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Infertility: HELP
Articles by Guillaume Legendre
Based on 13 articles published since 2009
(Why 13 articles?)
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Between 2009 and 2019, G. Legendre 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 Review Surgical treatment of septate uterus in cases of primary infertility and before assisted reproductive technologies. 2018

Corroenne, R / Legendre, G / May-Panloup, P / El Hachem, H / Dreux, C / Jeanneteau, P / Boucret, L / Ferré-L'Hotellier, V / Descamps, P / Bouet, P-E. ·Department of Reproductive Medicine, Angers University Hospital, 4, rue Larrey, 49000 Angers, France. Electronic address: corroenne.romain@gmail.com. · Department of Reproductive Medicine, Angers University Hospital, 4, rue Larrey, 49000 Angers, France. · Department of Reproductive Medicine, Clemenceau Medical Center, Clemenceau Street, Beirut, Lebanon. ·J Gynecol Obstet Hum Reprod · Pubmed #30149207.

ABSTRACT: Septate uterus is the most common congenital uterine malformation in women with infertility. Several criteria are available for the definition of septate uteri, such as the one proposed by the European Society of Human Reproduction and Embryology (ESHRE)/European Society for Gynecological Endoscopy (ESGE) (ESHRE/ESGE), or by the American Society for Reproductive Medicine (ASRM), with notable differences between the two. Recently, a simplified classification was proposed by the Congenital Uterine Malformations Experts (CUME), where a septum is defined as an internal indentation depth≥10mm. To date, there is no consensus on the management of women with a septate uterus and infertility. We have performed an extensive literature appraisal and reviewed all the available international guidelines in order to propose a management strategy for infertile patients with a uterine septum. Hysteroscopic septum incision seems to improve natural conception rates in the year following surgery. Moreover, it improves in vitro fertilization (IVF) outcomes when performed before the embryo transfer, by improving embryo implantation rates. On the other hand, for patients with an arcuate uterus (indentation<1.5cm according to the ASRM guidelines) and infertility, it seems that assisted reproductive technologies are the most appropriate first line treatment. However, in cases of recurrent implantation failure or recurrent pregnancy loss following IVF, hysteroscopic section could be proposed. Overall, we recommend hysteroscopic septum incision for patients with primary infertility, and for patients undergoing assisted reproductive technologies.

3 Review [Comparison of fertiloscopy versus laparoscopy in the exploration of the infertility: analysis of the literature]. 2014

Braidy, C / Nazac, A / Legendre, G / Capmas, P / Fernandez, H. ·Service de gynécologie obstétrique, hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France. · Service de gynécologie obstétrique, hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; Inserm U1018, 82, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; Université Paris-Sud 11, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France. Electronic address: herve.fernandez@bct.aphp.fr. ·J Gynecol Obstet Biol Reprod (Paris) · Pubmed #24767305.

ABSTRACT: BACKGROUND: Fertiloscopy is a recent technique designed to explore the tubo-ovarian axis in unexplained infertility. It is a simple outpatient technique, allowing to perform operative procedures, but its position relative to laparoscopy is yet to be defined. MATERIAL AND METHODS: A thorough and extensive bibliographical search was undertaken to fully embrace the question, challenging Medline at the National Library of Medicine, Cochrane Library, National Guideline Clearinghouse, Health Technology Assessment Database. All the retrieved articles were classified as either descriptive or comparative studies and evaluated on a set of criteria. RESULTS: Most of the papers described case series coming from a few teams, focusing mainly on the technical aspect of the procedure, like the access rate to the posterior cul-de-sac, the success rate in visualizing the pelvis, the complications rate (mainly rectal perforation), and its operative performance in drilling ovaries for resistant polycystic ovarian syndrome. Comparative studies numbered six trials. They all followed the same design, fertiloscopy preceding conventional laparoscopy in patients taken as their own control. The concordance rate between the two modalities reaches 80% in terms of tubal pathology, adherences and endometriosis, with an estimated reduction of laparoscopies varying from 40% to 93%. CONCLUSION: The current literature shows a concordance between fertiloscopy and conventional laparoscopic findings for certain parameters in cases of tubal pathology, adherences and endometriosis. The relative positions of these two modalities in unexplained infertility still remain elusive.

4 Review Relationship between ovarian cysts and infertility: what surgery and when? 2014

Legendre, Guillaume / Catala, Laurent / Morinière, Catherine / Lacoeuille, Céline / Boussion, Françoise / Sentilhes, Loïc / Descamps, Philippe. ·Service de Gynécologie-Obstétrique, Centre Hospitalier Universitaire d'Angers, Angers, France. Electronic address: g_legendre@hotmail.com. · Service de Gynécologie-Obstétrique, Centre Hospitalier Universitaire d'Angers, Angers, France. ·Fertil Steril · Pubmed #24559614.

ABSTRACT: The relationship between ovarian cysts and infertility is a subject of debate, mainly because it is difficult to determine the real impact of the cyst and its treatment on later fertility. For a long time it was hoped that surgical treatment could prevent potential complications (such as rupture or malignancy). For presumed benign ovarian tumors, fertility sparing should be the main concern. The goal of this survey of current knowledge on the subject is to thoroughly explore the potential relationship between cysts, their treatment, and infertility. Our study is based on a review of the literature dealing with the epidemiology of ovarian cysts and the effects of their surgical management in relation to infertility. Analysis of the epidemiologic data, drawn mainly from comparative studies and cohorts, shows that the role of cysts in infertility is controversial and that the effects of surgical treatment are often more harmful than the cyst itself to the ovarian reserve. Surgery does not seem to improve pregnancy rates. When a surgical option is nonetheless chosen, a conservative laparoscopic approach is more suitable. Besides excision, sclerotherapy and plasma vaporization are promising, offering a greater preservation of the ovarian parenchyma, especially in endometriomas. These techniques must be better defined. The context of the infertility is essential, and surgeons and specialists in reproductive medicine should decide management jointly.

5 Review [The place of myomectomy in woman of reproductive age]. 2011

Legendre, G / Brun, J-L / Fernandez, H. ·Département de gynécologie-obstétrique, hôpital universitaire du Kremlin-Bicêtre, 78, avenue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France. g_legendre@hotmail.com ·J Gynecol Obstet Biol Reprod (Paris) · Pubmed #22056179.

ABSTRACT: OBJECTIVE: To define the involvement of myomas and myomectomy in all stages from conception to post-partum in women of reproductive age. MATERIALS AND METHODS: A literature review was conducted using the Medline and Cochrane databases to March 2011 by matching the keywords "fertility, infertility, miscarriage, pregnancy, delivery" with "myomas, fibroids, myomectomy". RESULTS: An association between myomas and fertility has been observed but the responsibility fibroids in infertility remains unclear. Myomas are associated with an increased rate of obstetric complications. Adhesions are the main complication of myomectomy. Endoscopic procedures and the use of anti-adhesive barriers prevent adhesion formation. Pregnancy rate in cases of myomectomy by laparotomy and laparoscopy is similar. Myomectomy during pregnancy is exceptionally indicated. CONCLUSION: The discovery of a uterine myoma needs to consider the responsibility of myomas in infertility, but also its impact on a future pregnancy. The therapeutic management is based on myomectomy but expected benefits must be weighed with potential risks.

6 Article Timing therapeutic donor inseminations in natural cycles: human chorionic gonadotrophin administration versus urinary LH monitoring. 2017

El Hachem, Hady / Antaki, Roland / Sylvestre, Camille / Lapensée, Louise / Legendre, Guillaume / Bouet, Pierre Emmanuel. ·Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada; Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada. Electronic address: hadyhachem@hotmail.com. · Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada; Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada. · Department of Obstetrics and Gynecology, Angers University Hospital, Angers, France. · Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada; Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada; Department of Obstetrics and Gynecology, Angers University Hospital, Angers, France. ·Reprod Biomed Online · Pubmed #28571651.

ABSTRACT: This cohort study assessed whether timing therapeutic donor sperm inseminations (TDI) in natural cycles (NC) using ultrasound monitoring and ovulation trigger with human chorionic gonadotrophin (US/HCG) improves cumulative live birth rates (LBR) compared with detection of LH surge with urinary kits (u-LH). It included 232 normo-ovulatory women aged ≤40 years, undergoing 538 TDI in NC between 2011 and 2014. In the u-LH group (113 women, 267 cycles), TDI was performed the day following a positive test. In the US/HCG group (119 women, 271 cycles), ovulation was triggered with HCG when a follicle ≥17 mm was noted, and TDI performed 36 h later. The first three cycles were analysed per patient. Groups were comparable for baseline characteristics. Cumulative LBR were comparable between u-LH and US/HCG groups (31.47% versus 23.11%, respectively) (log-rank test). A generalized estimating equation analysis was performed to compare outcomes per cycle. The LBR per started cycle was comparable between the u-LH and US/HCG groups (12.4% versus 9.2%, respectively). Cancellation rate was significantly higher with u-LH (19.1% versus 11.4%, P = 0.011), but did not impact overall outcomes. In conclusion, urinary LH monitoring is as effective as ultrasound monitoring and ovulation trigger with HCG in TDI performed in NC.

7 Article Hysteroscopic resection of type 3 myoma: a new challenge? 2016

Capmas, Perrine / Voulgaropoulos, Audrey / Legendre, Guillaume / Pourcelot, Anne-Gaelle / Fernandez, Hervé. ·Service de Gynécologie Obstétrique, Hôpital Bicêtre, GHU Sud, AP-HP, F-94276 Le Kremlin Bicêtre, France; Inserm, Centre of Research in Epidemiology and Population Health (CESP), U1018, F-94276 Le Kremlin Bicêtre, France. Electronic address: perrine.capmas@aphp.fr. · Service de Gynécologie Obstétrique, Hôpital Bicêtre, GHU Sud, AP-HP, F-94276 Le Kremlin Bicêtre, France. · Service de Gynécologie Obstétrique, Hôpital Bicêtre, GHU Sud, AP-HP, F-94276 Le Kremlin Bicêtre, France; Faculty of Medicine, Univ Paris Sud, F-94276 Le Kremlin Bicêtre, France. · Service de Gynécologie Obstétrique, Hôpital Bicêtre, GHU Sud, AP-HP, F-94276 Le Kremlin Bicêtre, France; Inserm, Centre of Research in Epidemiology and Population Health (CESP), U1018, F-94276 Le Kremlin Bicêtre, France; Faculty of Medicine, Univ Paris Sud, F-94276 Le Kremlin Bicêtre, France. ·Eur J Obstet Gynecol Reprod Biol · Pubmed #27607740.

ABSTRACT: OBJECTIVE: Type 3 myomas are intramural within contact with the endometrium but lack any cavity deformation. There is no guideline for management of symptomatic type 3 myoma. The aim of this study was to evaluate the feasibility of symptomatic type 3 myoma hysteroscopic resection. METHOD: This retrospective study included symptomatic women (mainly pain, infertility or bleeding) who obtained an operative hysteroscopy for type 3 symptomatic myoma from June 2010 to December 2014 in the gynaecological unit of a teaching hospital. RESULT: Thirteen women with an operative resection using bipolar electrosurgery of type 3 myoma during the study period (June 2010 to December 2014) were included in the study. Two women had a hysterectomy 6 and 12 months after the procedure and one woman had an open myomectomy 30 months after the procedure for the recurrence of abnormal bleeding. Postoperative office hysteroscopy show a postoperative synechiae in 3 women out of 8. Incomplete resection was also obtained in 3 women out of 8. CONCLUSION: Hysteroscopic resection is a potential alternative to traditional surgery for type 3 myoma. This procedure must be confined to skilled surgeons because it is a difficult procedure. A postoperative office hysteroscopy is recommended in women of reproductive age.

8 Article Maternal outcomes after uterine balloon tamponade for postpartum hemorrhage. 2015

Martin, Emmanuelle / Legendre, Guillaume / Bouet, Pierre-Emmanuel / Cheve, Marie-Therese / Multon, Olivier / Sentilhes, Loïc. ·Department of Obstetrics and Gynecology, Angers University Hospital, Angers, France. ·Acta Obstet Gynecol Scand · Pubmed #25604036.

ABSTRACT: OBJECTIVE: To evaluate maternal outcomes following uterine balloon tamponade in the management of postpartum hemorrhage. DESIGN: Retrospective case-series. SETTING: Two French hospitals, a level 3 university referral center and a level 2 private hospital. POPULATION: All women who underwent balloon tamponade treatment for primary postpartum hemorrhage. METHODS: Uterine tamponade was used after standard treatment of postpartum hemorrhage had failed. The study population was divided into two groups, successful cases where the bleeding stopped after the balloon tamponade, and failures requiring subsequent surgery or embolization. MAIN OUTCOME MEASURES: Success rates. RESULTS: Uterine tamponade was used in 49 women: 30 (61%) after vaginal delivery and 19 (39%) after cesarean section. Uterine atony was the main cause of hemorrhage (86%). The overall success rate was 65%. Of 17 failures, surgery was required in 16 cases, including hysterectomy in 11, and uterine artery embolization in one case. Demographic and obstetric characteristics did not differ significantly between the success and failure groups. No complications were directly attributed to the balloon tamponade in the postpartum period. Two women had a subsequent full-term pregnancy without recurrence of postpartum hemorrhage. CONCLUSIONS: Balloon tamponade is an effective, safe and readily available method for treating primary postpartum hemorrhage and could reduce the need for invasive procedures.

9 Article [Adiana(®) hysteroscopic tubal occlusion device for the treatment of hydrosalpinx prior to in vitro fertilization: a case report]. 2013

Legendre, G / Gallot, V / Levaillant, J-M / Capmas, P / Fernandez, H. ·Service de gynécologie-obstétrique, hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, 78, rue Général-Leclerc, 94275 Le Kremlin-Bicêtre, France. guillaume.legendre@bct.aphp.fr ·J Gynecol Obstet Biol Reprod (Paris) · Pubmed #23597488.

ABSTRACT: This case report outlines a successful pregnancy after proximal occlusion of a fallopian tube with Adiana(®) micro-insert in a patient with hydrosalpinx. A 32-year-old nulligravid patient with pelvic adhesive disease and unilateral hydrosalpinx underwent a successful occlusion of the hydrosalpinx by Adiana(®) matrix with a pregnancy after IVF cycle. Adiana(®) hysteroscopic tubal occlusion device can be used prior to IVF and seems to be an alternative to Essure(®) procedure. The theoretical advantage of Adiana(®) is the ability to maintain a uterine cavity free of all foreign matter.

10 Article [Myomectomy]. 2013

Brun, Jean-Luc / Legendre, Guillaume / Bendifallah, Sofiane / Fernandez, Hervé. ·Hôpital Pellegrin, centre Aliénor d'Aquitaine, pôle d'obstétrique reproduction gynécologie, 33076 Bordeaux, France. jean-luc.brun@chu-bordeaux.fr ·Presse Med · Pubmed #23582900.

ABSTRACT: Myomas induce menorrhagia and pelvic pain, and increase the risk of infertility and obstetrical complications. Symptomatic sub-mucosal myomas are classically treated by hysteroscopic resection. Symptomatic interstitial and sub-serosal myomas may be treated by myomectomy, either by laparotomy or laparoscopy according to their number and size. Prophylactic myomectomy is not recommended to prevent from obstetrical complications or the risk of leiomyosarcoma. Although all myomas have a negative effect on fertility, the removal of sub-mucosal myomas is the sole recommendation to improve spontaneous fertility or assisted reproduction technology.

11 Article Metroplasty for AFS Class V and VI septate uterus in patients with infertility or miscarriage: reproductive outcomes study. 2013

Bendifallah, Sofiane / Faivre, Erika / Legendre, Guillaume / Deffieux, Xavier / Fernandez, Hervé. ·Assistance Publique Hôpitaux de Paris, Department of Obstetrics and Gynaecology, Hôpital Bicêtre, Le Kremlin Bicêtre, France. ·J Minim Invasive Gynecol · Pubmed #23317507.

ABSTRACT: STUDY OBJECTIVE: To assess reproductive outcomes in patients after surgical correction of septate uterus. DESIGN: Observational retrospective study (Canadian Task Force classification II-2). SETTING: Two university hospitals. PATIENTS: One hundred twenty-eight patients with primary infertility or recurrent miscarriage with partial (American Fertility Society [AFS] class Va), complete (AFS class Vb), or fundic (AFS class VI) septate uterus. Metroplasty is the current method of choice for surgically correcting septate uterus. The procedure and its indications are a matter of debate. INTERVENTIONS: Metroplasty via hysteroscopy. MEASUREMENTS AND MAIN RESULTS: Outcomes including the numbers of pregnancies, first live births (FLBs), and miscarriages were determined. After metroplasty, 78 women (60.9%) became pregnant, and 70 live neonates were delivered. The FLB rate in infertile women was 53.1%. Of the 25 pregnancies, 13 (52%) resulted from assisted reproductive technology. In women who experienced recurrent miscarriage, the miscarriage rate was significantly improved. Outcomes (miscarriages and FLBs) differed significantly according to anatomical type of septum after surgery. CONCLUSION: Hysteroscopic septum resection is accompanied by safe improvement in reproductive performance in patients with symptoms of AFS class V/VI septate uterus.

12 Article [What to do with sub-mucosal type 2 myomas in the infertile woman?]. 2012

Legendre, G / Fallet, C. ·Hôpital de Bicêtre, 78 rue du Général Leclerc, 94275 Le Kremlin Bicêtre cedex, France. ·J Gynecol Obstet Biol Reprod (Paris) · Pubmed #22445168.

ABSTRACT: -- No abstract --

13 Article [Fertility after ectopic pregnancy]. 2010

Desroque, D / Capmas, P / Legendre, G / Bouyer, J / Fernandez, H. ·Service de gynécologie obstétrique, hôpital Bicêtre, 78, rue du Général-Leclerc, 94275 le Kremlin-Bicêtre, France. ·J Gynecol Obstet Biol Reprod (Paris) · Pubmed #20478667.

ABSTRACT: BACKGROUND: The subsequent fertility of women who had experienced ectopic pregnancy (EP) is the best criteria of the effectiveness of the treatment. In the absence of randomised trials comparing laparotomy, laparoscopy, medical treatment by methotrexate (MTX) and expectative, the only way to compare treatments is to make use of data from observational studies. METHODS: The databases consulted were Medline, Cochrane Library, National Guideline Clearinghouse and Health Technology Assessment Database. Keywords used for research: fertility; ectopic pregnancy; expectative; methotrexate; salpingectomy; salpingotomy. RESULTS: Twenty-four papers of randomised control trial (RCT) or observational studies were analysed. No difference between laparotomy and laparoscopy for fertility was found. Tubal suture does not modify the subsequent fertility. The risk of normal pregnancy or ectopic recurrence is similar between salpingotomy or salpingectomy when controlateral tube is normal. Conversely, in case of altered tube, the fertility appears higher after conservative treatment. Between conservative treatments, surgical or medical, no difference appears. CONCLUSIONS: Conservative surgical treatment is the gold standard. However, the fertility seems similar with the other treatments. Three ongoing RCT could answer to the three main questions: Which is the best fertility between medical and conservative surgical treatment? Which is the best fertility between radical and conservative surgical treatment? Which is the best fertility between MTX and expectative?