[Infertility over forty: Pros and cons of IVF]. / Prendre en charge les femmes de 40ans et plus en FIV : pour ou contre ou pour et contre ?

The population attempting pregnancy and having babies is ageing. The declining fertility potential and the late age of motherhood are increasing significantly the number of patients over forty consulting infertility specialists. Assisted reproductive technologies (ART) cannot compensate the natural decline in fertility with age. In France, in public hospital, ART is free of charge for women until 43 years, over 43, social insurance does not reimburse ART. Hence, 43 years is the usual limit, but between 40 and 42 is ART useful? The answer varies according to physicians, couples or society. On medical level, the etiology of the infertility must be taken into account. If there is an explanation to infertility (male or tubal infertility) ART is better than abstention. If the infertility is only due to age the question is raised. In France, the reimbursement by the society of a technique with very low results is discussed. However efficacy is not absolutely compulsory in Medicine. On the opposite to give false hopes may be discussed too. To obtain a reasonable consensus is rather difficult.

[Pelvic inflammatory disease and intrauterine contraceptive device. Monocentric continuous study of 70 cases over 5 years]. / Stérilet et infections pelviennes sévères. Étude monocentrique en continu de 70 cas en cinq ans.

BACKGROUND: Evaluation of relation between uterine devices and severe pelvic inflammatory disease. PATIENTS AND METHODS: Medical and surgical data for 5 years were collected in an universitary center. RESULTS: Seventy patients were found whose seven needed reanimation and ten, two or more surgical procedures. Risks factors were old age (>45 years) and time exposure (>5 years). DISCUSSION AND CONCLUSION: Severe pelvic inflammatory disease and uterine devices in not uncommon association. Prolonged use seems to be a risk factor.