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F X Aubriot

Publications and source records attributed to F X Aubriot.

At least 19 recordsLinked to original sources
PubMed2003

[Difficult embryo transfer: what can be done in practice?].

Embryo transfer is an important step in the success of IVF treatment. One must avoid, at all cost, difficult transfers provoking bleeding, uterine contractions, and the retention of the embryo in the cervix, or even, its expulsion. Evaluation before IVF treatment, including a trial transfer, should allow one to evaluate the transfer step, anticipate problems, and thus improve treatment. The difficult insertion into the womb is most often associated with the presence of curves, which can be easily overcome by using pre-curved catheters.

Catheterization↗
PubMed2001

[Hysteroplasty for enlargement: apropos of the results].

The DiethylstilBbestrol (DES) is a synthetic estrogen which was prescribed from 1941 onwards for the prevention of miscarriage. As well as a possible risk of cancer, another side effect of this treatment was the possible of abnormality of the genitalia in the female issue of the prescribed user. Apart from possibly having a hypoplasic uterus, the patient is also prone, in the case where she has an undersized uterus, to having a much narrower than normal cavity. Consequently there is a tendency for an excess of muscle tissue on the uterus walls. This can be observed on an RMN. The most significant characteristics of this abnormality are: constriction rings around the proximal uterine segment, a T shaped uterus, uterus with an arched based. The idea of the plastic enlargement operation is to widen the cavity by making careful incisions on the excess muscle tissue located on the uterus wall. The objective of this is to obtain a triangular shaped cavity taking care though not to weaken the walls themselves. 51 patients were treated. We observed 31 pregnancies (49%) after 16 months with 25 ungoing pregnancies. Generally the anatomic results are excellent but it's difficult to measure the functional results or the success rate in future pregnancies. The reason for this is the enlarging of the cavity alone does not guarantee successful fertility. There are other problems to take in to account e.g. implantation, miscarriage and premature labor. There are risks with this operation: placenta percreta, a possible rupture of the uterus, though this can happen at any time with DES patients. This operation can only be recommended once a thorough examination of the patient has been made. It is not advisable with a patient who has a hypoplasic cavity in a hypoplasic uterus (hysterometry < 4 cm). This operation should never be done as a first course of action but it can be recommended above all if the patient has a constriction ring: as a sole reason for infertility; where infertility has been diagnosed and unsuccessfully treated; and an unexplained failure of ART, and where the patient has unexplained repeated miscarriages.

Abnormalities, Drug-Induced↗
PubMed2000

Embryos with high implantation potential after intracytoplasmic sperm injection can be recognized by a simple, non-invasive examination of pronuclear morphology.

Embryos are conventionally selected for transfer based on the evaluation of the cleavage speed and extent of blastomere fragmentation. Here we examined whether the predictive value of these criteria, as indicators of the chance of embryo implantation, can be further potentiated by adding previously described criteria reflecting the regularity of pronuclear development. In a group of embryos selected for transfer in 380 fresh embryo transfer cycles according to the conventional criteria, the transfer of only those embryos that developed from zygotes judged normal at the pronuclear stage (pattern 0) gave significantly higher pregnancy (44.8%) and implantation (30.2%) rates compared with the pregnancy (22.1%; P < 0. 05) and implantation rates (11.2%; P < 0.001) for the transfers of only those embryos that developed from zygotes judged abnormal (non-pattern 0). The transfer of only one pattern 0 embryo was sufficient for the optimal chance of pregnancy (no differences in pregnancy rates after transfer of one, two or three pattern 0 embryos), whereas the transfer of two pattern 0 embryos mostly resulted in a twin pregnancy. The inclusion of the criteria based on pronuclear morphology can thus lead to the application of a single embryo transfer policy and optimize the selection of embryos for transfer and cryopreservation.

Cell Nucleus↗
PubMed1998

[Non-obstructive azoospermia and ICSI].

50 cases of non obstructive azoospermia required testicular sperm extraction and ICSI. Results are promising but ability to find spermatozoa remains questionable. Further studies are necessary to improve success of the method. Genetic research also need to be developed for better understanding the process.

Cryopreservation↗
PubMed1995

Sterilization reversal: fertility results.

Fertility outcome following sterilization reversal by laparotomy was evaluated. We studied all sterilization reversals performed between January 1978 and December 1991; a total of 226 women were treated. Tubal anastomosis was performed according to the rules for microsurgery. The microsurgical technique comprised two main phases: preparation of the healthy tube segments and the anastomosis carried out on two layers. It was possible to study the subsequent fertility of 206 patients in all, as 20 patients were lost to follow-up (8.8%). Cumulative pregnancy rates were evaluated by life-table analysis. The overall intrauterine pregnancy rate, including births and miscarriages, was 69.9% (144 patients) after 2 years. The cumulative intrauterine pregnancy rate was 62% at 18 months. Analysis of the fertility results demonstrated that age was the most significant predictive factor. The cumulative intrauterine pregnancy rate at 2 years was 83.5% (61 cases) for patients < or = 33 years, 70% (35 cases) for patients aged 34-36 years, 62.5% (30 cases) for patients aged 37-39 years, and 51.4% (18 cases) for patients aged > or = 40 years. Even for patients aged approximately 40 years, microsurgical repermeabilization can be retained as the first choice rather than in-vitro fertilization.

Adult↗
PubMed1995

[Laparoscopic surgery of large uterine fibromas. Operative technique and results].

OBJECTIVE. To describe the technique of laparoscopic myomectomy for large myomas (5 cm and more) and to evaluate the results. RESULTS. Only myomas which are complicated (and/or resistant to properly conducted medical treatment) require surgical treatment. Between October 1, 1990 and October 31, 1994, we carried out 72 laparoscopic myomectomies for intramural myomas measuring 5 cm or more, in 71 patients. The operations lasted 130 +/- 60 min (range: 40-330 min). We converted to laparotomy for two cases (2.7%). We observed no serious per or postoperative complications. We never needed a repeat operation, whether by laparotomy or by laparoscopy. CONCLUSION. Despite these encouraging results, it must be remembered that the operation is lengthy and difficult and is reversed for laparoscopic surgeons perfectly familiar with endoscopic knot tying. Although it is a difficult technique, laparoscopic myomectomy is possible even for large myomas and those that are completely intramural. These results need to be assessed over the long term especially with respect to the risk of adhesions and the quality of the laparoscopic suture.

Adult↗
PubMed1995

[Total laparoscopic hysterectomy. Operative technique, results and indications].

Total hysterectomy was performed via laparoscopy alone in 50 patients. In all cases, the operation was carried out using conventional, re-usable instruments (grasping forceps, laparoscopic scissors, bipolar coagulation). The mean duration of the operation was 163 min (range: 110-270 min). The mean drop in haemoglobin was 1.97 g/100 ml (range: 0-4 g/100 ml) and the average length of hospital stay was 3.9 days (range: 2-13 days). In one case (2%), we converted to laparotomy because a lateral myoma made it impossible to achieve haemostasis of the uterine pedicule under suitably safe conditions. No serious peri or post-operative complications were encountered. No second surgery was necessary and no transfusion was required. These results confirm that total laparoscopic hysterectomy via laparoscopy is a safe, feasable and reproductible technique. Future work will establish the exact place and methods for laparoscopic surgery for hysterectomy. Laparoscopic surgery is only indicated when vaginal hysterectomy is contraindicated or impossible. Laparoscopic hysterectomy constitutes an alternative to laparotomy rather than the vaginal hysterectomy. The combination of an immobile uterus and poor vaginal accessibility is the prime indication for total hysterectomy via laparotomy.

Adult↗
PubMed1994

Treatment of ovarian dermoid cysts. Place and modalities of operative laparoscopy.

The purpose of this study was to discuss the place and the specific modalities of laparoscopic surgery in the management of ovarian dermoid cysts. This retrospective and noncomparative study was carried out in 65 patients who presented dermoid ovarian cyst between January 1986 and December 1990 in our institution. The surgical treatment was performed purely by laparoscopy in 86.2% of the cases (56 patients). The modalities of laparoscopic surgery were as follows: ovariectomy (8 cases; 14.3%), transparietal cystectomy (4 cases; 7.1%) and intraperitoneal cystectomy (44 cases; 78.6%). In 15 cases (15/44 = 34%) the intraperitoneal cystectomy was carried out without opening the cyst and the intact cyst was extracted using an endoscopic impermeable sack. We observed no cases of chemical peritonitis. The risk of recurrence after conservative treatment is 4% (two patients) and out of the ten patients for whom a second-look laparoscopy was performed only two (20%) presented adhesions. Laparoscopic treatment of dermoid ovarian cysts is feasible, safe, and effective. The treatment can be conservative in over 80% of the cases. The specific risk of chemical peritonitis can be countered by a change in the cystectomy technique. The use of an impermeable laparoscopic sack permits extraction of the cyst without any peritoneal contamination.

Adult↗
PubMed1994

[Uterine myoma: modalities and indications for coelioscopic treatment].

Only complicated fibromas refractory to medical treatment should be treated surgically. Two types of operations can be proposed for interstitial and subserosal fibromas: myomectomy and hysterectomy. The indication, based on a through preoperative assessment, depends on the patient's age and the size, number and sites of the fibromas and associated lesions. Preliminary series confirm the feasibility of these two operations performed by laparoscopy, as a result of the progress in this modality over recent years. In the future, larger series will determine the respective place of each of these surgical procedures in relation to others surgical possibilities.

Adult↗
PubMed1994

Failure of laparoscopic treatment for peritoneal trophoblastic implants.

We report on two cases of peritoneal trophoblastic tissue implants, one after salpingostomy, and one after salpingectomy for ectopic pregnancy. During each secondary laparoscopy, simple excision of implants with laparoscopic biopsy forceps resulted in persistent elevated beta-human chorionic gonadotrophin (beta-HCG) levels. Methotrexate therapy was used. Removal of all trophoblastic tissues present and avoidance of trophoblastic spillage during the laparoscopic procedure should prevent such an uncommon complication.

Adult↗
PubMed1994

Total laparoscopic hysterectomy: preliminary results.

Total hysterectomy carried out entirely via laparoscopy benefited 31 patients. In all cases the operation was carried out using conventional, re-usable instruments (grasping forceps, laparoscopic scissors, bipolar coagulation). The mean duration of the operation was 171 min. No serious peri- or post-operative complications were encountered and no transfusion was required. The mean drop in haemoglobin was 1.3 g/100 ml and the average length of hospital stay was 4 days. In one case (3.26%) we converted to laparotomy because a lateral myoma made it impossible to achieve haemostasis of the uterine pedicle under suitably safe conditions. These results confirm that total hysterectomy via laparoscopy is a safe, feasible and reproducible technique. Future work will establish the exact place and methods for laparoscopic surgery for hysterectomy; it can be suggested, however, that laparoscopic surgery is only indicated when vaginal hysterectomy is contra-indicated or impossible. So, laparoscopic hysterectomy constitutes an alternative to laparotomy rather than to vaginal hysterectomy. The combination of an immobile uterus and poor vaginal accessibility is the prime indication for total hysterectomy via laparoscopy.

Adult↗
PubMed1994

Laparoscopic salpingostomy: fertility results according to the tubal mucosal appearance.

Prognostic factors for fertility outcome following laparoscopic salpingostomy were evaluated. We studied all distal tuboplasties performed between May 1986 and June 1991. Ninety infertile women were treated. Tuboplasty was carried out bilaterally except when one tube was absent or when bifocal lesions were present. Salpingostomy was performed using either scissors and thermocoagulation for eversion, or the CO2 laser. Cumulative pregnancy rates were evaluated by life-table analysis, according to the tubal classification and the mucosal status. The 18 months estimated cumulative pregnancy rate with normal delivery was 28.7%. Pregnancy rates were significantly higher in patients classified in grades I and II versus grade III and IV (severely damaged tubes) according to the distal tubal scoring system, and in patients with normal or lightly atrophic mucosa versus alveolar or absent mucosa. Operative laparoscopy is effective for treatment of hydrosalpinges. Fertility outcome is related to the tubal damage. Our results demonstrate that the prognosis value of the mucosal status seems to be as predictive as the distal tubal scoring system.

Adult↗
PubMed1994

Pregnancy after laparoscopic partial cystectomy for bladder endometriosis.

We report a case of partial laparoscopic cystectomy in a 31-year-old infertile patient presenting vesical endometriosis. This patient had suffered severe dysmenorrhoea for 10 years previously together with repeated episodes of urinary infection, mostly occurring during the menstrual period. A diagnostic laparoscopy performed in another centre diagnosed a stage IV endometriosis. Gonadotrophin-releasing hormone agonists were prescribed for 9 months. After failure of this treatment, the patient came to consult us. A solid mass in the left supratrigone was detected by pelvic ultrasonography and confirmed by cystoscopy. Transurethral resection was carried out. A recurrence of the symptoms 9 months later prompted operative laparoscopy under cystoscopic control. This confirmed recurrence of a 3.5 cm endometriotic nodule. Laparoscopic partial cystectomy was performed using the monopolar electrode. The bladder was then sutured via laparoscopy. No complications occurred. No postoperative treatment was given. Second-look cystoscopy 2 months later revealed that healing was perfect. Eight months later, the patient is well and has a normal intra-uterine pregnancy.

Adult↗
PubMed1994

[Celiosurgery in gynecology. Indications, benefits and risks].

Initially used exclusively for diagnosis, laparoscopy is now a surgical method in gynecology but also in many other specialties. In gynecology, the results of laparoscopic surgery are comparable to those obtained by laparotomy in many indications: ectopic pregnancy, ovarian cysts, endometriosis, tubo-peritoneal sterility... Because of the advantages of laparoscopic surgery over traditional surgical treatment by laparotomy, operative laparoscopy is, in these indications, now recognized to be the best choice of surgical treatment. The most important advantages of operative laparoscopy are the following: less esthetic drawbacks, minimal risk of parietal and infectious complications, lower risk of post operative adhesions, more comfortable post operative course and lower cost due to considerably shortened hospital stay and recovery period. The risk of complications is directly correlated to the surgeon's experience and the importance of the surgery performed.

Endometriosis↗