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Infertility: HELP
Articles by Michel Canis
Based on 13 articles published since 2009
(Why 13 articles?)
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Between 2009 and 2019, M. Canis wrote the following 13 articles about Infertility.
 
+ Citations + Abstracts
1 Guideline [Management of endometriosis: CNGOF-HAS practice guidelines (short version)]. 2018

Collinet, P / Fritel, X / Revel-Delhom, C / Ballester, M / Bolze, P A / Borghese, B / Bornsztein, N / Boujenah, J / Bourdel, N / Brillac, T / Chabbert-Buffet, N / Chauffour, C / Clary, N / Cohen, J / Decanter, C / Denouël, A / Dubernard, G / Fauconnier, A / Fernandez, H / Gauthier, T / Golfier, F / Huchon, C / Legendre, G / Loriau, J / Mathieu-d'Argent, E / Merlot, B / Niro, J / Panel, P / Paparel, P / Philip, C A / Ploteau, S / Poncelet, C / Rabischong, B / Roman, H / Rubod, C / Santulli, P / Sauvan, M / Thomassin-Naggara, I / Torre, A / Wattier, J M / Yazbeck, C / Canis, M. ·Clinique de gynécologie, hôpital Jeanne-de-Flandre, CHRU de Lille, 59000 Lille, France; Université Lille-Nord-de-France, 59000 Lille, France. Electronic address: pierre.collinet@chru-lille.fr. · Service de gynécologie-obstétrique et médecine de la reproduction, Inserm CIC 1402, 2, rue de la Milétrie, 86000 Poitiers, France; Université de Poitiers, 86000 Poitiers, France; Inserm CIC 1402, 86000 Poitiers, France. · Haute Autorité de santé, 5, avenue du Stade-de-France, 93218 La Plaine-Saint-Denis cedex, France. · Service de gynécologie-obstétrique et médecine de la reproduction, CHU Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France. · Service de chirurgie gynécologique oncologique, obstétrique, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Université Claude-Bernard-Lyon 1, 69000 Lyon, France. · Service de chirurgie gynécologie-obstétrique 2 et médecine de la reproduction, CHU Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Équipe génomique, épigénétique et physiopathologie de la reproduction, département développement, reproduction, cancer, Inserm U1016, université Paris Descartes, Sorbonne Paris Cité, 12, rue de l'École-de-Médecine, 75270 Paris cedex 06, France. · 29, rue de l'Essonne, 91000 Evry, France. · Service de gynécologie-obstétrique, CHU Bondy, avenue du 14-Juillet, 93140 Bondy, France; Centre médical du Château, 22, rue Louis-Besquel, 94300 Vincennes, France. · Service de gynécologie-obstétrique et reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France; Faculté de médecine, Encov-ISIT, UMR6284 CNRS, université d'Auvergne, 28, place Henri-Dunant, 63000 Clermont-Ferrand, France. · 98, route de Blagnac, 31200 Toulouse, France. · Service de gynécologie-obstétrique et médecine de la reproduction, CHU Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; GRC-6 centre expert en endométriose (C3E), Sorbonne université, Paris, France; UMR-S938 Inserm Sorbonne université, Paris, France. · Service de gynécologie-obstétrique et reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France. · 3, rue Pablo-Picasso, 92160 Antony, France. · Service d'assistance médicale à la procréation et de préservation de la fertilité, hôpital Jeanne-de-Flandre, CHRU de Lille, 1, rue Eugène-Avinée, 59037 Lille cedex, France; EA 4308 gamétogenèse et qualité du gamète, CHRU de Lille, 59037 Lille cedex, France. · EndoFrance, BP 50053, 01124 Montluel cedex, France. · Université Claude-Bernard-Lyon 1, 69000 Lyon, France; Clinique gynécologique et obstétricale, hôpital de la Croix-Rousse, groupe hospitalier Nord, CHU de Lyon-HCL, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex, France. · Service de gynécologie-obstétrique, CHI Poissy-St-Germain, 10, rue du Champ-Gaillard, 78303 Poissy, France; EA 7285 risques cliniques et sécurité en santé des femmes, université Versailles-Saint-Quentin-en-Yvelines, Saint-Quentin-en-Yvelines, France. · Service de gynécologie-obstétrique, CHU Bicêtre, AP-HP, 78, avenue du Général-de-Gaulle, 94275 Le Kremlin-Bicêtre, France; CESP-INSERM, U1018, équipe épidémiologie et évaluation des stratégies de prise en charge, VIH, reproduction, pédiatrie, université Paris-Sud, Paris, France. · Service de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Limoges, 8, avenue Dominique-Larrey, 87042 Limoges, France; UMR-1248, faculté de médecine, 87042 Limoges, France. · Service de chirurgie gynécologique oncologique, obstétrique, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France. · Service de gynécologie-obstétrique, CHI Poissy-St-Germain, 10, rue du Champ-Gaillard, 78303 Poissy, France. · Service de gynécologie-obstétrique, CHU d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France; CESP-Inserm, U1018, équipe 7, genre, santé sexuelle et reproductive, université Paris-Sud, 94276 Le Kremlin-Bicêtre cedex, France. · Service de chirurgie digestive, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75001 Paris, France. · Service de gynécologie-obstétrique et médecine de la reproduction, CHU Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie Paris 6, Paris, France; GRC6-UPMC, centre expert en endométriose (C3E), hôpital Tenon, Paris, France. · Service de chirurgie gynécologique, clinique Tivoli, 220, rue Mandron, 33000 Bordeaux, France. · Service de gynécologie-obstétrique, centre hospitalier de Versailles, 177, route de Versailles, 78157 Le Chesnay cedex, France. · Service d'urologie, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, 60495 Pierre-Bénite, France. · Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Mère-Enfant, CHU de Nantes, 8, boulevard Jean-Monnet, 44093 Nantes, France. · Service de gynécologie-obstétrique, centre hospitalier Renée-Dubos, 6, avenue de l'Île-de-France, 95300 Pontoise, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, 93022 Bobigny, France. · Centre expert de diagnostic et prise en charge multidisciplinaire de l'endométriose, clinique gynécologique et obstétricale, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France. · Clinique de gynécologie, hôpital Jeanne-de-Flandre, CHRU de Lille, 59000 Lille, France; Université Lille-Nord-de-France, 59000 Lille, France. · Service de gynécologie-obstétrique, CHU Bicêtre, AP-HP, 78, avenue du Général-de-Gaulle, 94275 Le Kremlin-Bicêtre, France. · Service d'imagerie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Sorbonne universités, UPMC université Paris 06, Paris, France; Institut universitaire de cancérologie, Assistance publique, Paris, France. · Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Arnaud-de-Villeneuve, CHU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier, France. · Centre d'étude et traitement de la douleur, hôpital Claude-Huriez, CHRU de Lille, rue Michel-Polonowski, 59000 Lille, France. · Service de gynécologie-obstétrique, hôpital Foch, AP-HP, 40, rue Worth, 92151 Suresnes, France; Centre d'assistance médicale à la procréation, clinique Pierre-Cherest, 5, rue Pierre-Cherest, 92200 Neuilly-Sur-Seine, France. ·Gynecol Obstet Fertil Senol · Pubmed #29550339.

ABSTRACT: First-line investigations to diagnose endometriosis are clinical examination and pelvic ultrasound. Second-line investigations include pelvic examination performed by a referent clinician, transvaginal ultrasound performed by a referent echographist, and pelvic MRI. It is recommended to treat endometriosis when it is symptomatic. First-line hormonal treatments recommended for the management of painful endometriosis are combined with hormonal contraceptives or levonorgestrel 52mg IUD. There is no evidence to recommend systematic preoperative hormonal therapy for the unique purpose of preventing the risk of surgical complications or facilitating surgery. After endometriosis surgery, combined hormonal contraceptives or levonorgestrel SIU 52mg are recommended as first-line therapy in the absence of desire of pregnancy. In case of initial treatment failure, recurrence, or multiple organ involvement by endometriosis, medico-surgical and multidisciplinary discussion is recommended. The laparoscopic approach is recommended for the surgical treatment of endometriosis. HRT may be offered in postmenopausal women operated for endometriosis. In case of infertility related to endometriosis, it is not recommended to prescribe anti-gonadotropic hormone therapy to increase the rate of spontaneous pregnancy, including postoperatively. The possibilities of fertility preservation should be discussed with the patient in case of surgery for ovarian endometrioma.

2 Guideline [Minimal and mild endometriosis: Impact of the laparoscopic surgery on pelvic pain and fertility. CNGOF-HAS Endometriosis Guidelines]. 2018

Ploteau, S / Merlot, B / Roman, H / Canis, M / Collinet, P / Fritel, X. ·Service de gynécologie-obstétrique et médecine de la reproduction, hôpital mère-enfant, CHU de Nantes, 8, boulevard Jean-Monnet, 44093 Nantes, France. Electronic address: stephane.ploteau@chu-nantes.fr. · Service de chirurgie gynécologique, clinique Tivoli, 220, rue Mandron, 39000 Bordeaux, France. · Centre expert de diagnostic et prise en charge multidisciplinaire de l'endométriose, clinique gynécologique et obstétricale, CHU Charle-Nicolle, 1, rue de Germont, 76031 Rouen, France. · Service de gynécologie-obstétrique et reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France. · Clinique de gynécologie, hôpital Jeanne-de-Flandre, CHRU de Lille, 59000 Lille, France. · Service de gynécologie-obstétrique et médecine de la reproduction, Inserm CIC 1402, 2, rue de la Milétrie, 86000 Poitiers, France. ·Gynecol Obstet Fertil Senol · Pubmed #29510965.

ABSTRACT: Minimal and mild endometriosis (stage 1 and 2 AFSR) can lead to chronic pelvic pain and infertility but can also exist in asymptomatic patients. The prevalence of asymptomatic patients with minimal and mild endometriosis is not clear but typical endometriosis lesions are found in about 5 to 10% of asymptomatic women and more than 50% of painful and/or infertile women. Laparoscopic treatment of minimal and mild endometriotic lesions is justified in case of pelvic pain because their destruction decrease significatively the pain compared with diagnostic laparoscopy alone. In this context, ablation and excision give identical results in terms of pain reduction. Moreover, literature shows no interest in uterine nerve ablation in case of dysmenorrhea due to minimal and mild endometriosis. Then, it is recommended to treat these lesions during a laparoscopy realised as part of pelvic pain. On the other hand, it is not recommended to treat asymptomatic patients. With regard to treatment of minimal and mild endometriosis in infertile patients, only two studies can be selected and both show that laparoscopy with excision or ablation and ablation of adhesions is superior to diagnostic laparoscopy alone in terms of pregnancy rate. However, it is not recommended to treat these lesions when they are asymptomatic because there is no evidence that they can progress with symptomatic disease. There is no study assessing the interest to treat these lesions when they are found fortuitously. Adhesion barrier utilisation permits to reduce post-operative adhesions, however literature failed to demonstrate the clinical profit in terms of reduction of the risk of pain or infertility.

3 Guideline [Management of assisted reproductive technology (ART) in case of endometriosis related infertility: CNGOF-HAS Endometriosis Guidelines]. 2018

Santulli, P / Collinet, P / Fritel, X / Canis, M / d'Argent, E M / Chauffour, C / Cohen, J / Pouly, J L / Boujenah, J / Poncelet, C / Decanter, C / Borghese, B / Chapron, C. ·Service de chirurgie gynécologie obstétrique 2 et médecine de la reproduction, CHU Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Inserm U1016, équipe génomique, épigénétiques et physiopathologie de la reproduction, département développement, reproduction, cancer, université Paris Descartes, Sorbonne Paris Cité, 12, rue de l'École-de-Médecine, 75270 Paris cedex 06, France. Electronic address: pietro.santulli@cch.aphp.fr. · Clinique de gynécologie, hôpital Jeanne-de-Flandre, CHRU Lille, 59000 Lille, France; Université Lille-Nord-de-France, 59000 Lille, France; Inserm, U1189-ONCO Thai-image assisted laser therapy for oncology, CHU de Lille, 59000 Lille, France. · Inserm CIC 1402, service de gynécologie - obstétrique et médecine de la reproduction, 2, rue de la Milétrie, 86000 Poitiers, France; Université de Poitiers, 86000 Poitiers, France; Inserm CIC 1402, 86000 Poitiers, France. · Service de gynécologie-obstétrique et reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France. · Service de gynécologie-obstétrique et médecine de la reproduction, CHU Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie Paris 6, France; GRC6-UPMC : centre expert en endométriose (C3E), hôpital Tenon, Paris, France. · Service de gynécologie-obstétrique, CHU Bondy, avenue du 14-Juillet, 93140 Bondy, France; Centre médical du Château, 22, rue Louis-Besquel, 94300 Vincennes, France. · Service de gynécologie-obstétrique, centre hospitalier de Renée-Dubos, 6, avenue de l'Ile-de-France, 95300 Pontoise, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, 93022 Bobigny, France. · Service d'assistance médicale à la procréation et de préservation de la fertilité, hôpital Jeanne-de-Flandre, CHRU de Lille, 1, rue Eugène-Avinée, 59037 Lille cedex, France; EA 4308, gamétogenèse et qualité du gamète, CHRU de Lille, 59037 Lille cedex, France. · Service de chirurgie gynécologie obstétrique 2 et médecine de la reproduction, CHU Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Inserm U1016, équipe génomique, épigénétiques et physiopathologie de la reproduction, département développement, reproduction, cancer, université Paris Descartes, Sorbonne Paris Cité, 12, rue de l'École-de-Médecine, 75270 Paris cedex 06, France. ·Gynecol Obstet Fertil Senol · Pubmed #29503237.

ABSTRACT: The management of endometriosis related infertility requires a global approach. In this context, the prescription of an anti-gonadotropic hormonal treatment does not increase the rate of non-ART (assisted reproductive technologies) pregnancies and it is not recommended. In case of endometriosis related infertility, the results of IVF management in terms of pregnancy and birth rates are not negatively affected by the existence of endometriosis. Controlled ovarian stimulation during IVF does not increase the risk of endometriosis associated symptoms worsening, nor accelerate the intrinsic progression of endometriosis and does not increase the rate of recurrence. However, in the context of IVF management for women with endometriosis, pre-treatment with GnRH agonist or with oestrogen/progestin contraception improve IVF outcomes. There is currently no evidence of a positive or negative effect of endometriosis surgery on IVF outcomes. Information on the possibilities of preserving fertility should be considered, especially before surgery.

4 Editorial [Information to patients in endometriosis: We must stop the frightening machine!] 2016

Canis, M / Curinier, S / Campagne-Loiseau, S / Kaemerlen Rabischong, A G / Rabischong, B / Pouly, J L / Grémeau, A S / Botchorishvili, R / Bourdel, N. ·Department of gynecologic surgery, CHU Estaing, 1, place Lucie-et-Raymond-Aubrac, 63000 Clermont-Ferrand, France. Electronic address: mcanis@chu-clermontferrand.fr. · Department of gynecologic surgery, CHU Estaing, 1, place Lucie-et-Raymond-Aubrac, 63000 Clermont-Ferrand, France. ·Gynecol Obstet Fertil · Pubmed #27765429.

ABSTRACT: -- No abstract --

5 Editorial [Ovarian endometriomas: No-surgery has never been evaluated and surgery correctly performed should remain the gold-standard!] 2016

Canis, M / Botchorishvili, R / Bourdel, N / Chauffour, C / Gremeau, A-S / Rabischong, B / Campagne, S / Pouly, J-L / Matsuzaki, S. ·Department of Gynecologic Surgery, CHU Estaing, 1, place Lucie-et-Raymond-Aubrac, 63000 Clermont-Ferrand, France. Electronic address: mcanis@chu-clermontferrand.fr. · Department of Gynecologic Surgery, CHU Estaing, 1, place Lucie-et-Raymond-Aubrac, 63000 Clermont-Ferrand, France. ·Gynecol Obstet Fertil · Pubmed #27751749.

ABSTRACT: -- No abstract --

6 Review Pelvic adhesions and fertility: Where are we in 2018? 2018

Canis, M / Botchorishvili, R / Bourdel, N / Gremeau, A-S / Curinier, S / Rabischong, B. ·Department of Gynecologic Surgery, CHU Estaing, 1, place Lucie et Raymond Aubrac, 63000 Clermont-Ferrand, France. Electronic address: mcanis@chu-clermontferrand.fr. · Department of Gynecologic Surgery, CHU Estaing, 1, place Lucie et Raymond Aubrac, 63000 Clermont-Ferrand, France. ·J Visc Surg · Pubmed #29784584.

ABSTRACT: Peritoneal adhesions remain a major public health problem despite the development of laparoscopy. The rules of microsurgery must be known and followed during any pelvic surgery, even in patients who no longer have a desire for pregnancy. Anti-adhesion products are numerous. All have interest, confirmed by anatomical studies showing a smaller extent or a lesser severity of adhesions associated with their use. No studies, however, show clinical benefit in terms of improved pain or postoperative fertility. Pneumoperitoneum parameters, humidification, and lower abdominal pressure should be optimized to limit peritoneal trauma. Peri-operative corticosteroids, whose benefit has been has been demonstrated in at least one randomized trial, should be systematically used.

7 Article [Adverse pregnancy outcomes after Assisted Reproduction Technology in women with endometriosis]. 2014

Carassou-Maillan, A / Pouly, J-L / Mulliez, A / Dejou-Bouillet, L / Gremeau, A-S / Brugnon, F / Janny, L / Canis, M. ·Pôle gynéco-obstétrique-reproduction humaine, CHU Estaing, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand cedex 1, France. Electronic address: ananda_carassoumaillan@yahoo.fr. · Pôle gynéco-obstétrique-reproduction humaine, CHU Estaing, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand cedex 1, France. · Département d'information médicale, CHU de Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont-Ferrand, France. ·Gynecol Obstet Fertil · Pubmed #24679602.

ABSTRACT: OBJECTIVE: While association between endometriosis and infertility is well established, there are few studies about the impact of endometriosis on adverse pregnancy outcomes. The aim of this study was to determine the effect of endometriosis on obstetric outcomes and whether the severity of the disease had an influence on these. PATIENTS AND METHODS: We performed a retrospective study to investigate the obstetric outcomes of a population of 1204 subfertile women, including 258 with endometriosis, who obtained, thanks to assisted reproduction technology, a singleton pregnancy evolving beyond embryonic stage. Two analyzes were performed. The first compared women with endometriosis to women with other causes of infertility. The second observed adverse pregnancy outcomes according to AFS-R stages of endometriosis. RESULTS: The overall rate of live birth children was 95.8%. In case of endometriosis, there was a significant increase of the incidence of preterm delivery, especially before 32 weeks amenorrhea (6.2% vs 3.1% in the group "without endometriosis", P = 0.03), antenatal bleeding (5.3% vs 2.2%, P = 0.01) and placenta previa (4.9% vs 0.9%, P < 0.0001). The incidence of gestational diabetes was significantly decreased (0.4% vs 2.7%, P = 0.04). There was no correlation between endometriosis and cesarean section or preeclampsia, or between the AFS-R stage and adverse pregnancy outcomes. DISCUSSION AND CONCLUSION: Endometriosis is a factor of obstetrical risk, independently of the infertility it causes. The AFS-R score does not seem to be representative of obstetric outcomes beyond first trimester of pregnancy for women with endometriosis.

8 Article [Ovarian drilling by fertiloscopy: feasibility, results and predictive values]. 2013

Pouly, J-L / Krief, M / Rabischong, B / Brugnon, F / Gremeau, A-S / Dejou, L / Fabre, N / Mage, G / Canis, M / Folini, X. ·Service de gynécologie, pôle de gynécologie, obstétrique et reproduction, CHU de Clermont-Ferrand, CHU d'Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France. jlpouly@chu-clermontferrand.fr ·Gynecol Obstet Fertil · Pubmed #23566682.

ABSTRACT: OBJECTIVES: The aims of this study were to assess the effectiveness of the ovarian drilling, compare the techniques by fertiloscopy or by laparoscopy, and search for prognostic factors of success. PATIENTS AND METHODS: This retrospective study focused on 154 ovarian drilling carried out between June 1998 and December 2010 where the drilling has been proposed after failure of the clomifene and before stimulation by FSH among PCOS patients. RESULTS: The post-drilling ovulation rate is 62%. The spontaneous on-going pregnancy rate is 31% and the total pregnancy rate scalable including secondary stimulation is 58%. No significant difference was found between laparoscopy and the fertiloscopy. The peroperative complications in fertiloscopy were more frequent but without consequences and 20% of the fertiloscopy had to be converted to laparoscopy, half of them for complications and half of them for technical difficulties. The only found preoperative predictors of success are an euthyroidy that increases the chances of pregnancy in general (including the side stimulation) and a lower FSH levels. However, it appears that the chances of pregnancy in FSH stimulation are dramatically decreased if the drilling did not induce ovulation versus the cases where it induced ovulation but no pregnancy (28.8% versus 58.1%, P<0.003). DISCUSSION AND CONCLUSION: Fertiloscopy results are comparable with those of laparoscopy, which suggests an advantage to this technique in terms of cost, comfort, and length of hospital stay. No usable in practice patient selection criteria could be highlighted. The study suggests that the absence of ovulation after drilling may be a direct indication for IVF.

9 Article The burden of endometriosis: costs and quality of life of women with endometriosis and treated in referral centres. 2012

Simoens, Steven / Dunselman, Gerard / Dirksen, Carmen / Hummelshoj, Lone / Bokor, Attila / Brandes, Iris / Brodszky, Valentin / Canis, Michel / Colombo, Giorgio Lorenzo / DeLeire, Thomas / Falcone, Tommaso / Graham, Barbara / Halis, Gülden / Horne, Andrew / Kanj, Omar / Kjer, Jens Jørgen / Kristensen, Jens / Lebovic, Dan / Mueller, Michael / Vigano, Paola / Wullschleger, Marcel / D'Hooghe, Thomas. ·Katholieke Universiteit Leuven, Leuven, Belgium. ·Hum Reprod · Pubmed #22422778.

ABSTRACT: BACKGROUND: This study aimed to calculate costs and health-related quality of life of women with endometriosis-associated symptoms treated in referral centres. METHODS: A prospective, multi-centre, questionnaire-based survey measured costs and quality of life in ambulatory care and in 12 tertiary care centres in 10 countries. The study enrolled women with a diagnosis of endometriosis and with at least one centre-specific contact related to endometriosis-associated symptoms in 2008. The main outcome measures were health care costs, costs of productivity loss, total costs and quality-adjusted life years. Predictors of costs were identified using regression analysis. RESULTS: Data analysis of 909 women demonstrated that the average annual total cost per woman was €9579 (95% confidence interval €8559-€10 599). Costs of productivity loss of €6298 per woman were double the health care costs of €3113 per woman. Health care costs were mainly due to surgery (29%), monitoring tests (19%) and hospitalization (18%) and physician visits (16%). Endometriosis-associated symptoms generated 0.809 quality-adjusted life years per woman. Decreased quality of life was the most important predictor of direct health care and total costs. Costs were greater with increasing severity of endometriosis, presence of pelvic pain, presence of infertility and a higher number of years since diagnosis. CONCLUSIONS: Our study invited women to report resource use based on endometriosis-associated symptoms only, rather than drawing on a control population of women without endometriosis. Our study showed that the economic burden associated with endometriosis treated in referral centres is high and is similar to other chronic diseases (diabetes, Crohn's disease, rheumatoid arthritis). It arises predominantly from productivity loss, and is predicted by decreased quality of life.

10 Article [Endometriosis and postoperative infertility. A prospective study (Auvergne cohort of endometriosis)]. 2012

Bourdel, N / Dejou-Bouillet, L / Roman, H / Jaffeux, P / Aublet-Cuvelier, B / Mage, G / Pouly, J-L / Canis, M. ·Pôle de gynécologie-obstétrique, CHU Estaing Clermont-Ferrand, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France. nicolas.bourdel@gmail.com ·Gynecol Obstet Fertil · Pubmed #22019744.

ABSTRACT: OBJECTIVE: To evaluate in infertile women the benefit of laparoscopic surgical treatment of endometriosis. PATIENTS AND METHODS: All infertile patients aged 18 to 43 years old, operated between February 2004 and March 2008, with a minimal follow-up of 18 months, coming from the Auvergne cohort of endometriosis has been, were included. The primary end point was the achievement of a pregnancy. RESULTS: One hundred and twenty-three patients have been included. Global pregnancy rate was 48%, which 47% was spontaneous with a mean postoperative delay of 6±4.5 months. Sixty-three patients had benefited from Assisted Reproductive Technology (ART) and 25 pregnancies were obtained (pregnancy rate: 39.7% with a mean delay of 10±3.8 months). Eighty-one percent of spontaneous pregnancies were obtained during the first 12 postoperative months. Duration of preoperative infertility and tubal involvement were significantly associated with lower spontaneous pregnancy rate. No significant differences were found between endometriosis stage I and II compared to stage III and IV, and between patient under 34 years old compared to older. DISCUSSION AND CONCLUSION: With this first study on infertility from the Auvergne cohort of endometriosis, we are confirmed that surgery is one of the central issues in the treatment of infertile endometriosis patient. The postoperative delay to obtain a spontaneous pregnancy requires a quick management by ART after 6 to 12 postoperative month and an immediate management by ART in case of tubal involvement or former infertility.

11 Article Do patients manage to achieve pregnancy after a major complication of deeply infiltrating endometriosis resection? 2011

Kondo, William / Daraï, Emile / Yazbeck, Chadi / Panel, Pierre / Tamburro, Stefano / Dubuisson, Jean / Jardon, Kris / Mage, Gérard / Madelenat, Patrick / Canis, Michel. ·CHU de Clermont-Ferrand, Polyclinique de l'Hôtel Dieu, Clermont-Ferrand, France. williamkondo@yahoo.com ·Eur J Obstet Gynecol Reprod Biol · Pubmed #20970915.

ABSTRACT: OBJECTIVE: To evaluate the fertility status in women suffering from major postoperative complications following deep endometriosis surgery. STUDY DESIGN: A retrospective study in teaching and research hospitals (tertiary centers) including 23 women submitted to the surgical treatment for deep endometriosis and presenting a major postoperative complication. Postoperatively, women desiring pregnancy who conceived were compared to those who did not conceive using Mann-Whitney test and Fisher's exact test. Main outcome measure included the pregnancy rate among these women. RESULTS: The overall intrauterine pregnancy rate was 47.8% and the live birth rate was 30.4%. There were 10 spontaneous conceptions and 3 IVF conceptions among 11 patients. Women who did not conceive were older than those who conceived (33.9 vs. 29.3 years; p = 0.02). The pregnancy rate after intestinal complications was lower than after urinary complications (33.3% vs. 83.3%; p = 0.04). CONCLUSION: Fertility remains preserved among women experiencing a major complication after removal of deep endometriosis with a live birth rate of 30.4%. Women experiencing bowel complications have a reduced probability of conception compared with those who experience a urologic complication.

12 Article Impaired down-regulation of E-cadherin and beta-catenin protein expression in endometrial epithelial cells in the mid-secretory endometrium of infertile patients with endometriosis. 2010

Matsuzaki, Sachiko / Darcha, Claude / Maleysson, Elodie / Canis, Michel / Mage, Gérard. ·CHU Clermont-Ferrand, Polyclinique- Hôtel-Dieu, Gynécologie Obstétrique et Médecine de la Reproduction, Clermont-Ferrand, Boulevard Léon Malfreyt, 63058 Clermont-Ferrand, France. sachikoma@aol.com ·J Clin Endocrinol Metab · Pubmed #20410224.

ABSTRACT: CONTEXT: Only a few, small, human studies on E-cadherin and beta-catenin expression in normal cycling human endometrium have been reported. It remains unclear whether expression of these molecules might be altered in the endometrium of infertile patients with endometriosis. OBJECTIVES: The aim of the present study was to investigate E-cadherin and beta-catenin expression in the endometrium of infertile patients with endometriosis, those with uterine fibromas, and patients with unexplained infertility. DESIGN: Expression levels of E-cadherin and beta-catenin mRNA and/or protein in the endometrium of infertile patients with endometriosis (n = 151), those with uterine fibromas (n = 41), patients with unexplained infertility (n = 9), as well as healthy fertile controls (n = 57) were measured. This study utilized laser capture microdissection, real-time RT-PCR, and immunohistochemistry. RESULTS: No significant differences in E-cadherin or beta-catenin mRNA expression in microdissected epithelial cells were observed among the different groups throughout the menstrual cycle. However, very low or no protein expression of E-cadherin, total beta-catenin, or dephosphorylated beta-catenin in luminal and glandular epithelial cells was detected in the mid-secretory endometrium of healthy fertile controls. E-cadherin, total beta-catenin, and dephosphorylated beta-catenin protein expression in the mid-secretory endometrium of infertile patients with endometriosis or unexplained infertility was significantly higher compared to that of healthy fertile controls in both luminal and glandular epithelial cells. CONCLUSIONS: These findings suggest that impaired down-regulation of E-cadherin and beta-catenin protein expression, along with Wnt/beta-catenin signaling pathway activation during the window of implantation, might be one of the potential molecular mechanisms of infertility in patients with endometriosis.

13 Article HOXA-10 expression in the mid-secretory endometrium of infertile patients with either endometriosis, uterine fibromas or unexplained infertility. 2009

Matsuzaki, Sachiko / Canis, Michel / Darcha, Claude / Pouly, Jean-Luc / Mage, Gérard. ·CHU Clermont-Ferrand, Polyclinique-Hôtel-Dieu, Gynécologie Obstétrique et Médecine de la Reproduction, Boulevard Léon Malfreyt, 63058 Clermont-Ferrand, France. sachikoma@aol.com ·Hum Reprod · Pubmed #19736237.

ABSTRACT: BACKGROUND: The aim of this study was to investigate HOXA-10 expression in endometrium from infertile patients with different forms of endometriosis; with uterine fibromas, or with unexplained infertility and from normal fertile women. METHODS: Expression levels of HOXA-10 mRNA and protein in endometrium were measured during the mid-secretory phase. This study utilized laser capture microdissection, real-time RT-PCR and immunohistochemistry. RESULTS: HOXA-10 mRNA and protein expression levels in endometrial stromal cells were significantly lower in infertile patients with different types of endometriosis (deep infiltrating endometriosis, ovarian endometriosis and superficial peritoneal endometriosis), with uterine myoma, and unexplained infertility patients as compared with healthy fertile controls. HOXA-10 mRNA expression levels of microdissected glandular epithelial cells were significantly lower than those of microdissected stromal cells, without significant differences among the different groups. No protein expression was detected in glandular epithelial cells. The percentage of patients with altered protein expression of HOXA-10 in stromal cells were significantly higher in patients with only superficial peritoneal endometriosis (100%, 20/20, P < 0.05) compared with the other infertile groups (deep infiltrating endometriosis: 72.7%, 16/22; ovarian endometriosis: 70.0%, 14/20; uterine myoma: 68.8%, 11/16; unexplained infertility: 55.6%, 5/9). CONCLUSION: The present findings suggested that altered expression of HOXA-10 in endometrial stromal cells during the window of implantation may be one of the potential molecular mechanisms of infertility in infertile patients, particularly in patients with only superficial peritoneal endometriosis. One of the underlying causes of infertility in patients with only superficial endometriosis may be altered expression of HOXA-10 in endometrial stromal cells.