[Embryo reduction techniques].
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Biomedical subjects
Publications and source records attributed to P Arvis.
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The pregnancy rate per transfer does not appear to be increased if the embryos are placed in the Fallopian tube rather than using in-vitro fertilization or inserting the gametes into the tubule ampulla. Consequently, the indications are specific to particular cases.
The authors report the advantage of fertilization in vitro and ancillary techniques in hypofertility by male component. In their fertilization in vitro program, a male indication is individually found in 10% of the cases, but also in female indications, even those of tubal origin. In summary, sperm anomalies are reported in 25% of couples entering a program of fertilization in vitro. Therefore they explain their current approach toward one or two cycles of diagnostic FIV, and then propose the most appropriate technique of assisted procreation for each case.
The authors report 3 cases of fetal malformations consisting of amputation of the limbs. These were found in their cases of selective abortion carried out around the 10th week of amenorrhoea by injection under ultrasonic needle guidance of hypertonic saline into selected sacs. These malformations seem to be associated with either the existence of amniotic bands or with a toxic mechanism (direct contact of the limbs of the embryo with neighbouring hyperosmolar membranes). This technique is to be given up in favour of transcervical aspiration, or direct needling of the fetus. The different techniques for selective abortion have been reviewed as well as the so-called "alternative" techniques (such as follicular aspiration) which are preferable.