[Impressions od couples treated with fertilization in vitro of their treatment by the IVF center]. / Impressions des couples traités par fécondation in vitro sur leur prise en charge par le centre de FIV.

A preliminary study was designed to evaluate, among French couples treated for in vitro fertilization, their feelings about the delivered information on IVF and the degree of satisfaction about their treatment by the center. Anonymous forms were mailed to 3,000 couples, from which 835 were returned on time to be analyzed. Most of the couples expressed their satisfaction. However, 25% were disappointed by their first consultation, too short (14%) or too long to obtain (13%), especially for those treated in a public hospital. One quarter of couples waited for more than six months before their first cycle, more often in public practice than in private one, and 80% found this time lapse too long. One third of the couples changed of unit, 62% of them because of disappointment, mostly because of their relationship with the medical team, and only 20% because of poor results. Two thirds of the couples found IVF had repercussions on their couple's life, negatively in 31% of the cases. This percentage was higher for those with unsuccessful IVF (45%) than for those who got a pregnancy (22%). Information on IVF was judged as satisfactory only for two thirds of the couples, for any kind of information, and less than half of men were told how the inseminated semen quality was. Moreover, only 57% of the couples found the information reassuring. Local conditions for semen collection were judged to be bad by 30% of the men. Finally, this study showed that efforts still have to be made by units to better treat and inform IVF couples. It also seems necessary to undertake a prospective and more detailed study to better investigate the degree of satisfaction and its parameters.

[Non-obstructive azoospermia and ICSI]. / Azoospermies sécrétoires et ICSI.

50 cases of non obstructive azoospermia required testicular sperm extraction and ICSI. Results are promising but ability to find spermatozoa remains questionable. Further studies are necessary to improve success of the method. Genetic research also need to be developed for better understanding the process.

Molecular diagnosis of congenital bilateral absence of the vas deferens: analyses of the CFTR gene in 64 French patients.

Congenital bilateral absence of the vas deferens is a congenital reproductive disorder that affects about one in 1000 male individuals. Screening of the entire coding and flanking sequences of the cystic fibrosis transmembrane conductance regulator (CFTR) gene in 64 males with CBAVD revealed that in only 23% CBAVD was caused by two CFTR mutations. The 5T allele in one copy, that causes reduced levels of the normal CFTR protein, in combination with a CFTR mutation in the other copy, was one of the most common causes of CBAVD. Twenty six per cent of men with CBAVD had the 5T allele. The presence of only one CFTR mutation or the 5T allele in 34% of patients suggests that undetected changes in CFTR may be involved in CBAVD. These molecular defects are probably mutations with partial penetrance. Moreover, the high proportion (20%) of patients with CBAVD who did not have CFTR mutations or the 5T allele allows to propose that another gene or genes could be responsible for CBAVD. In these cases, in vitro fertilization may be required and the genetic counselling appears to be very complex and additional studies, including CFTR mRNA and linkage analyses, are required to resolve these questions.

[Varicocele and male hypofertility. Report of 100 cases]. / Varicocèle et stérilité masculine. A propos de cent observations.

100 cases of man-hypofertility associated with a varicocele have been submitted to a varicocelectomy using Ivanissevitch's procedure. Pre-operative spermogram and spermocytogram as well as testicular biopsy proved to be of no prognostic value. The only difference between pre-operative and post-operative spermocytograms concerns sperm motility. The main prognostic factor seems to be normal findings in the gynecologic examination of the female partner. Ligation of spermatic artery appears to be associated with a higher rate of failure.

[The surgery of low seminal obstruction. A study of 110 consecutive cases (authors' transl)]. / Chirurgie des obstructions séminales basses. Etude d'une série continue de 110 cas.

The author has studied 152 cases of seminal obstruction and now gives a list of the different aetiologies of the condition. The evolution of the pathology of low obstruction is given with the reason for the frequent failures that occur with this type of surgery.