1
|
Mourad A, Antaki R, Rowen M, Lévesque É, Lapensée L. The POPI-Plus tool: prediction model of outcome of pregnancy in in vitro fertilization from a large retrospective cohort. Fertil Steril 2024; 121:489-496. [PMID: 38043845 DOI: 10.1016/j.fertnstert.2023.11.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE To create a tool that accurately predicts live birth chances after a positive pregnancy test after elective single embryo transfer (ET). DESIGN Retrospective cohort. SETTING CHUM hospital and Ovo clinic in Montreal, Canada. PATIENT(S) Patients with a positive pregnancy test result who underwent their first single ET after in vitro fertilization (IVF) at the CHUM hospital and Ovo clinic in Montreal, Canada, from 2012 to 2016 were selected. A total of 1,995 patients were included in this study. INTERVENTION(S) The data from both centers were combined and divided into training (70%, n = 1,398) and validation (30%, n = 597) sets. The predictive model was developed using backward selection method for the following variables: age of patient at egg retrieval; log β-human chorionic gonadotropin (β-hCG) (β-hCG) 1; log β-hCG 2; and IVF treatment type. Moreover, the classification tree, random forest, and neural network models were generated. MAIN OUTCOME MEASURE(S) The measured outcomes were live birth (live fetus ≥24 weeks of gestation) and nonviable pregnancies. The performance of all models was evaluated by area under the receiver operating characteristic curve (AUC). RESULT(S) Advancing age was negatively correlated with live birth. The odds ratio (OR) of age of patient at the time of egg retrieval was 0.95 (95% confidence interval [CI], 0.91-0.99). The log β-hCG 1 and log β-hCG 2 were positively correlated with live birth in the univariate analysis (OR, 4.15 [95% CI, 3.19-5.39], and OR, 3.84 [95% CI, 2.99-4.93], respectively). The β-hCG 1 level needed for a successful pregnancy was lower in frozen ET and modified natural IVF than in simulated IVF (OR, 0.55 [95% CI, 0.34-0.91], and OR, 0.49 [95% CI, 0.26-0.95], respectively). The best performance in terms of the AUC was the updated logistic model: POPI-Plus. The AUC values were 0.76 (95% CI, 0.73-0.79) and 0.78 (95% CI, 0.74-0.82) for the training and validation data, respectively. The other models (classification tree, random forest, and neural network) also performed adequately, with an AUC of ≥0.7, but remained below POPI-Plus. An open-access calculator was generated and can be found on the website of the University of Montreal on the following link: https://deptobsgyn.umontreal.ca/departement/divisions/medecine-et-biologie-de-la-reproduction/the-popi-plus-tool/. CONCLUSION(S) The POPI-Plus tool offers individualized counseling for patients after an initial positive β-hCG test result. Future studies will assess its impact on patient anxiety while awaiting viability ultrasound and perform prospective validation on new patients.
Collapse
Affiliation(s)
- Ali Mourad
- Department of Obstetrics and Gynecology, Western University, London, Ontario, Canada
| | - Roland Antaki
- Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada; Reproductive Endocrinology and Infertility, Ovo Fertility Clinic, Montreal, Quebec, Canada
| | - Mélanie Rowen
- Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada
| | - Étienne Lévesque
- Faculty of Public Health, University of Montreal, Montreal, Quebec, Canada
| | - Louise Lapensée
- Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada; Reproductive Endocrinology and Infertility, Ovo Fertility Clinic, Montreal, Quebec, Canada.
| |
Collapse
|
2
|
Shaulov T, Zanré N, Phillips S, Lapensée L. The association between the type of progesterone supplementation and miscarriage risk in women who have had a positive pregnancy test following embryo transfer: a retrospective cohort study. Arch Gynecol Obstet 2023; 308:569-577. [PMID: 37156908 DOI: 10.1007/s00404-023-07047-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 04/17/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE The purpose of this study was to identify if switching from intramuscular (IM) to vaginal progesterone compared to staying on IM progesterone after a positive pregnancy test following embryo transfer (ET) is associated with miscarriage risk. METHODS A retrospective cohort study was performed in a private university-affiliated fertility clinic and included women aged 18-50 years with a positive pregnancy test following ET. The two groups studied were: women who stayed on IM progesterone following a positive pregnancy test and those who switched to vaginal progesterone after a positive test. The main outcome measured was risk of miscarriage < 24 weeks gestation as a proportion of non-biochemical pregnancies. RESULTS 1988 women were included in the analysis. Among the baseline characteristics, the presence of prior miscarriages as well as prior failed ETs, and frozen cycles (vs fresh) as type of transfer were associated with IM progesterone use (p values ≤ 0.01). As per miscarriage risk < 24 weeks, 22.4% (274/1221) of patients in the IM progesterone group experienced a miscarriage compared with 20.7% (159/767) in the vaginal progesterone group (OR 0.90; 95% CI 0.73-1.13). A multivariable logistic regression model revealed an adjusted OR (aOR) of 0.97 (95% CI 0.77-1.22). CONCLUSION This study suggests that switching from IM to vaginal progesterone after a positive pregnancy test following an ET is not associated with miscarriage risk. Considering that IM progesterone imposes substantial discomfort, this study offers reassurance and some flexibility in treatment protocols. Further prospective studies are necessary to corroborate the results of this study.
Collapse
Affiliation(s)
- Talya Shaulov
- OVO Fertility Clinic, 8000 Decarie Blvd, Montreal, QC, H4P 2S4, Canada.
- Department of Obstetrics and Gynecology, University of Montreal, 2900 Edouard Montpetit Blvd, Montreal, QC, H3T 1J4, Canada.
| | - Nadège Zanré
- Department of Obstetrics and Gynecology, University of Montreal, 2900 Edouard Montpetit Blvd, Montreal, QC, H3T 1J4, Canada
| | - Simon Phillips
- OVO Fertility Clinic, 8000 Decarie Blvd, Montreal, QC, H4P 2S4, Canada
| | - Louise Lapensée
- OVO Fertility Clinic, 8000 Decarie Blvd, Montreal, QC, H4P 2S4, Canada
- Department of Obstetrics and Gynecology, University of Montreal, 2900 Edouard Montpetit Blvd, Montreal, QC, H3T 1J4, Canada
| |
Collapse
|
3
|
Genest G, Banjar S, Almasri W, Beauchamp C, Benoit J, Buckett W, Dzineku F, Gold P, Dahan MH, Jamal W, Jacques Kadoch I, Kadour-Peero E, Lapensée L, Miron P, Shaulov T, Sylvestre C, Tulandi T, Mazer BD, Laskin CA, Mahutte N. Immunomodulation for unexplained recurrent implantation failure: where are we now? Reproduction 2023; 165:R39-R60. [PMID: 36322478 DOI: 10.1530/rep-22-0150] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 11/02/2022] [Indexed: 11/05/2022]
Abstract
In brief Immune dysfunction may contribute to or cause recurrent implantation failure. This article summarizes normal and pathologic immune responses at implantation and critically appraises currently used immunomodulatory therapies. Abstract Recurrent implantation failure (RIF) may be defined as the absence of pregnancy despite the transfer of ≥3 good-quality blastocysts and is unexplained in up to 50% of cases. There are currently no effective treatments for patients with unexplained RIF. Since the maternal immune system is intricately involved in mediating endometrial receptivity and embryo implantation, both insufficient and excessive endometrial inflammatory responses during the window of implantation are proposed to lead to implantation failure. Recent strategies to improve conception rates in RIF patients have focused on modulating maternal immune responses at implantation, through either promoting or suppressing inflammation. Unfortunately, there are no validated, readily available diagnostic tests to confirm immune-mediated RIF. As such, immune therapies are often started empirically without robust evidence as to their efficacy. Like other chronic diseases, patient selection for immunomodulatory therapy is crucial, and personalized medicine for RIF patients is emerging. As the literature on the subject is heterogenous and rapidly evolving, we aim to summarize the potential efficacy, mechanisms of actions and side effects of select therapies for the practicing clinician.
Collapse
Affiliation(s)
- Geneviève Genest
- Department of Allergy and Immunology, McGill University, Montreal Quebec, Canada
| | - Shorooq Banjar
- Department of Allergy and Immunology, McGill University, Montreal Quebec, Canada
| | - Walaa Almasri
- Department of Allergy and Immunology, McGill University, Montreal Quebec, Canada
| | - Coralie Beauchamp
- Department of Gynaecology, University of Montreal, Montreal, Quebec, Canada
| | - Joanne Benoit
- Department of Gynaecology, University of Montreal, Montreal, Quebec, Canada
| | - William Buckett
- McGill University Health Centre Reproductive Centre, Montreal, Quebec, Canada
| | | | - Phil Gold
- Department of Allergy and Immunology, McGill University, Montreal Quebec, Canada
| | - Michael H Dahan
- Department of Obstetrics and Gynecology, McGill University, McGill University Health Centre, Montreal, Quebec, Canada
| | - Wael Jamal
- Department of Gynaecology, University of Montreal, Montreal, Quebec, Canada
| | | | - Einav Kadour-Peero
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, McGill University, Montréal, Quebec, Canada
| | - Louise Lapensée
- Department of Gynaecology, University of Montreal, Montreal, Quebec, Canada
| | - Pierre Miron
- Fertilys Reproductive Center, Laval, Quebec, Canada
| | - Talya Shaulov
- Department of Obstetrics and Gynecology, McGill University, McGill University Health Centre, Montreal, Quebec, Canada
| | - Camille Sylvestre
- Division of Reproductive Endocrinology and Infertility, University of Montreal, Montreal, Quebec, Canada
| | - Togas Tulandi
- Department of Obstetrics and Gynecology, McGill University, McGill University Health Centre, Montreal, Quebec, Canada
| | - Bruce D Mazer
- Department of Pediatrics, McGill University, Division of Allergy Immunology and Clinical Dermatology, Montreal Children's Hospital, McGill University, Montréal, Quebec, Canada
| | - Carl A Laskin
- Deptartments of Medicine and Obstetrics & Gynecology University of Toronto, Toronto, Ontario, Canada
| | - Neal Mahutte
- The Montreal Fertility Centre, Montreal, Quebec, Canada
| |
Collapse
|
4
|
Bentaleb J, Lapensée L, Antaki R, Phillips S, Ledjiar O. ENDOMETRIAL FLUID ASSOCIATED PATHOLOGIES IN FROZEN EMBRYO TRANSFER (FET) CYCLES. Fertil Steril 2021. [DOI: 10.1016/j.fertnstert.2021.07.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
5
|
Pradervand PA, Antaki R, Phillips S, Guedon AC, Lapensée L, Preaubert L. Risk factors for the development of endometrial fluid in women undergoing IVF: A retrospective cohort study ✰. J Gynecol Obstet Hum Reprod 2021; 50:102143. [PMID: 33862265 DOI: 10.1016/j.jogoh.2021.102143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 03/30/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
RESEARCH QUESTION Presence of endometrial fluid (EF) is a poorly understood pathology and remains a challenge for clinicians, as very little data exists to explain its consequences and treatment. Our objective was to investigate risk factors for EF during IVF. DESIGN This retrospective cohort study included all women with a freeze all embryos cycle (FAE) for EF between 2010 and 2016 at a university-affiliated private IVF center. Controls (2:1) were randomly selected out of the database of our fresh autologous IVF cycles during the same period. Main outcome measures were possible risk factors for EF, comprising polycystic ovarian syndrome (PCOS), ovarian hyperstimulation syndrome (OHSS), previous pelvic or endometrial surgery (polypectomy or synechia removal), cesarean section, myomas and severe endometriosis. A logistic regression model was used to assess independent risk factors for EF. RESULTS Out of 9000 IVF cycles, 1204 were FAE cycles, among which we identified 86 EF cases. We then selected 171 controls. Independent risk factors for presence of EF were a history of previous myomectomy (adjusted odds ratio (aOR) 19.77, 95%CI [4.01-97.53]), severe endometriosis (aOR 5.97, 95%CI [2.09-17.05]), PCOS (aOR 5.72, 95%CI [2.66-12.33]) and previous cesarean section (aOR 5.17, 95%CI [1.84-14.49]). CONCLUSIONS Our results are not only confirming the association between PCOS, severe endometriosis, previous cesarean procedure and EF, but also reporting for the first time an association between previous myomectomy and EF.
Collapse
Affiliation(s)
- Pierre-Antoine Pradervand
- OVO Clinic, Montreal, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Canada
| | - Roland Antaki
- OVO Clinic, Montreal, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Canada
| | - Simon Phillips
- OVO Clinic, Montreal, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Canada
| | | | - Louise Lapensée
- OVO Clinic, Montreal, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Canada
| | - Lise Preaubert
- OVO Clinic, Montreal, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Canada.
| |
Collapse
|
6
|
Shaulov T, Zanré N, Phillips S, Lapensée L. THE ASSOCIATION BETWEEN TYPE OF PROGESTERONE SUPPLEMENTATION AND MISCARRIAGE RISK IN WOMEN WITH A POSITIVE PREGNANCY TEST FOLLOWING EMBRYO TRANSFER: A RETROSPECTIVE COHORT STUDY. Fertil Steril 2020. [DOI: 10.1016/j.fertnstert.2020.08.825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
7
|
Bond RT, Nachef A, Adam C, Couturier M, Kadoch IJ, Lapensée L, Bleau G, Godbout A. Obesity and Infertility: A Metabolic Assessment Strategy to Improve Pregnancy Rate. J Reprod Infertil 2020; 21:34-41. [PMID: 32175263 PMCID: PMC7048694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 08/14/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The metabolic global approach is a multidisciplinary intervention for obese women before undergoing assisted reproductive techniques, with the goal of improving fertility and decreasing adverse pregnancy outcomes. The objective of this study was to evaluate the impact of the metabolic global approach on pregnancy rate. METHODS This retrospective cohort study included 127 women and was conducted at the Centre hospitalier de l'Université de Montréal fertility center. Eligibility included BMI at initial consultation of ≥30 kg/m 2. Fertility treatments were considered when a weight loss of minimum 5% and normal metabolic indices were achieved. The p<0.05 was considered statistically significant. RESULTS Median baseline and last clinical assessment BMIs were 38.2 kg/m 2 and 35.8 kg/m 2 respectively (p<0.001), representing a median weight loss of 5.1%. At baseline, at least one metabolic parameter was abnormal in 66% of women. Total pregnancy rate was 53%. The majority of women (63%) who achieved pregnancy did so with weight loss and metabolic stabilization alone (11%) or combined with metformin (36%) and/or oral ovulation drugs (16%). Normal vitamin D (p<0.001) and triglyceride levels (p<0.05) as well as lower BMI after weight loss (p<0.05) were associated with an increased relative risk of pregnancy. CONCLUSION Replete vitamin D status, weight loss of 5% and lower BMI as well as normal triglyceride level are significant and independent predictors of pregnancy in obese women presenting to our fertility center. The metabolic global approach is an effective program to detect metabolic abnormalities and improve obese women's pregnancy rate.
Collapse
Affiliation(s)
- Rachel Talia Bond
- Endocrinology Division, Department of Medicine, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada
| | - Alexandra Nachef
- Clinique de Procréation Assistée du Centre Hospitalier de l'Université de Montréal (CHUM), Department of Obstetrics and Gynecology, Montreal, Quebec, Canada
| | - Catherine Adam
- Endocrinology Division, Department of Medicine, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada
| | - Marielle Couturier
- Clinique de Procréation Assistée du Centre Hospitalier de l'Université de Montréal (CHUM), Department of Obstetrics and Gynecology, Montreal, Quebec, Canada
| | - Isaac-Jacques Kadoch
- Clinique de Procréation Assistée du Centre Hospitalier de l'Université de Montréal (CHUM), Department of Obstetrics and Gynecology, Montreal, Quebec, Canada
| | - Louise Lapensée
- Clinique de Procréation Assistée du Centre Hospitalier de l'Université de Montréal (CHUM), Department of Obstetrics and Gynecology, Montreal, Quebec, Canada
| | - Gilles Bleau
- Clinique de Procréation Assistée du Centre Hospitalier de l'Université de Montréal (CHUM), Department of Obstetrics and Gynecology, Montreal, Quebec, Canada
| | - Ariane Godbout
- Endocrinology Division, Department of Medicine, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada
- Endocrinology Division, Department of Medicine, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada
| |
Collapse
|
8
|
Grysole C, Phillips S, Preaubert L, Lapensée L. What are the chances of success for couples performing an IVF cycle with only poor quality day-3 embryos cultured to the blastocyst stage? Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.07.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
9
|
Jarrell JF, Vilos GA, Allaire C, Burgess S, Fortin C, Gerwin R, Lapensée L, Lea RH, Leyland NA, Martyn P, Shenassa H, Taenzer P. No 164 - Directive clinique de consensus pour la prise en charge de la douleur pelvienne chronique. Journal of Obstetrics and Gynaecology Canada 2018; 40:e788-e836. [DOI: 10.1016/j.jogc.2018.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
10
|
Rowen M, Dehghan G, Guedon A, Antaki R, Mayrand M, Dean N, Phillips S, Lapensée L. The POPI tool: prediction model of outcome of pregnancy in IVF. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
11
|
Simard-Émond L, Nicholls-Dempsey L, Ngande-Kamga C, Bélisle S, Lapensée L, Michaud R, Roy G, Tremblay C. Endometrial Biopsy in an Outpatient Gynecological Setting : Overinvestigation. Journal of Obstetrics and Gynaecology Canada 2018. [DOI: 10.1016/j.jogc.2018.03.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
12
|
El Hachem H, Antaki R, Sylvestre C, Lapensée L, Legendre G, Bouet PE. Timing therapeutic donor inseminations in natural cycles: human chorionic gonadotrophin administration versus urinary LH monitoring. Reprod Biomed Online 2017; 35:174-179. [PMID: 28571651 DOI: 10.1016/j.rbmo.2017.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 05/02/2017] [Accepted: 05/03/2017] [Indexed: 11/29/2022]
Abstract
This cohort study assessed whether timing therapeutic donor sperm inseminations (TDI) in natural cycles (NC) using ultrasound monitoring and ovulation trigger with human chorionic gonadotrophin (US/HCG) improves cumulative live birth rates (LBR) compared with detection of LH surge with urinary kits (u-LH). It included 232 normo-ovulatory women aged ≤40 years, undergoing 538 TDI in NC between 2011 and 2014. In the u-LH group (113 women, 267 cycles), TDI was performed the day following a positive test. In the US/HCG group (119 women, 271 cycles), ovulation was triggered with HCG when a follicle ≥17 mm was noted, and TDI performed 36 h later. The first three cycles were analysed per patient. Groups were comparable for baseline characteristics. Cumulative LBR were comparable between u-LH and US/HCG groups (31.47% versus 23.11%, respectively) (log-rank test). A generalized estimating equation analysis was performed to compare outcomes per cycle. The LBR per started cycle was comparable between the u-LH and US/HCG groups (12.4% versus 9.2%, respectively). Cancellation rate was significantly higher with u-LH (19.1% versus 11.4%, P = 0.011), but did not impact overall outcomes. In conclusion, urinary LH monitoring is as effective as ultrasound monitoring and ovulation trigger with HCG in TDI performed in NC.
Collapse
Affiliation(s)
- Hady El Hachem
- Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada; Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada.
| | - Roland Antaki
- Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada; Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada
| | - Camille Sylvestre
- Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada; Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada
| | - Louise Lapensée
- Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada; Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada
| | - Guillaume Legendre
- Department of Obstetrics and Gynecology, Angers University Hospital, Angers, France
| | - Pierre Emmanuel Bouet
- Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada; Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada; Department of Obstetrics and Gynecology, Angers University Hospital, Angers, France
| |
Collapse
|
13
|
El Hachem H, Antaki R, Sylvestre C, Kadoch IJ, Lapensée L, Bouet PE. Clomiphene Citrate versus Letrozole for Ovarian Stimulation in Therapeutic Donor Sperm Insemination. Gynecol Obstet Invest 2016; 82:481-486. [PMID: 27852078 DOI: 10.1159/000452665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 10/14/2016] [Indexed: 11/19/2022]
Abstract
AIM To compare clomiphene citrate (CC) and letrozole for ovarian stimulation (OS) in therapeutic donor sperm insemination (TDI) cycles. METHODS Retrospective cohort study between January 2011 and June 2014 at a University-affiliated private IVF clinic in Montreal, Canada. 257 normo-ovulatory women ≤40 years of age with no history of infertility undergoing 590 TDI cycles in the absence of a male partner (single women and same-sex couples) or azoospermia were included. Patients received 100 mg CC daily (145 women, 321 cycles) or letrozole 5 mg daily (112 women, 269 cycles), from days 3 to 7. Only the first 3 cycles were included per patient. Our main outcome measure was cumulative live birth rates (LBR). RESULTS Baseline characteristics were comparable between the 2 groups. There were no differences in LBR per cycle (16.5% (53/321) vs. 11.5% (31/269), p = 0.08) and cumulative LBR (36.6% (53/145) vs. 27.7% (31/112), p = 0.13), between CC and letrozole, respectively. Multiple pregnancy rate (11.6% (8/69) vs. 8.7% (4/46), p = 0.6) and miscarriage rate (21.7 vs. 21.7%, p = 1) were also comparable between CC and letrozole, respectively. CONCLUSION In normo-ovulatory women undergoing TDI, OS with CC or letrozole resulted in similar live birth and twin pregnancy rates.
Collapse
Affiliation(s)
- Hady El Hachem
- Department of Reproductive Medicine, Ovo Clinic, University of Montreal, Montreal, Que., Canada
| | | | | | | | | | | |
Collapse
|
14
|
Lehmann P, Vélez MDP, Saumet J, Lapensée L, Bissonnette F, Kadoch J. Anti-müllerian hormone (AMH): a reliable biomarker of oocytes quality in stimulated in vitro fertilization (IVF). Fertil Steril 2012. [DOI: 10.1016/j.fertnstert.2012.07.427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
15
|
Antaki R, Dean NL, Lapensée L, Racicot MH, Ménard S, Kadoch IJ. An algorithm combining ultrasound monitoring and urinary luteinizing hormone testing: a novel approach for intrauterine insemination timing. J Obstet Gynaecol Can 2011; 33:1248-52. [PMID: 22166279 DOI: 10.1016/s1701-2163(16)35110-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Intrauterine insemination (IUI) is a commonly used treatment for infertility. Optimal timing of insemination is achieved either by ultrasound monitoring of follicular growth followed by the administration of human chorionic gonadotropin (hCG) or by the detection of a luteinizing hormone (LH) surge through urinary LH testing (uLH). However, in cycles where follicular growth is monitored, there is a possibility of a premature LH rise which may affect the outcome of treatment. The objective of the current study was to determine the frequency of spontaneous LH surges in ultrasound-monitored IUI cycles. METHODS One hundred IUI cycles were followed for this prospective cohort study. In combination with ultrasound monitoring, uLH testing was performed twice daily. A serum LH test was performed in the case of an inconclusive uLH test result. IUI was performed either on the day after a positive LH test or, if the diameter of the dominant follicle reached 18 mm and the LH test was still negative, 36 hours after ovulation triggering by administration of hCG. RESULTS Of the 87 analyzed cycles, 19 (21.8%) exhibited a premature LH surge as detected by urine testing. Eleven further cycles had an inconclusive urine result, and in six of these (6.9% of cycles) the result was confirmed positive by serum LH testing, giving a total of 25 cycles (28.7%) experiencing a premature LH surge. CONCLUSION A considerable proportion of patients undergoing ultrasound-monitored IUI cycle had a spontaneous LH surge before ovulation triggering was scheduled. This could affect pregnancy rates following IUI.
Collapse
|
16
|
Kadoch IJ, Jamal W, Phillips SJ, Hemmings R, Lapensée L, Couturier B, Bissonnette F. Successful pregnancy in an ovarian agenesis patient after modified natural cycle IVF oocyte donation. Reprod Biomed Online 2009; 19:221-3. [PMID: 19712558 DOI: 10.1016/s1472-6483(10)60076-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The recovery of a mature oocyte from a modified natural cycle followed by in-vitro fertilization (nIVF) is an attractive alternative to conventional IVF, involving ovarian stimulation, in the treatment of female infertility. Ovarian agenesis is a rare disorder resulting in primary amenorrhoea and infertility in affected females. A couple sought help for infertility due to ovarian agenesis of the female partner and decided to pursue treatment utilizing oocyte donation. Modified natural-cycle egg retrieval was carried out on the donor; one mature oocyte was retrieved and underwent IVF using a sperm sample from the male partner. A good-quality embryo was transferred, A viable pregnancy was confirmed by ultrasound scan and resulted in the delivery of a healthy baby boy at 36 weeks' gestation. This is the second published report of an ongoing clinical pregnancy and subsequent birth resulting from oocyte donation recovered during a modified natural cycle. The use of less invasive assisted reproduction techniques such as nIVF can be used in oocyte donation cycles successfully.
Collapse
Affiliation(s)
- Isaac Jacques Kadoch
- University of Montreal, Department of Obstetrics and Gynecology, Saint Luc Hospital (CHUM), 1058 rue Saint-Denis, Montreal, Québec, Canada.
| | | | | | | | | | | | | |
Collapse
|
17
|
Kadoch IJ, Al-Khaduri M, Phillips SJ, Lapensée L, Couturier B, Hemmings R, Bissonnette F. Spontaneous ovulation rate before oocyte retrieval in modified natural cycle IVF with and without indomethacin. Reprod Biomed Online 2008; 16:245-9. [PMID: 18284881 DOI: 10.1016/s1472-6483(10)60581-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The objective of this retrospective analysis was to evaluate the number of spontaneous ovulations occurring before oocyte retrieval in natural cycle IVF (nIVF) with and without the use of indomethacin. A total of 121 patients who underwent modified nIVF cycle between December 2003 and July 2006 were included in the study; 171 cycles without indomethacin and 84 cycles with indomethacin, started when the leading follicle reached 14 mm in size, were compared. The number of cycles with ovulation before oocyte retrieval and the number of cycles with no oocytes at retrieval were assessed with and without indomethacin. In addition, the pregnancy rates in the two groups of patients were analysed. There were 28 cycles (16%) in which ovulation occurred before oocyte retrieval in the group where no indomethacin was used and five cycles (6%) in which ovulation occurred before retrieval in the group where indomethacin was used. There was a statistically significant association between premature ovulation and indomethacin, with an odds ratio of 3.8 (95% confidence interval, 1.2-12.3). The oocyte retrieval per started cycle was 64% without indomethacin and 76% with indomethacin (P < 0.04). The clinical pregnancy rate per embryo transfer was 14% without indomethacin and 21% with indomethacin (not significant).
Collapse
|
18
|
Al-Khaduri M, Kadoch IJ, Couturier B, Dubé J, Lapensée L, Bissonnette F. Vasa praevia after IVF: should there be guidelines? Report of two cases and literature review. Reprod Biomed Online 2007; 14:372-4. [PMID: 17359594 DOI: 10.1016/s1472-6483(10)60881-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The paper gives an illustration and reminder of the risk of problems with placentation resulting from IVF and embryo transfer. Reported here is one neonatal death related to vasa praevia when the condition was not diagnosed antenatally and a neonatal survival when vasa praevia was detected antenatally. A search of the English literature was performed using PubMed for 'vasa praevia and in vitro fertilization'. There were four articles that directly addressed this relationship. Case reports of IVF-embryo transfer pregnancies with vasa praevia and also studies that look at the incidence of vasa praevia in such pregnancies are included in this report. Hence, since vasa praevia is thought to be caused by a disturbed orientation of the blastocyst at implantation, it is probably related to the IVF-embryo transfer procedure. Screening of all IVF-embryo transfer pregnancies with transvaginal sonography and colour Doppler to rule out vasa praevia is recommended in the second trimester.
Collapse
Affiliation(s)
- Maha Al-Khaduri
- University of Montreal, Department of Obstetrics and Gynecology, Saint Luc Hospital (CHUM), 1058 rue Saint-Denis, Montréal, Québec, Canada H2X 3J4
| | | | | | | | | | | |
Collapse
|
19
|
Abstract
A total of 134 controlled natural IVF (nIVF) cycles were reviewed retrospectively and compared with 370 stimulated IVF (sIVF) cycles. The clinical pregnancy rate per embryo transfer following nIVF was 27% and 47% in sIVF cycles for patients aged less than 35. However, natural cycle patients could attempt consecutive cycles with much less impact on their lives, both medically and financially. In patients under 35 years of age, the choice of controlled nIVF reduces the cost and risk to the patient, permitting her to have multiple, consecutive attempts, and cumulatively offers a clinical pregnancy rate which approaches that of sIVF. The multiple pregnancy rate in nIVF is significantly reduced compared with sIVF treatment cycles. In patients over 35 years of age the benefits of nIVF were much less evident (clinical pregnancy rate: 8% per embryo transfer) and the opportunity to transfer multiple embryos in these patients seems to be advantageous.
Collapse
Affiliation(s)
- Simon J Phillips
- OVO Fertility Clinic, 8000 boulevard Décarie, Montréal, Québec, Canada H4P 2S4.
| | | | | | | | | | | |
Collapse
|
20
|
Min JK, Claman P, Hughes E, Cheung AP, Claman P, Fluker M, Goodrow GJ, Graham J, Graves GR, Lapensée L, Min JK, Stewart S, Ward S, Chee-Man Wong B, Armson AB, Delisle MF, Farine D, Gagnon R, Keenan-Lindsay L, Morin V, Mundle W, Pressey T, Schneider C, Van Aerde J. Directive clinique en ce qui concerne le nombred’embryons à transférer à la suite de la fécondation in vitro. Journal of Obstetrics and Gynaecology Canada 2006. [DOI: 10.1016/s1701-2163(16)32248-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
21
|
Kadoch I, Hemmings R, Couturier B, Lapensée L, Phillips S, Bissonnette F. Successful Pregnancy by Transmyometrial Embryo Transfer After IVF - S.M.A.R.T. Protocol in a Patient Who Underwent Radical Vaginal Trachelectomy: Case Report. Fertil Steril 2005. [DOI: 10.1016/j.fertnstert.2005.07.855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
22
|
Jarrell JF, Vilos GA, Allaire C, Burgess S, Fortin C, Gerwin R, Lapensée L, Lea RH, Leyland NA, Martyn P, Shenassa H, Taenzer P, Abu-Rafea B. Consensus Guidelines for the Management of Chronic Pelvic Pain. Journal of Obstetrics and Gynaecology Canada 2005; 27:781-826. [PMID: 16287011 DOI: 10.1016/s1701-2163(16)30732-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To improve the understanding of chronic pelvic pain (CPP) and to provide evidence-based guidelines of value to primary care health professionals, general obstetricians and gynaecologists, and those who specialize in chronic pain. BURDEN OF SUFFERING: CPP is a common, debilitating condition affecting women. It accounts for substantial personal suffering and health care expenditure for interventions, including multiple consultations and medical and surgical therapies. Because the underlying pathophysiology of this complex condition is poorly understood, these treatments have met with variable success rates. OUTCOMES Effectiveness of diagnostic and therapeutic options, including assessment of myofascial dysfunction, multidisciplinary care, a rehabilitation model that emphasizes achieving higher function with some pain rather than a cure, and appropriate use of opiates for the chronic pain state. EVIDENCE Medline and the Cochrane Database from 1982 to 2004 were searched for articles in English on subjects related to CPP, including acute care management, myofascial dysfunction, and medical and surgical therapeutic options. The committee reviewed the literature and available data from a needs assessment of subjects with CPP, using a consensus approach to develop recommendations. VALUES The quality of the evidence was rated using the criteria described in the Report of the Canadian Task Force on the Periodic Health Examination. Recommendations for practice were ranked according to the method described in that report (Table 1). RECOMMENDATIONS The recommendations are directed to the following areas: (a) an understanding of the needs of women with CPP; (b) general clinical assessment; (c) practical assessment of pain levels; (d) myofascial pain; (e) medications and surgical procedures; (d) principles of opiate management; (f) increased use of magnetic resonance imaging (MRI); (g) documentation of the surgically observed extent of disease; (h) alternative therapies; (i) access to multidisciplinary care models that have components of physical therapy (such as exercise and posture) and psychology (such as cognitive-behavioural therapy), along with other medical disciplines, such as gynaecology and anesthesia; (j) increased attention to CPP in the training of health care professionals; and (k) increased attention to CPP in formal, high-calibre research. The committee recommends that provincial ministries of health pursue the creation of multidisciplinary teams to manage the condition.
Collapse
|
23
|
Kadoch IJ, Phillips SJ, Hemmings R, Lapensée L, Couturier B, Bissonnette F. Ongoing pregnancy after ICSI of frozen–thawed PESA-retrieved spermatozoa and IVF in a controlled natural cycle. Reprod Biomed Online 2005; 10:650-2. [PMID: 15949225 DOI: 10.1016/s1472-6483(10)61674-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The recovery of a mature oocyte from a natural cycle followed by IVF (nIVF) is an attractive alternative to conventional IVF, involving ovarian stimulation, in the treatment of female infertility. Similarly, surgical recovery of spermatozoa from the epididymis by percutaneous sperm aspiration (PESA) has simplified the treatment of men with obstructive azoospermia. A couple sought treatment for diminished ovarian reserve and male factor infertility using IVF. A mature oocyte was retrieved and was inseminated by intracytoplasmic sperm injection (ICSI), following recovery of spermatozoa by PESA. A good quality embryo was transferred. A viable pregnancy was confirmed by ultrasound scan. A healthy baby boy was delivered naturally at 37 weeks gestation. This study reports the first ongoing clinical pregnancy and subsequent birth resulting from ICSI of spermatozoa retrieved by PESA into an oocyte recovered during a natural cycle. The use of a combination of less invasive assisted reproductive techniques (PESA and nIVF) can overcome barriers to fertility.
Collapse
Affiliation(s)
- Isaac Jacques Kadoch
- Department of Obstetrics and Gynecology, Université de Montréal and Saint Luc Hospital (CHUM), 1058 rue Saint-Denis, Montréal, Québec, Canada H2X 3J4.
| | | | | | | | | | | |
Collapse
|
24
|
Chian RC, Lapensée L, Phillips S, Tan SL. Observation of pronuclei may not be an absolute indicator for fertilization in rescue intracytoplasmic sperm injection oocytes. Reprod Med Biol 2003; 2:83-85. [PMID: 29662376 DOI: 10.1046/j.1445-5781.2003.00020.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This case report describes a successful full-term pregnancy and birth after the transfer of rescue intracytoplasmic sperm injection (ICSI) embryos derived from 1-day-old oocytes. A total of eight oocytes were retrieved and inseminated 3 h after collection. No oocytes were fertilized 16-18 h after insemination. A rescue ICSI was performed on the four metaphase II stage oocytes. At the regular time (16 h after ICSI) of examination for fertilization, there were no distinct two pronuclei (2PN) in the cytoplasm of any oocytes, but the culture of these oocytes led to the development of four two-cell stage embryos 26 h after ICSI. Further culture of these four embryos showed development to a four-cell stage the following day. The transfer of three embryos resulted in a full-term pregnancy with the delivery of a pair of healthy twins. This result suggests that the observation of 2PN at the normal time of fertilization assessment may not appear to be an absolute indicator of fertilization in the case of rescue ICSI. (Reprod Med Biol 2003; 2: 83-85).
Collapse
Affiliation(s)
- Ri-Cheng Chian
- McGill Reproductive Center, Department of Obstetrics and Gynecology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada
| | - Louise Lapensée
- McGill Reproductive Center, Department of Obstetrics and Gynecology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada
| | - Simon Phillips
- McGill Reproductive Center, Department of Obstetrics and Gynecology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada
| | - Seang-Lin Tan
- McGill Reproductive Center, Department of Obstetrics and Gynecology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
25
|
Bissonnette F, Sergerie M, Hamel A, Lapensée L, Benoit J, Bélisle S. Pregnancy rates after double versus single insemination: a randomized crossover study. Fertil Steril 2001. [DOI: 10.1016/s0015-0282(01)02570-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
26
|
Biljan MM, Lapensée L, Mahutte NG, Bissonnette F, Hemmings R, Tan SL. Effects of functional ovarian cysts detected on the 7th day of gonadotropin-releasing hormone analog administration on the outcome of IVF treatment. Fertil Steril 2000; 74:941-5. [PMID: 11056237 DOI: 10.1016/s0015-0282(00)01555-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the impact of functional ovarian cysts on the time required to achieve pituitary suppression, follicular development, embryo quality, and pregnancy rates during IVF treatment. DESIGN Prospective observational study. INTERVENTION(S) Daily treatment with buserelin (sc 500 microg) was initiated on day 2 of menstruation. Ultrasound and hormonal tests were performed on days 1, 7, 11, 14, and weekly thereafter until pituitary suppression was achieved. RESULT(S) 48 patients underwent 51 cycles of IVF treatment. A functional cyst was detected in three cycles (5.8%) with baseline ultrasound scan and in 27 cycles (52.9%) on day 7 of buserelin administration. Patients who developed a cyst required a significantly longer time to achieve pituitary suppression (21 vs. 7 days), had a significantly lower FSH level at the time of initiation of gonadotropins, required more ampules of gonadotropin (45 vs. 41 ampules), developed less follicles (13 vs. 17.5), and had lower embryo quality. However, there were no differences in the implantation (23.5% vs. 17.2%) and pregnancy rates (37.2% vs. 29.2%) between two groups. CONCLUSION(S) Functional cysts prolong the period to achieving pituitary suppression, increase gonadotropin requirements, and decrease follicular recruitment and embryo quality. They have, however, no negative effect on pregnancy rates.
Collapse
Affiliation(s)
- M M Biljan
- McGill Reproductive Center, Department of Obstetrics and Gynecology, Royal Victoria Hospital, McGill University, Montreal, Québec, Canada.
| | | | | | | | | | | |
Collapse
|
27
|
Abstract
OBJECTIVE To determine the reproductive outcome of women who undergo laparoscopic tubal anastomosis. DESIGN Observational prospective study. SETTING University-affiliated infertility medical center. PATIENT(S) One hundred two patients seeking reversal of tubal sterilization. INTERVENTION(S) Laparoscopic tubal anastomosis was performed with a one-suture technique. MAIN OUTCOME MEASURE(S) Pregnancy rate. RESULT(S) There were 69 isthmic-isthmic, 16 isthmic-ampullary, 12 cornual-isthmic, and 5 ampullary-ampullary anastomoses. The mean operative time was 71.35 minutes. Eight patients had bilateral tubal obstruction on postoperative hysterosalpingography. Sixty-nine patients (70%) conceived. Sixty-four (65.3%) had ongoing intrauterine pregnancies, 15 (21.7%) had spontaneous abortions, and 5 (7.2%) had ectopic pregnancies. CONCLUSION(S) This study demonstrates that laparoscopic tubal anastomosis can be done safely and successfully on an outpatient basis, reducing costs and postoperative morbidity while accelerating the patient's return to normal activities.
Collapse
Affiliation(s)
- F Bissonnette
- Department of Obstetrics and Gynecology, Centre Hospitalier de l'Université de Montréal, Québec, Canada.
| | | | | |
Collapse
|
28
|
Abstract
OBJECTIVE To determine if the gene coding for human oviductin (the estrogen-dependent, oviduct-specific glycoprotein with an affinity for the zona pellucida) shows length polymorphism in the region of tandem repeats. To determine the frequencies of the length alleles in health and disease. DESIGN Descriptive fundamental and clinical studies. SETTING Fertility clinic and research center, university teaching hospital. PATIENT(S) Fertile women, women with a history of ectopic pregnancy or tubal disease, and women with stage I or II endometriosis. INTERVENTION(S) Blood samples were drawn for DNA analysis. MAIN OUTCOME MEASURE(S) Length and sequence of the region of tandem repeats. RESULT(S) Four different length alleles of the human oviductin gene were identified. Their relative frequencies in pathologic cases were not statistically significant compared with those found in normal fertile women. The human genome contains a single copy of the oviductin gene located on chromosome 1p13. CONCLUSION(S) The human oviductin gene codes for a glycoprotein that shares the characteristics of epithelial mucins. Because eight epithelial mucin genes have been identified so far, we therefore propose to name this gene MUC9. The biologic function of the protein is likely to include protection of the early embryo and of the fallopian tube itself.
Collapse
Affiliation(s)
- L Lapensée
- Maisonneuve-Rosemount Research Center, Université de Montréal, Québec, Canada
| | | | | |
Collapse
|
29
|
|