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1.
Gynecol Obstet Fertil ; 41(9): 511-4, 2013 Sep.
Article in French | MEDLINE | ID: mdl-23972925

ABSTRACT

OBJECTIVE: To evaluate the efficacy and safety of ovulation triggering by agonists in antagonists IVF cycles with fresh embryo transfer in modulating low HCG dose for luteal phase support in patients at risk of ovarian hyperstimulation syndrome (OHSS). PATIENTS AND METHODS: In an observational study from September 2011 to March 2013, we triggered with agonist 107 cycles with OHSS risk, we initially triggered 39 cycles with 2 doses of Triptorelin 0.1 mg. Injection of 1500 IU HCG was performed one hour after the pick up and a second injection of 1500 IU was made 5 days later (group 1) combined with 400 mg of natural progesterone vaginally. In the following 68 cycles we removed the second HCG injection and increased to 600 mg vaginal progesterone associated with E2 4 mg orally (group 2). RESULTS: Group 1: the ongoing pregnancy rate and birth rate in fresh cycle is respectively 37.1% and 34.3% and the cumulative ongoing pregnancy rate and birth rate per patient is 43.6% and 41%. We recorded three late onset OHSS in pregnant women. Group 2: ongoing pregnancy rate in fresh cycle is 39.6%, the current cumulative ongoing pregnancy rate per patient was 45.6%. We observed a case of early onset OHSS. DISCUSSION AND CONCLUSION: Triggering with agonist and administering an injection of 1500 IU of HCG the day of the pick up appears to be effective in women at risk of OHSS. The exclusion of all OHSS is still not reached. The search for the best protocol and its indications should continue.


Subject(s)
Fertilization in Vitro , Gonadotropin-Releasing Hormone/agonists , Luteal Phase , Ovarian Hyperstimulation Syndrome/prevention & control , Ovulation Induction/methods , Administration, Intravaginal , Chorionic Gonadotropin/administration & dosage , Embryo Transfer , Female , Humans , Luteolytic Agents/administration & dosage , Ovulation Induction/adverse effects , Pregnancy , Progesterone/administration & dosage , Risk Factors , Triptorelin Pamoate/administration & dosage
2.
Prog Urol ; 23(4): 237-43, 2013 Apr.
Article in French | MEDLINE | ID: mdl-23544980

ABSTRACT

OBJECTIVE: To assess safety and efficacy at short-term of a light-weight polypropylene mesh (28 g/m2) for stage 3-4 cystocele repair by the vaginal route. MATERIAL AND METHODS: A multicentric prospective cohort study, performed between 2010 and 2011 in seven centers. Pre-operative assessment included prolapse quantification using the POP-Q. Pre- and postoperative validated symptoms and quality of life questionnaires were used. Main objective was mesh safety. Secondary objectives were anatomical and functional success. RESULTS: One hundred and eleven patients, with a mean age of 67±9 years, were included in the study, and 94 were included in the analysis (84.7%). In 14 cases (12.8%), it was a secondary surgery. Two intra-operative complications occurred (2.2%). Safety analysis on 86 patients followed up at 12 months (91.5%) has shown satisfaction rate of 98.8% (85/86), mesh contraction rate of 9.3% (8/86), one case of vaginal mesh exposure (1.2%), no cases of pelvic pain and rate of postoperative dyspareunia of 5.5% (3/55). Anatomic success rate on cystocele (Ba point < -1) at short-term was 82/86 (95.3%) and improvement of symptoms and quality of life was highly significant. Five patients (5.3%) were reoperated. CONCLUSION: Cystocele repair by the vaginal route using a light-weight transobturator polypropylene mesh was safe and efficient at short-term. Long-term data are needed.


Subject(s)
Cystocele/surgery , Surgical Mesh , Aged , Aged, 80 and over , Cohort Studies , Female , Humans , Middle Aged , Polypropylenes , Prospective Studies , Prosthesis Design , Severity of Illness Index , Time Factors , Vagina
3.
J Gynecol Obstet Biol Reprod (Paris) ; 40(6): 498-502, 2011 Oct.
Article in French | MEDLINE | ID: mdl-21514077

ABSTRACT

OBJECTIVE: To evaluate by the birth rate the impact of the number of days of estrogens continued beyond the menses in a four days estradiol IVF antagonist programming cycles. PATIENTS AND METHODS: Retrospective study from September 2004 to January 2009 among women of age ranging between 25 and 38 years. Four milligrams of provames is prescribed 3 to 5 days before the theorical menses and continued until the beginning day of stimulation, which is distributed equitably between Thursday and Sunday. The birth rate is evaluated according to the number of days of estrogen continued beyond the menses within a limit from 1 to 8. RESULTS: No significant difference appears neither in the duration of stimulation, in the quantity of gonadotrophin, the oocytes pick up, nor in the rate of birth between the groups. CONCLUSION: The programming by estrogens of the antagonist IVF cycles implies a variable number of days of estrogens continued beyond the menses, which does not seem to affect the birth rate.


Subject(s)
Estrogen Antagonists/therapeutic use , Estrogens/administration & dosage , Fertilization in Vitro/methods , Menstruation/drug effects , Ovulation Induction/methods , Adult , Drug Administration Schedule , Estrogen Antagonists/adverse effects , Estrogens/adverse effects , Estrogens/pharmacology , Female , Fertility Agents, Female/adverse effects , Fertility Agents, Female/therapeutic use , Gonadotropins/adverse effects , Gonadotropins/pharmacology , Gonadotropins/therapeutic use , Humans , Menstrual Cycle/drug effects , Menstrual Cycle/physiology , Menstruation/physiology , Periodicity , Pregnancy , Pregnancy Rate , Retrospective Studies , Time Factors
4.
Gynecol Obstet Fertil ; 38(1): 18-22, 2010 Jan.
Article in French | MEDLINE | ID: mdl-20022282

ABSTRACT

OBJECTIVE: Assess the efficiency of estradiol programming in In Vitro Fertilization (IVF) with antagonists by comparing with classical long luteal agonist protocol. PATIENTS AND METHODS: It is a prospective randomized study, comparing 426 cycles in the arm estradiol antagonist with 412 cycles in the arm long agonist. Estradiol 4 mg/day begins on the 25th day of the previous cycle and continues during the menses until the first day of the stimulation which is from Thursday to Sunday whatever the beginning of the menses. The luteal protocol use Decapeptyl 0,1mg which begins on the 20th day of the previous cycle. RESULTS: Our two populations are similar. No pick-up has been done on Sunday. We have got significantly less oocytes and embryos in estradiol-antagonist (6,8+/-5,3 vs 7,6+/-5,7) and (3,7+/-3,2 vs 4,1+/-3,6) respectively. The ongoing pregnancy rate is comparable in the two groups: 28,6 % for estradiol antagonist 27,9 % for agonist for the whole population and 37 % vs 34,8 % respectively when at least one top embryo was transferred. DISCUSSION AND CONCLUSION: Programming antagonist cycles with estradiol allows the organization of the center; it is easy to implement and seems to give results as good as a long agonist protocol.


Subject(s)
Estradiol/administration & dosage , Estrogen Antagonists/administration & dosage , Fertilization in Vitro/methods , Luteolytic Agents/administration & dosage , Ovulation Induction/methods , Triptorelin Pamoate/administration & dosage , Adult , Embryo Transfer , Female , Gonadotropin-Releasing Hormone/agonists , Humans , Oocyte Retrieval , Oocytes/growth & development , Pregnancy , Pregnancy Rate , Prospective Studies
5.
Contracept Fertil Sex ; 24(9): 647-9, 1996 Sep.
Article in French | MEDLINE | ID: mdl-8998510

ABSTRACT

Ovarian hyperstimulation syndrome (OHS) with serious grade could be a live threatening disease, that occurs in 0.5% to 1% of in vitro fertilization program. The prevention of OHS is based on the recognition of risk factors and on ultrasonic and hormonal monitoring, with well adapted treatment in order to reduce the number of follicles. The level of oestradiol will determine the injection of human chorionic gonadotropins: between 2500 and 3000 pg/ml, the injection of HCG is reduced to 5000 U for the induction of ovulation, and the injections of HCG 1500 during the luteal period are avoided: between 3000 and 5000 pg/ml, the injection of HCG is reduced to 5000 U and the replacement of fresh embryos is deferred to an other cycle: after 5000 pg/ml, the injection of HCG must be abandoned. The treatment of the confirmed OHS is based on the rest, with hospitalization, correction of fluid, electrolyte and protein imbalance, prevention of thrombo embolism and aspiration of ascite fluid.


Subject(s)
Ovarian Hyperstimulation Syndrome/therapy , Reproductive Techniques , Female , Humans , Severity of Illness Index
6.
Article in French | MEDLINE | ID: mdl-8360443

ABSTRACT

Having treated a case which resulted in the delivery at term of an intrauterine twin when the other twin had been lost after the rupture of a uterine cornu which itself followed a salpingectomy without removal of the interstitial portion of the tube brings the authors to discuss the physiopathology and the symptomatology of such cases. They also discuss the value of resecting the interstitial portion of the tube and what management should be when there is a live intrauterine pregnancy.


Subject(s)
Gestational Age , Pregnancy Outcome , Pregnancy, Ectopic , Pregnancy, Multiple , Twins , Uterine Rupture/physiopathology , Adult , Fallopian Tubes/surgery , Female , Humans , Pregnancy , Pregnancy, Ectopic/complications , Uterine Rupture/etiology
8.
Rev Fr Gynecol Obstet ; 85(5): 329-35, 1990 May.
Article in French | MEDLINE | ID: mdl-2165275

ABSTRACT

The authors report 46 cases of nipple discharge without any palpable lesion. The diagnostic is made, most of the time, by 3-views bilateral mammograms. The place of other examinations (ultrasonography, galactography) is reported. The cytology of the discharge, as well as its macroscopic appearance (bloody, serous or greenish), determine the surgical indications. Quadrantectomy centered around the discharging duct, is the procedure of choice in this disease, at the interface between diagnostic and treatment, in fact, if benign tumors (papillomas) or non tumoral diseases (fibrocystic mastopathy and duct ectasia) predominate, invasive or in-situ malignant lesions represent 13 p. cent of these 46 discharges, justifying the significance of this clinical sign.


Subject(s)
Breast/pathology , Nipples/pathology , Aged , Breast Diseases/diagnosis , Breast Neoplasms/diagnosis , Carcinoma in Situ/diagnosis , Carcinoma, Intraductal, Noninfiltrating/diagnosis , Diagnosis, Differential , Exudates and Transudates/analysis , Female , Fibrocystic Breast Disease/diagnosis , Humans , Mammography , Middle Aged , Milk, Human/analysis , Papilloma/diagnosis
9.
Rev Fr Gynecol Obstet ; 84(2): 129-33, 1989 Feb.
Article in French | MEDLINE | ID: mdl-2646689

ABSTRACT

The authors report the advantage of fertilization in vitro and ancillary techniques in hypofertility by male component. In their fertilization in vitro program, a male indication is individually found in 10% of the cases, but also in female indications, even those of tubal origin. In summary, sperm anomalies are reported in 25% of couples entering a program of fertilization in vitro. Therefore they explain their current approach toward one or two cycles of diagnostic FIV, and then propose the most appropriate technique of assisted procreation for each case.


Subject(s)
Fertilization in Vitro , Oligospermia/physiopathology , Female , Gamete Intrafallopian Transfer , Humans , Male , Oligospermia/diagnosis , Spermatozoa/abnormalities , Spermatozoa/physiology
10.
Article in French | MEDLINE | ID: mdl-4078246

ABSTRACT

Microbiopsies were taken from the tubes of 13 women who were sterile with hydrosalpinges. They were studied using scanning electron microscopy. It was possible to point out several degrees in the evolution of these lesions of the tubal epithelium. These lesions occurred in the fimbrial portion, the ampulla and the isthmus of the tubes. The value of this investigation in diagnosis and prognosis in cases of sterility due to hydrosalpinx is discussed.


Subject(s)
Fallopian Tube Diseases/pathology , Fallopian Tubes/pathology , Infertility, Female/pathology , Biopsy , Fallopian Tube Diseases/complications , Fallopian Tubes/ultrastructure , Female , Humans , Infertility, Female/etiology , Microscopy, Electron, Scanning
11.
Rev Fr Gynecol Obstet ; 79(7-9): 579-80, 1984.
Article in French | MEDLINE | ID: mdl-6528178

ABSTRACT

On the basis of one case, the authors discuss the clinical, paraclinical and evolutive features of Demons-Meigs syndrome. They review the literature in an attempt to define the pathogenesis of this rare syndrome.


Subject(s)
Hydrothorax/etiology , Meigs Syndrome/complications , Ascites/complications , Female , Humans , Meigs Syndrome/pathology , Meigs Syndrome/surgery , Middle Aged
12.
J Radiol ; 65(4): 285-8, 1984 Apr.
Article in French | MEDLINE | ID: mdl-6332904

ABSTRACT

Acute post-partum hemorrhage secondary to a coagulation disorder was successfully treated by embolization of the uterine arteries. The technique used is described, and the place of embolization as an alternative to surgical procedures discussed.


Subject(s)
Disseminated Intravascular Coagulation/complications , Embolization, Therapeutic/methods , Postpartum Hemorrhage/therapy , Adolescent , Emergencies , Female , Follow-Up Studies , Humans , Iliac Artery/diagnostic imaging , Postpartum Hemorrhage/etiology , Pregnancy , Radiography
13.
Rev Fr Gynecol Obstet ; 79(2): 137-40, 1984 Feb.
Article in French | MEDLINE | ID: mdl-6398898

ABSTRACT

In discussing a case of isolated A-V block, the authors note that this condition occurs frequently in association with other cardiac and non-cardiac foetal malformations. Diagnosis of this type of disorder has been greatly facilitated by the development of ultrasonography. Obstetric management depends on the degree of malformation. Neonatal monitoring is mandatory, as is the presence of a paediatric ressuscitation team at delivery.


Subject(s)
Bradycardia/etiology , Fetal Diseases/diagnosis , Heart Block/complications , Ultrasonography , Adult , Female , Fetal Monitoring , Heart Block/diagnosis , Humans , Infant, Newborn , Pregnancy , Prenatal Diagnosis , Prognosis
14.
Article in French | MEDLINE | ID: mdl-6237146

ABSTRACT

The authors report on a retrospective study of 184 laparoscopies carried out assessing the aetiology of chronic pelvic pain. The population that was studied has a mean age of 28.8 years, with most of the patients being between 20 and 30 years of age. The mean length of the history of the pain was 51 1/2 months. 51% of the cases had pain of a rhythmical nature associated with the menstrual cycle, 11.3% of cases had deep dyspareunia and 37.7% of the cases had repeated attacks of pain. Previous gynaecological pathology was found in 30% of cases and previous pelvis surgery in 11.1% of cases. 41.5% of the population were multiparous. Laparoscopy was only performed after a full clinical and paraclinical examination. It showed the presence of: endometriosis in 22.2% of cases, pelvic adhesions in 17.4%, varicose veins in the pelvis in 11.4%, ovarian cysts in 6.5%, ovarian dystrophies in 3.2%, Masters and Allen syndrome in 3.8%, sub-serous fibroids in 2.1%.


Subject(s)
Laparoscopy , Pain/etiology , Pelvis , Adolescent , Adult , Chronic Disease , Female , Genital Diseases, Female/complications , Humans , Middle Aged , Retrospective Studies
16.
Article in French | MEDLINE | ID: mdl-6350418

ABSTRACT

Five cases of acute hydramnios occurring in twin pregnancies are reported here. The obstetrical management is discussed in the light of our results and the facts given in the literature. It would seem that abdominal route amniocentesis drawing off quantities of liquor is a simple manoeuvre which can be repeated and work so that the inexorable progress to late abortion or premature labour is avoided.


Subject(s)
Polyhydramnios/therapy , Pregnancy Complications/therapy , Pregnancy, Multiple , Twins , Acute Disease , Adult , Female , Humans , Polyhydramnios/diagnosis , Pregnancy , Pregnancy Complications/diagnosis
17.
Article in French | MEDLINE | ID: mdl-6686238

ABSTRACT

Damage to the umbilical cord is a rare complication of late amniocentesis. It is so serious for the fetus that it should be recognized immediately and the baby should be delivered as quickly as possible. We report a new case here and analyse the principal features to be found in the literature.


Subject(s)
Amniocentesis/adverse effects , Umbilical Cord , Adult , Arrhythmias, Cardiac/diagnosis , Cesarean Section , Female , Fetal Diseases/diagnosis , Humans , Pregnancy
19.
Article in French | MEDLINE | ID: mdl-6863865

ABSTRACT

The authors report a new case of cervical pregnancy in a primigravid woman of 31 years of age who had had 15 weeks of amenorrhoea. They review the clinical and anatomo-pathological criteria necessary to make the diagnosis. The diagnosis which had become suspected because of ultrasound was confirmed by examination under a general anaesthetic before interrupting pregnancy. Conservative treatment was made possible because there was no very heavy bleeding after the curettage to evacuate the products.


Subject(s)
Pregnancy, Ectopic/diagnosis , Adult , Cervix Uteri , Female , Humans , Pregnancy , Pregnancy Trimester, Second , Pregnancy, Ectopic/pathology
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