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Biomedical subjects

J de Mouzon

Publications and source records attributed to J de Mouzon.

At least 37 records · Page 2Linked to original sources
PubMed1994

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

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

Birth Weight↗
PubMed1993

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

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

Adult↗
PubMed1993

[Evaluation of FIVNAT 1992].

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

Adult↗
PubMed1993

[Ectopic pregnancy risk factors after assisted reproductive technology].

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

Adult↗
PubMed1993

[Multiple pregnancy risk factors in medically assisted reproduction].

FIVNAT registry collected 4,323 clinical pregnancies from 1987 to 1991, and allowed us to analyse the risk factors for multiple pregnancies. The multiple pregnancy rate is around 28%, 23% for twin pregnancies and 5% for triplet pregnancies. The number of transferred embryos is not the only factor to be significantly related with the risk of multiple pregnancy: male infertilities, cleavage rate over 50%, and women's age (at young ages multiple pregnancy rate are higher) are also significant. A multivariate logistic model was applied to analyse the relative part of these different factors. We also estimated the success rate and the multiple pregnancy rate which should have been obtained if the number of transferred embryos has been limited, in order to reduce the multiple pregnancy rate to 3%.

Adult↗
PubMed1993

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

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

Adult↗
PubMed1991

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

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

Adult↗
PubMed1990

In-vitro fertilization: influence of women's age on pregnancy rates.

An analysis of the influence of women's age on the results of in-vitro fertilization was performed, using 5590 attempts collected during the year 1986. Increasing age was found to be related to decreased success rates from 19.8% per attempt below the age of 25 years, to 9% per attempt at 40 years or more. A cut-off point was found between the ages of 36 and 37 years, using a mathematical model. The decrease was related to a reduction in oocyte production (4.3 +/- 2.8 at 25 years or less and 3.3 +/- 2.1 at 40 years or more, P less than 0.001), and to a reduced implantation rate, whatever the number of transferred embryos. These findings were not due to spouse's age, rank of attempt, infertility diagnosis or oocyte stimulation regimen, since the effect of age remained significant when a logistical model including these confounders was applied. Finally, a woman's age must be considered as a prognostic factor when IVF is proposed to infertile couples.

Adult↗
PubMed1989

Intra-uterine device failure: relation with drug use.

A case-control study was undertaken in order to test the relationship between commonly used anti-inflammatory agents and the efficacy of intra-uterine devices (IUDs). Women who had become pregnant while wearing an IUD were compared with non-pregnant IUD users. 717 cases and 717 controls were recruited from the same medical practices. The case-women (IUD failure) used anti-inflammatory drugs, particularly aspirin, more frequently than the controls (p less than 0.001). In contrast, oral progestins, taken in the second part of the cycle (16th to 25th day) were more frequently used by the control-women group (p less than 0.001). Although cases and controls differed in age and gravidity (younger and higher, respectively) standardization for these items did not change the findings for drug use.

Age Factors↗
PubMed1988

A prospective study of the relation between smoking and fertility.

A prospective study of fertility was conducted from 1977 to 1982. Analysis of the relation between cigarette smoking and occurrence of a pregnancy was performed on 1887 couples. The actuarial pregnancy rate was 82.9% at the end of a year. Cigarette smoking by both members of the couple was found to be related to decreased fertility when this factor was considered alone. But after including all the confounding covariates in a Cox semi-proportional hazards model for survival data, no relationship remained between cigarette smoking and fertility. Odds ratios were respectively 0.86 (95% confidence interval: 0.63, 1.19) and 0.99 (0.85, 1.14) for women smoking and men smoking. This could suggest that the relationship found by other authors might be at least partly explained by a relation between cigarette smoking and other factors related to fertility.

Adult↗
PubMed1988

[Echography in comparing the fetal growth of infants of African and European mothers].

Ethnic differences after delivery between babies of black or white origin are well know. However, until now, fetal growth during pregnancy has not been studied in relation to ethnic factors. In this study, two groups of 201 women, one of african origin, the other of european origin, were compared for their ultrasonic measurements of fetal abdominal transverse diameter (ATD), biparietal diameter (BPD) and femoral length. The two groups were matched by hospital, date of delivery, parity and socio-economic status. Multiple pregnancies were excluded. ATD was not different between the two groups, whereas BPD was significantly smaller among african fetuses mainly during late pregnancy and femur was greater during the entire pregnancy. Ethnic factor remained significant when taking into account confounding factors. Observed differences appeared to be more probably related to a racial factor than to hypotrophy. These findings have to be considered in order to appreciate fetal growth among african fetuses during pregnancy.

Africa↗
PubMed1985

Factors affecting human in vitro fertilization: a multifactorial study.

The influence of four factors on the cleavage rate of 705 mature oocytes submitted for in vitro fertilization (IVF) was assessed with the use of a multifactorial method, i.e., logistic regression. The studied factors were (1) the regimen for cycle stimulation, (2) cumulus cell mass appearance, (3) semen quality, and (4) the time of incubation of oocytes before insemination. The logistic function permitted testing the respective influence of each factor on the cleavage rate, with the level of the other factors taken into account. The most important factor was the stimulation treatment, the association of human menopausal gonadotropin with clomiphene citrate (CC) giving better results than CC alone. Time of incubation was demonstrated to have no influence on the cleavage rate, whereas semen quality had an influence. A problem was raised by the existence of an interaction between the stimulation treatment used and the appearance of the cumulus cell mass. It can be concluded that adequate cycle treatment and eventually couple selection with respect to the semen quality of the male partner are to be considered in view of obtaining better results in IVF attempts.

Adult↗
PubMed1985

Ultrasound study of the endometrium during in vitro fertilization cycles.

Ultrasonography is a noninvasive technique for studying the characteristics of the endometrium. This method was used in our in vitro fertilization and embryo transfer program during the periovulatory period for determination of whether there exists a moment at which the uterine mucosa is most favorable for implantation of the ovum. The endometrial thickness was noted in the course of the periovulatory phase. No correlation was found between the ultrasound image and hormonal assays. The endometrial thickness was significantly greater (P less than 0.01) when the in vitro fertilization attempt resulted in a pregnancy, even when considering the number of embryos transferred. However, it was not possible to predict the probability of pregnancy with the use of endometrial thickness.

Embryo Transfer↗
PubMed1985

[Epiphyseal points of the fetal knee. The impact of growth disorders on bone maturation].

The radiological appearance of bone maturity can be used as a criterion for fetal maturity. This examination with limited irradiation to the fetus is an alternative to amniocentesis. The practice of the latter is not without risk. The authors carried out 194 examinations of the contents of the uterus to look at the epiphyses of the knee between the 34th and 40th week of amenorrhoea. The found three groups: 1) those with normal development; 2) those with delayed development and 3) those with more advanced development. They did not find significant correlation between small-for-dates growth and bony maturity. On the other hand, where there was increased growth of the fetus in cases where maternal diabetes was excluded there was demonstrated that bony maturity accelerated with the presence of Béclard's point from the 34th week onwards. With such great variation in the dates of the appearance of points of ossification the presence of epiphyseal points in the knee cannot be taken as a criterion to establish fetal maturity nor the minimum duration of the pregnancy.

Birth Weight↗
PubMed1984

Time relationships between basal body temperature and ovulation or plasma progestins.

The basal body temperature (BBT) curve and the estimated time of ovulation, defined by the onset of gonadotropin preovulatory discharge, were analyzed in 38 spontaneous cycles. The BBT nadir was usually located at the beginning of the luteinizing hormone surge, and the first high point was 8 hours after ovulation, which was itself usually at the time when the temperature passed 37 degrees C. This temperature rise was related to the increases in plasma progesterone and 17-hydroxyprogesterone with 24 to 36 hours' delay. The BBT was found to be an unreliable technique for precise ovulation timing but would be of use if the clinical precision required for the diagnosis of ovulation were less.

17-alpha-Hydroxyprogesterone↗
PubMed1982

[A review of six years use of a computerised case history in obstetrics (author's transl)].

The University Centre for Gynaecology and Obstetrics in Toulouse have been using a computerised record system for obstetrics since 1974. This makes it possible for a review for a review to be undertaken each year of the work carried out in the Service and has made it possible to study over six years the evolution of the characteristics of the population who have been followed, as well as the changes in attitudes and techniques adopted during pregnancy and labour. A study has been carried out on the factors associated with perinatal mortality and prematurity. Computerisation of 13,500 records has made it possible to draw curves of birth weights, according to the duration of the pregnancy, and characterising the service given. Finally the adoption of a prospective record system used in common by several teams and checked by people specialised in this work has improved the quality and quantity of retrieval and has made it possible to foresee cooperative studies between different departments.

Birth Weight↗