Two GnRH agonist long-stimulation protocols, in association with HMG, are compared on a random basis. Group A (n = 53) was monitored daily from the 6th day of stimulation, whereas monitoring in group B (n = 55) began on the 11th day of stimulation. There was no significant difference in the numbers of follicles which matured, the numbers of collected oocytes, the numbers of embryos obtained in vitro and the clinical pregnancy rate. But the power of such a study is very weak (6%). It would have been necessary to include greater than 1000 patients in each group to obtain a bioequivalence test. Such a study is unrealistic for a single centre and multicentric studies are very difficult to achieve because of practical difficulties. A pooled analysis is perhaps the methodological answer.

L'utilisation des agonistes de la GnRH a ameliore les resultats obtenus en fecondation in vitro chez les patientes qui repondaient mal a une stimulation de l'ovulation de type classique. Mais certaines patientes continuent a avoir une reponse insuffisante pour pratiquer le prelevement folliculaire avec des chances raisonnables de succes. Le dosage de la FSH a une bonne valeur pronostique, les patientes ayant un taux de base eleve (> 10 UI/l) etant plus particulierement exposees au risque de moins repondre au traitement de stimulation

From January 1986 to July 1987, 143 patients with unexplained infertility (UI) following 217 IVF attempts were studied and randomly assigned for statistical analysis to be compared with 434 tubal infertility (TI) patients undergoing 748 IVF attempts. The age of patients, previous pregnancy history and stimulation protocols were identical in both groups. In comparison with tubal patients, IVF attempts on the UI group were characterized by the same rates of cycle failure, mean number of oocytes retrieved per cycle, a lower fertilization rate (45.7% UI/59.8% TI) (P less than 0.01) and no difference in cleavage and nidation rates. However, a decrease in the pregnancy rate/attempt (13.8% UI/19.5% TI) tended towards a significant value (P = 0.06). Although the semen parameters were found to be in the normal range during the previous fertility screening in both groups, the incidence of at least one abnormality (count less than 20 X 10(6)/ml, and/or total motility less than 30% and/or abnormal forms greater than 75%) on the day of insemination was found to be significantly higher in UI (20%) than in TI (11%) patients. Moreover, 25% of UI patients did not fertilize any oocytes inseminated, whatever the number of oocytes retrieved. This rate of failed fertilization was significantly lower (9%) in tubal patients. The oestrogen response profiles were similar in both groups, analyzed according to the stimulation protocols.(ABSTRACT TRUNCATED AT 250 WORDS)

L'etude du pronostic obstetrical des grossesses obtenues par FIV a porte sur 320 grossesses monofœtales, 120 grossesses gemellaires, 55 triples, 10 quadruples, 1 quintuple diagnostiquees a 7 semaines d'amenorrhee. 15 reductions embryonnaires ont ete realisees. Le devenir de ces grossesses differe peu de celui d'une population standard quand on tient compte du nombre d'embryons. Le taux de malformation est de 2,6% et celui de la mortalite perinatale de 1,3%

Sur 3335 tentatives (ponctions) de fecondation in vitro effectuees de 1985 a 1988 au Centre Montpellier-Languedoc-Roussillon, ayant abouti a 672 grossesses cliniques, nous avons obtenu 139 grossesses gemellaires, 48 triples, 4 quadruples et une quintuple. Nous avons evalue les risques de grossesses triples (ou plus) en fonction du type de stimulation (plus eleves avec les agonistes) et le nombre d'embryons transferes (plus eleves avec 4 et 5 embryons). Dans ces derniers cas, transfert de 4 ou 5 embryons apres traitement par les agonistes, nous avons evalue les risques de grossesses triples (ou plus) en fonction de la qualite des embryons de l'indication, du rang de la tentative et de l'âge des femmes

Annals of the New York Academy of SciencesVolume 541, Issue 1 p. 761-766 DIRECT INTRAPERITONEAL INSEMINATION New Treatment for Cervical and Unexplained Infertility P. DELLENBACH, P. DELLENBACH Department of Obstetrics and Gynecology Centre Médico-Chirurgical et Obstétrical de la Sécurité Sociale Schiltigheim, 67042 Strasbourg Cedex, FranceSearch for more papers by this authorA. FORRLER, A. FORRLER Department of Obstetrics and Gynecology Centre Médico-Chirurgical et Obstétrical de la Sécurité Sociale Schiltigheim, 67042 Strasbourg Cedex, FranceSearch for more papers by this authorL. MOREAU, L. MOREAU Department of Obstetrics and Gynecology Centre Médico-Chirurgical et Obstétrical de la Sécurité Sociale Schiltigheim, 67042 Strasbourg Cedex, FranceSearch for more papers by this authorM. ROUARD, M. ROUARD Department of Obstetrics and Gynecology Centre Médico-Chirurgical et Obstétrical de la Sécurité Sociale Schiltigheim, 67042 Strasbourg Cedex, FranceSearch for more papers by this authorE. BADOC, E. BADOC Department of Obstetrics and Gynecology Centre Médico-Chirurgical et Obstétrical de la Sécurité Sociale Schiltigheim, 67042 Strasbourg Cedex, FranceSearch for more papers by this authorC. CRANZ, C. CRANZ Embryology Laboratory Faculté de Médecine Université Louis Pasteur Strasbourg, FranceSearch for more papers by this authorA. CLAVERT, A. CLAVERT Embryology Laboratory Faculté de Médecine Université Louis Pasteur Strasbourg, FranceSearch for more papers by this author P. DELLENBACH, P. DELLENBACH Department of Obstetrics and Gynecology Centre Médico-Chirurgical et Obstétrical de la Sécurité Sociale Schiltigheim, 67042 Strasbourg Cedex, FranceSearch for more papers by this authorA. FORRLER, A. FORRLER Department of Obstetrics and Gynecology Centre Médico-Chirurgical et Obstétrical de la Sécurité Sociale Schiltigheim, 67042 Strasbourg Cedex, FranceSearch for more papers by this authorL. MOREAU, L. MOREAU Department of Obstetrics and Gynecology Centre Médico-Chirurgical et Obstétrical de la Sécurité Sociale Schiltigheim, 67042 Strasbourg Cedex, FranceSearch for more papers by this authorM. ROUARD, M. ROUARD Department of Obstetrics and Gynecology Centre Médico-Chirurgical et Obstétrical de la Sécurité Sociale Schiltigheim, 67042 Strasbourg Cedex, FranceSearch for more papers by this authorE. BADOC, E. BADOC Department of Obstetrics and Gynecology Centre Médico-Chirurgical et Obstétrical de la Sécurité Sociale Schiltigheim, 67042 Strasbourg Cedex, FranceSearch for more papers by this authorC. CRANZ, C. CRANZ Embryology Laboratory Faculté de Médecine Université Louis Pasteur Strasbourg, FranceSearch for more papers by this authorA. CLAVERT, A. CLAVERT Embryology Laboratory Faculté de Médecine Université Louis Pasteur Strasbourg, FranceSearch for more papers by this author First published: October 1988 https://doi.org/10.1111/j.1749-6632.1988.tb22314.xCitations: 3AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume541, Issue1In Vitro Fertilization and Other Assisted ReproductionOctober 1988Pages 761-766 RelatedInformation

RU-486 was used to induce labor in 12 cases to terminate singleton pregnancies of at least 30 weeks gestational age. The fetus was living and without signs of distress on monitoring and no patient showed any sign of spontaneous labor. The average gestational age was 34.2 weeks. In 9 cases the fetus had a malformation incompatible with survival or with normal cognitive life and in the other 3 cases the extraction was necessitated by severe maternal or fetal pathology. RU-486 was administered in single doses of 400 mg/day for 2 days. In 6 cases labor began within 72 hours using only RU-486. In 4 cases labor was induced with RU-486 and Syntocinon. In 2 cases administration of RU-486 and Syntocinon failed to induce labor and a cesarean was necessary. The average delay to expulsion was 48.6 hours in the 6 patients responding to RU-486 alone. No sign of fetal distress was noted after administration of RU-486. The malformed infants all died immediately after birth as a result of their malformations. 2 of the live born infants without malformations were delivered vaginally and 1 by cesarean. 1 infant was delivered at 37 weeks due to an anti-Rh immunization. The birth weight was 3200 g the Apgar score was 10 in the 1st and 5th minute and no side effects were noted at 9 months of life. The 2nd infant was delivered at 34 weeks due to severe hypertension. Birth weight was 1500 g and the Apgar score was 9 at the 1st minute and 10 at the 5th. Cardiac sonography recorded a permeable arterial canal which was no longer noted in the 5th month when the infants health was judged normal. The infant delivered by cesarean in the 33rd week had an anti-C rhesus immunization. Birth weight was 3000 g. The Apgar score was 4 in the 1st minute and 8 in the 5th. No problems were noted at 9 months. RU-486 appears to be a useful agent for 3rd trimester therapeutic pregnancy terminations but its utility should be confirmed on a larger number of cases with well defined protocols.

The authors report 12 cases of induction of labour which was carried out with the help of RU 486 in the 3rd trimester of pregnancy (mean duration of the pregnancy 34.2 weeks). Nine cases had malformed fetuses and 3 cases had normal infants. In 6 cases out of the 12 delivery took place within 48 hours after RU had been administered by itself and in 3 cases induction with Syntocinon was helped when RU was given beforehand. In 3 cases the live-born children showed no secondary ill effects.