Publications by authors named "Florence Boitrelle"
Congenital absence of the vas deferens (CAVD) is a syndrome with a heterogeneous presentation: bilateral (CBAVD) or unilateral (CUAVD), complete or partial and associated or not with other anomalies of the male urogenital system. A turning point came in 1968 when CBAVD was associated with cystic fibrosis and its CFTR gene mutations. Genetic studies then revealed that a minority of CBAVD but a majority of CUAVD are CFTR-independent.
View Article and Find Full Text PDFPurpose: The objective of this manuscript is to assess the effect of varicocele repair (VR) in patients with clinical varicoceles on serum total testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and inhibin B serum levels.
Materials And Methods: The study was performed in compliance with the Meta-Analysis and Systematic Reviews of Observational Studies (MOOSE) guidelines and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). All eligible studies were selected following the PICOS (Population, Intervention, Comparison/Comparator, Outcomes, Study design) model.
Article Synopsis
- Non-obstructive azoospermia (NOA) is a prevalent and complex issue with varied treatment options and no definitive guidelines, leading to differing management practices internationally.
- A comprehensive survey with 336 responses from specialists in 49 countries explored current medical and surgical strategies for NOA, analyzing results against existing guidelines and offering expert recommendations.
- Key findings included diverse approaches to hormonal therapy, significant variation in sperm retrieval success rates, and differing protocols around varicocele repair and follicle-stimulating hormone cutoff levels for sperm retrieval.
Article Synopsis
- * Conducted from July to September 2022, a questionnaire gathered responses from 367 doctors in 49 countries, focusing on how they diagnose NOA through methods like hormone tests and genetic analyses.
- * The survey identified that while many practices align with guidelines, significant differences in approaches were found, underscoring the need for standardized, evidence-based international guidelines for NOA evaluation.
Article Synopsis
- * A study surveyed 1,451 members of a physician social network to evaluate the impact of these online tools on medical education.
- * Results showed that most respondents felt they gained valuable medical knowledge and access to resources through the group, especially benefiting general practitioners and those in limited healthcare areas.
Article Synopsis
- The updated clinical practice guidelines aim to improve the first-line management of infertility in couples by revisiting existing recommendations based on recent research.
- A systematic review was conducted by expert working groups on five major themes, resulting in 28 PICO-formulated questions addressing both male and female infertility assessments, environmental factors, ovulation induction, and reproductive surgery techniques.
- Key recommendations include tailored fertility evaluations based on the woman's age, specific tests for both partners, and the dismissal of certain outdated procedures, with an emphasis on evidence-based approaches to optimize infertility treatment.
Article Synopsis
- - The study aimed to evaluate patient-reported outcome measures (PROMs) for assessing sexual function in women with endometriosis, focusing on their reliability and validity to enhance research and clinical practices
- - A systematic review from January 2000 to September 2023 examined 74 studies on sexual function in endometriosis, identifying 25 different PROMs, with the Female Sexual Function Index (FSFI) being the most used
- - Findings revealed that key measurement properties like "hypothesis testing" and "responsiveness" were most common among PROMs, with the FSFI and Sexual Activity Questionnaire being particularly valuable for evaluating medical and surgical treatments respectively
Article Synopsis
- Urogenital cancer treatments can negatively affect fertility, leading to ongoing debates about how to preserve it, with little evidence and no international guidelines available.
- An online survey conducted with urologists across five European countries revealed that while a majority recommend sperm cryopreservation before orchidectomy, practices for sperm extraction vary widely and proposals for cryopreservation in prostate and bladder cancer cases are inconsistent.
- The study highlights significant differences in fertility preservation practices based on national guidelines, emphasizing the need for standardized international recommendations to better address this issue for urological cancer patients.
Article Synopsis
- This systematic review and meta-analysis investigates whether varicocele repair (VR) can lower sperm DNA fragmentation (SDF) and seminal oxidative stress (measured by malondialdehyde or MDA) in infertile men.
- An analysis of 29 studies involving 1,491 men shows a significant reduction in SDF post-VR, regardless of the surgical technique used and the method of SDF testing.
- The findings also indicate a notable decrease in seminal MDA levels following VR, supporting the effectiveness of varicocele repair in improving reproductive parameters in affected men.
Article Synopsis
- There have been significant advancements in male infertility diagnosis and treatment, including assisted reproductive technologies and improved sperm selection techniques.
- *Recent innovations like oxidative stress testing and sperm DNA fragmentation assessment highlight the ongoing need for new developments in this area.
- *The role of reproductive urologists is expected to grow, focusing on various topics in male infertility, training future researchers, and establishing andrology as an independent specialty.
Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations.
Ashok Agarwal Ala'a Farkouh Ramadan Saleh Taha Abo-Almagd Abdel-Meguid Hamoda Gianmaria Salvio Florence Boitrelle
World J Mens Health
January 2024
Article Synopsis
- The study investigates global practices and challenges in using sperm DNA fragmentation (SDF) assays, which can affect male reproductive potential, as outlined in the latest WHO manual.
- A survey of 436 reproductive clinicians revealed that the most popular SDF assay is TUNEL, with a significant influence from availability on their choices.
- Clinicians see the value of SDF testing in understanding infertility but face barriers like insufficient professional guidelines and a lack of accepted reference values for interpreting SDF results.
Article Synopsis
- The Global Andrology Forum (GAF) is the first worldwide online research collaboration focused on andrology, aimed at uniting experts in the field.
- A survey conducted among GAF members revealed that 77.4% of respondents were urologists with significant experience, and a large majority were keen on contributing to scientific literature and collaboration.
- Within its first year, GAF published 29 original articles on diverse topics related to male reproductive health, showcasing effective teamwork and high-quality outcomes among its members from 48 different countries.
Article Synopsis
- The meta-analysis investigates the effects of varicocele repair on semen parameters in infertile males, combining data from diverse studies without language restrictions.
- A total of 351 studies were analyzed, revealing significant improvements in several semen parameters post-repair, including semen volume, sperm concentration, total sperm count, motility, and morphology, while sperm vitality showed no improvement.
- This research is the largest of its kind and highlights the benefits of varicocele repair for male infertility, contributing valuable insights for clinical practice.
Article Synopsis
- AI has rapidly advanced in medicine, particularly benefiting fields like andrology and reproductive medicine through technologies like machine learning and neural networks.
- AI tools can enhance the diagnosis and treatment of male infertility, improve patient care accuracy, and increase efficiency in clinical management and research.
- Future advancements in AI integration are expected to lead to significant breakthroughs and improvements in evidence-based practices within andrology and reproductive medicine.
Article Synopsis
- Epigenetics involves changes in gene activity that don't alter the DNA sequence, impacting sperm development and function during spermatogenesis through various internal and external factors.
- The paternal epigenome plays a significant role in sperm function, affecting fertilization, embryo development, and offspring health; deviations in epigenetic states are linked to male infertility and associated risks.
- The review emphasizes the importance of understanding sperm epigenetics for improving fertility diagnosis, treatment options, and outcomes, stressing the need for further research and advancements in high-throughput technologies to explore these mechanisms.
Article Synopsis
- Increased sperm DNA fragmentation (SDF) negatively affects fertility, leading to lower pregnancy and delivery rates in both natural conception and assisted reproduction methods like intrauterine insemination and in-vitro fertilization.
- Although high SDF does not impact fertilization or pregnancy rates with intracytoplasmic sperm injection (ICSI), it is associated with poorer embryo quality and a higher likelihood of miscarriage.
- The article reviews various sperm selection techniques aimed at improving DNA quality for assisted reproductive technology, discussing their principles, benefits, and limitations.
Article Synopsis
- Intracytoplasmic sperm injection (ICSI) was originally developed to address severe male infertility issues that conventional in-vitro fertilization (cIVF) could not solve, but it is increasingly being used for other infertility cases.
- Various non-male factor reasons for using ICSI include previous failed fertilizations, poor-quality or few oocytes, advanced maternal age, preimplantation genetic testing, and unexplained infertility.
- Despite the growing popularity of ICSI, there is limited data to support better outcomes compared to cIVF, and it's important to consider factors such as fertilization failure risk, procedure costs, and associated risks when choosing between the two techniques.
Controversy and Consensus on the Management of Elevated Sperm DNA Fragmentation in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations.
Ala'a Farkouh Ashok Agarwal Taha Abo-Almagd Abdel-Meguid Hamoda Parviz Kavoussi Ramadan Saleh Florence Boitrelle
World J Mens Health
October 2023
Article Synopsis
- The study investigates global practices for managing sperm DNA fragmentation (SDF) in infertile men, highlighting its impact on fertility and assisted reproductive technology (ART).
- A survey collecting data from 436 reproductive experts across 55 countries revealed a common recommendation for lifestyle changes and antioxidants, with varying durations for treatment and differing management approaches for specific infertility cases.
- The findings indicate a lack of uniformity in practices, emphasizing the need for standardized guidelines and expert consensus for treating men with elevated SDF.
Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations.
Ashok Agarwal Ala'a Farkouh Ramadan Saleh Taha Abo-Almagd Abdel-Meguid Hamoda Ahmed M Harraz Florence Boitrelle
World J Mens Health
July 2023
Article Synopsis
- The study explores global practices for sperm DNA fragmentation (SDF) testing in infertile men, following its inclusion in the WHO laboratory manual.
- A survey conducted among 436 infertility clinicians across 55 countries reveals varied testing practices, with many testing SDF in cases of unexplained infertility, recurrent pregnancy loss, and among smokers.
- The findings highlight the need for clearer professional guidelines on SDF testing, given the diversity in current practices and the potential benefits for certain patient populations.
Article Synopsis
- - The search for reliable markers to evaluate oocyte quality and its impact on embryonic development has been challenging, with no universally accepted criteria for oocyte competence as advanced maternal age is a significant factor, but numerous other influences exist.
- - Factors like obesity, lifestyle, genetic issues, ovarian stimulation, and environmental conditions all potentially affect oocyte quality, with morphological evaluations being the most common method for assessing reproductive potential.
- - While some abnormalities in oocytes may indicate lower developmental potential, no single issue is predictive enough, and many innovative techniques are still in research phases rather than clinical use, leading to a lack of consistent methods for assessing oocytes.
Article Synopsis
- Time-lapse systems (TLSs) for embryo incubation have evolved significantly, moving from traditional incubators to more suitable benchtop models for human IVF.
- Advances in imaging technology and developments in wireless and smartphone tech have made TLSs more accessible for both labs and patients, enhancing user experience.
- The review discusses the history, available TLSs, clinical results, and limitations of this technology in modern IVF laboratories.
Article Synopsis
- - Male infertility can be caused by various factors, particularly high levels of sperm DNA fragmentation (SDF), which conventional semen analysis may not fully address.
- - Emerging sperm DNA fragmentation assays are gaining recognition as valuable diagnostic tools to assess sperm function and are being considered for routine use in evaluating male infertility.
- - Excessive SDF is associated with lower fertility potential, poor embryo quality, and challenges in achieving successful pregnancies, sparking discussions on the necessity of routine SDF testing in infertility assessments.
Article Synopsis
- Repeated embryo implantation failures (RIF) are a significant issue for couples and doctors, largely caused by factors like poor endometrial receptivity and low-quality embryos.
- *Recent research highlights that immune dysregulation, particularly an imbalance between T-helper (Th) cytokines, may affect RIF, leading to new treatment possibilities.
- *In a study of 77 women with RIF, abnormal endometrial cytokine profiles were found in 72.7%, and personalized treatments showed a 30.2% clinical pregnancy rate, suggesting a need for further validation in larger studies.