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Rubod C, de Prémare C, Kerbage Y, Kyheng M, Plouvier P, Chossegros C, Robin G. Does surgery for colorectal endometriosis prior to IVF±ICSI have an impact on cumulative live birth rates? Reprod Biomed Online 2024; 48:103649. [PMID: 38335899 DOI: 10.1016/j.rbmo.2023.103649] [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: 07/02/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 02/12/2024]
Abstract
RESEARCH QUESTION Does colorectal endometriosis surgery prior to IVF ± intracytoplasmic sperm injection (ICSI) impact cumulative live birth rates? DESIGN This retrospective, monocentric study (Lille University Hospital) was conducted between 1 January 2007 and 31 December 2018. Two groups of patients from the JFIV database were included: a group undergoing IVF±ICSI alone (120 patients, 215 oocyte retrievals), and a group undergoing surgery and then IVF±ICSI (69 patients, 109 oocyte retrievals). The mode of management was decided after a multidisciplinary team meeting. Different criteria such as age (cut-off 35 years), anti-Müllerian hormone concentration (cut off 2 ng/ml), imaging results and the patient's symptomatology were considered: the most symptomatic patients underwent surgery prior to IVF±ICSI. The cumulative clinical pregnancy and live birth rates obtained after four IVF attempts were estimated and compared between the two groups using competing risk survival methods. RESULTS The cumulative live birth rates after four IVF attempts in the two groups were not statistically significantly different (50.8% in the IVF±ICSI group versus 52.2% in the surgery followed by IVF±ICSI group, P = 0.43). The results for the cumulative clinical pregnancy rates were the same (56.7% in the IVF±ICSI group versus 58% in the surgery followed by IVF±ICSI group, P = 0.47). CONCLUSION The study shows that cumulative live birth and pregnancy rates were similar in infertile patients with colorectal endometriosis who underwent IVF±ICSI either with or without prior colorectal endometriosis surgery.
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Affiliation(s)
- Chrystèle Rubod
- Service de chirurgie gynécologique, CHU Lille, Lille, France.; Univ. Lille, CHU Lille, Lille, France
| | | | - Yohan Kerbage
- Service de chirurgie gynécologique, CHU Lille, Lille, France
| | - Maeva Kyheng
- Service de Biostatistiques, CHU Lille, Lille, France
| | - Pauline Plouvier
- Service d'Assistance Médicale à la Procréation et Préservation de la Fertilité, CHU Lille, Lille, France
| | | | - Geoffroy Robin
- Univ. Lille, CHU Lille, Lille, France.; Service d'Assistance Médicale à la Procréation et Préservation de la Fertilité, CHU Lille, Lille, France
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Cathelain A, Simon V, Wattier JM, Robin G, Ramdane N, Decanter C, Plouvier P, Rubod C. Pain assessment in women with or without endometriosis during the IVF process: a prospective study. Reprod Biomed Online 2023; 47:103250. [PMID: 37748370 DOI: 10.1016/j.rbmo.2023.06.005] [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: 02/09/2023] [Revised: 06/01/2023] [Accepted: 06/12/2023] [Indexed: 09/27/2023]
Abstract
RESEARCH QUESTION How does the typology and effect of pain vary between infertile patients with or without endometriosis during the different stages of the IVF process? DESIGN A prospective, monocentric, observational cohort study was conducted at Lille University Hospital between November 2019 and June 2021. The study was proposed to all patients starting an IVF cycle. Pain assessment questionnaires using validated scales (about type of pain, without specific location), were completed by patients at key points during IVF: before starting treatment, at the end of stimulation and on the day of oocyte retrieval. RESULTS A total of 278 patients were analysed: 73 patients with endometriosis and 205 without. At the start of the IVF process, patients with endometriosis had higher pain scores than disease-free women (mean numerical scale score 3.47 versus 1.12 [P < 0.0001]) and 17.81% of patients with endometriosis had neuropathic pain. For mental disorders before starting treatment, 22% of patients with endometriosis had suspected or confirmed depression, and 33% had anxiety compared with 8% and 20% in patients without endometriosis, respectively. During IVF, for patients without endometriosis, pain increased significantly between the baseline, the end of stimulation and on the day of retrieval (P ≤ 0.05). In patients with endometriosis, however, pain did not significantly vary during these times. CONCLUSION Endometriosis is associated with higher pain scores, but no increase in pain was observed during IVF for these patients. It seems essential to screen and characterize pain phenotypes in all patients before starting treatment and during stimulation to improve pain management.
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Affiliation(s)
- Alice Cathelain
- CHU Lille, Departments of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, F-59000, Lille, France; CHU Lille, Gynaecology Surgery Department, F-59000, Lille, France.
| | - Virginie Simon
- CHU Lille, Departments of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, F-59000, Lille, France
| | - Jean Michel Wattier
- CHU Lille, Department of Anesthesiology and Intensive Care-Section of Pain, Claude Huriez University Hospital, F-59000, Lille, France
| | - Geoffroy Robin
- CHU Lille, Departments of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, F-59000, Lille, France; University of Lille, Faculty of Medicine, F-59000, Lille, France
| | - Nassima Ramdane
- CHU Lille, EA 2694, public health: epidemiology and quality of care, Lille University, F-59000 Lille, France
| | - Christine Decanter
- CHU Lille, Departments of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, F-59000, Lille, France
| | - Pauline Plouvier
- CHU Lille, Departments of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, F-59000, Lille, France
| | - Chrystele Rubod
- CHU Lille, Gynaecology Surgery Department, F-59000, Lille, France; University of Lille, Faculty of Medicine, F-59000, Lille, France
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Simon V, Robin G, Keller L, Ternynck C, Jonard S, Robin C, Decanter C, Plouvier P. Systematic use of long-acting intramuscular progesterone in addition to oral dydrogesterone as luteal phase support for single fresh blastocyst transfer: A pilot study. Front Endocrinol (Lausanne) 2022; 13:1039579. [PMID: 36619564 PMCID: PMC9822263 DOI: 10.3389/fendo.2022.1039579] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The need of luteal support after FET is no longer to be proven. Different routes of progesterone administration are available with interindividual differences in metabolization and serum progesterone levels, the latter being highly correlated with pregnancy and delivery rates. The administration of 2 different routes of progestogen significantly improves success rates in FET. The aim of the current study was to investigate the added value to combine intramuscular administration of progesterone to dydrogesterone in fresh embryo transfer. METHODS This is a retrospective study from prospectively collected data. Patient, aged between 18 and 43 years old, had received a fresh blastocyst transfer between January 2021 and June 2021. In the first group, all patients received only oral dydrogesterone 10mg, three times a day, beginning the evening of oocyte retrieval. In the second group, patients received, in addition to dydrogesterone, a weekly intramuscular injection of progesterone started the day of embryo transfer. Primary endpoint was ongoing pregnancy rate. RESULTS 171 fresh single blastocyst transfers have been performed during this period. 82 patients were included in "dydrogesterone only" and 89 patients in "dydrogesterone + IM". Our two groups were comparable except for body mass index. After adjustment on BMI, our two groups were comparable regarding implantation rate, early pregnancy rate (46.1 versus 54.9, OR 1.44 [0.78; 2.67], p=0.25) miscarriage rate, ongoing pregnancy rate (30.3 versus 43.9, OR 1.85 [0.97; 3.53] p= 0.06). CONCLUSION Using systematically long acting intramuscular progesterone injection in addition to oral dydrogesterone as luteal phase support seems to have no significant impact on IVF outcomes when a single fresh blastocyst transfer is performed.
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Affiliation(s)
- Virginie Simon
- Department of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, Lille, France
- Univ. Lille, Faculty of Medicine, Lille, France
- *Correspondence: Virginie Simon,
| | - Geoffroy Robin
- Department of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, Lille, France
- Univ. Lille, Faculty of Medicine, Lille, France
| | - Laura Keller
- Institut de Biologie de la Reproduction-Spermiologie-Centre d'étude et de Conservation des Oeufs et du Sperme Humain (CECOS), Hôpital Jeanne de Flandre, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Camille Ternynck
- Univ. Lille, University Hospital Center (CHU) Lille, Research Unity (ULR) 2694-METRICS: Evaluation des Technologies de Santé et des Pratiques médicales, Lille, France
- University Hospital Center (CHU) Lille, Department of Biostatistics, Lille, France
| | - Sophie Jonard
- Department of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, Lille, France
- Univ. Lille, Faculty of Medicine, Lille, France
| | - Camille Robin
- Department of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, Lille, France
| | - Christine Decanter
- Department of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, Lille, France
| | - Pauline Plouvier
- Department of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, Lille, France
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Delcour C, Robin G, Delesalle AS, Drumez E, Plouvier P, Dewailly D, Catteau-Jonard S. Weekly intramuscular progesterone for luteal phase support in women receiving oocyte donation is associated with a decreased miscarriage rate. Reprod Biomed Online 2019; 39:446-451. [DOI: 10.1016/j.rbmo.2019.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/02/2019] [Accepted: 05/02/2019] [Indexed: 11/29/2022]
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Robin G, Plouvier P, Delesalle AS, Rolland AL. [Effectiveness and use of hormonal contraceptives (except for intrauterine devices): CNGOF Contraception Guidelines]. ACTA ACUST UNITED AC 2018; 46:845-857. [PMID: 30413374 DOI: 10.1016/j.gofs.2018.10.003] [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: 10/04/2018] [Indexed: 11/20/2022]
Abstract
Hormonal contraceptives remain among the most popular methods used by women. The purpose of this work is to review the effectiveness and use of these different methods. In addition, some side-effects are feared and/or frequently reported by users of hormonal contraceptives: unscheduled bleeding, acne, catamenial migraines, weight gain, libido and/or mood disorders. In this review of the literature, the accountability of hormonal contraceptives for the occurrence of some of these side-effects was discussed and a management strategy was proposed.
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Affiliation(s)
- G Robin
- Service de gynécologie médicale, orthogénie et sexologie, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France; Service d'assistance médicale à la procréation et de préservation de la fertilité, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France.
| | - P Plouvier
- Service de gynécologie médicale, orthogénie et sexologie, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France; Service d'assistance médicale à la procréation et de préservation de la fertilité, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - A-S Delesalle
- Service de gynécologie médicale, orthogénie et sexologie, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France; Service de gynécologie-obstétrique, centre hospitalier régional de Saint-Omer, route de Blendecques, 62570 Helfaut, France
| | - A-L Rolland
- Service de gynécologie médicale, orthogénie et sexologie, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France; Service de gynécologie-obstétrique, maternité de Beaumont, 80, rue de Beaumont, 59100 Roubaix, France
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Rolland AL, Peigné M, Plouvier P, Dumont A, Catteau-Jonard S, Dewailly D. Could myo-inositol soft gel capsules outperform clomiphene in inducing ovulation? Results of a pilot study. Eur Rev Med Pharmacol Sci 2017; 21:10-14. [PMID: 28724178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Insulin resistance is known to worsen polycystic ovarian syndrome (PCOS). The management of insulin resistance is crucial in the treatment of PCOS and insulin-sensitizing molecule as myo-inositol (MYO) seems to have promising effects. The aim of our pilot study was to study whether supplementation with MYO can improve patients' sensitivity to clomiphene citrate (CC) in terms of ovulation and pregnancy rates. PATIENTS AND METHODS This study included 26 patients with PCOS, eligible to ovulation induction with CC. All of them received MYO in combination with CC and folic acid, following the usual protocol. Results concerning ovulation and pregnancy rates were compared to those from our historical cohort of PCOS patients treated with CC alone. RESULTS Ovulation rate was significantly higher with MYO+CC than with CC alone (65.5% vs. 42%, p=0.0001). The number of patients sensitive to 50 mg/d was 54% with MYO vs. 40% in our reference cohort (NS). The total resistance rate was 19% vs. 27% in the reference cohort (NS). Cumulative pregnancy rate with MYO+CC was 53.8% vs. 42.2% with CC alone (NS). Pregnancy rates per initiated cycle were 16.1% with MYO vs. 12.6% in the historical cohort (NS). DISCUSSION Although the differences were not significant for most outcomes, probably due to the small number of patients, our pilot study seemed to show a benefit of supplementation with MYO during ovulation induction with CC in PCOS patients. CONCLUSIONS This study proves the great interest of a RCT and re-opens the possibilities of insulin-sensitizing agents in the treatment of anovulatory patients with PCOS, such as natural products like MYO.
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Affiliation(s)
- A-L Rolland
- CHU Lille, Service de Gynécologie Endocrinienne et Médecine de la Reproduction, Hôpital Jeanne de Flandre, Lille Cedex, France.
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Mailliez A, Keller L, Menu-Hespel S, Plouvier P, D'Orazio E, Basson L, Pigny P, Bonneterre J, Decanter C. Abstract P5-09-06: Ovarian reserve and response to controlled ovarian hyperstimulation (COH) in breast cancer women with and without BRCA mutation. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-09-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: 6300 new cases of breast cancer arise in young women under 40 each year in France. Some of them are BRCA 1 or 2 mutation carriers. Most of them receive a potentially gonadotoxic chemotherapy while they have not yet completed their family. Since 2011, a systematic proposal of ovarian reserve follow-up and fertility preservation by oocyte freezing is provided to each young early breast cancer (BC) patients (pts) of our program (NCT 01614704). Preliminary results were presented at the SABCS in 2013. We now investigate the impact of BRCA mutation on the ovarian reserve and the ovarian response to simulation.
Methods: 115 young BC pts were systematically referred to a reproductive medicine centre before starting chemotherapy. Inclusion criteria were age 18 to 38, histologically confirmed invasive breast carcinoma, absence of metastases. According to their personal and familial history, genetic counselling was performed and if the patient met the criteria and agreed, BRCA genes were analysed. Pts in an adjuvant setting and who were asking for fertility preservation underwent COH during the interval between complete surgery and start of adjuvant chemotherapy. Ovarian stimulation protocol consisted in a conventional antagonist protocol with recombinant FSH starting on day 2 of the menstrual cycles. The GnRh antagonist was started on day of the COH and the final oocyte maturation was achieved by an injection of triptorelin 0.2 mg when at least 3 follicles reached 18 mm of diameter. All pts gave their informed consent for COH, egg/embryo freezing and follow-up.
Results: 115 pts achieved pre-treatment AMH and AFC assessment. 60 (52,1%) were eligible for COH in order to cryopreserve egg or embryos. BRCA analysis was performed in 83 pts. 23 did not meet the criteria or refused. 9 analyses are still in process. 17 (20.4%) pts were positive for BRCA mutation (BRCA1: 13; BRCA2: 4) and 66 were not. In the mutation carriers group (n=17), median age was 32 years (Range 25-37). Median initial AMH levels and AFC were 23 pmol/l (5.1–223) and 20 (6-100), respectively. Eight pts underwent COH. Median duration of stimulation was 9,5 days (8-13) with a median cumulative dose of gonadotropins of 2875 UI (1200-5450). The median number of vitrified oocytes was 5,5 (0-15). Two patients chose frozen embryo preservation (1 and 2 eggs respectively). In the non-carriers group (n=66), median age was 31 years (24-37). Median initial AMH levels and AFC were 23.4 pmol/l (0.8-136) and 24 (1-68). 27 pts underwent COH. Median duration of stimulation was 10 days (7-14). Dose of gonadotropins was 2700 UI (1365-5600). The median number of vitrified oocytes was 6 (0-18). The 3 patients chose eggs preservation (0.0 and 3 eggs respectively). There was no significant difference in the two groups.
Discussion/ Conclusion: Few studies stated that BRCA1 mutation may be associated with reduced ovarian reserve in healthy BRCA mutation carriers. Meirow and al concluded that both healthy and BC BRCA mutation carriers demonstrated normal ovarian response in vitro fertilization cycles. Our results show that ovarian reserve of BRCA 1/2 mutations BC carriers do not differ from that of non-carriers. Response to COH seems similar in both groups too.
Citation Format: Mailliez A, Keller L, Menu-Hespel S, Plouvier P, D'Orazio E, Basson L, Pigny P, Bonneterre J, Decanter C. Ovarian reserve and response to controlled ovarian hyperstimulation (COH) in breast cancer women with and without BRCA mutation [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-09-06.
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Affiliation(s)
- A Mailliez
- Centre Oscar Lambret, Lille, France; Hôpital Jeanne de Flandre, Lille, France; Centre de Biologie Pathotologie - CHRU, Lille, France
| | - L Keller
- Centre Oscar Lambret, Lille, France; Hôpital Jeanne de Flandre, Lille, France; Centre de Biologie Pathotologie - CHRU, Lille, France
| | - S Menu-Hespel
- Centre Oscar Lambret, Lille, France; Hôpital Jeanne de Flandre, Lille, France; Centre de Biologie Pathotologie - CHRU, Lille, France
| | - P Plouvier
- Centre Oscar Lambret, Lille, France; Hôpital Jeanne de Flandre, Lille, France; Centre de Biologie Pathotologie - CHRU, Lille, France
| | - E D'Orazio
- Centre Oscar Lambret, Lille, France; Hôpital Jeanne de Flandre, Lille, France; Centre de Biologie Pathotologie - CHRU, Lille, France
| | - L Basson
- Centre Oscar Lambret, Lille, France; Hôpital Jeanne de Flandre, Lille, France; Centre de Biologie Pathotologie - CHRU, Lille, France
| | - P Pigny
- Centre Oscar Lambret, Lille, France; Hôpital Jeanne de Flandre, Lille, France; Centre de Biologie Pathotologie - CHRU, Lille, France
| | - J Bonneterre
- Centre Oscar Lambret, Lille, France; Hôpital Jeanne de Flandre, Lille, France; Centre de Biologie Pathotologie - CHRU, Lille, France
| | - C Decanter
- Centre Oscar Lambret, Lille, France; Hôpital Jeanne de Flandre, Lille, France; Centre de Biologie Pathotologie - CHRU, Lille, France
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Plouvier P, Barbotin AL, Boitrelle F, Dewailly D, Mitchell V, Rigot JM, Lefebvre-Khalil V, Robin G. Extreme spermatogenesis failure: andrological phenotype and intracytoplasmic sperm injection outcomes. Andrology 2017; 5:219-225. [PMID: 28187504 DOI: 10.1111/andr.12323] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 12/01/2016] [Accepted: 12/02/2016] [Indexed: 11/30/2022]
Abstract
Patients with very low sperm count through direct sperm examination can exhibit extreme oligozoospermia or cryptozoospermia (after centrifugation). The management of these patients is a real challenge for both clinicians and biologists. In this retrospective and comparative cohort study, we compared the andrological phenotype of patients with extreme alterations of spermatogenesis and assessed whether the origin of spermatozoa (testicular or ejaculate) had any influence on intracytoplasmic sperm injection (ICSI) outcomes. A total of 161 ICSI cycles were performed using ejaculated spermatozoa from 75 patients with extreme oligozoospermia (EOS) or cryptozoospermia (CS) and 150 ICSI cycles using extracted testicular spermatozoa from 74 patients with non-obstructive azoospermia (NOA). Physical, hormonal, ultrasound assessments, and ICSI outcomes were performed in each group. Cryptorchidism was significantly more frequent in the NOA group (60.8% vs. 22.6%, p = 0.001). FSH levels were significantly higher [18.9 IU/L (5.9-27.0) vs. 15.3 IU/L (9.0-46.5), p = 0.001] and the majority of inhibin B levels measured were found mostly undetectable in the NOA group as compared to EOS/CS group (31.1% vs. 10.7%, p = 0.0004). Moreover, we found no significant differences in the respect to the fertilization rates (48.9% and 43.3%, p = 0.43), implantation rates (17.4% and 15.9%, p = 0.77), and percentage of top quality embryo (22.4% and 20.4%, p = 0.73) between the two groups. The clinical pregnancy rates per embryo transferred were comparable in both groups (28.3% and 27.4%, p = 0.89). In this study, we showed for the first time a different andrological phenotype between EOS/CS and NOA groups. Indeed, cryptorchidism was significantly more frequent with more severe endocrine parameters found in the NOA group. These results reflect a more profound alteration in spermatogenesis in NOA patients. However, there was no difference in ICSI outcomes between NOA and EOS/CS groups.
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Affiliation(s)
- P Plouvier
- Service de Gynécologie Endocrinienne et Médecine de la Reproduction, Hôpital Jeanne de Flandre, Centre Hospitalier Régional Universitaire, Lille, France
| | - A-L Barbotin
- Service de Biologie de la Reproduction-Spermiologie-CECOS, Hôpital Jeanne de Flandre, Centre Hospitalier Régional Universitaire, Lille
| | - F Boitrelle
- Service de Biologie de la Reproduction et Cytogénétique, Hôpital de Poissy, Yvelines, France
| | - D Dewailly
- Service de Gynécologie Endocrinienne et Médecine de la Reproduction, Hôpital Jeanne de Flandre, Centre Hospitalier Régional Universitaire, Lille, France
| | - V Mitchell
- Service de Biologie de la Reproduction-Spermiologie-CECOS, Hôpital Jeanne de Flandre, Centre Hospitalier Régional Universitaire, Lille.,EA 4308 Gametogenese et qualite du gamete, Institut de Biologie de la Reproduction-Spermiologie-CECOS, Hôpital Albert Calmette, Centre Hospitalier Régional Universitaire, Lille, France
| | - J-M Rigot
- EA 4308 Gametogenese et qualite du gamete, Institut de Biologie de la Reproduction-Spermiologie-CECOS, Hôpital Albert Calmette, Centre Hospitalier Régional Universitaire, Lille, France.,Service d'Andrologie, Hôpital Albert Calmette, Centre Hospitalier Régional Universitaire, Lille, France
| | - V Lefebvre-Khalil
- Service de Biologie de la Reproduction-Spermiologie-CECOS, Hôpital Jeanne de Flandre, Centre Hospitalier Régional Universitaire, Lille
| | - G Robin
- Service de Gynécologie Endocrinienne et Médecine de la Reproduction, Hôpital Jeanne de Flandre, Centre Hospitalier Régional Universitaire, Lille, France.,EA 4308 Gametogenese et qualite du gamete, Institut de Biologie de la Reproduction-Spermiologie-CECOS, Hôpital Albert Calmette, Centre Hospitalier Régional Universitaire, Lille, France.,Service d'Andrologie, Hôpital Albert Calmette, Centre Hospitalier Régional Universitaire, Lille, France
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Boitrelle F, Plouvier P, Dumont A, Barbotin AL, Rigot JM, Belaïsch-Allart J, Robin G. [Effects of father's age on fertility, results of ART and health of children]. ACTA ACUST UNITED AC 2017; 45:28-31. [PMID: 28238311 DOI: 10.1016/j.gofs.2016.12.004] [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: 09/09/2016] [Accepted: 09/09/2016] [Indexed: 10/20/2022]
Abstract
Many studies exist on the impact of female age on fertility, success of assisted reproductive technologies and on obstetric, fetal and neonatal adverse outcomes. Late paternity seems commonplace especially in the media… But there are reliable scientific data which confirm decline of fertility related to male age but also an increased risk of genetic diseases for the offspring. The objective of this article is to make a synthesis of the literature on this subject.
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Affiliation(s)
- F Boitrelle
- Laboratoire de biologie de la reproduction, CHI de Poissy-Saint-Germain-en-Laye, 78303 Poissy, France; EA 7404 GIG, faculté des sciences de la santé Simone-Veil, 78180 Montigny-Le-Bretonneux, France
| | - P Plouvier
- Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - A Dumont
- Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - A-L Barbotin
- Service de biologie de la reproduction-histologie-embryologie, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France; EA 4308 gamétogenèse et qualité du gamète, institut de biologie de la reproduction-spermiologie-CECOS, hôpital Albert-Calmette, centre hospitalier régional universitaire, 59000 Lille, France
| | - J-M Rigot
- EA 4308 gamétogenèse et qualité du gamète, institut de biologie de la reproduction-spermiologie-CECOS, hôpital Albert-Calmette, centre hospitalier régional universitaire, 59000 Lille, France; Service d'andrologie, hôpital Albert-Calmette, CHRU de Lille, boulevard Jules-Leclercq, 59037 Lille cedex, France
| | - J Belaïsch-Allart
- Service de gynécologie-obstétrique et assistance médicale à la procréation, centre hospitalier des Quatre-Villes, rue Lauer, 92210 Saint-Cloud, France
| | - G Robin
- Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France; EA 4308 gamétogenèse et qualité du gamète, institut de biologie de la reproduction-spermiologie-CECOS, hôpital Albert-Calmette, centre hospitalier régional universitaire, 59000 Lille, France; Service d'andrologie, hôpital Albert-Calmette, CHRU de Lille, boulevard Jules-Leclercq, 59037 Lille cedex, France.
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Dumont A, Dewailly D, Plouvier P, Catteau-Jonard S, Robin G. Comparison between pulsatile GnRH therapy and gonadotropins for ovulation induction in women with both functional hypothalamic amenorrhea and polycystic ovarian morphology. Gynecol Endocrinol 2016; 32:999-1004. [PMID: 27258574 DOI: 10.1080/09513590.2016.1191462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
CONTEXT Ovulation induction in patients having both functional hypothalamic amenorrhea (FHA) and polycystic ovarian morphology (PCOM) has been less studied in the literature. As results remain contradictory, no recommendations have yet been established. OBJECTIVE To compare pulsatile GnRH therapy versus gonadotropins for ovulation induction in "FHA-PCOM" patients and to determine if one treatment strikes as superior to the other. METHODS A 12-year retrospective study, comparing 55 "FHA-PCOM" patients, treated either with GnRH therapy (38 patients, 93 cycles) or with gonadotropins (17 patients, 53 cycles). RESULTS Both groups were similar, defined by low serum LH and E2 levels, low BMI, excessive follicle number per ovary and/or high serum AMH level. Ovulation rates were significantly lower with gonadotropins (56.6% versus 78.6%, p = 0.005), with more cancellation and ovarian hyper-responses (14% versus 34% per initiated cycle, p < 0.005). Pregnancy rates were significantly higher with GnRH therapy, whether per initiated cycle (26.9% versus 7.6%, p = 0.005) or per patient (65.8% versus 23.5%, p = 0.007). CONCLUSION In our study, GnRH therapy was more successful and safer than gonadotropins, for ovulation induction in "FHA-PCOM" patients. If results were confirmed by prospective studies, it could become a first-line treatment for this population, just as it is for FHA women without PCOM.
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Affiliation(s)
- Agathe Dumont
- a Service de Gynécologie Endocrinienne et de Médecine de la Reproduction, Hôpital Jeanne de Flandre , CHRU Lille , France
| | - Didier Dewailly
- a Service de Gynécologie Endocrinienne et de Médecine de la Reproduction, Hôpital Jeanne de Flandre , CHRU Lille , France
| | - Pauline Plouvier
- a Service de Gynécologie Endocrinienne et de Médecine de la Reproduction, Hôpital Jeanne de Flandre , CHRU Lille , France
| | - Sophie Catteau-Jonard
- a Service de Gynécologie Endocrinienne et de Médecine de la Reproduction, Hôpital Jeanne de Flandre , CHRU Lille , France
| | - Geoffroy Robin
- a Service de Gynécologie Endocrinienne et de Médecine de la Reproduction, Hôpital Jeanne de Flandre , CHRU Lille , France
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Plouvier P, Peigné M, Gronier H, Robin G, Catteau-Jonard S, Dewailly D. Is the suppressive effect of cyproterone acetate on serum anti-Müllerian-hormone levels in women with polycystic ovary syndrome stronger than under oral contraceptive pill? Gynecol Endocrinol 2016; 32:612-616. [PMID: 26890873 DOI: 10.3109/09513590.2016.1145647] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To compare the suppressive effect of anti-androgen therapy by cyproterone acetate (CPA) and by oral contraceptive pill (OCP) on anti-müllerian hormone (AMH) levels in women with polycystic ovary syndrome (PCOS) in order to detect a putative direct anti-androgen effect on AMH excess. METHODS This is a prospective longitudinal study including 58 women with PCOS between January 2010 and April 2014 at the Lille University Hospital. A total of 47 women with clinical hyperandrogenism were treated by CPA (50 mg/d was administered 20 days out of 28) and 11 women with PCOS but without clinical hyperandrogenism received OCP. RESULT(S) Serum AHM levels at baseline were similar in CPA and OCP groups (median [5-95th percentiles]: 60.4 pmol/l [25.1-200.2] versus 58 pmol/l [27.6-100], respectively, p = 0.39). After 3 months of treatment, serum AMH levels decreased significantly by 28% ± 20% and by 22% ± 27% in CPA and OCP groups, respectively. The decrease under both treatments was similar (p = 0.48). CONCLUSION(S) That any anti-androgen effect could be observed on AMH in our CPA group in addition to the gonadotropin-suppressing effect suggests that either androgens are not involved in AMH regulation or that they act by interfering with gonadotropin effects on granulosa cells.
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Affiliation(s)
- Pauline Plouvier
- a Department of Endocrine Gynaecology and Reproductive Medicine , Hôpital Jeanne De Flandre , Lille , France and
| | - Maëliss Peigné
- a Department of Endocrine Gynaecology and Reproductive Medicine , Hôpital Jeanne De Flandre , Lille , France and
| | - Héloïse Gronier
- b Department of Reproductive Medicine , Hôpital Jean Verdier , Bondy , France
| | - Geoffroy Robin
- a Department of Endocrine Gynaecology and Reproductive Medicine , Hôpital Jeanne De Flandre , Lille , France and
| | - Sophie Catteau-Jonard
- a Department of Endocrine Gynaecology and Reproductive Medicine , Hôpital Jeanne De Flandre , Lille , France and
| | - Didier Dewailly
- a Department of Endocrine Gynaecology and Reproductive Medicine , Hôpital Jeanne De Flandre , Lille , France and
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Dumont A, Dewailly D, Plouvier P, Catteau-Jonard S, Robin G. Does polycystic ovarian morphology influence the response to treatment with pulsatile GnRH in functional hypothalamic amenorrhea? Reprod Biol Endocrinol 2016; 14:24. [PMID: 27129705 PMCID: PMC4850648 DOI: 10.1186/s12958-016-0159-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 04/22/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Pulsatile GnRH therapy is the gold standard treatment for ovulation induction in women having functional hypothalamic amenorrhea (FHA). The use of pulsatile GnRH therapy in FHA patients with polycystic ovarian morphology (PCOM), called "FHA-PCOM", has been little studied in the literature and results remain contradictory. The aim of this study was to compare the outcomes of pulsatile GnRH therapy for ovulation induction between FHA and "FHA-PCOM" patients in order to search for an eventual impact of PCOM. METHODS Retrospective study from August 2002 to June 2015, including 27 patients with FHA and 40 "FHA-PCOM" patients (85 and 104 initiated cycles, respectively) treated by pulsatile GnRH therapy for induction ovulation. RESULTS The two groups were similar except for markers of PCOM (follicle number per ovary, serum Anti-Müllerian Hormone level and ovarian area), which were significantly higher in patients with "FHA-PCOM". There was no significant difference between the groups concerning the ovarian response: with equivalent doses of GnRH, both groups had similar ovulation (80.8 vs 77.7 %, NS) and excessive response rates (12.5 vs 10.6 %, NS). There was no significant difference in on-going pregnancy rates (26.9 vs 20 % per initiated cycle, NS), as well as in miscarriage, multiple pregnancy or biochemical pregnancy rates. CONCLUSION Pulsatile GnRH seems to be a successful and safe method for ovulation induction in "FHA-PCOM" patients. If results were confirmed by prospective studies, GnRH therapy could therefore become a first-line treatment for this specific population, just as it is for women with FHA without PCOM.
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Affiliation(s)
- Agathe Dumont
- Service de Gynécologie Endocrinienne et de Médecine de la Reproduction, Hôpital Jeanne de Flandre, Centre hospitalier régional universitaire de Lille, CHRU, Avenue Eugène Avinée, 59037, Lille, France.
| | - Didier Dewailly
- Service de Gynécologie Endocrinienne et de Médecine de la Reproduction, Hôpital Jeanne de Flandre, Centre hospitalier régional universitaire de Lille, CHRU, Avenue Eugène Avinée, 59037, Lille, France
| | - Pauline Plouvier
- Service de Gynécologie Endocrinienne et de Médecine de la Reproduction, Hôpital Jeanne de Flandre, Centre hospitalier régional universitaire de Lille, CHRU, Avenue Eugène Avinée, 59037, Lille, France
| | - Sophie Catteau-Jonard
- Service de Gynécologie Endocrinienne et de Médecine de la Reproduction, Hôpital Jeanne de Flandre, Centre hospitalier régional universitaire de Lille, CHRU, Avenue Eugène Avinée, 59037, Lille, France
| | - Geoffroy Robin
- Service de Gynécologie Endocrinienne et de Médecine de la Reproduction, Hôpital Jeanne de Flandre, Centre hospitalier régional universitaire de Lille, CHRU, Avenue Eugène Avinée, 59037, Lille, France
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Lafay-Cousin L, Plouvier P, Méchinaud F, Boutard P, Oberlin O. High-dose thiotepa and hematopoietic stem cell transplantation in pediatric malignant mesenchymal tumors: a phase II study. Bone Marrow Transplant 2000; 26:627-32. [PMID: 11035368 DOI: 10.1038/sj.bmt.1702573] [Citation(s) in RCA: 16] [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: 11/08/2022]
Abstract
The prognosis of metastatic malignant mesenchymal tumors (MMT) remains poor. Given the chemosensitivity of these neoplasms, a phase II study of high-dose thiotepa (HDT) was performed to evaluate the efficacy of this drug in this particular subset of pediatric tumors. Between 1986 and 1998, 18 patients, previously treated with conventional therapy for metastatic or refractory MMT, entered the study. Thiotepa was administered at a daily dose of 300 mg/m2 for 3 consecutive days. Hematopoietic stem cell rescue, consisting of bone marrow transplantation or peripheral stem cell transplantation, was performed 2 days after completion of HDT. A response exceeding 50% was observed in 6/18 patients (response rate 33%). Toxicity was severe but never led to death. HDT used at a dose of 900 mg/m2 yields measurable anti-tumor activity in previously treated patients. The next step in these particularly poor prognosis metastatic MMT will be to investigate HDT combined with other drugs, known to be efficient at high doses.
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MESH Headings
- Adolescent
- Antineoplastic Agents, Alkylating/adverse effects
- Antineoplastic Agents, Alkylating/therapeutic use
- Child
- Child, Preschool
- Combined Modality Therapy
- Dose-Response Relationship, Drug
- Female
- Hematopoietic Stem Cell Transplantation
- Humans
- Male
- Neoplasms, Germ Cell and Embryonal/drug therapy
- Neoplasms, Germ Cell and Embryonal/therapy
- Rhabdomyosarcoma, Alveolar/drug therapy
- Rhabdomyosarcoma, Alveolar/therapy
- Rhabdomyosarcoma, Embryonal/drug therapy
- Rhabdomyosarcoma, Embryonal/therapy
- Sarcoma/drug therapy
- Sarcoma/pathology
- Sarcoma/therapy
- Thiotepa/adverse effects
- Thiotepa/therapeutic use
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Affiliation(s)
- L Lafay-Cousin
- Service d'Oncologie Pédiatrique, Institut Gustave Roussy, Villejuif, France
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