ABSTRACT
Chromosomal abnormalities are common in patients with oligozoospermia or azoospermia. We report the case of a 32-year patient, with male phenotype, and without hormonal or morphological abnormalities, with a severely reduced spermatogenesis. It was revealed a 45,X/46,XY gonadal dysgenesis. We have reviewed the various problems inherent in the discovery of this rare gonadal dysgenesis, including genetic, cancer and fertility risks.
Subject(s)
Azoospermia/genetics , Chromosome Disorders/genetics , Gonadal Dysgenesis, 46,XY/genetics , Turner Syndrome/genetics , Adult , Chromosomes, Human, X/genetics , Chromosomes, Human, Y/genetics , Humans , Male , MosaicismABSTRACT
OBJECTIVES: Despite the implementation of prospective payment approach in France, induced legal abortion are still paid by capitation. Our aim was to evaluate the real cost of induced abortion in a public hospital in France. MATERIALS AND METHODS: This study took place during the year 2008 in a public health hospital. Induced abortion cost was calculated according to national study cost's recommendations. The cost drawn from this was compared to what is paid by the medical insurance for spontaneous abortion. RESULTS: Induced abortion calculated cost was 562 , the capitation amount was 286.86 , the spontaneous abortion compensation amount was 645 . CONCLUSION: Induced abortion should be paid by a prospective payment evaluation similar to diagnosis related groups approaches rather than a capitation payment, in order to reduce misstatements.
Subject(s)
Abortion, Induced/economics , Fees and Charges , Prospective Payment System , Capitation Fee , Diagnosis-Related Groups , Female , France , Humans , PregnancyABSTRACT
Because of the high degree of complexity of assisted reproduction techniques (ART), the human and conscious dimensions of infertility problems are often neglected. Different strategies may help infertile couples coping with infertility and related treatments; among these, Caycedian sophrology relies on the cognitive, emotional, and somatic aspects of consciousness. In the present article, the authors report on their experience with sophrologic support for infertile patients by a midwife qualified in caycedian sophrology. Overall, since 1988, 310 couples have benefied from this kind of support, with an average of 10 sophrologic trainings per patient. Whereas some couples consider sophrology as a short time training to better cope with any particular aspect of their infertility treatment, others want to undertake more profound work on their body scheme. The authors wish to call the attention of ART professionals to this kind of medical support for infertile couples, and also to the particular role of midwives with sophrologic competence in an ART center.
Subject(s)
Holistic Health , Infertility/psychology , Midwifery/methods , Mind-Body Relations, Metaphysical , Reproductive Techniques, Assisted/psychology , Adult , Female , Humans , MaleABSTRACT
Cigarette smoking has negative effects on male fertility. Recent studies showed an active transfer of several components of cigarettes through the blood-testis barrier. The presence of these components in the seminal plasma may induce a degradation of sperm parameters and nuclear quality of spermatozoa, and compromise the chances of pregnancy. Moreover, smoking may have a negative impact on the smokers'offspring: poor quality embryos, development of childhood cancers. Oxidative stress-induced DNA damage seems to be one of the major causes of sperm quality alteration. Several methods are now available to analyze the degree of DNA fragmentation. In order to optimize the success rate of assisted reproduction technologies, the deleterious effects of smoking on male fertility and the necessity of cessation have to be explained in detail to these patients.
Subject(s)
Infertility, Male/etiology , Smoking/adverse effects , Spermatozoa/physiology , Blood-Testis Barrier , DNA Damage , DNA Fragmentation , Humans , Male , Neoplasms/etiology , Oxidative StressABSTRACT
An autologous blood donation with cryopreservation in a pregnant woman with natural antibody against a high frequency alloantigen is reported. A natural anti Gerbich antibody and a rare erythrocyte phenotype at high risk of polyimmunization was discovered during the third month of pregnancy. This leads to recommend the constitution of an autologous blood reserve. Before first sampling a moderate iron deficiency anaemia (10.3 g.dL-1) was treated with 600 mg of intravenous iron sucrose. Four blood packs of 350 mL were taken; after every sampling 200 mg of iron sucrose were injected intravenously. No maternal or foetal adverse effects occurred. Five weeks before delivery, an autologous blood reserve consisting in 4 cryopreserved red cells packs and 4 fresh frozen plasma was constituted. Epidural analgesia was used for delivery. No haemorrhage occurred. The reserve was not used and remained available for future use (one year for fresh frozen plasma and without limit for red cells).
Subject(s)
Anemia, Iron-Deficiency/blood , Anemia, Iron-Deficiency/drug therapy , Autoantibodies/immunology , Blood Transfusion, Autologous , Ferric Compounds/therapeutic use , Pregnancy Complications, Hematologic/drug therapy , Adult , Autoantibodies/blood , Blood Preservation , Cryopreservation , Female , Ferric Compounds/adverse effects , Ferric Oxide, Saccharated , Glucaric Acid , Humans , Infant, Newborn , Injections, Intravenous , Iron/blood , Pregnancy , Pregnancy Complications, Hematologic/blood , Pregnancy Complications, Hematologic/immunologyABSTRACT
UNLABELLED: We compared two techniques of local anesthesia used in transvaginal ultrasound guided oocyte recovery in in vitro fertilization: paracervical lidocaïne block versus vaginal application of Emla, a topical anesthesic cream. STUDY DESIGN: The study included 103 patients divided in two groups. Pain was evaluated by visual analog scale and questionnaire. RESULTS: Univariate analysis showed that the patients were satisfied with neither of the two protocols. Multivariate analysis revealed paracervical lidocaïne block to be superior. The premedication appeared inadequate. CONCLUSION: We decide to use paracervical lidocaïne block and to improve the premedication. Indications for general and locoregional anesthesia were also enlarged. A new study showed a significantly greater patient satisfaction. One variable analysis indicated that no one of these protocols satisfied our patients.
Subject(s)
Analgesia , Fertilization in Vitro , Ovary/cytology , Tissue and Organ Harvesting/methods , Administration, Intravaginal , Female , Humans , Lidocaine/administration & dosage , Lidocaine, Prilocaine Drug Combination , Patient Satisfaction , Prilocaine/administration & dosageABSTRACT
OBJECTIVE: To evaluate the efficacy and safety of ofloxacin+coamoxiclav versus doxycycline-coamoxiclav in the treatment of chlamydial pelvic infections. DESIGN: An open, comparative, randomised, monocentric study. SUBJECTS: A hundred and eighteen patients (85 endometritis and 33 salpingitis) were included. Clinical, laparoscopic and bacteriological assessments were performed before treatment. 30.4% of salpingitis were considered as severe (COGIT score > 6). 25.4% of acute pelvic infections were only caused by Chlamydia trachomatis. TREATMENT: A hundred and eighteen patients were treated orally with 3 week combination ofloxacin (200 mg b.i.d.) + coamoxiclav (1 g b.i.d.) (n = 60) or with a 6 week coamoxiclav (1 g b.i.d.) + doxycycline (100 mg b.i.d.) (n = 58). RESULTS: Oral combination ofloxacin-coamoxiclav is as effective as oral combination doxycycline+coamoxyclav with respectively 96.7% versus 96.6% and 100% versus 98.4% satisfactory clinical et bacteriological results.
