay between testing and IVF.

To examine the diagnostic significance of several criteria of semen quality and to determine whether their prognostic value is eroded by the time interval between assessment and the attempt at in-vitro fertilization (IVF) with embryo transfer, 73 couples undergoing IVF and embryo transfer therapy were studied. The ability of human spermatozoa to achieve fertilization in vitro was examined in relation to the conventional semen profile, sperm morphology, the computer-aided assessment of sperm movement, ionophore-induced acrosome reaction, acridine orange staining, and chemiluminescent signals induced by phorbol ester and N-formyl-methionyl-leucyl-phenylalanine (FMLP). Spermatozoa were examined both in semen and after preparation on Percoll, some weeks prior to IVF. Fertilization rates were noted to be significantly correlated with elements of sperm movement characteristics, sperm morphology, and reactive oxygen species generation. Prediction of fertilization rates in a stepwise multiple regression analysis was obtained using four variables: sperm morphology, FMLP-induced chemi-luminescence and sperm movement characteristics (beat cross frequency and straightness) (r approximately 0.5). When multiple logistic regression analysis was used to predict which samples would achieve fertilization rates above and below a 50% threshold, three variables of predictive value including linearity, average path velocity and FMLP-induced chemiluminescence were selected. Combination of these variables classified the samples achieving good or poor fertilization with an overall accuracy of 83.6%. The time interval between semen assessment and IVF had little effect on the predictive value of these tests. In conclusion, the fertilizing ability of human spermatozoa is related to sperm morphology, attributes of sperm movement and reactive oxygen species production. The time delay between testing and IVF did not appear to affect predictive accuracy.

Acridine Orange↗
PubMed1996

Effects of occupational lead exposure on spermatogenesis.

In summary, there were significant differences in blood and semen lead levels, LH levels and prolactin levels in workmen who were exposed to lead. However, all hormonal profiles still remained within the normal adult range for Thai men. Higher levels of blood lead were found to have no significant effect on the sperm variables and hormonal profiles except testosterone levels at second follow-up and prolactin levels at sixth follow-up. However, these differences were not consistent during the study period. It should be noted that the present data are preliminary, pertain only to short-term exposure and require confirmation. The actual prospective long-term risk of lead exposure, remains to be determined. However, our study highlights the feasibility and importance of a prospective cohort study in assessment of the risk of lead exposure on male reproductive system. Long-term longitudinal controlled studies of semen quality and hormonal profiles in workmen examined before and during lead exposure and prospective studies of time to pregnancy in couples attempting to achieve pregnancy are probably necessary in order to obtain further knowledge. This study also indicates that the reproductive function surveillance of these workmen must be investigated as well as other physical health. In conclusion, an increase of blood lead levels due to occupational exposure cause no immediate and significant changes in spermatogenesis and hormonal profiles.

Adolescent↗
PubMed1996

Suppression of spermatogenesis by testosterone enanthate in Thai men.

To investigate the effect of testosterone enanthate on suppression of spermatogenesis in Thai men, 17 normal Thai men were given 200 mg testosterone enanthate weekly by intramuscular injection. During treatment, semen was collected regularly to monitor spermatogenesis. Median times for the first semen sample reaching sperm concentration threshold of 5, 3, 1 and 0 million/ml were 58, 70, 84, and 85, respectively. Subsequently, all men became azoospermic. Among 17 men entering the efficacy phase, 14 (82.3%) achieved consistent azoospermic from the beginning of efficacy phase, the remaining 3 (17.7%) were initially severe oligozoospermic but later became azoospermic. Only one case achieved consistent oligozoospermia but did not achieve azoospermia within 6 months. After stopping injection, sperm first reappeared in the ejaculate of formerly azoospermia men at 73 days. Recovery of sperm output to normal sperm concentration (> 20 million/ml) was achieved by all men at a median time of 3.9 months and recovery to their own baseline in one year after the last injection was established in 13/17 (76.5%) at a median time of 4.9 months, respectively. In conclusion, testosterone enanthate alone is effective in suppression of spermatogenesis for male hormonal contraception due to the high rate of azoospermia induced, which is known to ensure reliable and effective, reversible contraception.

Adult↗
PubMed1996

Determination of the ratio of X and Y bearing spermatozoa after albumin gradient method using double-labelled fluorescence in situ hybridization (FISH).

Determination of X and Y human spermatozoa by double labelled fluorescence in situ hybridization (FISH) is a new and more reliable method than Quinacrine hydrochloride staining for Y sperm identification. A preliminary report on determination of the ratio of X and Y sperm of normal semen of fifteen donors by double labelled FISH method before and after Y sperm separation by Ericsson albumin column method. This is currently popularized in Thailand. Results of standardized FISH technique has an average success rate of approximately 95 percent. Results of the experiment showed that the ratio of X:Y sperm before and after albumin column filtration is 50.03:49.80 and 48.77:51.00, respectively. Few spermatozoa have double sex chromosomes, XX, XY or YY. In conclusion, Y sperm selection by Ericsson's method is ineffective for male sex preselection.

Cell Separation↗
PubMed1996

Contraceptive efficacy and adverse effects of testosterone enanthate in Thai men.

In conclusion, the present study demonstrated that induced severe oligozoospermia or azoospermia by weekly testosterone enanthate injection was sufficient for male contraception. The low rates of discontinuation due to side-effects of the hormone and incidental medical conditions in this study confirms the safety and acceptability of such androgen administration found in studies with up to 18 months exposure. The long-term hazards remain uncertain and require investigation for risk. The possible long-term benefits from androgen use for bone, muscle and blood metabolism will also need to be assessed before the net risk-benefit effects of an androgen-containing regimen can be fully evaluated. In summary, the contraceptive efficacy for male contraception in this study demonstrated that weekly injections of testosterone enanthate can provide safe and effective contraceptive protection. The practicability of this approach may be improved by the use of longer-acting testosterone preparations which are under development.

Adult↗
PubMed1995

Predicting the fertilizing potential of human sperm suspensions in vitro: importance of sperm morphology and leukocyte contamination.

OBJECTIVE: To determine the relationships between sperm function tests and fertilization of human oocytes in vitro. DESIGN: Analysis of infertile patients undergoing IVF therapy. SETTING: Diagnostic Andrology Laboratory and Assisted Conception Service. PATIENTS: Forty-one couples who underwent IVF-ET therapy were studied. INTERVENTIONS: None. MAIN OUTCOME MEASURES: The ability of human spermatozoa to achieve fertilization in vitro was examined in relation to numerous criteria of semen quality, including the conventional semen profile, the computer-aided assessment of sperm movement, ionophore-induced acrosome reaction, acridine orange staining, sperm morphology, and chemiluminescent signals induced by phorbol ester and N-formyl-methionyl-leucyl-phenylalanine (FMLP). RESULTS: Significant correlations were observed between fertilization rates and several attributes of the sperm preparations, including elements of sperm function (acrosome reaction), movement (percentage motile, hyperactivation, the amplitude of lateral sperm head displacement), morphology (normal morphology, midpiece defects, multiple anomalies index), nuclear normality (acridine orange staining), and reactive oxygen species generation (chemiluminescence induced by phorbol ester and FMLP). In a stepwise multiple regression analysis, an accurate prediction of fertilization rates was obtained using a multiple regression equation incorporating six variables of which sperm morphology and FMLP-induced chemiluminescence were the most informative. CONCLUSIONS: A set of criteria have been identified that accurately predict the fertilizing potential of human sperm suspensions in vitro and that place particular emphasis on sperm morphology and the degree of leukocyte contamination.

Acridine Orange↗
PubMed1995

Randomized trial of misoprostol and cervagem in combination with a reduced dose of mifepristone for induction of abortion.

Mifepristone (600 mg) in combination with a prostaglandin has been demonstrated to be a safe, acceptable alternative to vacuum aspiration for induction of abortion in the first 9 weeks of pregnancy. However, the efficacy and side-effects of different prostaglandins used in combination with mifepristone have not been assessed in a randomized trial. In this study, 800 women seeking an abortion at gestational age < or = 63 days amenorrhoea were randomized to receive either 0.5 mg gemeprost by vaginal pessary (group I) or 600 micrograms misoprostol (group II) by mouth approximately 48 h after taking 200 mg mifepristone by mouth. The side-effects and number of complete abortions were used as measures of efficacy. There was no significant difference in the rate of complete abortion between group I [96.7%; 95% confidence interval (CI) 94.9-98.5%, n = 391] and group II (94.6%; 95% CI 92.3-96.9, n = 386). It was not possible to assess the outcome with certainty in the remaining 23 women. However, there were significantly more ongoing pregnancies in the women who received misoprostol than in those who received gemeprost (nine versus one, P < 0.01) and in eight of these 10 women the gestation was > 49 days. Fewer women in group II required analgesia than in group I (48 versus 60%, P < 0.001) although the number requesting opiate was similar in each group (6.9 versus 5.2%, P > 0.4). The incidence of nausea and vomiting after misoprostol (47.8 and 21.9% respectively) was higher (P < 0.001) than after gemeprost (33.9 and 12% respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Abortifacient Agents, Nonsteroidal↗
PubMed1995

Definition of the optimal criteria for identifying hyperactivated human spermatozoa at 25 Hz using in-vitro fertilization as a functional end-point.

Spermatozoa from fertile donors were used to select and validate criteria for the automated classification of hyperactivated (HA) motility using a computer-aided sperm analysis (CASA) system operating at 25 Hz. In the first phase of this analysis, 710 sperm trajectories were analysed and classified as forward progressive (FP), transition phase (TP) or HA. These tracks were then subjected to a CASA analysis and the various attributes of sperm movement defined for each category of motion. From this analysis, criteria were identified and subsequently validated that permitted the automated selection of FP, TP+HA and HA cells, with > 90% accuracy. To determine which attributes of movement best predicted the fertilizing potential of human spermatozoa, a detailed analysis of sperm motion was undertaken in patients undergoing in-vitro fertilization therapy. This analysis indicated that the single most important aspect of sperm movement was the incidence of HA motility (defined as curvilinear velocity > 90 microns/s, linearity < 20%, dancemean [amplitude of lateral head displacement/linearity x 100] > 45.8 microns) after 3 h of incubation. Using the latter criterion as the first incorporated variable, multiple regression equations were created that explained up to 50% of the variance in fertilization rates. None of the other patterns of motion (FP, TP, TP+HA) was correlated with fertilization rates, and none of the other published algorithms for identifying HA cells were as efficient as those described here.

Cohort Studies↗
PubMed1995

Intrauterine insemination of washed spermatozoa for treatment of oligozoospermia.

Efficacy of intrauterine insemination (IUI) using washed spermatozoa for treatment of oligozoospermia was evaluated by a prospective randomized study in 50 couples, using LH-timed natural intercourse in the alternate menstrual cycles as a control. The quality of spermatozoa in terms of their concentration and motility before and after sperm washing was compared. Sperm motility increased significantly after sperm preparation but the number of sperm was reduced. Eight pregnancies occurred in 253 cycles of IUI with washed spermatozoa and clomiphene citrate-stimulated cycles (3.16% per cycle). Only one patient conceived in 242 LH-timed natural intercourse cycles (0.41% per cycle). Compared with LH-timed natural intercourse, IUI provided a significantly improved pregnancy rate. When the sperm count was < 5 x 10(6) per ml, no pregnancy occurred with the IUI method. Therefore, IUI is a of rather limited usefulness when the sperm quality is very poor. Few complications occurred after IUI, but included slight cervical contact bleeding and mild abdominal discomfort and/or cramps. In conclusion, IUI should be considered as a useful and relatively non-invasive therapeutic modality for treating caused by moderate oligozoospermia (> 5 x 10(6)/ml), when sexual intercourse fails.

Clomiphene↗
PubMed1995

Prediction of post-thaw sperm motility and sperm cryosurvival rate using the pre-freeze sperm parameters.

To determine the relationships between pre-freeze semen variables and cryosurvival rate and post-thaw motility and examine whether they have any predictive value for the cryosurvival rate and post-thaw sperm motility, conventional semen analysis, supravital staining for sperm viability and hypo-osmotic swelling test were performed on 50 semen samples before cryopreservation. Thawed semen samples were examined for post-thaw sperm motility and cryosurvival rate. Significant correlations were observed between post-thaw sperm motility and several pre-freeze semen variables, such as, hypo-osmotic swelling test, pre-freeze sperm motility and sperm viability. In a stepwise regression analysis, an accurate prediction of post-thaw sperm motility (R = 0.826) was obtained using a multiple regression equation incorporating 3 variables including hypo-osmotic swelling test, pre-freeze sperm motility and sperm concentration. In conclusion, a set of criteria have been identified that accurately predicts post-thaw sperm motility and which place particular emphasis on hypo-osmotic swelling test. Conventional semen analysis and hypo-osmotic swelling test are simple and effective assays for the prediction of post-thaw motility.

Cryopreservation↗
PubMed1995

The effect of discontinuous Percoll gradient centrifugation on sperm morphology and nuclear DNA normality.

To determine the improvement of sperm morphology and sperm nuclear DNA normality after discontinuous Percoll gradients preparation, sperm morphology and sperm nuclear DNA normality from 157 semen samples from 45 donors and 63 male partners of infertile couples were assessed before and after discontinuous Percoll gradients preparation. In semen samples, about 67.5 per cent of the nuclei exhibited green acridine orange fluorescence. The percentage of normal sperm morphology, percentage of progressive motility, and percentage of green-fluorescing sperm were significantly better after this sperm preparation. Therefore, this sperm preparation technique is a convenient and efficient method to select progressive motile, normal morphological and normal nuclear DNA sperm for assisted conceptive technology.

Centrifugation, Density Gradient↗