Increased pregnancy rate using standardized coculture on autologous endometrial cells and single blastocyst transfer : a multicentre randomized controlled trial.

Despite excellent published results, the lack of well-designed, multicentre, randomized clinical trials results in an absence of general consensus on the efficacy of autologous endometrial cells coculture (AECC) in Assisted Reproductive Technology (ART). An open, multicentre, prospective, randomized controlled trial was designed to compare the pregnancy rate (PR) after the transfer of one blastocyst on day 5 after AECC to the transfer of one embryo on day 3 (control group). Patients were women aged 18 to 36, undergoing an ART cycle with no more than 1 embryo transfer failure.

[Informations for the infertile couple].

The aim of the first consultation related to infertility is supposed to be the optimization of all factors that can increase the chances of pregnancy: more frequent sexual intercourse during the fertility windows; lifestyle modifications (better diet, decreased exposure to tobacco or other toxics); older couples can enjoy the same advice but should be proposed a quicker medical support. Maternal preconceptional advice must be transmitted. A testicular cancer must always be excluded in infertile men, while the risk of hormone-dependent cancers in infertile women remains undetermined.

Pregnancy and delivery after in vitro maturation of naked ICSI-GV oocytes with GH and transfer of a frozen thawed blastocyst: case report.

Purpose: To determine if GV oocytes, collected at the time of ICSI, can be matured in vitro and rescued for therapeutic treatment. A patient for whom all the collected oocytes at the GV stage after a classical COH protocol were matured in vitro with GH.

Method: All the naked oocytes were matured in a culture medium (ISM2) containing 15% patient serum +1.

Pregnancy and delivery after stimulation with rFSH of a galatosemia patient suffering hypergonadotropic hypogonadism: case report.

Purpose: To determine if hypergonadotropic hypogonadism related to galactosemia could be linked to anomaly of the circulating FSH. A 26-year-old woman, suffering GALT (Galactoso-1-phosphate uridyltransferase) had a premature ovarian failure with amenorrhea since the age of 19. The circulating level for FSH was 83 and 34 mU/mL for LH.

[Fort Lauderdale congress report: advances in infertility treatment - Florida, 24-26 January 2002].

The goal of the treatment of infertility is to apply therapeutic techniques to patients in a safe manner and at the same time increase the chances for conceiving and delivering healthy babies: basic and clinical research is more and more finalized directed to these goals. The conference "Advances in Infertility Treatment" held in Fort Lauderdale, Florida on January 24-26, 2002 covered many clinical and research aspects of this important therapeutic area. Important discussed issues included the impact of age, lifestyle, and the genetic set-up of patients in the pathogenesis and development of infertility-causing disorders such as male reproductive dysfunction, polycystic ovary syndrome, and ovarian failure.

Prospective, randomized, controlled study of in vitro fertilization-embryo transfer with a single dose of a luteinizing hormone-releasing hormone (LH-RH) antagonist (cetrorelix) or a depot formula of an LH-RH agonist (triptorelin).

Objective: To confirm the value of a single dose of 3 mg of cetrorelix in preventing the occurrence of premature LH surges.

Design: Multicenter randomized, prospective study.

Setting: Reproductive medicine units.

[Luteal phase support after vaginal progesterone: comparative study with micronized oral progesterone].

Two progesterone presentations, a vaginal application of 90 mg progesterone per day (Crinone) or 300 mg progesterone orally administered (Utrogestan) were compared for luteal phase support of patients undergoing an in vitro fertilisation (IVF) procedure. 283 patients were randomly allocated to either treatment. The treatment started within 24 hours after the embryo transfer procedure and continued until day 30 in cases of implantation.

Interest of co-cultures for embryos obtained by in-vitro fertilization: a French collaborative study.

Co-cultures of human embryos, particularly with Vero cells, are used by several French groups, mainly in cases of successive failures of implantation. In most cases co-culture is continued until the blastocyst stage, expanded if possible. A total of 1603 co-cultures have been performed by 11 groups over a 2-year period.

Luteal support after in-vitro fertilization: Crinone 8%, a sustained release vaginal progesterone gel, versus Utrogestan, an oral micronized progesterone.

Two progesterone presentations, a vaginal application of 90 mg progesterone per day (Crinone) or 300 mg progesterone administered orally (Utrogestan), were compared for luteal phase support of patients undergoing an in-vitro fertilization (IVF) procedure. A total of 283 patients were randomly allocated to either treatment. The treatment started within 24 h after the embryo transfer procedure and continued until day 30 in cases of implantation.

[Quality of the conceptus: embryo transfer strategy].

Embryo transfer is one of the key points of human IVF. Success or failure, as well as further incidence of multiple pregnancies are the immediate consequence of this technical point. The IVF transferus has also to manage with the patient anxiety.

[Acute pleurisy secondary to ovarian hyperstimulation after in vitro fertilization].

Pleurisies due to the syndrome of ovarian hyperstimulation typically accompany ascites and in their most severe form are associated with haemoconcentration, hypovolaemia and thromboembolic phenomena. It is not unusual in this context for pleural effusions to be isolated. They may occur during treatment for sterility by inducing ovulation, they are exudates and predominantly right sided.

Cocultured blastocyst cryopreservation: experience of more than 500 transfer cycles.

Objective: To present our experience using cocultured cryopreserved and transferred blastocysts.

Design: Retrospective study of patients undergoing transfer of cryopreserved blastocysts.

Setting: Three different IVF centers.

Factors affecting human blastocyst formation in vitro and freezing at the blastocyst stage.

Whatever the culture medium, embryo culture generally leads to a major loss of viability in mouse, rabbits even if the morphological development of the embryo is preserved. Moreover, Embryo metabolism is commonly depressed in culture media. The protein turnover is accelerated and the quality of the metabolites transport systems is impaired.

[Cocultures: diagnostic and therapeutic value].

Results of french multiple collaborative studies are reported to evaluate the possible benefits of coculture in human IVF program. Prospective randomized study of IVF with transfer on day two versus IVF with transfer on day 6 shows that coculture does not improve overall results but leads to a reduction of triple or quadruple pregnancies. When applied to patients with more than 4 failures of embryo transfers on day 2, delayed transfer of blastocyst results in a high rate of clinical pregnancy (39%).

[Multiple pregnancy risk factors in medically assisted reproduction].

FIVNAT registry collected 4,323 clinical pregnancies from 1987 to 1991, and allowed us to analyse the risk factors for multiple pregnancies. The multiple pregnancy rate is around 28%, 23% for twin pregnancies and 5% for triplet pregnancies. The number of transferred embryos is not the only factor to be significantly related with the risk of multiple pregnancy: male infertilities, cleavage rate over 50%, and women's age (at young ages multiple pregnancy rate are higher) are also significant.

Freezing cocultured human blastocysts.

Objective: To determine the possibility of obtaining good pregnancy rates (PRs) after freezing and thawing cocultured blastocysts.

Design: Human blastocysts were frozen first according to a protocol available from literature. Two other protocols including the addition of glycerol were designed to improve the results.

Coculture of embryos on Vero cells and transfer of blastocysts in humans.

Preliminary results are presented concerning the first clinical application of cocultures of human embryos. In the experimental group, the embryos were cultured and transferred on day 5 post-insemination. Blastocyst formation was not dependent upon the stimulation regimen.

Culture of epithelial cells derived from the oviduct of different species.

This study proposes a procedure for the isolation and culture of oviduct epithelial cells of several species. In-vitro culture on such a feeder seems to allow full embryonic development and viability. The inner linings of Fallopian tubes from mouse, rabbit, cow and human were trypsinized and the epithelial cells were enriched with Percoll gradient.

[Sterility of tubal origin: microsurgery and fertilization in vitro].

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 vitro fertilization or surgery in the treatment of tubal sterility].

Although it is very difficult to compare the results of the two methods, it would seem that those of tubal surgery remain more or less stationary whilst those of fertilisation in vitro improve and the technique becomes more simple.

[Polycystic ovaries. Round table].

Because of the variety and inconstancy of the clinical symptoms, it is difficult to establish a classification of the clinical forms. However, the laboratory profile, essentially a raised serum LH, is fairly constant in every case. The pathophysiology of the disequilibrium of androgen and gonadotrophin secretion can be explained on the basis of various initial functional abnormalities, such as an excess of adrenal androgens or LH or, conversely, a deficiency of FSH.

[Value of differential cytology in the diagnosis of preclinical forms of cervix uteri cancer].

The value of "differential cytology" in the diagnosis of preclinical carcinoma of the cervix uteri was assessed from serial sections of operative specimens in a series of 452 patients. Although not absolute, this value was found to be considerable. Used to supplement colposcopy-guided biopsy, it makes it possible to decide on the therapeutic approach (notably simple destruction by laser) without having recourse to conization.