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C Rongières

Publications and source records attributed to C Rongières.

At least 19 recordsLinked to original sources
PubMed2007

[Embryo donation in France: practice and difficulties. Strasbourg's experience].

OBJECTIVE: The aim of this study was to present the situation of embryo donation in France and around the world, to expound the difficulties of its practice and the results obtained in our centre 3 years after the introduction of this procedure. PATIENTS AND METHODS: Embryo donation in France is controlled by implemented decrees published between 1999 and 2004. The couples, who have stored frozen embryos since at least two years, were contacted for a pluridisciplinary medical consultation. The indication of embryo donation was evaluated for the recipients through a pluridisciplinary approach. RESULTS: Among the interviewed couples, 16.7% have chosen embryo donation but only half of them have completed the procedure (6% of the couples with frozen embryos). The main indications for embryo donation were a double sterility, unexplained genetic disease, ART failures (poor fertilization or bad embryo quality) and oocyte donation when the delay was too long for the couples. The pregnancy rate was 28.6% after the 21 first embryo transfers. DISCUSSION AND CONCLUSION: The results of embryo donation confirm the international experience both considering the poor number of donated embryos, medical indications and results. Embryo donation has its place among ART techniques, but one should not ignore the general debate on ethical questions raised by this procedure.

Embryo Disposition↗
PubMed2006

[Do hysteroscopic metroplasties really improve really reproductive outcome?].

The aim of metroplasties is to restore a normal uterine anatomy to improve obstetrical outcomes in some uterine malformations. The hysteroscopic septoplasty cures the septate uterus. It is an effective procedure in the case of recurrent abortion losses. It probably improves the rate of live birth in women without obstetrical antecedent. For some authors, it could be considered at the time of the diagnosis, because of the simplicity of the gesture and the low complication rate. The enlarging hysteroscopic metroplasty has certainly a positive impact on the obstetrical outcome in patients presenting a uterine hypotrophy or dysmorphy, in particular in women exposed in utero to DES. However, the proofs are poor to propose this procedure as first-line treatment, apart from specific cases such as old null gravid patient or before inclusion in an Assisted Reproductive Techniques (ART) program.

Diethylstilbestrol↗
PubMed2006

[Monitoring ovarian stimulation: are hormonal assessments necessary?].

Standard monitoring of controlled ovarian hyperstimulation (COH) includes hormone assays (estradiol, LH, progesterone) and regular pelvic ultrasound examination. We report a randomized study on an attempt to simplify monitoring of COH. Ultrasound monitoring of the cycle alone did not affect pregnancy rates and did not increase the risks of OHSS. These results encourage the future simplification of stimulation protocols.

Adult↗
PubMed2004

[Abnormal bacterial colonisation of the vagina and implantation during assisted reproduction].

OBJECTIVE: To evaluate the efficiency of our treatment of vaginal infection for couples included in an IVF program. PATIENTS AND METHODS: Microbiologic screening of vaginal flora and semen has been performed one month prior to in vitro fertilization for 951 couples in 2000. Antibiotic treatment was prescribed in case of positive culture. RESULTS: Positive microbial growths were observed from endocervical and vaginal cultures in 218 women (22.9%). The clinical pregnancy rate was 30.29% in the group of patients without growth and 30.27% in the group with positive microbial growth. The implantation rate was significantly diminished in case of bacterial growth: 14.6 compared to 19.3% (P <0.02) for sterile endocervical culture. Five main bacterial species were found at the cervical level: Candida albicans (69 cases), Ureaplasma urealyticum (49 cases), Gardnerella vaginalis (43 cases), Streptococcus B or D (24 cases) and Escherichia coli (22 cases). Positive cultures from both vagina and semen were observed for 77 couples whose clinical pregnancy rate was 19.5 vs 36.2% in case of vaginal infection alone (P <0.01) with a spontaneous miscarriage rate of 46.7 compared to 17.6% (P <0.01). DISCUSSION AND CONCLUSION: Endocervical microorganisms, even treated with adapted antibiotics, may affect embryonic implantation. Positive culture from both female and male partner may enhance this negative effect. In this case, the best strategy would be to cancel the IVF treatment.

Bacterial Infections↗
PubMed2003

[Towards a single embryo transfer: predictive value of uterine and embryological parameters in assisted reproduction outcome].

OBJECTIVE: The transfer of a single embryo would avoid obstetrical and neonatal complications due to multiple pregnancies. We studied the clinical value of both uterine and embryological parameters to define precise conditions allowing a single embryo transfer without decreasing pregnancy rates. PATIENTS AND METHODS: Endometrial parameters expressed by a uterine score together with biological criteria of 131 in vitro fertilization or intracytoplasmic sperm injection attempts were retrospectively analysed. RESULTS: Two hundred and sixty-two day-3 embryos were replaced through 131 transfers. Fifty-seven pregnancies were induced and 16 twins were obtained. The clinical pregnancy rate was 35.9% and the embryonic implantation rate 24.0%. After the transfer of two embryos, successful implantation was determined by the occurrence of top-quality embryos and simultaneously by a receptive endometrium. The uterine pulsatility index was significantly decreased for twin compared to singleton pregnancies. DISCUSSION AND CONCLUSION: This study confirms that a uterine score constitutes a powerful tool for evaluating the uterine receptivity. This parameter has to be taken into account as well as the embryonic quality, in order to optimise the success rate. Young patients with at least two top-quality embryos available, a high uterine score and a low pulsatility index, have a high risk of multiple births and are suitable for a single-embryo transfer.

Adult↗
PubMed2003

[About two complications of ovarian drilling by fertiloscopy].

Two complications of ovarian drilling by fertiloscopy are described about two patients with polycystic ovary syndrome. Ovarian drilling by fertiloscopy is a new minimally invasive surgery, but this procedure is not without risks. It requires larger studies with longer follow-up to evaluate effectiveness and risks.

Adult↗
PubMed2003

[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. New ovulation induction regimens that may optimize, reduce complications, and lower costs of ovarian stimulation procedures and of assisted reproduction in general were presented. This was the 5th Ferring Pharmaceuticals Conference in the area of reproductive medicine held in Florida.

Abortion, Spontaneous↗
PubMed2003

Is laparoscopy still the gold standard in infertility assessment? A comparison of fertiloscopy versus laparoscopy in infertility. Results of an international multicentre prospective trial: the 'FLY' (Fertiloscopy-LaparoscopY) study.

BACKGROUND: The aim of this prospective multicentre study was to compare the two endoscopic techniques of laparoscopy and fertiloscopy in routine evaluation of the pelvis in infertile women. METHODS: A total of 92 women was selected in 14 University Hospitals to undergo fertiloscopy followed by transabdominal laparoscopy by a team of two surgeons in each hospital. RESULTS: A high degree of concordance was observed between these two techniques, in that if fertiloscopy did not detect any abnormalities, this was also confirmed by laparoscopy. Discordance was observed in similar numbers of cases: eight after laparoscopy and nine after fertiloscopy. The diagnostic index for fertiloscopy and laparoscopy was calculated; sensitivity (86 and 87% respectively) and negative predictive value (64 and 67% respectively) were similar. The kappa index was also calculated for each of the six structures/regions (right/left tube; right/left ovary; peritoneum of pouch of Douglas; posterior uterus), and concordance (0.78 to 0.91) was considered almost complete. CONCLUSIONS: These results confirm fertiloscopy as a minimally invasive safe procedure that may be considered as an alternative to diagnostic laparoscopy in the routine assessment of women without clinical or ultrasound evidence of pelvic disease. On the basis of the additional advantages of fertiloscopy, namely salpingoscopy or microsalpingoscopy, it is considered that fertiloscopy could replace laparoscopy as a routine procedure in such women.

Adult↗
PubMed2003

[Fertility after ectopic pregnancy and indications of ART].

There is no simple answer to the problem of fertility after one ectopic pregnancy. Results reported in the literature have been satisfactory with rate of subsequent pregnancy about 60% and the risk of new ectopic pregnancy (EP) around 28%. We have deliberately excluded studies before 1990 except when the methodology was particularly good or the treatment particularly interesting. Strict and exhaustive criteria were lacking in most of these studies due to widely varying aims, the prospective or retrospective nature of the data, the number of patients included, and varying therapeutic decision-making schemes. Many patients were lost to and no mention is given concerning the proportion of patients who desired a subsequent pregnancy. Infertility factors were not considered in most cases. We were looking for fertility results according to treatment used. Among the 50 studies we retained, pregnancy rates after ectopic pregnancy were satisfactory whatever treatment was used, with laparoscopy being the gold standard. Medical treatment was at least as effective as surgical treatment. Associated infertility factors appeared to be the most important for fertility outcome. It is unfortunate that so few study have analyzed outcome in these patients without considering risks factors of EP, infertility factors and the proportion of women who attempted to conceive again.

Abortifacient Agents, Nonsteroidal↗
PubMed2002

C-reactive protein should accelerate the diagnosis of bowel injury after gynecologic surgery.

STUDY OBJECTIVE: To search for a marker that could aid in earlier diagnosis of bowel injury after gynecologic surgery. DESIGN: Retrospective case study with prospective controls (Canadian Task Force classification II-2). SETTING: University hospital. PATIENTS: Fourteen women with bowel injuries and 50 controls with no postoperative complications. MEASUREMENTS AND MAIN RESULTS: Bowel injury occurred in 14 (2.4/1000) of 5901 gynecologic procedures. Of these, eight were recognized intraoperatively and treated immediately. In six women C-reactive protein levels were markedly increased (>100 mg/L) relative to control patients (p <0.0001). CONCLUSION: Systematic postoperative assessment of C-reactive protein in patients at high risk for bowel injury may help identify this complication earlier in the postoperative period.

Adult↗
PubMed2002

[Evolution of homocysteine during ovarian stimulation for IVF or ICSI].

OBJECTIVE: To determine the homocysteine evolution during ovarian stimulation in IVF or ICSI protocols and in, a second time, to evaluate the role of hyperhomocysteine as thrombotic risk factor for the treated patients. MATERIAL AND METHODS: Plasma homocysteine was determined three times for each of 31 women included in an IVF/ICSI program. Dosages were realised before stimulation, after gonadotrophin-releasing hormone agonist treatment (GnRH) and on the day of hCG injection. Vitamin B12 and folates were determined before stimulation. In case of hyperhomocysteinemia, a research of APCR (Activated Protein C Resistance) was realised. RESULTS: Five hyperhomocysteinemia cases were discovered (16.12% of studied population). APCR was found in a patient with hyperhomocysteinemia (14 mumol/L, before stimulation). Molecular biology has confirmed an heterozygous mutation of factor V Leiden. During the ovarian stimulation the evolution of homocysteine was independent of the 17 beta oestradiol evolution. CONCLUSION: The prevalence of hyperhomocysteinemia was not significative according to the limited size of the studied population. The increase of oestradiol during induction protocols is unrelated to the homocysteine level. This work must be continued with largest population to have better knowledge of the prevalence of hyperhomocysteinemia among women included in ovarian stimulation protocols.

Adult↗
PubMed2001

Allele-specific amplification for preimplantation genetic diagnosis (PGD) of spinal muscular atrophy.

We have developed a new allele-specific amplification method for the preimplantation genetic diagnosis (PGD) of spinal muscular atrophy (SMA; Werdnig-Hoffmann disease) from a single cell. This method is based on the detection of the deletion of exon 7 of the telomeric copy of the survival motor neurone (SMN(t)) gene. An oligonucleotide was designed to be specific to the SMN(t) nucleotidic sequence with exonic mismatch G (for SMN(t))-->A (for SMN(c)) at its 3' end. This test produces reliable PCR products in 95% of single lymphoblasts (85/88) tested as well as in 16/16 blastomeres from normal controls. Specificity analysis showed that we were able to detect homozygous deletion of the SMN(t) gene in 99% of single lymphoblasts (103/104) from a SMA patient. No contamination was detected in 68 blanks tested. Multiple cell and DNA dilution analysis revealed that the test is accurate and specific up to 100 pg DNA and should thus also be suitable for PGD at the blastocyst stage. This rapid procedure requires a single round of fluorescent PCR and no restriction digestion, while previously described single cell methods include nested PCR followed by restriction enzyme digestion. Two PGD cycles for SMA using this procedure were performed in our centre.

Adult↗
PubMed2000

Zygote evaluation: an efficient tool for embryo selection.

One of the main problems concerning IVF units is the need to decrease the occurrence of multiple pregnancies in their practice without affecting the overall success rate. Different embryological parameters concerning every step of the early embryo development are known to have some predictive value for implantation potential. In this prospective study, a pronuclear scoring system was used to classify zygotes into six patterns from 0 to 5. Cleaved, day 3 embryos developed from pattern 0 zygotes, which was described as the normal pattern, were transferred when available. For each zygote pattern, the subsequent embryological development was analysed. Pattern 0 zygotes led to significantly more 'good quality' embryos with higher implantation potential than embryos developing from the other zygote patterns (P < 0.01). Embryo transfers including at least one pattern 0 resulted in significantly more pregnancies than transfers without any pattern 0 zygotes (39.3 versus 19.7%, P < 0. 01). No relationship between clinical parameters (age of female partner, infertility cause) and zygote pattern distribution was demonstrated.

Aging↗
PubMed2000

[Future perspectives: oocyte cryopreservation and in vitro maturation].

After treatment for neoplasia, a young patient can nowadays hope to be pregnant. The aim of this paper is to establish a review of the literature about cryopreservation of oocytes and ovarian tissue, and in vitro maturation of oocytes. These studies also concern patients for which ovarian stimulation is difficult, such as PCOS. These techniques could also facilitate the creation of an oocyte bank as the one already existing for sperm. So far the main studies published, in spite of very timid first results, allow us to look to a great future for cryopreservation and in vitro maturation of oocytes.

Cryopreservation↗