ABSTRACT
AIM: The self-regulation systems develop during early childhood resulting from the meeting of the constitutional characteristics of the child, his/her adaptability and environmental responses. The failure of the intersection of these dimensions leads to the onset of symptoms that can seriously affect the child's behavior and his/her relationship. Regulatory disorders of sensory processes (DR) were identified as independent nosographic category in the "Diagnostic Classification 0-3". The aim of this study was the description of the clinical features of a group of children for whom a diagnosis of regulatory disorders was made before the three years, and their development at school age. METHODS: The sample was composed of 28 children, 22 males and 6 females, selected from a group of 60 children, with a mean age at T0 of 34.8 months (range 14-56 months). The clinical reassessment was conducted after five years (T1), with a children's mean age of 103.5 months (range 71-150 months). RESULTS: Approximately 40% of school age participants shows no longer any disturbance, while the remaining % shows a very heterogeneous spectrum of disorders. CONCLUSION: The diagnosis of DR is sensitive enough to detect in infancy a wide range of developmental difficulties, but it is quite specific and relatively predictive about the child's subsequent development. Retrospectively the entire diagnostic profile provides more information than the primary diagnosis and the greatest impairment of the different dimensions explored predicts a more severe evolution.
Subject(s)
Child Behavior Disorders/diagnosis , Child Behavior Disorders/psychology , Learning , Parent-Child Relations , Parents/psychology , Achievement , Adult , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Male , Patient Education as Topic , Personality Assessment , Psychotherapy , Risk Assessment , Risk Factors , Sampling StudiesABSTRACT
OBJECTIVES: Different ovarian stimulation protocols are used for in vitro fertilization (IVF) in "poor responder" patients. Our work aims at comparing two ovarian stimulation protocols (long agonist half-dose protocol versus short agonist protocol without pretreatment) in this population of women. PATIENTS AND METHODS: This prospective, randomized study was realized at the University Hospital of Saint-Étienne and concerns "poor responder" patients (age between 38 and 42 years and FSH at day 3 more than 9.5 IU/L; and/or antral follicles count less or equal to 6; and/or failure of previous stimulation). The primary endpoint is based on the number of oocytes retrieved at the end of an IVF cycle. RESULTS: Out of the 44 patients randomized, 39 cycles were taken into account (20 in the long protocol, 19 in the short one). At the end of the stimulation (FSH-r 300 to 450 UI/d), the number of follicles recruited appears higher in the long protocol but the difference is not significant (diameter between 14 and 18 mm: 3.0±2.31 vs. 1.88±1.89 and diameter greater than 18 mm: 3.9±2 85 vs. 3.06±2.77). The same tendency is observed for all the following criteria: the number of retrieved oocytes (6.74±2.73 vs. 6.38±4.26), the total number of embryos (3.16±2.03 vs. 2.25±2.11), the pregnancy rate per retrieval (21% vs. 19%) and per cycle (20% vs. 16%), and the number of children born alive. DISCUSSION AND CONCLUSION: The study did not reveal any difference between the two protocols but the long half-dose seems to be better.
Subject(s)
Fertilization in Vitro/methods , Ovulation Induction/methods , Adult , Cell Count , Female , Follicle Stimulating Hormone/administration & dosage , Follicle Stimulating Hormone/blood , Humans , Oocytes , Ovarian Follicle/anatomy & histology , Pregnancy , Prospective Studies , Tissue and Organ HarvestingABSTRACT
OBJECTIVE: More and more young women are delaying childbearing until the fourth decade of life: thus, Assisted Reproductive Techniques centres receive more and more requests from ageing women. The aim of the study is to analyse the purpose of these requests, the biological and clinical features of these patients and the results in our infertility centre. PATIENTS AND METHODS: A retrospective study was carried out at the CHU of Saint-Etienne from 01.01.01 to 31.12.04. We analysed the social, clinical and biological features of 84 couples when the woman's age was equal or superior to 38 years, representing 218 cycles. A questionnaire was used to collect social data. RESULTS: Several factors can explain the increasing number of ageing women consulting for infertility: extend university time and professional career, professional stability, contraception and late meeting of the partner, false reassuring information concerning progress in ART, second child desire after a late first pregnancy, but also second marital unions and child desire in the redefined couple. In our study, above 40 years old, the pregnancy (19.4 versus 10.5%) and delivery rates (16.7 versus 5.8%) clearly decreased in IUI. Thus, most of the clinicians propose, in first choice, an IVF cycle to a 40 year-old woman. The ultrasound measurement of antral follicle count can accurately evaluate the prognosis in terms of pregnancy (P<0.01) and delivery rate (P=0.03). For patients with unfavourable prognosis, oocyte donation, embryo donation, or adoption can be considered. DISCUSSION AND CONCLUSION: ART cannot compensate for the natural decrease in pregnancy rates and the increase in early miscarriages in ageing women. Therefore, it is essential to inform young women of the negative effects of age on their potential fertility.
