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Biomedical subjects

F Olivennes

Publications and source records attributed to F Olivennes.

At least 109 records · Page 6Linked to original sources
PubMed1993

Per-urethral transvesical first-trimester amniocentesis.

Early amniocentesis (before 13 weeks' gestation) using a per-urethral transvesical route is studied. Eight samples were obtained in eight patients scheduled for elective termination of pregnancy. The volume of amniotic fluid averaged 12.5 +/- 7.8 ml. Culture was successful in all samples. In one case, culture was achieved with only 2 ml of amniotic fluid. The amniotic fluid can be easily obtained via the per-urethral transvesical route. We conclude that early per-urethral amniocentesis before 13 weeks amenorrhea may be an alternative to the transabdominal route. A clinical trial should be carried out in order to evaluate both techniques.

Amniocentesis↗
PubMed1993

Nonsurgical treatment of heterotopic pregnancy: a report of six cases.

OBJECTIVE: To evaluate nonsurgical management of heterotopic pregnancy. DESIGN: Retrospective case series. SETTING: Department of Obstetrics and Gynecology (Antoine Béclère Hospital, Clamart, France, Paris-Sud University). PATIENTS: Six women with heterotopic pregnancy who conceived in four cases after ovulation induction. INTERVENTION: Transvaginal ultrasound (US)-guided aspiration/injection of potassium chloride (KCl) was performed in three cornual pregnancies with alive embryo. Expectant management was realized in three other cases. The regression was followed by serial US examination. MAIN OUTCOME MEASURES: Early and late complications related to the procedure, outcome of intrauterine pregnancy (IUP). RESULTS: Five of six patients were treated successfully (3 with KCl and 2 after expectant management). Three of these five patients had a spontaneous vaginal delivery, and two abortions occurred in the remaining two patients. Salpingectomy had to be performed in one case 10 days after medical treatment. This twin pregnancy ended with an abortion at 23 weeks of amenorrhea. Four cornual heterotopic pregnancies were treated successfully. No complication occurred after the initial management. CONCLUSION: Ultrasound permits a reliable and early diagnosis of heterotopic pregnancy. In such cases nonsurgical management is an efficient alternative with a good IUP prognosis.

Adult↗
PubMed1993

Microsurgical correction of partially degenerate mouse embryos promotes hatching and restores their viability.

We have evaluated the effects of degeneration of blastomeres on the developmental fate of mouse embryos. Micromanipulation techniques were used first to destroy one or two blastomeres of a 4-cell embryo (thereby creating three-quarter and half embryos), and later to repair the anomaly by removing the degenerate material. The embryos were either cultured in protein-free or protein-supplemented medium. When cultured in protein-supplemented medium, three-quarter embryos hatched at the same rate as intact embryos (84 and 91%, respectively), but this rate was reduced (54%; 67/125) when the embryos were cultured in a protein-free environment. Destruction of two blastomeres of a 4-cell embryo and culture in protein-free medium was detrimental, as only 3.2% (4/124) hatched. By supplementing the culture medium with protein, some of these half embryos were rescued, as shown by a 34% (32/95) hatching rate. A more dramatic increase in hatching was achieved, however, after repair of the half embryos by microsurgical removal of the degenerate material. In this case, 72% (78/109) of the repaired embryos were able to hatch. These findings may have implications for human in-vitro fertilization where partial embryonic degeneration or fragmentation often leads to embryonic demise and reduced implantation. Moreover, these observations may provide important clues to mechanisms of mammalian embryonic hatching.

Animals↗
PubMed1993

The increased risk of complication observed in singleton pregnancies resulting from in-vitro fertilization (IVF) does not seem to be related to the IVF method itself.

Singleton pregnancies resulting from in-vitro fertilization (IVF) seem to have an increased risk of obstetric and paediatric complications. In a retrospective study we compared, during the same period, 162 IVF singleton pregnancies with 263 pregnancies resulting from stimulated cycles (without IVF) and with 5096 natural pregnancies. No significant difference was found between the first two groups concerning complications (i.e. prematurity, low birthweight, small-for-gestational-age and perinatal mortality). The results indicate that an adverse outcome is more common for pregnancies after ovarian stimulation (with or without IVF) compared to natural pregnancies. Therefore the increased risk does not appear to be linked to the IVF method itself but rather to a common factor in these two populations, i.e. population characteristics, underlying infertile status and/or ovarian stimulation.

Adult↗
PubMed1993

[Techniques, interrogations and results of medically assisted procreation].

In vitro fertilization has obtained a foreground position in therapeutics proposed to infertile couples. Technical developments could be improved in the obstetrical and pediatric field through a better understanding of events occurring in embryos implantation, and through a specific management of the subsequent pregnancies.

Adult↗
PubMed1993

[Assisted embryo hatching].

In spite of the progress in in vitro fertilization (IVF), implantation rate of IVF embryos remains low. Many factors seem to be involved in these results. Among them, impairment of the hatching process was incriminated by some authors. Assisted hatching seems to be an interesting method for repeated failures of IVF.

Adult↗
PubMed1992

[Sterility and medically assisted fertilization].

In vitro fertilization is now part of the treatment of infertility. Since 12 years, indication have been extended to male or female infertility factors. The successes have also been increased and the actual pregnancy rate is about 18% pregnancies by retrieval. Different methods are available such as GIFT, ZIFT, TET and progresses will certainly come from new techniques such as micro-manipulation, oocyte freezing and genetic procedures applied to assisted reproduction technologies.

Female↗
PubMed1991

[Puerperal psychoses. Autonomy or dismantlement? A contribution to the nosographic discussion].

Since the DSM III has contested the nosographic autonomy of puerperal psychosis, various works have confirmed that exist a genuine similarity between the post-partum severe crisis and the psycho-biological definition of psychosis. The dismantling is nevertheless not always total nor convincing because the state of pregnancy and birth giving modify deeply the women personality as ist was before as well as capacity to react to events. Three cases are reported by the authors in confirmation of the above.

Adult↗
PubMed1990

Transfusion syndrome in a triplet pregnancy.

A case is reported of a transfusion syndrome in a triplet pregnancy with intrauterine death of two of the fetuses. This is an exceptional occurrence in a triplet pregnancy and raises the problem of the management of multiple pregnancies associated with the death of one or more of the fetuses. The problem of the method of delivery and the complications arising in triplet dizygotic pregnancies is discussed.

Adult↗
PubMedDate not supplied

Perinatal outcome and developmental studies on children born after IVF.

Since the first birth after IVF, many scientific papers have been published on the technical aspects of the IVF procedure, but few studies have addressed the issue of the perinatal outcome of IVF pregnancies and of the children's development and well-being. A high rate of adverse outcome has been demonstrated in a large group of IVF pregnancies. Prematurity, low birth weight and perinatal mortality are higher than in the general population. The majority of these complications are related to multiple births, but they are also found in singleton pregnancies. An analysis of the multiple risk factors involved in these complications is needed. The infertile status of IVF patients clearly plays a role in the risk of adverse outcome. Age and parity may be important factors. The role of IVF itself has not been demonstrated convincingly. The effect of ovarian stimulation deserves further study. Most of the studies published on the follow-up of IVF children are reassuring, but it is clear that these studies are not sufficient to eliminate without doubt any adverse effects on the well-being of IVF children. All IVF pregnancies should be followed with great care, not because they are more precious than spontaneous pregnancies, but because they are exposed to an increased risk of complications. The main problem of IVF remains the high rate of multiple pregnancies, including twins.

Age Factors↗
PubMedDate not supplied

The use of GnRH antagonists in ovarian stimulation.

GnRH antagonists induce a rapid decrease in LH and FSH, preventing and interrupting LH surges. Their properties do not require a desensitization period, and this allows their use in the late follicular phase. GnRH antagonists could replace GnRH agonists in controlled ovarian stimulation without their side-effects and their long desensitization period. Two protocols for assisted reproduction technology (ART) cycles were designed: the single-dose protocol allies simplicity and efficacy, while the multiple-dose protocol is efficient and could reduce monitoring of the cycle, though compliance is mandatory. A review of the available literature on GnRH antagonists in ART cycles is presented, focusing on phase III controlled trials and ART results. Both protocols using GnRH antagonists were associated with the need for a smaller dose of gonadotrophin, a shorter stimulation period and a lower incidence of ovarian hyperstimulation syndrome (OHSS), albeit with statistically comparable pregnancy rates. A trend is observed in all studies showing a lower pregnancy rates in GnRH antagonist cycles as compared with GnRH agonist cycles. The role of the lower number of embryos, and the potential adverse effects of GnRH antagonists on endometrium or follicle must be studied. More cycles using GnRH antagonists are necessary to confirm their equivalent pregnancy rates. There is room for improvement in both protocols with regard to scheduling, antagonist dose level and the timing of its administration. Until further studies have been conducted, luteal support seems to remain mandatory. Perinatal outcome appears similar to that with other stimulation regimens. Triggering of ovulation can be obtained with GnRH agonist for patients at risk of OHSS. With regard to GnRH antagonists, questions remain regarding pregnancy rates, the indications of their use in patients with polycystic ovary syndrome or poor responders, and in ovarian stimulation outside IVF.

Controlled Clinical Trials as Topic↗
PubMedDate not supplied

[Cytogenetic analysis of human oocytes after sperm microinjection].

After standard in vitro fertilization (IVF) chromosome analysis of uncleaved oocytes has shown that in about 80% of the cases, there was no fertilization at all while in 10% of the cases there was a premature chromosome condensation and a development arrest. After micro-injection our results suggest that both the technique itself and the pathologies which require micro-injection can influence the results. On the other hand about 20-30% of the metaphase II oocytes are cytogenetically abnormal after IVF attempt while ICSI might increase chromosome breakage. Our results suggest that both the technique used and the gamete pathologies can influence the different steps of development arrest.

Chromosome Aberrations↗
PubMedDate not supplied

[Results of oocyte donation in women with different indications, ages and therapeutic strategies].

PURPOSE: Compare the effectiveness of oocyte donation for various indications, ages and treatments. METHODS: Retrospective analysis of 319 transfers for 184 couples (243 with fresh embryos and 76 with frozen embryos). Transfers are divided into: -7 groups according to indication: premature ovarian failure (POF) with normal caryotype n = 122, surgical POF n = 26, postchemotherapy and postradiation therapy POF n = 23, genetic disease carrier n = 11, IVF failure n = 69, primary amenorrhea n = 58, POF with abnormal caryotype n = 10. -2 groups according to the recipient's age (Group I < or = 40 years, Group II > 40 years); -3 groups according to the dose and the mode of administration of the treatment. Oocytes were donated by volunteer donors of less than 38 years having at last one child. RESULT: According to the recipient's age 31.3% clinical pregnancies (CP) and 24.2% ongoing pregnancies (OP) for group I, versus 19.4% CP and 11.9% OP for group II. The results according to the indication were similar except for postchemotherapy and postradiation therapy POF for which the rate of CP as well as the rate of OP were particularly low. For the treatment groups there is a significant reduction of CP and OP as the treatment dose increases. CONCLUSION: The recipient's age plays an important role for the development of pregnancy and this shows that apparently uterine ageing also plays an undeniable role for the decline of female fertility. Increasing doses of estradiol reduces the rate of CP and OP. Postchemotherapy and postradition therapy POF has much lower results than other indications.

Adult↗