Biomedical subjects
N Lavergne
Publications and source records attributed to N Lavergne.
Uterine anomalies and in vitro fertilization: what are the results?
OBJECTIVE: To evaluate the influence of uterine anomalies on the implantation rates after embryo transfer. STUDY DESIGN: A retrospective, multicentric study. This study compare patients presenting a uterine anomaly (septate uterus, umicornuate, pseudonicornuate, bicornuate uterus) having attempted FIVETE between 1987 and 1992 with the normal population treated by IVF, as well as with FIVNAT results. RESULTS: Thirty-eight patients were part of the studied population and total 119 oocyt retrievals which lead to 103 embryo transfers (corresponding to 1.35% of the realised transfers during the same period in the three centers of the study). The pregnancy rate obtained by these patients is significantly lower than those obtained by the control group (11.7% pregnancies by retrievals vs. 19.1%, and 13.6% pregnancies by transfer vs. 24.9%). The implantation rate by embryo transfer is 5.8% in the population studied vs. 11.7% in the control group (P < 0.01). These results significantly improve when the uterine anomaly can be treated (septate uterus). CONCLUSION: The uterine anomalies are associated with a lowered rate of embryo implantation. This implantation rate improves when the anomaly can be treated (septate uterus).
[Results and indications of laparoscopic distal tuboplasty].
We present a retrospective study of a series of 46 patients who have benefited from a laparoscopic treatment for a distal tubal disease. The results have been expressed in terms of tubulars and adherentiels scores, of the type of plastic effected and of the sterility (pure tubular sterility or associated). The global pregnancy rate is 39, 1% of which 34,8% is IUP and 4,3% EP. We have observed: an average delay of 10,8 months to obtain a pregnancy; the superiority of the fimbrioplasties (rate of pregnancy 75%); the predicted value of tubular score (the cases scored I and II obtain pregnancy rates of 57,7%). The association of endometriosis or of light oligoasthenoteratospermia do not constitute a counter indication of the tuboplasty (in those cases, cumulative rate of pregnancy is 50% and 40% respectively). If no pregnancy is observed during the 18 months following the intervention we recommend that the couple be treated by IVF.
[Analgesics in the treatment of chronic pelvic pain].
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[Delivery after 2 previous cesarean sections. A series of 41 uterine trials].
It has been possible to consider how delivery should be carried out in view of the progress that has been made handling scarred uteruses. Over 21 months 41 tests of uterine function have been authorized in our department out of 67 cases where there were two scars in the uterus (67%). 26 patients delivered vaginally (63.4%) and 5 had Caesarean sections because of failure of the test of the scar. When the relationship between the fetus and the pelvis was satisfactory, the fact that the cervix was not ripe and the presenting part was not engaged, did not prevent carrying out a trial of scar in 78% of cases. It is important to assess conditions continuously during labour and this assessment should include fetal heart monitoring, internal tokometry, fetal pH assessment and ultrasound of the scar at the onset of labour. Oxytocics had to be used in 96.2% of cases because there was at the outset marked dynamic dystocia. Epidural anaesthesia was used in 90.2% of cases. A full obstetric team must be present throughout the whole labour so that the conduct of the labour can be observed, and if necessary corrected quickly if anything in its progress is becoming abnormal. It has become reasonable to carry out tests of uterine scars even after two scars have been made in the uterus because of the absence of any maternal or fetal complications in this series or in the literature.
[Economic aspiration cannula for celioscopic surgery].
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