[Value of microfertilization for repeated in vitro fertilization failures: the role of female parameters].

Unlabelled: Microfertilization technics as SUZI (sub-zonal insemination) can be indicated in cases of repeated in vitro fertilization (IVF) failure. Feminine parameters seem to play however an important role in optimalization of results. We studied 27 couples (32 IVF-SUZI cycles) who had previously presented 2 to 4 in vitro fertilization failures.

[The value of RU-486 (mifepristone) in medical indications of the induction of labor at term. Results of a double-blind randomized prospective study (RU-486 versus placebo)].

One hundred and twenty term women (> 37.5 weeks amenorrhea) with unripe cervixes (Bishop < 4) and with a clear clinical indication for labour induction were randomized to receive either mifepristone (RU 486) or placebo. The patients' regimens consisted of 200 mg of mifepristone on days 1 and 2 over an observation period of 4 days, with labour induction planned for day 4.

[Gestational age and fetal lung maturity].

In order to assess the lung maturity of the fetus, a biochemical analysis using two reliable, simple and rapid methods (FLM-TDX Abbott and determination of phosphatidylglycerol (PG) have been carried out on 166 amniotic fluids taken by amniocentesis. The patients were particularly pregnant women presenting disorders such as diabetes (n = 41), premature rupture of the membranes (n = 30), hypertension (n = 20), intra uterine growth retardation (n = 13) and gemellar pregnancies (n = 27). The lung maturity of the fetus has been considered as mature (no risk of any hyaline membrane disease: HMD) when the phospholipid rate is higher than 50 mg/g albumin (FLM-TDX Abbott), associated or not with the presence of PG (PG positive).

[Weak transplacental passage of prazosin (Alpress) during the third trimester of pregnancy. 3 cases].

Prazosin is a selective peripheral alpha 1-adrenoceptor antagonist used in the treatment of hypertension and heart failure. This drug has the disadvantage of relatively short terminal half-life (of the order of 2 to 3 hours); its wide use has been limited by the number of daily administrations. Recently, a new formulation of prazosin has been commercialized i.

[Techniques, interrogations and results of medically assisted procreation].

In vitro fertilization has obtained a foreground position in therapeutics proposed to infertile couples. Technical developments could be improved in the obstetrical and pediatric field through a better understanding of events occurring in embryos implantation, and through a specific management of the subsequent pregnancies.

[Value in gynecology of transvaginal pulsed and color Doppler. Study of ovarian vascularization].

Recently, pulsed Doppler has become available on high resolution vaginal ultrasound probes for studying ovarian blood flow. Doppler studies of ovarian blood flow are based on: semiquantitative analysis of Doppler flow waves recorded over the ovarian artery at its entry into the ovary; color Doppler mapping of intraovarian vessels. Semiquantitative analysis of the ovarian artery Doppler flow waves suffers from frequent difficulties at properly identifying the ovarian artery, particularly in multiparous women.

[Must we still operate on ectopic pregnancies?].

Non surgical management of ectopic pregnancy has recently become an alternative to surgery. We have investigated a pretherapeutic score to define the indication for non-surgical and surgical treatment in 123 patients with ectopic pregnancy. The score was performed before the patients' inclusion in a non-surgical management scheme.

[Oocyte donors. Psychological aspects].

This study concerns 63 oocyte donors who were investigated after a semi-directed interview. In our procedure all "personalized anonymity" donation took place on two levels: symbolic donation for close recipient, real donation for unknown recipient. All donors agree with anonymity without which some would not have preceded.

Labor induction in women at term with mifepristone (RU 486): a double-blind, randomized, placebo-controlled study.

Objective: To determine the efficacy and safety of mifepristone as an induction agent for the initiation of labor or as a cervical ripening agent in women at term.

Methods: Our study group contained 120 women at term (after 37.5 weeks' amenorrhea) who had clear clinical indications for labor induction.

Influence of sperm parameters on outcome of subzonal insemination in the case of previous IVF failure. off.

Subzonal insemination (SUZI) has been proposed for patients with sperm male factor infertility, and in cases of in-vitro fertilization (IVF) failures. However despite SUZI, there still remain couples with very low fertilization rates and even with fertilization failures. Since sperm parameters are known to influence the IVF fertilization rate, we investigated the relation between sperm parameters and the SUZI issue in cases of previous IVF failures with normal or subnormal sperm.

Controlled preparation of the endometrium with exogenous oestradiol and progesterone: a novel regimen not using a gonadotrophin-releasing hormone agonist.

In women having inactive ovaries, controlled preparation of the endometrium has been achieved with exogenous oestradiol and progesterone. We report on the feasibility and practicality of using a similar regimen for timing transfers of cryopreserved embryos in women whose ovaries have not been suppressed. A total of 91 women having cryopreserved embryos from previous in-vitro fertilization (IVF) attempts received 4 mg/day of oestradiol valerate, starting on cycle day 1 of spontaneous (n = 85) or induced (n = 6) menstruation.

The interplay between basicity, conformation, and enzymatic reduction in biliverdins.

Biliverdins with extended conformations are reduced by biliverdin reductase (BvR) at higher rates than biliverdins with helical conformations. To find out the molecular basis for this important feature of BvR mechanism, helical and extended biliverdins were titrated for their acid-base equilibria in a protic solvent (methanol). It was found that the basicity of biliverdins increases with the stretching of the conformation.

First-trimester diagnosis of nuchal anomalies: significance and fetal outcome.

High-resolution real-time ultrasonography now permits the differentiation between nuchal translucencies and cystic hygromata of the neck in the first trimester. A series of 85 nuchal anomalies are presented that were diagnosed by ultrasonography at 9-14 weeks' gestation; their association with chromosomal defects and fetal outcome are also presented. Chromosomal anomalies were found in 8/29 nuchal translucencies and in 16/56 cystic hygromata of the neck.

Spontaneous luteinizing hormone surges can be reliably prevented by the timely administration of a gonadotrophin releasing hormone antagonist (Nal-Glu) during the late follicular phase.

A new gonadotrophin releasing hormone antagonist (Nal-Glu) was used during the late follicular phase of the natural cycle in order to prevent spontaneous surges of luteinizing hormone (LH). Eight regularly ovulating women (group 1) received two injections of Nal-Glu (5 mg) administered 48 h apart when plasma oestradiol levels exceeded 125 pg/ml. Human menopausal gonadotrophin (HMG, 225 IU) was administered simultaneously with Nal-Glu and repeated every 12 h thereafter until either a spontaneous LH surge occurred or human chorionic gonadotrophin (HCG, 5000 IU) was administered.

[Sterility and medically assisted fertilization].

In vitro fertilization is now part of the treatment of infertility. Since 12 years, indication have been extended to male or female infertility factors. The successes have also been increased and the actual pregnancy rate is about 18% pregnancies by retrieval.

Reconstitution of apomyoglobin with extended biliverdins.

An analysis of the reconstitution of biliverdins with extended conformations and horse heart apomyoglobin was carried out. Biliverdins with the 5Z-syn, 10Z-syn, 15Z-anti and 5Z-anti, 10Z-syn, 15Z-anti conformations, as well as biliverdins with the Z,Z,Z, all-syn conformation recombined with apomyoglobin. In every case the P enantiomers were bound in excess to the M enantiomers, with exception of the 5-syn, 10-syn, 15-anti biliverdin where the M enantiomer bound preferentially to the protein.

Effects of luteal estradiol on the secretory transformation of human endometrium and plasma gonadotropins.

To study the role of luteal estradiol (E2), we interrupted the supply of E2 during the luteal phase of E2 and progesterone (P) replacement cycles. Thirty-one women, aged 26-37 yr, with absent or inactive ovaries received three different treatment regimens: group I (n = 11) received transdermal E2 and vaginal P according to a protocol designed to approximate levels of estrone (E1), E2, and P seen during the menstrual cycle. Groups II (n = 11) and III (n = 9) received identical treatments, except that in group II no E2, and in group III no E2 or P, was administered after day 15.

[RU 486 (mifepristone) and therapeutic abortions in the second and third trimesters].

RU 486 activity for therapeutic pregnancy termination through prostaglandin was studied in a controlled survey including 50 patients, in the second and third trimester of pregnancy (in conformity with the French law). Patients were randomly divided into two groups. The first one was administered orally 200 mg of RU 486, 48 hours before the first Sulprostone injection.