[Pregnancy after ovariectomy as a result of preservation of the embryos]. / Grossesse après castration grâce à une autoconservation embryonnaire.

We report the first published case of pregnancy obtained with a self-preserved embryo in a woman who, in 1987, had been castrated for a tumoral and painful pelvic disease retrospectively diagnosed as endometriosis. This woman had an old-standing tuboperitoneal infertility, and in vitro fertilization had been performed, followed by cryopreservation of the embryos. Two embryos were transferred during an artificially induced oestro-progestogenic cycle. Pregnancy developed and progressed normally with a simplified therapeutic regimen. This case suggests that preservation of the embryos is a possible solution to the problem of women about to undergo medical or surgical castration and wishing to become pregnant after cure of the disease which motivated the castration.

[Sterility of tubal origin: microsurgery and fertilization in vitro]. / Stérilité d'origine tubaire: microchirurgie ou FIV.

Thanks to recent advances, in-vitro fertilization should alter the clinical indications in cases of sterility due to tubar obstruction. In this article, the authors compare two groups of patients: one group of 109 women treated by means of in-vitro fertilization and another group of 117, treated by microsurgery. In tubar sterility, IVF achieved a 16% pregnancy rate per attempt. In the case of microsurgery, the actuarial rates were calculated (Kaplan Meier method) from a prognostic score. It was found that in the group of women with a "good score", tubar surgery gave results which could be achieved only after 3 or 4 attempts at IVF. On the other hand, in the "poor prognosis" group, IVF was better than microsurgery after a single attempt. Clinical teams should, therefore, reconsider the indications for tubar surgery in the light of the indications for in-vitro fertilization.