The fertility profile of 307 Thai male volunteers whose wives were currently in early pregnancy was established by genital examination, semen analysis and serum hormone analysis. Ninety percent of the subjects had testicular volumes of 12-25 ml (mean 17.2 ml) which was found to relate to body weight, height and the ponderal index as well as to the sperm count. However, values for semen analysis were significantly below the recognised standard for Caucasian males. There was an inverse relationship between testicular volume and the serum concentration of FSH, LH and prolactin. It is suggested that a common protocol for male fertility assessment should be used to establish standard parameters for racially different male populations.

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Summary Labial adhesions separated spontaneously after one month of the topical oestrogen therapy in 22 (88 per cent) out of 25 children. This treatment was safe, painless, without significant complications and of lasting value.

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.

Abstract. To evaluate prospectively vaginal bleeding in young children with emphasis on the cause, management and outcome, we analyzed the data of all children aged under 10 years old who presented with vaginal bleeding at the King Chulalongkorn Memorial Hospital between 1981 and 2000. There were 55 girls presenting with vaginal bleeding with variable degrees of severity. In 41 of the 55 girls (74.5%), the bleeding resulted from a local lesion of the genital tract. Genital tumors were seen in four girls, ie hemangioma of the vulva, sarcoma botryoides of the vagina, functional ovarian cyst and granulosa cell tumor of the ovary. In the remaining 14 girls (25.5%), the bleeding originated from systemic hormonal etiology. In one girl with precocious puberty, it was associated with hypothyroidism, whereas in the other six girls it was due to constitutional causes. In addition, the cause of bleeding in 10 girls was the vaginal manifestation of leeches, which is a unique problem for Thailand. Although vaginal bleeding in young children is rare, it can be an alarming clinical presentation, and serious underlying causes should be excluded. Prompt and correct diagnosis will lead to successful management.