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J de Mouzon

Publications and source records attributed to J de Mouzon.

At least 19 recordsLinked to original sources
PubMed2002

[Impressions od couples treated with fertilization in vitro of their treatment by the IVF center].

A preliminary study was designed to evaluate, among French couples treated for in vitro fertilization, their feelings about the delivered information on IVF and the degree of satisfaction about their treatment by the center. Anonymous forms were mailed to 3,000 couples, from which 835 were returned on time to be analyzed. Most of the couples expressed their satisfaction. However, 25% were disappointed by their first consultation, too short (14%) or too long to obtain (13%), especially for those treated in a public hospital. One quarter of couples waited for more than six months before their first cycle, more often in public practice than in private one, and 80% found this time lapse too long. One third of the couples changed of unit, 62% of them because of disappointment, mostly because of their relationship with the medical team, and only 20% because of poor results. Two thirds of the couples found IVF had repercussions on their couple's life, negatively in 31% of the cases. This percentage was higher for those with unsuccessful IVF (45%) than for those who got a pregnancy (22%). Information on IVF was judged as satisfactory only for two thirds of the couples, for any kind of information, and less than half of men were told how the inseminated semen quality was. Moreover, only 57% of the couples found the information reassuring. Local conditions for semen collection were judged to be bad by 30% of the men. Finally, this study showed that efforts still have to be made by units to better treat and inform IVF couples. It also seems necessary to undertake a prospective and more detailed study to better investigate the degree of satisfaction and its parameters.

Adult↗
PubMed2002

[Consequences of oocyte dysmorphy on the fertilization rate and embryo development after intracytoplasmic sperm injection. A prospective multicenter study].

OBJECTIVES: This prospective study aimed to evaluate the impact of oocyte dysmorphy on the fertilization rate and embryonic development rate in an ICSI programme. PATIENTS AND METHODS: Three hundred and two couples have been included during 302 ICSI cycles, and 1970 oocytes have been studied in 4 ART centres. After decoronisation, 18 morphological criteria, including the size and shape of the oocyte, the thickness of the zona pellucida, the presence or not of debris in the perivitelline space, as well as the appearance of the cytoplasm and polar body have been noted. RESULTS: In total 61.3% of the oocytes presented a dysmorphy, involving, almost equally, the different oocyte compartments. Among the dysmorphic oocytes, half presented more than one anomaly. On average, 9.2% of the oocytes were lysed the day after the micro-injection. The oocytes presenting an enlarged perivitelline space, or multiple vacuoles had a significantly raised lyse rate, 16.3% and 27.8%, respectively. The day after micro-injection, 61.3% of the intact oocytes were fertilized. The rate of fertilization was correlated to the number of abnormalities per oocyte: 1 anomaly: 64.6%, > or = 3 anomalies: 54.6%. The oocytes presenting a large perivitelline space had a slightly lowered fertilization rate (53.4%). On the other hand, those showing a cytoplasm containing refractile bodies had a slightly raised fertilization rate (68.6%). We did not see any statistically significant difference between the different types of oocytes concerning embryonic development at d2. CONCLUSION: These results confirm and contribute new elements with respect to previously published data, showing that (i) oocyte morphology little affects fertilization and the first stages of embryonic development; (ii) certain dysmorphies, (enlargement of the perivitelline space) are specifically deleterious at certain stages in the process (lowering the fertilization rate); (iii) certain morphological differences (the presence of refringent bodies) are not anomalies, but can reflect physiological cellular changes.

Cell Size↗
PubMed1995

[Assisted reproduction vigilance].

Reports on assisted reproduction outcome show that some complications are more frequent than in the general population. These complications include preterm birth, low birthweight and perinatal mortality. Concern has been expressed that exposure to fertility drugs might be associated with the risk of ovarian cancer. Therefore it is important that new assisted reproduction technics (A.R.T.) be evaluated as rigorously and completely as every new drug before it is on the market. Evaluation of short term efficacy and safety of new A.R.Ts should be done using the methodology proposed for the evaluation of new drugs. To evaluate long term safety it is recommended that every A.R.T. center keeps on a standardized form informations on every attempt and its outcome. This information could be the basis for case control surveys looking at the long term consequences of A.R.T.

Case-Control Studies↗
PubMed1994

A single injection of a gonadotropin-releasing hormone (GnRH) antagonist (Cetrorelix) postpones the luteinizing hormone (LH) surge: further evidence for the role of GnRH during the LH surge.

OBJECTIVES: To assess the ability of a new third-generation GnRH antagonist, Cetrorelix (Asta Medica AG, Frankfurt am Main, Germany), to postpone the LH surge after a single injection during the late follicular phase. DESIGN: A single 5-mg (group 1, n = 7) or 3-mg (group 2, n = 3) dose SC of Cetrorelix was administered during the late follicular phase, on the day of the cycle when plasma E2 exceeded 150 pg/mL (550 pmol/L). Estradiol, LH, FSH, and P levels were measured daily from day 5 of the cycle until day 10 after antagonist administration. Transvaginal ultrasonographies were performed on the day of injection and after antagonist treatment. SUBJECTS: Ten normal women with regular ovulatory menstrual cycles. RESULTS: In group 1, Cetrorelix was administered on day 14.6 +/- 5 (mean +/- SD) of the cycle, when the mean plasma E2 level was 181 +/- 32 pg/mL (664 +/- 117 pmol/L) (mean +/- SD). Plasma LH and FSH decreased by 56% +/- 19% and 29.5% +/- 16% (mean +/- SD), respectively, reaching the nadir 24 hours after Cetrorelix administration. Estradiol decreased by 85% +/- 17%, reaching the nadir 48 hours after antagonist injection. In group 2, Cetrorelix was administered on day 14.3 +/- 1.2 of the cycle when the mean plasma E2 level was 169 +/- 21 pg/mL (618 +/- 77 pmol/L). Plasma LH and FSH decreased by 66% +/- 18% and 32% +/- 6%, respectively, reaching a nadir 24 hours after Cetrorelix administration. Estradiol decreased by 81% +/- 9%, reaching the nadir 24 to 48 hours after antagonist administration. The LH surge was interrupted in every case. In six of seven subjects from group 1, the LH surge was delayed, occurring 6 to 17 days after the antagonist injection. In the remaining woman, Cetrorelix was administered at the beginning of the LH surge (LH = 13 IU/L): the LH level fell immediately by 54%, and the surge was postponed by 3 days. In group 2, in three of three subjects, the LH surge was delayed, occurring 6 to 9 days after the antagonist injection. No adverse effects were observed, except for very slight and transient erythema and pruritus at the injection site. CONCLUSION: Cetrorelix is a very potent new GnRH antagonist. A single injection during the late follicular phase delays the LH surge, even if the latter has already begun. In addition, this new-generation GnRH antagonist is very well tolerated and simple to use. Our data reinforce the role of GnRH during the LH surge and point to a role for new GnRH antagonists in controlled ovarian hyperstimulation to avoid premature LH surges and subsequent luteinization.

Adult↗
PubMed1994

Task force report on the outcome of pregnancies and children conceived by in vitro fertilization (France: 1987 to 1989).

OBJECTIVE: To describe the outcome of pregnancies conceived by IVF and the follow-up of the children after a minimum of 1 year of life. DESIGN: Survey of clinical pregnancies and follow-up of the children and comparison with national statistics. SETTINGS: All clinical pregnancies from 11 French centers between January 1987 and June 1989. PATIENTS: A total of 1,637 pregnancies resulting in 1,263 deliveries and 1,669 live-born or still-born children and 1,411 alive children after 1 year. MAIN OUTCOME MEASURES: Gestational age of birth, birth weight, mortality rates, prevalence of congenital malformation, and prevalence of disorders during the follow-up of the children. RESULTS: The preterm birth rate was 22.7% of all deliveries and 12.2% of single deliveries compared with 5.6% in France, and 34.7% of babies weighed < 2,500 g compared with 5.2% in France. The rate of perinatal, neonatal, and infant mortality were higher than the national average. The rate of malformation (2.86%) was comparable with national survey (2.08%). The health of children diseased during the whole follow-up was approximately 2%. CONCLUSION: The health of children after 1 year of live is close normal.

Birth Weight↗
PubMed1993

Establishing a national in vitro fertilization registry: methodological problems and analysis of success rates.

A national registry for in vitro fertilization (IVF) was established in France in January 1986 and has been in operation since that date. During 1987, data on 14,763 attempts were collected from 72 teams, representing 80 per cent of all French IVF activity. In this registry, a form is completed for every oocyte recovery attempt, containing information about the infertility diagnosis, the attempt itself and its result. This paper presents results for the years 1986 and 1987 and studies the relationship between pregnancy occurrence and some couple or cycle characteristics. Methodological aspects are discussed, concerning the possible sources of bias, and the analysis of results. Results obtained in this registry are compared with those from other similar registries.

Adult↗
PubMed1993

[Evaluation of FIVNAT 1992].

FIVNAT registry collected information on 21,960 individual assisted reproductive technology (ART) cycles in 1992. The present analysis concerns 15,557 cycles arrived on time to be incorporated, 97.9% being in vitro fertilization (IVF) cycles. The transfer rate was 80.9% and the clinical pregnancy rate was 19.2% per oocyte recovery cycle and 23.7% per transfer. The mean oocyte number slightly increased compared to 1991 (8.5 +/- 5.6 vs 8.2 +/- 5.6, p < 0.001) whereas the mean number of embryos obtained was not modified and the mean number of transferred oocytes slightly decreased. The mean fertilization rate slightly increased (53.0% +/- 30.2% vs 48.3% +/- 32.7%, p < 0.001). Infertility of tubal origin represented 59.1% of infertilities, and cycles realised with donor semen were associated to the highest pregnancy rate. GnRH analogues were widely used (87.5%), but those using a short blocking period tended to decrease, replaced by protocols without GnRH analogues. Stimulation regimen using a long blockage phase were associated to a higher pregnancy rate than the others (19.8% per recovery). The proportion of transfers involving 4 or more embryos decreased in 1991 to 22.9%. The analysis of 7,960 pregnancy forms resulting of recoveries realised from 1987 to 1991 showed a preterm birth rate of 9.2% for singleton, but a still high rate for twins and multiple pregnancies. For singleton pregnancies, in utero mortality concerned 6.9/1000 of the children, and the neonatal mortality rate (< 7 days) was 6.7/1000. The overall malformation rate was 2.8%.

Adult↗
PubMed1993

[Ectopic pregnancy risk factors after assisted reproductive technology].

Ectopic pregnancies are more frequent among pregnancies resulting from assisted reproductive technology (ART) than in natural conceptions (6% to 7% vs 1%). Fivnat registry has allowed us to analyse 349 ectopics among 6049 clinical pregnancies collected from 1986 to 1990. Ectopic rate decreased with increasing women's age, and since 1986. The risk was also decreased in infertilities of non tubal origin, except for those of unknown origin in which it was at the same level than for tubal infertility. The risk was increased by 65% in stimulation regimens involving clomiphene citrate (CC). The observed decrease from 1986 to 1990 was strongly related to the decrease in use of CC.

Adult↗
PubMed1993

[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. A multivariate logistic model was applied to analyse the relative part of these different factors. We also estimated the success rate and the multiple pregnancy rate which should have been obtained if the number of transferred embryos has been limited, in order to reduce the multiple pregnancy rate to 3%.

Adult↗
PubMed1993

[In vitro fertilization in women over the age of 40].

IVF practice is increasing for women aged over fourty, in France. Analysis shows that when women's age increases, stimulation protocols with GnRH analogues using a short blocking period or "classical" protocols (without GnRH) are more and more used. However, the highest pregnancy rates are still obtained for protocols using GnRH analogues with a long blocking period. The proportion of the stimulation regimen using pure FSH is also increasing, but pregnancy rates do not show any difference between these protocols and those using hMG.

Adult↗
PubMed1991

Estrogen replacement therapy and the risk of breast cancer: results from the case-control surveillance study.

To examine the relation of noncontraceptive estrogen use to the risk of breast cancer among postmenopausal women, the authors conducted a case-control study: 1,686 cases were compared with 2,077 hospital control subjects, of whom 1,120 had non-gynecologic cancers and 957 had nonmalignant (also non-gynecologic) conditions. Data were obtained from 1980 to 1986, by interview of subjects in hospitals in the United States and Canada. The relative risk estimate for any use of replacement estrogens unopposed by progestogens was 1.2 (95% confidence interval (Cl) 1.0-1.4), after adjustment for age and type of menopause; when all known risk factors for breast cancer were taken into account in a multivariate analysis, the estimate was similar. For use of at least 15 years duration, the estimate was 0.9 (95% Cl 0.5-1.9). Most of the unopposed use was of conjugated estrogens: overall, the relative risk (95% Cl) was 1.3 (1.0-1.6); for durations of 15 or more years, it was 0.9 (0.4-1.9); for use of 5 years followed by a latent interval of 15 or more years, it was 1.3 (0.7-2.4); and for current use it was 1.1 (0.7-1.6). There was no evidence of increased breast cancer risk when the conjugated estrogen users were divided according to dose. There was little use of estrogens opposed by progestogens; the relative risk estimate was 1.7 (95% Cl 0.9-3.3). The results of this large study provide no evidence that the use of unopposed conjugated estrogens increases the risk of breast cancer, even after long durations of use or long latent intervals, but the possibility of a modest increase (less than a doubling) could not be excluded. There were insufficient data to evaluate the effects of nonconjugated estrogens and of combined estrogen and progestogen therapy.

Adult↗