Workshop in Andrology - Ho Chi Minh, Vietnam, 1995

This workshop was conducted at the University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam on November 15-18, 1995. The faculty members were welcomed by the Chairman of Department of Obstetrics and Gynecology, Le van Dien. Anek Aribarg, organizer, responded on behalf of the visiting team of Thai lecturers.

The Workshop was conducted in the conference room of the University of Medicine and Pharmacy and the laboratory in the Hung Vuong Hospital. There were 23 participants - including 13 obstetricians, 9 surgeons, and 1 sexologist - and 10 observers. They were selected by the Ministry of Health, the Dean and Professor Dien and were drawn from the staff of Obstetrics & Gynecology and Medical Departments and Hospitals in Ho Chi Minh City and neighboring provinces. The program was composed of lectures during the first three days and practical sessions in the morning of the last day. Periods were set aside for the discussion of research protocols prepared by the participants. Proceedings of the workshop in English were also distributed. Translation of English into Vietnamese during lectures was provided throughout.

The opening session of the workshop summarized the WHO Special Programme of Research, Development and Research Training in Human Reproduction (HRP) and the history of the Andrology Workshops since their inception in 1980. Chumpol Pholpramool reviewed current knowledge on spermatogenesis, sperm maturation, and endocrinology of the testis. Krisada Ratano-Olarn gave a talk on sexual dysfunction describing the hemodynamic events and the role of the autonomic nervous system in erection. He reviewed the diagnosis and treatment of impotence emphasizing the importance of involving the patient in the choice of treatment options at each stage. Sompop Limpongsanuruk gave three lectures. The first on methods of research, the second on statistics in research and the third on planning a research project. This was based on HRP's guidelines on preparing a research project proposal.

On the second day, Kitpramuk Tantayaporn gave a lecture on male fertility assessment and male infertility. He emphasized the basic clinical evaluation of male fertility and primary health care for male fertility including diagnosis and treatment based on the WHO manual. Nares Sukcharoen gave two lectures concerning semen analysis and various aspects of sperm function, drawing on experience gained in an IVF program. In the lecture on sperm function, he emphasized the usefulness of sperm function tests in research in male contraception, male reproductive toxicology, and environmental hazards for the male reproductive function. The second talk generated a discussion on the quality control of semen analysis among the technicians and among the centers.

In his lectures on cryopreservation and artificial insemination, Dr. Aribarg discussed the dangers of STD with the use of donor semen, particularly AIDS, and the rights of children to know their method of conception. Dr. Sukchaoen gave two lectures, the first on sperm preparation and the second on aspects of male infertility and assisted reproductive technology including micromanipulation techniques. He also showed a videotape about intra-uterine insemination and IVF for the treatment of male infertility. Dr. Aribarg gave a lecture on environmental factors and male infertility. He emphasized the possible adverse effect of chemical and heavy metal contamination in the environment on male reproductive function. He also presented his experience in lead toxicity among Thai workers in motor car battery plants.

On the third day, Dr. Ratana-Olarn spoke on vas occlusion methods. He emphasized "no scalpel" vasectomy which is now popular in many countries. He also gave a lecture on the complications which might arise from vasectomy and described his experience with reversal of vasectomy. It was emphasized that men should be counseled that the operation is offered as a sterilization procedure and that reversal is difficult with limited success and is only conducted in special circumstances. He stated his belief that the success of reversal is greater if granuloma is present at the site of operation rather than in the caput epididymis.

In his lectures on the conduct of clinical trials, Dr. Limpongsanurak emphasized the importance of sample size in relation to the known variability and magnitude of the effect being studied. He also pointed out the need for a double blind placebo-treatment approach with randomization in clinical studies. Dr. Pholpramool gave a lecture on drug testing in animals and emphasized the importance of animal models and basic knowledge of reproductive process of the animals used for experiments. Dr. Aribarg discussed male hormonal contraception and his experience using testosterone enanthate as a male hormonal contraceptive in Thai men, as part of the WHO multicenter study of the Male Task Force.

As part of the Workshop, recommendations were made for further development as follows: Medline should be made available in the University Library. Five trainees should receive a one-month intensive course in andrological laboratory technique at Chulalongkorn University, Bangkok, Thailand.

Consideration should be given to organizing an andrology symposium in Vietnam to stimulate research activities and exchange of knowledge and experience among the hospitals and universities in Vietnam and neighboring countries. Another workshop in Andrology could be held in Burma with support from WHO.
The WHO faculty team thank the Ministry of Health and professor Do Trong Hieu for their assistance with the organization of the Workshop, and the authorities of the University of Medicine and Pharmacy, particularly Dean Prof. Hoi, for making facilities available.

Anek Aribarg, Indonesia