We report on a case of loiasis revealed during an assisted reproductive technology (ART) cycle. Loa loa could limit implantation outcome. We propose to focus on an ART strategy with frozen embryos to treat the patient before any transfer.

Objectives. - In France, oocyte donation program is still underdeveloped because of lack of donors and this situation entails an important wave of cross border medical tourism to different European countries mainly Spain and Greece. In 2011, the General inspection of social affairs report recommended to the biomedicine agency to promote spontaneous oocyte donation via different channels of information to develop this national program. The main objective of this study is to assess the knowledge of womenafter baby delivery about oocyte donation. The second objective is the identification of ways to assure better information and to promote oocyte donation.Patients and methods. - We conducted a prospective study with anonymous questionnaire distribution to women after delivery at obstetrics/gynecology department of the Regional University Hospital and Maternity-Children Unit "Victor-Pauchet" of Amiens, from December 2012 to January 2013.Results. - Two hundred and fifty-five questionnaires were distributed and 242 of them were analyzed (94.9%). About oocyte donation knowledge: 28% did not know it was possible, 45% did not know it was legal in France, 54% did not know who was concerned and 36% know that a treatment is necessary, 9% think that oocyte donation is paid and 10% it is non-anonymous. If 67% seems to be favorable to this initiative, only 35% could accept to realize it. About information efficiency, 88% think not to receive enough information, 64% would like to have more information. The health care professional wanted to give this information is an obstetrician (51%), a midwife (37%) and a nurse (12%).Discussion and Conclusion. - Oocyte donation program is misoriented due to a lack of information. Obstetricians and midwives have an important educational and informative role to support oocyte donation. Specific strategy of communication and valuable targeted information are needed to motivate potential donor and achieve the objectives of the program. (C) 2014 Elsevier Masson SAS. All rights reserved.

L’accueil d’embryon par un couple infertile receveur représente depuis 1999, une des possibilités offertes aux couples qui disposent d’embryons congelés pour lesquels ils n’ont plus, à titre personnel, de projet parental. En pratique, cette nouvelle technique d’Assistance médicale à la procréation (AMP) que représente l’accueil d’embryon est assez peu réalisée en France depuis son autorisation alors qu’elle ne présente pas de problème technique particulier. Pourquoi tant de réticence à la mise en place de l’accueil d’embryon en France ? Le but de cet article est d’analyser les raisons du retard à la mise en place de l’accueil d’embryon en France. Les difficultés rencontrées semblent être de plusieurs ordres : organisationnel, éthique et psychologique.

Les principes de bénévolat, d’anonymat, volontariat et non-profit constituent les piliers du don d’éléments et produits du corps humain en France et le don du sang a servi de modèle dans la structuration des dons d’organes, de cellules souches hématopoïétiques ou de gamètes. Ces principes, qui de prime abord apparaissent comme intangibles, communément admis et transposables entre les différents types de dons, révèlent toutefois des singularités au regard d’un imaginaire collectif, d’une réalité biologique, de l’évolution de la société, de la médecine et de la science. Au travers de l’étude de ces différents principes appliqués aux éléments du corps humains objets de don, cet article vise à souligner les limites sur le plan éthique d’une seule approche principiste. Les notions d’anonymat, de consentement, volontariat, non-profit, sous leur caractère universel, révèlent des variabilités d’interprétation et de portées du fait même de caractéristiques, d’implications et de finalités hétérogènes entre ces dons d’éléments différents et des utilisations qui en sont faites.Voluntary, non-remunerated donations are fundamental principles with anonymity regarding donations of elements and products of the human body in France. Blood donation was a model to organize donation of organs, hematopoietic stem cell or gamete. These principles, which at first glance appear to be intangible, commonly accepted and transposable between the different types of donation, though reveal singularities regarding to a collective imagination, a biological reality, evolution of society, medicine and science. Through the study of these different principles applied to donated human body parts, this article aims to highlight the ethical limitations of a single principlist approach. The notions of anonymity, consent, voluntariness, non for profit, under their universal aknowledge, reveal variability of interpretation and scope due to the heterogeneous characteristics, implications and purposes between these donations of different elements and the uses made of them.

OBJECTIVES:ART transparency of results and ways to submit are in centre of present biologists and clinical cares. This work aims at identifying ART results' presentation pertinent tests. PATIENTS AND METHODS:At first time, we propose a questions' list to French ART professionals. Next, we apply results on Amiens' ART center 2006, 2007 and 2008 IVF parameters. RESULTS:One hundred and twenty questions' lists were analysed. Ninety percent of interrogated people were in favour of the results' center public communication. Most quoting criterions hold to define a reference population are (percentage of favourable opinions): IVF/ICSI treatment (96%), first of second rank's attempts (71%), women age less than 35 years old (68%), one or two top embryos quality transfer (60%). In 2007, 2008 and 2009, we made 1123 tentative IVF±ICSI in Amiens' ART center. Pregnancy rates were analysed for these years with criterions next quoting as most pertinent (women's age and rank's attempt), and in function of puncture retrieval oocytes number and indications. DISCUSSION AND CONCLUSION:Most of professionals are in favour of ART transparency of results. All would like that results presentation holds to special criterions to allow a fair comparison. Pregnancy predictive factors, which are women age, rank attempt, puncture retrieval oocytes number, seem to be main criterions for evaluation. These criterions pertinence has been shown thanks to Amiens ART center results.

Since 1999, French legislation has stipulated that embryo donation is one of the possibilities afforded to couples who have a surplus of cryopreserved embryos. Donation of embryos with no foreseeable future use by the genetic couple can therefore be given to infertile couples. In practice however, since the authorization of this novel Medically Assisted Reproduction technique, embryo donation is not widely performed in France even though it is not technically difficult. Why then is there reluctance towards the implementation of embryo donation in France? The aim of this article is to analyze the grounds for the delay in the realization of embryo donation in France. Our findings propose that a myriad of factors including organizational, ethical and psychological determinants have deterred the implementation of embryo donation in France. (C) 2011 Elsevier Masson SAS. All rights reserved.

Objectives. - To identify IVF +/- ICSI pregnancy predictive factors during "Top Quality" attempts in case of double embryo transfer.Patients and methods. - Three years retrospective study (2007, 2008 and 2009) on parameters and results obtained during IVF +/- ICSI defined as "Top Quality" attempts: first or second attempts on less than 35 years old women (age inferior or equal to) with one or two "Top Quality" embryo transfer.Results. - In case of double embryo transfer, pregnancy predictive factors are (OR [IC 95%], P): average endometrial thickness on start (4.6 [2.9-5.5], P < 0.01), women smoking (4.2 [3.5-4.9], P < 0.01), average stimulation duration (3.4 [2.7-3.9], P < 0.01), average men age (2.2 [1.7-2.5], P < 0.05), gonadotrophins total dose (2.1 [1.1-3.2], P < 0.05) and first rank's attempts (1.6 [1.2-2.5], P < 0.05).Discussion and conclusion. - Age patient, rank attempts and quality embryo are criteria, which used to guide to a single embryo transfer. Our results incite us to consider other parameters, in particular men age and women smoking status. (C) 2011 Elsevier Masson SAS. All rights reserved.

L’évaluation de nos pratiques est nécessaire en insémination avec sperme de donneur afin de proposer aux patientes une prise en charge adaptée et personnalisée. Nous avons souhaité déterminer les facteurs prédictifs de réussite dans notre centre afin de mettre en place un algorithme de prise en charge standardisé.Nous avons rétrospectivement analysé les couples pris en charge en IAD dans notre centre entre le 1er janvier 2000 et le 31 décembre 2010.Sur 551 cycles étudiés chez 188 patientes, le taux de grossesse par cycle était de 19,8 % et le taux de naissance vivante par cycle de 16,7 %. Le taux de grossesse cumulé augmentait jusqu’à la quatrième tentative puis se stabilisait. Par patiente, les facteurs de réussite étaient l’âge (p = 0,04), le fait d’avoir déjà eu un enfant en IAD (p = 0,02), et l’absence d’échec préalable en ICSI-C (p = 0,035). Par cycle, les facteurs de réussite étaient le nombre de follicules de plus de 15 mm (p = 0,04) et le nombre de follicules de plus de 18 mm (p = 0,001). Un pourcentage de 68,1 % des patientes ont obtenu un enfant en FIV-D après échec en IAD.Deux facteurs semblent jouer un rôle primordial en IAD : l’âge de la patiente et le nombre de follicules matures. Il apparaît licite d’orienter les patientes vers la FIV-D au terme de quatre tentatives d’IAD infructueuses, cette stratégie devant être modulée en fonction de l’âge de la patiente et de son bilan hormonal.Improving our practice by a constant evaluation is essential in the field of donor semen insemination (DI). Our center examined the prognosis factors for DI success in order to standardize patient treatment options.We retrospectively analysed all couples referred for DI from January 2000 till December 2010.We analysed 551 cycles among 188 patients. Pregnancy rate by stimulation cycle was 19,8% with birth rate of 16.7%. The rate of pregnancy was improved till the fourth trial then plateau. On a patient-based analysis, success factors were age (P = 0.04), previous successful DSI (P = 0.02), and no previous failure of an ICSI-C (P = 0.035). On a cycle-based analysis, success factors were the number of follicles greater than 15 mm (P = 0.04) and than 18 mm (P = 0.001). The percentage of 68.1 patients obtained a child by IVF-D after a failed DI.There are two predictive factors for DI success: the age of the patient and the number of mature follicles. It seems accurate to referred patients to IVF-D after four unsuccessful cycles of DSI. This recommendation may be adapted according to patient's age and hormonal evaluation.

Comparer les taux de grossesse et d’accouchement entre les IIU effectuées à 24 ou 48 heures de l’injection d’HCG.Il s’agit d’une étude rétrospective monocentrique incluant les couples ayant bénéficié d’une insémination intra-utérine entre janvier 2013 et décembre 2014 au centre médico-chirurgical obstétrical de Schiltigheim. La stimulation de l’ovulation était effectuée par de la FSH ou de l’HMG, et le déclenchement de l’ovulation par 250 μg d’HCG recombinante. L’insémination unique était réalisée 2 jours après (groupe j2), ou le lendemain (groupe j1).Parmi les 1092 cycles d’insémination intra-utérine inclus dans notre étude, 62 ont été effectués le lendemain du déclenchement de l’ovulation par HCG (j1), et 1030 le surlendemain (j2). Notre étude ne montre pas de différence significative sur le taux de grossesses biologiques, définies par un taux de BHCG > 15 UI/L, entre le groupe j1 (19,35 %) et le groupe j2 (18,12 %), p = 0,94, ni de différence sur le taux d’accouchement qui est respectivement de 14,50 % et 11,75 %, p = 0,18.Notre étude rapporte des taux comparables de grossesse et d’accouchement dans les groupes ayant bénéficié d’une IIU à j1 versus j2 du déclenchement de l’ovulation, suggérant la possibilité de réaliser les IIU à j1 lorsque l’organisation du service le justifie, sans perte de chance pour le devenir de la grossesse.Comparing rates of pregnancy and childbirth between IUI at either 24 or 48 hours after injection of HCG.This is a single-center retrospective study of couples who underwent intrauterine insemination between January 2013 and December 2014 at Medical-Surgical Obstetrical Centre of Schiltigheim. Stimulation of ovulation was done by FSH or HMG, and ovulation induction by 250 μg of recombinant HCG. The insemination was performed after 2 days (group D2) or the day after (group D1).Among the 1092 intrauterine insemination cycles included in our study, 62 were done the day after ovulation induction by HCG (D1), and 1030 the day after (D2). Our study showed no significant difference in the rate of biological pregnancy, defined by a rate of BHCG > 15 IU/L, between the group D1 (19.35%) and the group D2 (18.12%), P = 0.94, and no difference in live birth rate: respectively 14,50% and 11.75%, P = 0.18.Our study reported similar rates of pregnancy and childbirth in the group who underwent IUI at D1 and D2 of ovulation induction, suggesting the possibility of IUI on day 1 when the organization of the service needs it, without loss of opportunity for pregnancy.

Objectives. - The Professional Practice Evaluation (PPE) is at the heart of quality management in procreation centers. Hereby, we report 3 years of EPP in Cytogenetics and Reproduction laboratory in Amiens University Hospital.Patients and methods. - This PPE is based upon prospective analysis of in vitro fertilization techniques regarding two major parameters. clinically in improving embryo transfer and biologically by determining fecundation levels. Clinical pregnancies in "Top Quality" trial is chosen as a major indicator of our results.Results. - Per transfer, there is an increase of 8% for clinical pregnancies and 31% in "Top quality" trials. Discussion and conclusion. - The improvement in our results allowed us to propose, in favourable conditions. single embryo transfer (C) 2010 Published by Elsevier Masson SAS.

The revision of the bioethics law of 2004 must occur in a five year's time For this revision, the authorities decided to organize general slates of bioethics and requested the production of contribution by the companies, institutions or associations These texts tackle various subjects, like the Assisted Reproductive Technologies, research on the embryo and the stem cells and the banks of umbilical cord blood Certain opinions converge. others differ, but all take part in the great debate which will take place at the time of the general conference (C) 2009 Elsevier Masson SAS All rights reserved

The ovarian stimulation and the follicular puncture in ART present risks which must be planned in order to better prevent them. These complications are the ovarian hyperstimulation syndrome, the thromboembolic and carcinologic risks; the anaesthetic, hemorrhagic and infectious risks of the punctures. The presence of an endometrioma can generate an increase in the infectious risk. (C) 2009 Elsevier Masson SAS. All rights reserved.

Ce travail a été effectué afin de proposer une nouvelle échelle de mesure permettant aux cellules d’écoute et aux numéros d’urgence affiliés aux unités d’intervention dans le cadre de la pandémie du SARS-CoV2 de distinguer les sujets contaminés par ce virus de ceux qui présentent une anxiété due aux circonstances du confinement. Cette échelle permet également de distinguer les sujets présentant une anxiété légère de ceux présentant une anxiété sévère qui a de fortes probabilités d’évoluer en un trouble psychologique à part entière durant les mois qui suivront le déconfinement. Hors de la période de pandémie, cette échelle peut être le meilleur allié de dépistage précoce des troubles anxieux survenant chez le jeune adulte et le sujet âgé et permet de cette façon de distinguer les sujets qui somatisent durant les consultations de ceux qui ont une atteinte organique.This work was carried out in order to propose a new measurement scale enabling helplines and emergency numbers affiliated to the intervention units in the setting of the SARS-CoV 2 pandemic to distinguish subjects infected by this virus from those with anxiety resulting from the circumstances of lock-down. This scale also makes it possible to distinguish subjects with mild anxiety from those with severe anxiety that have a high probability of developing into a fully-fledged psychological disorder in the months following the end of lock-down. Outside the pandemic period, this scale could be a major asset for the early detection of anxiety disorders occurring in young adults and the elderly, thus making it possible to distinguish between subjects who are somatizing and those with an organic disorder.