Aim: This study aimed to evaluate the unique phenotype of the Vietnamese polycystic ovarian syndrome (PCOS) population. Methods: In this multicenter cross-sectional descriptive study, a total of 901 reproductive-age women were recruited at three medical centers in Vietnam from June 2016 to May 2018. Group I included 479 patients with PCOS (Rotterdam 2003 consensus) and Group II included 422 non-PCOS women, consisted of women with regular menstrual cycle, collected at the same time of PCOS recruitment, without ovarian disease or ovarian failure. Main outcome measures were anthropomorphic, serum hormone, ultrasound and physical characteristics of PCOS. Results: The Vietnamese PCOS population was lean, but with a higher weight and body mass index compared to controls. About 34.4% of PCOS subjects had hirsutism, primarily confined to the leg, arm and pubis. The PCOS population had higher serum luteinizing hormone (LH), LH : follicle stimulating hormone ratio, anti-Mullerian hormone and testosterone. The PCOS population had double the ovarian volume compared to controls. PCOS subjects had no increase in metabolic disease history and had on average optimal serum markers for low metabolic disease risk. Group D (O + polycystic ovary morphology [PCOM]) was the most prevalent phenotype noted in our Vietnamese PCOS cohort (67.6%). Modified Ferriman-Gallwey, levels of LH, testosterone and anti-Mullerian hormone were highest in Group A (O + H + PCOM) and lowest in Group D (O + PCOM). Conclusion: The Vietnamese PCOS population is characterized by a lean body type, nonfacial hirsutism, anovulatory, enlarged ovaries and typical PCOS serum hormone markers, low risk factors for metabolic syndrome. Nonclassical phenotypes for PCOS were more frequent than the classic phenotype.

<b><i>Objective: </i></b>Scrotal ultrasound is not a routine investigation in the clinical approach to male infertility analysis. This study aims to identify the role of testicular Doppler ultrasound in male infertility assessment and its relation to semen parameters in non-azoospermic men. <b><i>Methods: </i></b>Cross-sectional descriptive analysis of 558 men from infertile couples were examined at the Hue Center for Reproductive Endocrinology and Infertility, Hue University Hospital from June 2016 to May 2018. Some cohort characteristics, semen analysis and testicular Doppler ultrasound were analyzed. Men with acute systemic diseases, acute urinary tract infection, hepatic dysfunction, malignant diseases, retrograde ejaculation, cryptorchidism or azoospermia were excluded. <b><i>Results: </i></b>The mean volumes of the right and left testicles were 8.87 and 8.77 ml, respectively. The total volume of the 2 sides was 17.63 ± 4.34 ml (95% confidence interval 17.27-18.00 ml). The mean right resistive index (RI) was 0.61 ± 0.23, and the mean left RI was 0.59 ± 0.01. The rate of normal semen quality was 23.2% in group with varicocele and 30.6% in group with non-varicocele. The ultrasound results from the normal semen group were much different from those of the abnormal semen group regarding testicular volume: mean right testis volume: 9.67 ± 1.88 vs. 8.75 ± 2.34 ml, p = 0.0096; mean left testis volume: 9.54 ± 1.78 vs. 8.51 ± 2.44 ml, p = 0.0047; mean total volume of 2 sides: 19.21 ± 3.60 vs. 17.26 ± 4.59 ml, p = 0.005 (varicocele group); mean right testis volume: 9.21 ± 2.21 vs. 8.63 ± 2.21 ml, p = 0.029 (non-varicocele group). The other indexes of color Doppler ultrasound (peak systolic velocity, end diastolic velocity, RI) were not found to correlate with semen quality. <b><i>Conclusions: </i></b>Testicular volume which has a close relation to the semen parameters could be used as a clinical prediction factor for the quality of semen.

Background: In clinical obstetrics, many guidelines recommended the use of Doppler fetal ductus venosus blood flow to monitor and to manage fetal growth restriction (FGR). The ductus venosus and the pulmonary venous flow pattern of fetuses are similar. Umbilical artery pH (UA pH) is essential in identifying adverse pregnancy outcomes, particularly in fetal growth restriction cases. Nevertheless, the literature indicates that the relationship between pulmonary vein pulsatility index (PVPI) and UA pH in FGR cases has not been well investigated. This study aimed to identify the alteration in PVPI in FGR cases and evaluate the correlation between PVPI and UA pH in FGR newborns. Methods: This matched cohort study of singleton pregnancies from 28+0 to 40+0 weeks of gestation without congenital abnormalities included 135 cases of FGR (disease group) and 135 cases of normal growth (control group). The PVPI was measured at the proximal segment of the right or left pulmonary vein, approximately 5 mm from the left atrium wall. The umbilical artery pulsatility index (UAPI) was measured on the free umbilical cord. An elective cesarean section or labor induction are both options for ending the pregnancy, depending on the condition of the mother or fetus. Umbilical artery blood samples were collected within 5 minutes of delivery for UA pH measurement. SPSS version 20 and Medcalc version 20.1 were used for data analysis. Results: FGR cases had a significantly higher mean fetal PVPI than the control group (1.16 ± 0.26 vs. 0.84 ± 0.16; p < 0.01), and PVPI and UAPI were positively correlated (r = 0.63; p < 0.001). PVPI and UA pH were negatively correlated in FGR patients, with r = -0.68; p < 0.001. The PVPI value on the 95th percentile had a prognostic value of UA pH < 7.20 with a sensitivity of 88.2%, specificity of 66.3%, positive predictive value of 46.9%, and negative predictive value of 94.3%. Conclusions: There was a statistically significant difference in PVPI values in FGR cases compared to the normal growth group, a positive correlation between PVPI and UAPI, and a negative correlation between PVPI and UA pH. PVPI might have a prognostic meaning in predicting UA pH at birth.

Mở đầu: Khởi phát chuyển dạ là sự kích thích gây ra cơn co tử cung trước khi quá trình chuyển dạ tự nhiên bắt đầu. Hiện tại, ở Việt Nam trong khi các phương pháp khởi phát chuyển dạ bằng hoá học còn chưa được áp dụng rộng rãi do các lo ngại về tính an toàn và chi phí cao, thì các phương pháp cơ học được sử dụng chủ yếu. Mục tiêu: Xác định tỉ lệ KPCD thành công bằng ống thông foley. Xác định tỉ lệ biến chứng và tác dụng không mong muốn của phương pháp. Đánh giá kết cuộc thai kỳ sau KPCD bằng thông Foley. Phương pháp: nghiên cứu báo cáo loạt ca (dọc tiến cứu) trên 78 thai phụ đơn thai, tuổi thai từ 37 tuần, có chỉ định khởi phát chuyển dạ từ 11/2016 đến 09/2017 vào khoa Sinh BV Phụ Sản Nhi Đà Nẵng. Tất cả các thai phụ đều được KPCD với ống thông Foley 16 Fr qua lỗ trong cổ tử cung, bơm 60 ml nước muối sinh lý, theo dõi trong 12 giờ. Kết quả: Tỷ lệ KPCD thành công là 89,7%. Tỷ lệ sinh ngả âm đạo là 39,7%, tỷ lệ sinh mổ là 60,3%. Thời gian trung bình từ lúc KPCD đến chuyển dạ 9.36±3,23 giờ. Không có tác dụng ngoại ý nghiêm trọng, ghi nhận có 27 TH (34,6%) có cảm giác khó chịu hoặc đau khi đặt thông. Sau sinh, tình trạng với Apgar <7 điểm/1 phút chỉ có 5 TH, đó là những trường hợp thai tử lưu được khởi phát chuyển dạ. Không có TH nào bị ngạt cần phải hồi sức. Kết luận: KPCD với thông Foley qua lỗ trong cổ tử cung là phương pháp cơ học an toàn và hiệu quả cao cho thai kỳ có tuổi thai ≥ 37 tuần. Tuy nhiên cần có thêm nhiều nghiên cứu hơn trong tương lai.

Introduction: Polycystic ovary syndrome (STD) is a common endocrine and metabolic disorder that affects significantly the general health of 6-18% of women. Data on metabolic disorders in PCOS is so far still limited and lack of uniformity in terms of race, geographic location, human-origin, age, sample size or lifestyle. Methodology: A cross-sectional description of 759 cases of reproductive-age women who were diagnosed with PCOS by Rotterdam criteria (391) and non-PCOS (368) visited 3 ART centers in central Vietnam including Hue University Hospital, Hue Central Hospital and Danang Hospital for Women and Children, from June 2016 to June 2017. Inclusion criteria to the control group consisted of infertile women without PCOS, regular menstrual cycle, no ovarian disease (ovary cyst/tumor or endometriosis), without history of ovarian surgery or determined ovarian failure. Clinical characteristics and basic hormonal profile, AMH, lipidemia variables, fasting blood glucose and glucose tolerance testing were performed to evaluate endocrine and metabolic status. Input and process data using SPSS 19.0 software. Results: The PCOS group had a 1.2-fold increase in overweight BMI (RR=1.20 with 95%CI: 1.02-1.42). The mean of waist circumference and waist / hip ratio was higher than that of control group. Lipidemia dysfunction was observed in 176 cases of PCOS (45%), of which total cholesterol abnormalities accounted for 21.0%, triglycerides 21.5%, LDL-C 25.6% and decreased HDL in 7.9%. Glycemia disturbances occurred in 119 cases (accounting for 30.4%) with abnormal blood glucose 16.4% and abnormal glucose tolerance test after 2 hours was 25.0%. Considering the metabolic factors, 68.8% of PCOS cases have at least one disorder. There is a correlation between metabolic disorders and clinical and endocrine factors: increased WHR with age, body mass index, AMH and prolactin; Total cholesterol associated with BMI and prolactin; Triglycerides related to age; HDL-C decrease is associated with BMI, LH and FSH; Hyperglycemia is associated with BMI. Conclusions: Endocrine disorders and especially metabolic syndrome are common in the infertile patients with PCOS in Central Vietnam. Appropriate screening strategy, early detection and timely intervention are needed to prevent systemic complications related to metabolic disorders. Key words: polycystic ovary syndrome, endocrine disorders, metabolic disorders