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Infertility: HELP
Articles by Christophe Poncelet
Based on 25 articles published since 2008
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Between 2008 and 2019, C. Poncelet wrote the following 25 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 [Deeply infiltrating endometriosis and infertility: CNGOF-HAS Endometriosis Guidelines]. 2018

Mathieu d'Argent, E / Cohen, J / Chauffour, C / Pouly, J L / Boujenah, J / Poncelet, C / Decanter, C / Santulli, P. ·Service de gynécologie obstétrique et médecine de la reproduction, GRC6-UPMC, centre expert en endométriose (C3E), université Pierre-et-Marie-Curie Paris 6, hôpital Tenon, CHU de Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France. Electronic address: emmanuelle.mathieu@aphp.fr. · Service de gynécologie obstétrique et médecine de la reproduction, GRC6-UPMC, centre expert en endométriose (C3E), université Pierre-et-Marie-Curie Paris 6, hôpital Tenon, CHU de Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France. · Service de gynécologie obstétrique et reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France. · Service de gynécologie obstétrique, CHU de 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 Renée-Dubos, 6, avenue de l'Île-de-France, 95300 Pontoise, France; UFR SMBH, université Paris 13, Sorbonne Paris-Cité, 93022 Bobigny, France. · EA 4308 Gamétogenèse et qualité du gamète, 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. · Service de chirurgie gynécologie obstétrique 2 et médecine de la reproduction, CHU de Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Inserm U1016, équipe génomique, épigénétique 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 #29544710.

ABSTRACT: Deeply infiltrating endometriosis is a severe form of the disease, defined by endometriotic tissue peritoneal infiltration. The disease may involve the rectovaginal septum, uterosacral ligaments, digestive tract or bladder. Deeply infiltrating endometriosis is responsible for disabling pain and infertility. The purpose of these recommendations is to answer the following question: in case of deeply infiltrating endometriosis associated infertility, what is the best therapeutic strategy? First-line surgery and then in vitro fertilization (IVF) in case of persistent infertility or first-line IVF, without surgery? After exhaustive literature analysis, we suggest the following recommendations: studies focusing on spontaneous fertility of infertile patients with deeply infiltrating endometriosis found spontaneous pregnancy rates about 10%. Treatment should be considered in infertile women with deeply infiltrating endometriosis when they wish to conceive. First-line IVF is a good option in case of no operated deeply infiltrating endometriosis associated infertility. Pregnancy rates (spontaneous and following assisted reproductive techniques) after surgery (deep lesions without colorectal involvement) varie from 40 to 85%. After colorectal endometriosis resection, pregnancy rates vary from 47 to 59%. The studies comparing the pregnancy rates after IVF, whether or not preceded by surgery, are contradictory and do not allow, to date, to conclude on the interest of any surgical management of deep lesions before IVF. In case of alteration of ovarian reserve parameters (age, AMH, antral follicle count), there is no argument to recommend first-line surgery or IVF. The study of the literature does not identify any prognostic factors, allowing to chose between surgical management or IVF. The use of IVF in the indication "deep infiltrating endometriosis" allows satisfactory pregnancy rates without significant risk, regarding disease progression or oocyte retrieval procedure morbidity.

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 [The Endometriosis Fertility Index (EFI) is simple to use]. 2016

Boujenah, J / Poncelet, C / Madelenat, P. ·Pôle femme et enfant, groupe hospitalier universitaire Paris Seine-Saint-Denis, site Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; UFR SMBH, université Paris 13, Sorbonne Paris-Cité, 93000 Bobigny, France. Electronic address: jeremy.boujenah@gmail.com. · Pôle femme et enfant, groupe hospitalier universitaire Paris Seine-Saint-Denis, site Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; UFR SMBH, université Paris 13, Sorbonne Paris-Cité, 93000 Bobigny, France. · 5, avenue Émile-Deschnanel, 75007 Paris, France. ·Gynecol Obstet Fertil · Pubmed #27133917.

ABSTRACT: -- No abstract --

5 Article Use of the endometriosis fertility index in daily practice: A prospective evaluation. 2017

Boujenah, J / Cedrin-Durnerin, I / Herbemont, C / Bricou, A / Sifer, C / Poncelet, C. ·Department of Obstetrics, Gynaecology and Assisted Reproductive Technologies Centre, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France; Université Paris 13, Sorbonne Paris Cité, Bobigny, France. Electronic address: jeremy.boujenah@gmail.com. · Department of Obstetrics, Gynaecology and Assisted Reproductive Technologies Centre, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France. · Department of Obstetrics, Gynaecology and Assisted Reproductive Technologies Centre, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France; Université Paris 13, Sorbonne Paris Cité, Bobigny, France. ·Eur J Obstet Gynecol Reprod Biol · Pubmed #29035799.

ABSTRACT: OBJECTIVE: To perform a prospective evaluation of postoperative fertility management using the endometriosis fertility index (EFI). STUDY: This prospective non-interventional observational study was performed from January 2013 to February 2016 in a tertiary care university hospital and an assisted reproductive technology (ART) centre. In total, 196 patients underwent laparoscopic surgery for endometriosis-related infertility. Indications for surgery included pelvic pain (dysmenorrhoea, and/or deep dyspareunia), abnormal hysterosalpingogram, and failure to conceive after three or more superovulation cycles with or without intra-uterine insemination. Multidisciplinary fertility management followed the surgical diagnosis and treatment of endometriosis. Three postoperative options were proposed to couples based on the EFI score: EFI score ≤4, ART (Option 1); EFI score 5-6, non-ART management for 4-6 months followed by ART (Option 2); or EFI score ≥7, non-ART management for 6-9 months followed by ART (Option 3). The main outcomes were non-ART pregnancy rates and cumulative pregnancy rates according to EFI score. Univariate and multivariate analyses with backward stepwise logistic regression were used to explain the occurrence of non-ART pregnancy after surgery for women with EFI scores ≥5. Adjustment was made for potential confounding variables that were significant (p<0.05) or tending towards significance (p<0.1) on univariate analysis. RESULTS: The cumulative pregnancy rate was 76%. The total number of women and pregnancy rates for Options 1, 2 and 3 were: 26 and 42.3%; 56 and 67.9%; and 114 and 87.7%, respectively. The non-ART pregnancy rates for Options 1, 2 and 3 were 0%, 30.5% and 48.2%, respectively. The ART pregnancy rates for Options 1, 2 and 3 were 50%, 60.6% and 80.3%, respectively. The mean time to conceive for non-ART pregnancies was 4.2 months. The benefit of ART was inversely correlated with the mean EFI score. On multivariate analysis, the EFI score was significantly associated with non-ART pregnancy (odds ratio 1.629, 95% confidence interval 1.235-2.150). CONCLUSION: In daily prospective practice, the EFI was useful for subsequent postoperative fertility management in infertile patients with endometriosis.

6 Article Non-ART pregnancy predictive factors in infertile patients with peritoneal superficial endometriosis. 2017

Boujenah, J / Cedrin-Durnerin, I / Herbemont, C / Sifer, C / Poncelet, C. ·Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Avenue du 14 Juillet, 93340 Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, 93000 Bobigny, France. Electronic address: jeremy.boujenah@gmail.com. · Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Avenue du 14 Juillet, 93340 Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, 93000 Bobigny, France. Electronic address: isabelle.cedrdin-durnerin@aphp.fr. · Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Avenue du 14 Juillet, 93340 Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, 93000 Bobigny, France. Electronic address: Charlene.Herbemont@aphp.fr. · Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Avenue du 14 Juillet, 93340 Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, 93000 Bobigny, France. Electronic address: christophe.sifer@aphp.fr. · Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Avenue du 14 Juillet, 93340 Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, 93000 Bobigny, France. Electronic address: christophe.poncelet@ch-pontoise.fr. ·Eur J Obstet Gynecol Reprod Biol · Pubmed #28288431.

ABSTRACT: OBJECTIVE: To study the predictive factors for non-ART pregnancy in infertile women after laparoscopic diagnosis and surgery for isolated superficial peritoneal endometriosis (SUP). STUDY DESIGN: Retrospective observational study from January-2004 to December-2015 in a tertiary care university hospital and Assisted Reproductive Technology (ART) centre. Infertile women with laparoscopic surgery for SUP (with histologic diagnosis) were included. The surgical treatment was followed by spontaneous fertility or post-operative ovarian stimulation (pOS) using superovulation (gonadotrophins)±Intra Uterine Insemination (IUI). The main outcomes were the non-ART clinical pregnancy rates and its predictive factors. RESULT(S): Over the period study, 315 women were included. Of these, 133 (42.3%) women had non-ART pregnancy. The mean time to conceive was 6 months (±6days). Univariate analysis for non-ART pregnancy after surgery showed that: (i) no difference was observed according to age, length of infertility, Body Mass Index (BMI), the rate of previous pregnancy, and the pre-operative ovarian stimulation rate; (ii) diminished ovarian reserve and previous miscarriage were higher in the non-pregnant women group (8.3 versus 19.1%, p<0.05; 3.5% versus 9%, p=0.06, respectively); (iii) the mean EFI score and pOS were higher in pregnant women (7.7 versus 7.2, p=0.02; 49.2% versus 26.7%, p<0.01); and (iv) IUI did not show any benefit for pregnancy (22% after superovulation versus 27.2% after superovulation and IUI). In the multivariate analysis, only pOS (adjusted OR 2.504, 95% CI [1.537-4.077]) and DOR (aOR 0.420, 95% CI [0.198-0.891]) remained significantly associated with the incidence of pregnancy. CONCLUSION(S): After laparoscopic surgery for peritoneal superficial endometriosis related infertility, ovarian stimulation improved pregnancy rate, while diminished ovarian reserve had a worse prognosis for pregnancy.

7 Article Endometriosis and uterine malformations: infertility may increase severity of endometriosis. 2017

Boujenah, Jeremy / Salakos, Eleonora / Pinto, Mélodie / Shore, Joanna / Sifer, Christophe / Poncelet, Christophe / Bricou, Alexandre. ·Department of Obstetrics, Gynecology and Reproductive Medecine, University Hospitals Paris Seine-Saint-Denis, Public Assistance Hospitals Paris, CHU Jean Verdier, Bondy, France. · University Paris 13, Sorbonne Paris City, UFR SMBH, Bobigny, France. ·Acta Obstet Gynecol Scand · Pubmed #27861710.

ABSTRACT: INTRODUCTION: The aim of our study was to compare the stage and severity of endometriosis in fertile and infertile women with congenital uterine malformations. MATERIAL AND METHODS: We performed an observational study from September 2007 to December 2015 in a tertiary care university hospital and assisted reproductive technology center. A total of 52 patients with surgically proven uterine malformations were included. We compared 41 infertile patients with uterine malformations with 11 fertile patients with uterine malformation. The main outcome was the stage, score and type of endometriosis in regard to infertility and class of uterine malformation. RESULTS: The rate of endometriosis did not differ between the two groups (43.9 vs. 36.4%). The mean revised American Fertility Society score was higher in infertile patients with uterine malformations (19.02 vs. 6, p < 0.05). No significant difference was found in the rate of superficial peritoneal endometriosis (43.9 vs. 37.5%). Endometrioma and deep infiltrating endometriosis were associated with uterine malformations in infertile women, respectively 14.6 and 0%. No difference in the characteristics of endometriosis was found regarding the class of malformation. CONCLUSIONS: The association of uterine malformations and infertility may increase the severity of endometriosis and raise the issue of their diagnosis and management.

8 Article Second live birth after undergoing assisted reproductive technology in women operated on for endometriosis. 2016

Boujenah, Jérémy / Hugues, Jean-Noel / Sifer, Christophe / Cedrin-Durnerin, Isabelle / Bricou, Alexandre / Poncelet, Christophe. ·Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France. Electronic address: jeremy.boujenah@gmail.com. · Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France. · Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France; Reproductive Biology, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France. ·Fertil Steril · Pubmed #26493118.

ABSTRACT: OBJECTIVE: To determine prognostic factors for a second live birth, after a first child obtained through assisted reproductive techniques (ART). DESIGN: Observational study from January 2004 to December 2014. SETTING: Tertiary care university hospital and ART center. PATIENT(S): A total of 164 infertile patients with endometriosis, who underwent laparoscopy surgery and had a first baby obtained by ART, were included and 65 wished a second baby. INTERVENTION(S): No iterative surgery. MAIN OUTCOME MEASURE(S): Spontaneous pregnancy rate (PR) according to endometriosis fertility index. RESULT(S): Among the cohort, 27 patients (41.5%) gave birth to a second child through spontaneous pregnancy, whereas 23 patients (35.3%) required ART to obtain a second live birth. No difference was observed between patients regarding age, endometriosis staging, complete removal of endometriosis lesions and pelvic adhesion, except for the least function score, and the endometriosis fertility index. Taking into account irrespective of both mode of conception a total of 78% of patients obtained a second child, with a median conception time of 17 months. CONCLUSION(S): The second live birth rate in infertile patients with endometriosis and with surgical treatment was high (78%). Spontaneous PR was 54%. Endometriosis fertility index could be considered as a predictive factor for a spontaneous second pregnancy in fertility management. Our results need to be confirmed in larger prospective studies.

9 Article [Endometriosis Fertility Index, or classification of the American Society of Reproductive Medicine for postoperative endometriosis patients with infertility: Which is more relevant?]. 2015

Boujenah, J / Hugues, J N / Sifer, C / Bricou, A / Cédrin-Durnerin, I / Sonigo, C / Monforte, M / Poncelet, C. ·Pôle femme et enfant, groupe hospitalier universitaire Paris Seine Saint-Denis, site Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; Université Paris 13, Sorbonne Paris cité, UFR SMBH, 93000 Bobigny, France. Electronic address: jeremy.boujenah@gmail.com. · Pôle femme et enfant, groupe hospitalier universitaire Paris Seine Saint-Denis, site Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; Université Paris 13, Sorbonne Paris cité, UFR SMBH, 93000 Bobigny, France. · Service de biologie de la reproduction et du développement, groupe hospitalier universitaire Paris Seine Saint-Denis, site Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; Université Paris 13, Sorbonne Paris cité, UFR SMBH, 93000 Bobigny, France. ·Gynecol Obstet Fertil · Pubmed #26597487.

ABSTRACT: The revised American Fertility Society classification system has been most used after surgery by all consensus on endometriosis fertility. However, it does not predict pregnancy. The EFI score has been recently developed to aim at predicting clinical pregnancy after surgery. Several study performed its external validation. It may be a useful new tool to counsel couples for personalized postoperative management.

10 Article [Laparoscopy in ART?]. 2015

Boujenah, J / Montforte, M / Hugues, J N / Sifer, C / Poncelet, C. ·Pôle Femme et Enfant, groupe hospitalier universitaire Paris Seine-Saint-Denis, site Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, 93000 Bobigny, France. ·Gynecol Obstet Fertil · Pubmed #26297160.

ABSTRACT: The use of laparoscopy in infertility is currently controversial. However, laparoscopic treatment of tubal and peritoneal disease, or endometriosis improves natural fecundity and ART results. The use of laparoscopy in unexplained infertility can be considered because of underestimated pelvic pathology. The result of laparoscopy may help the practitioner for choosing spontaneous pregnancy or ART postoperative management. Although there is a lack of randomized study, laparoscopy is useful for a high overall pregnancy rate (surgery and ART treatment). Rather than opposing ART and laparoscopy, the integrated approach seems better for personal management.

11 Article External validation of the Endometriosis Fertility Index in a French population. 2015

Boujenah, Jeremy / Bonneau, Claire / Hugues, Jean-Noel / Sifer, Christophe / Poncelet, Christophe. ·Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France. Electronic address: jeremy.boujenah@gmail.com. · Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France. · Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France. · Reproductive Biology, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France. ·Fertil Steril · Pubmed #25935492.

ABSTRACT: OBJECTIVE: To show an external validation of the Endometriosis Fertility Index (EFI) and to observe cumulated pregnancy rates after infertility management combining surgery and assisted reproductive technologies (ART). DESIGN: Observational study from January 2004 to December 2012. SETTING: Tertiary-care university hospital and ART center. PATIENT(S): Four hundred twelve infertile and endometriotic patients after laparoscopic surgery. INTERVENTION(S): Surgical diagnosis and treatment followed by spontaneous fertility or ART management. MAIN OUTCOME MEASURE(S): Spontaneous pregnancy rates and cumulative (spontaneous and ART) pregnancy rates according to the EFI. RESULT(S): A significant relationship between EFI and spontaneous pregnancy rates was observed at 12 months (P=.001). The least function score and complete removal of endometriotic lesions and pelvic adhesions were significantly associated with spontaneous pregnancy (P=.006). Cumulative pregnancy rate at 18 months was 78.8%. ART benefits for pregnancy rates were higher for patients with poor EFI. CONCLUSION(S): External validation of the EFI in a French population was demonstrated. Combining surgery for endometriosis and ART led to a 78.8% pregnancy rate at 18 months after surgery.

12 Article Stress Experienced by Obstetrics and Gynecology Residents during Planned Laparoscopy: A Prospective, Multicentric, Observational, Blinded, and Comparative Study. 2015

Ducarme, Guillaume / Bricou, Alexandre / Chanelles, Olivier / Sifer, Christophe / Poncelet, Christophe. ·Department of Obstetrics and Gynecology, University Hospital Jean Verdier, AP-HP, Bondy, France. ·Gynecol Obstet Invest · Pubmed #25765973.

ABSTRACT: AIMS: To describe heart rate (HR) variations in surgical residents during laparoscopy and to assess their intraoperative stress. METHODS: We performed a prospective, multicentric, observational, blinded, and comparative analysis of the HR in 75 obstetrics and gynecology residents during planned laparoscopy for infertility in five teaching hospitals with assisted reproductive technology centers. The surgical residents had neither heart disease nor were under medical treatment or using tobacco or drugs. We describe HR variations at 9 preselected operative steps using real-time noninvasive measures of the HR during laparoscopy. RESULTS: Residents performed 124 laparoscopies for unexplained infertility. Their HR increased significantly during the introduction of the Palmer needle, umbilical port and second port, and during abdominopelvic exploration and dye test compared to the baseline HR, the HR after hand washing, at the end of surgery and during skin suture (91.6 ± 1.9, 104.8 ± 2.3, 95.3 ± 2.2, 93.7 ± 2.5, 90.7 ± 1.7 vs. 83.2 ± 1.6, 88.6 ± 1.9, 87.4 ± 2.1, 88.2 ± 1.9 bpm, respectively, p < 0.02). CONCLUSION: Our results point to a potential stress for the surgeon assessed by HR variations during planned laparoscopy compared to the baseline HR before surgery. This 'static' stress can be repeated on the same day.

13 Article Clinical predictive criteria associated with live birth following elective single embryo transfer. 2014

Sifer, Christophe / Herbemont, Charlène / Adda-Herzog, Elodie / Sermondade, Nathalie / Dupont, Charlotte / Cedrin-Durnerin, Isabelle / Poncelet, Christophe / Levy, Rachel / Grynberg, Michael / Hugues, Jean-Noël. ·Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, Avenue du 14 Juillet, 93140 Bondy, France; Université Paris 13, Sorbonne Paris Cité, Unité de Recherche en Epidémiologie Nutritionnelle, UMR U557 Inserm, U1125 Inra, Cnam, CRNH IdF, 93017 Bobigny, France. Electronic address: christophe.sifer@jvr.aphp.fr. · Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, Avenue du 14 Juillet, 93140 Bondy, France. · Service de Médecine de la Reproduction, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, Avenue du 14 Juillet, 9340 Bondy, France. · Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, Avenue du 14 Juillet, 93140 Bondy, France; Université Paris 13, Sorbonne Paris Cité, Unité de Recherche en Epidémiologie Nutritionnelle, UMR U557 Inserm, U1125 Inra, Cnam, CRNH IdF, 93017 Bobigny, France. ·Eur J Obstet Gynecol Reprod Biol · Pubmed #25171268.

ABSTRACT: OBJECTIVE: We aimed to define clinical criteria from the patients related to the occurrence of live birth in case of elective single embryo transfer (eSET). STUDY DESIGN: We analyzed retrospectively 409 eSET at day 2/3 between March 2005 and July 2012, proposed in case of (i) woman's age <37 years, (ii) first/second IVF0 cycle, (iii) ≥2 good quality embryos obtained (3-5/6-10 blastomeres at day 2/3 and <20% fragmentation), including one top embryo (4/8 cells). In all, 124/409 live births (30.3%) were obtained, separating patients into groups of women who had birth or not. Different clinical parameters of interest were compared between each group, using appropriate statistical tests at p<0.05 significance level. RESULTS: By comparing Body Mass Index (BMI), we report a statistically higher BMI among women who did not deliver (24.6 vs. 23.4kg/m(2); p=0.014). Using an analysis by BMI categories, we also precise a threshold of BMI≥30kg/m(2), negatively associated with the occurrence of live birth. CONCLUSION: BMI appears to be the only clinical parameter statistically associated with delivery following eSET strategy in a good prognosis infertile population.

14 Article Could sperm grade under high magnification condition predict IMSI clinical outcome? 2014

Sifer, Christophe / El Khattabi, Laïla / Dupont, Charlotte / Sermondade, Nathalie / Herbemont, Charlène / Porcher, Raphael / Cedrin-Durnerin, Isabelle / Faure, Céline / Lévy, Rachel / Grynberg, Michael / Poncelet, Christophe / Hugues, Jean-Noël. ·Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, 93143 Bondy, France; Unité de Recherche en Epidémiologie Nutritionnelle, UMR U557 Inserm; U1125 Inra; Cnam; Université Paris 13, CRNH IdF, 93017 Bobigny, France. Electronic address: christophe.sifer@jvr.aphp.fr. · Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, 93143 Bondy, France. · Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, 93143 Bondy, France; Unité de Recherche en Epidémiologie Nutritionnelle, UMR U557 Inserm; U1125 Inra; Cnam; Université Paris 13, CRNH IdF, 93017 Bobigny, France. · Service de Biostatistique et d'Informatique Médicale, Centre Hospitalier Universitaire Saint-Louis, Assistance Publique - Hôpitaux de Paris, 75475 Paris cedex 10, France. · Unité de Recherche en Epidémiologie Nutritionnelle, UMR U557 Inserm; U1125 Inra; Cnam; Université Paris 13, CRNH IdF, 93017 Bobigny, France; Service de Médecine de la Reproduction, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, 93143 Bondy, France. · Service de Médecine de la Reproduction, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, 93143 Bondy, France. ·Eur J Obstet Gynecol Reprod Biol · Pubmed #25150959.

ABSTRACT: OBJECTIVE: The aim of this study was to examine whether injection of first-best morphology grade selected spermatozoa improves live birth rate (LBR) compared to intracytoplasmic morphologically selected sperm injection (IMSI) using second-best grade sperm. STUDY DESIGN: In this prospective observational study, 132 patients were enrolled. Inclusion criteria were the presence of severe male factor (normal spermatozoa <10% in fresh ejaculated semen and <10% in selected sperm according to David's classification) associated with ≤2 previous ICSI failure. Results of IMSI performed with either first- or second-best morphology grade spermatozoa (according to Vanderzwalmen's classification) were compared. IMSI attempts performed using mixed first- and second-best grade spermatozoa were excluded (n=41). The primary endpoint was LBR. RESULTS: LBR following IMSI was not statistically different using first- (33.3% (13/39)) or second-best morphology grade spermatozoa (28.9% (15/52)). Our study shows that sperm grading under high magnification using Vanderzwalmen's classification is not correlated to IMSI outcome. CONCLUSION: We do not validate Vanderzwalmen classification in our external and prospective series. These results point out the need for improving our knowledge about the impact of observed vacuoles under high magnification condition.

15 Article [48,XXYY men with azoospermia: how to manage infertility?]. 2014

Roche, C / Sonigo, C / Benmiloud-Tandjaoui, N / Boujenah, J / Benzacken, B / Poncelet, C / Hugues, J-N. ·Pôle femme et enfant, site Jean-Verdier, groupe hospitalier HUPSSD, AP-HP, avenue du 14-Juillet, 93143 Bondy, France; Université SMBH Leonard-de-Vinci, Paris-13, 93000 Bobigny, France. ·Gynecol Obstet Fertil · Pubmed #24934769.

ABSTRACT: 48,XXYY syndrome is a rare form of sex chromosomal aneuploidy. Usually considered as a variant of Klinefelter syndrome because of shared features (azoospermia, tall stature, hypergonadotropic hypogonadism), it is a separate entity because diagnostic is currently made in prepubertal boy with neuro-psychological disorders. We here report the case of a 48,XXYY patient consulting for adult infertility and the indication to perform testicular sperm extraction is discussed.

16 Article Is intracytoplasmic morphologically selected sperm injection effective in patients with infertility related to teratozoospermia or repeated implantation failure? 2013

El Khattabi, Laïla / Dupont, Charlotte / Sermondade, Nathalie / Hugues, Jean-Noël / Poncelet, Christophe / Porcher, Raphael / Cedrin-Durnerin, Isabelle / Lévy, Rachel / Sifer, Christophe. ·Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique-Hôpitaux de Paris, Bondy, France. ·Fertil Steril · Pubmed #23548938.

ABSTRACT: OBJECTIVE: To evaluate the potential benefit of intracytoplasmic morphologically selected sperm injection (IMSI) in patients selected for either severe teratozoospermia or repeated implantation failure after conventional intracytoplasmic sperm injection (ICSI). DESIGN: Prospective nonrandomized observational study. SETTING: University hospital assisted reproduction unit. PATIENT(S): Four hundred seventy-eight patients were enrolled to evaluate ICSI and IMSI results for two indications. The first group (T) was composed of patients with severe teratozoospermia (<10% normal spermatozoa in fresh ejaculated and selected semen, according to David classification) and no or one previous ICSI failure. In the second group (IF), patients with at least two previous failed ICSI attempts were enrolled in absence of severe male factor (>10% normal spermatozoa in fresh ejaculated semen and >20% in selected sperm). INTERVENTION(S): ICSI/IMSI, biologic, and clinical data collection. MAIN OUTCOME MEASURE(S): Live-birth rate (LBR). RESULT(S): In group T, LBR was significantly higher when IMSI procedure was used compared with ICSI (38% [50/132] vs. 20% [25/126]). However, LBR observed in group IF was not significantly different between IMSI and ICSI procedures (21% [19/90] vs. 22% [28/130]). CONCLUSION(S): IMSI procedure is a valuable option for patients with severe teratozoospermia at their first or second attempts, but it does not improve pregnancy rate in patients with repeated ICSI failures in the absence of severe male factor.

17 Article Use of laparoscopy in unexplained infertility. 2012

Bonneau, C / Chanelles, O / Sifer, C / Poncelet, C. ·Department of Obstetrics and Gynaecology, Pôle Femme-et-Enfant, CHU Jean Verdier, APHP, Bondy, France. ·Eur J Obstet Gynecol Reprod Biol · Pubmed #22512828.

ABSTRACT: OBJECTIVE: The use of laparoscopy in unexplained infertility work-up is still a subject of debate, although laparoscopy remains the gold standard for diagnosis and treatment of several pelvic pathologies. The objective of this study was to assess the rates and types of pelvic pathologies observed during diagnostic laparoscopy, and the pregnancy rate in couples with unexplained infertility following laparoscopy. STUDY DESIGN: Prospective study, from November 2003 to October 2009, including 114 infertile, spontaneously ovulating women with normal clinical examination, ovarian reserve assessment, pelvic ultrasound scan and patent tubes on hysterosalpingography. Semen analyses were normal according to the World Health Organization criteria. After three cycles of ovulation induction with or without intra-uterine insemination and no pregnancy, women were referred for diagnostic laparoscopy. RESULTS: Laparoscopy revealed pelvic pathology in 95 patients. Endometriosis, pelvic adhesions and tubal disease were observed and treated in 72, 46 and 24 patients, respectively. Following laparoscopy, bilateral and unilateral tubal patencies were observed in 107 and five patients, respectively. Pregnancy was observed in 77 out of 102 patients who tried to conceive after surgery, 35 of whom conceived using their own tubes. CONCLUSION: Diagnostic laparoscopy should be strongly considered in unexplained infertility work-up, and tubal efficiency should not be underestimated.

18 Article Can ovariopexy at the end of surgery for endometriosis be recommended? A case report. 2012

Daraï, Emile / Touboul, Cyril / Ballester, Marcos / Poncelet, Christophe. ·Department of Gynecology-Obstetrics, Hôpital Tenon, Université Pierre et Marie Curie, Paris. emile.darai@tnn.aphp.fr ·J Reprod Med · Pubmed #22324276.

ABSTRACT: BACKGROUND: Endometriosis affects 10-15% of the female population in the reproductive period and is detected in up to 40% of infertile women. Surgery is indicated to improve fertility and symptoms in these women, but some patients experience severe complications and develop postoperative adhesion. We discuss the potential impact on adhesion of systematic ovariopexy at the end of surgery for endometriosis. CASE: We report a case of a 31-year-old woman who underwent initial laparoscopic removal of endometriomas and rectovaginal endometriosis with bilateral transient ovariopexy five years ago. She was referred for recurrence of symptoms and infertility. Preoperative transvaginal sonography and MRI confirmed the recurrence of endometriosis with bilateral uterosacral ligament and rectal involvement. At laparoscopy severe and dense adhesions of the ovaries to the anterior abdominal wall using nonabsorbable suture were observed associated with distortion of tubal anatomy. In addition to the removal of these adhesions, a sigmoid adhesiolysis was performed with uterosacral ligament, rectosigmoid and vaginal resections, followed by a systematic protective colostomy. CONCLUSION: This case illustrates the deleterious impact on adhesions to the abdominal wall of transient ovariopexy at the end of surgery for endometriosis.

19 Article Successful childbirth after intracytoplasmic morphologically selected sperm injection without assisted oocyte activation in a patient with globozoospermia. 2011

Sermondade, N / Hafhouf, E / Dupont, C / Bechoua, S / Palacios, C / Eustache, F / Poncelet, C / Benzacken, B / Lévy, R / Sifer, C. ·Service d'Histologie-Embryologie-Cytogénétique-CECOS, Hôpital Jean Verdier (AP-HP), Avenue du 14 Juillet, 93143 Bondy, France. nathalie.sermondade@jvr.aphp.fr ·Hum Reprod · Pubmed #21857011.

ABSTRACT: We here report a successful pregnancy and healthy childbirth obtained in a case of total globozoospermia after intracytoplasmic morphologically selected sperm injection (IMSI) without assisted oocyte activation (AOA). Two semen analyses showed 100% globozoospermia on classic spermocytogram. Motile sperm organelle morphology examination (MSOME) analysis at ×10,000 magnification confirmed the round-headed aspect for 100% of sperm cells, but 1% of the spermatozoa seemed to present a small bud of acrosome. This particular aspect was confirmed by transmission electron microscopy and anti-CD46 staining analysis. Results from sperm DNA fragmentation and fluorescence in situ hybridization analyses were normal. The karyotype was 46XY, and no mutations or deletions in SPATA16 and DPY19L2 genes were detected. Considering these results, a single IMSI cycle was performed, and spermatozoa were selected for the absence of vacuoles and the presence of a small bud of acrosome. A comparable fertilization rate with or without calcium-ionophore AOA was observed. Two fresh top-quality embryos obtained without AOA were transferred at Day 2 after IMSI, leading to pregnancy and birth of a healthy baby boy. This successful outcome suggests that MSOME may be useful in cases of globozoospermia in order to carefully evaluate sperm morphology and to maximize the benefit of ICSI/IMSI.

20 Article Hydrosalpinx and infertility: what about conservative surgical management? 2011

Chanelles, Olivier / Ducarme, Guillaume / Sifer, Christophe / Hugues, Jean-Noel / Touboul, Cyril / Poncelet, Christophe. ·Department of Obstetrics and Gynecology, Jean Verdier Hospital, AP-HP, avenue du 14 Juillet, Bondy 93143, University Paris XIII, Bobigny, France. ochanelles@gmail.com ·Eur J Obstet Gynecol Reprod Biol · Pubmed #21824716.

ABSTRACT: OBJECTIVE: The aim of this study was to assess and validate a management protocol for infertile patients affected by at least one hydrosalpinx. STUDY DESIGN: Eighty-one consecutive infertile normo-ovulatory patients with uni or bilateral hydrosalpinx planed to be surgically managed were included in the protocol from November 2003 to May 2007. During laparoscopy, a systematic evaluation of the tubes was firstly conducted and the local management protocol based on validated tubal prognostic scores was applied. Surgery for hydrosalpinx was either conservative by neosalpingostomy or radical by salpingectomy. The primary end-point was the cumulative clinical pregnancy rate. RESULTS: 115 hydrosalpinges out of 153 present tubes were confirmed during laparoscopy. Neosalpingostomy was possible in 35 patients featuring 50 hydrosalpinges (43.2% and 43.5%, respectively). Salpingectomy was necessary for the others (46 patients representing 65 hydrosalpinges). The mean follow-up period was 31.8 ± 12.4 months. The overall cumulative pregnancy rate was 61% per couple who completed the protocol (33/54 patients). The cumulative pregnancy rate was 50% after IVF in patients who underwent bilateral salpingectomy. Among patients with at least one functional tube, the overall cumulative pregnancy rate was 63.3%, with a spontaneous pregnancy rate of 30.4%. CONCLUSION: Hydrosalpinx management can be conservative with a tubal conservative of 43.5% and fair chances for spontaneous conception. An integrated management of hydrosalpinx including ART actually leads to a cumulative pregnancy rate of 61% per patient.

21 Article Efficacy of transient abdominal ovariopexy in patients with severe endometriosis. 2011

Carbonnel, Marie / Ducarme, Guillaume / Dessapt, Anne-Lucie / Yazbeck, Chadi / Hugues, Jean-Noel / Madelenat, Patrick / Poncelet, Christophe. ·Services de Gynécologie Obstétrique et Médecine de la Reproduction, Centre Hospitalier Universitaire Jean Verdier, Paris, France. carbonnelmarie@yahoo.fr ·Eur J Obstet Gynecol Reprod Biol · Pubmed #21168257.

ABSTRACT: OBJECTIVE: To assess adhesion formation and fertility outcome after transient abdominal ovariopexy performed in patients with severe endometriosis. STUDY DESIGN: Retrospective study including 218 patients who underwent surgery for severe endometriosis from 1997 to 2009. One hundred and thirty-nine (64%) patients were infertile. The initial ASRM stage was IV in 139 cases, III in 43 cases and II in 36 cases. Adnexal adhesions were scored by using the Operative Laparoscopy Study Group (OLSG) and modified AFS scoring systems. Unilateral or bilateral transient abdominal ovariopexy of 336 ovaries was performed to prevent adhesion formation or reformation for extensive surgery. In patients who underwent a second operation, adnexal adhesion scores were reported. Fertility outcome was evaluated by a questionnaire. RESULTS: Second-look surgery was performed after 11.7 ± 2.4 months in 24 patients (11%) who had undergone 38 ovariopexies. Transient abdominal ovariopexy significantly decreased adnexal adhesion scores (p<0.05). Regarding fertility outcome, the median follow up was 19.6 ± 1.5 months. Fifty-eight patients, out of 105 infertile women who actively tried to conceive after surgery, conceived, 21 (36%) spontaneously and 37 (64%) after ART. The median time interval for conception was 8.6 ± 1 months. CONCLUSION: In patients with severe endometriosis, transient abdominal ovariopexy is an effective technique in preventing postoperative adhesion formation and in improving fertility outcome. CONDENSATION: In 218 patients with severe endometriosis, transient abdominal ovariopexy was an effective technique in preventing adhesion formation and improving fertility outcome.

22 Article Biological predictive criteria for clinical pregnancy after elective single embryo transfer. 2011

Sifer, Christophe / Sermondade, Nathalie / Poncelet, Christophe / Hafhouf, Emna / Porcher, Raphaël / Cedrin-Durnerin, Isabelle / Benzacken, Brigitte / Levy, Rachel / Hugues, Jean-Noël. ·Service d'Histologie-Embryologie-Cytogénétique, Laboratoire de Biologie de la Reproduction, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique-Hôpitaux de Paris, Bondy, France. christophe.sifer@jvr.aphp.fr ·Fertil Steril · Pubmed #20810106.

ABSTRACT: In this prospective observational study, the onset of a clinical pregnancy after elective single embryo transfer (eSET) was significantly associated with: 1) the woman's age as well as the number of good- and top-quality embryos; and 2) the day of the embryo transfer (day 3>day 2). Good-quality embryos had the same ability to implant, regardless of the zygotic score, the day 1 early cleavage rate, the fragmentation degree, and the top-quality assessment, specifying the eligibility criteria for eSET.

23 Article [How to prevent postoperative intrauterine adhesions?]. 2010

Frey, C / Chanelles, O / Poncelet, C. ·Service de gynécologie-obstétrique, CHU Jean-Verdier (AP-HP), avenue du 14-Juillet, 93143 Bondy cedex, France. ·Gynecol Obstet Fertil · Pubmed #20709587.

ABSTRACT: Operative hysteroscopic surgery can lead to intra-uterine adhesions reducing procreation chances. Prevention of this kind of adhesions is necessary. Several pre-, per-, and post-operative means have been proposed against these adhesions. However data concerning their functional interest are lacking.

24 Article Expression of E- and N-cadherin and CD44 in endometrium and hydrosalpinges from infertile women. 2010

Poncelet, Christophe / Cornelis, Françoise / Tepper, Maryline / Sauce, Emmanuel / Magan, Nathalie / Wolf, Jean Philippe / Ziol, Marianne. ·Department of Obstetrics and Gynecology, CHU Jean Verdier, Assistance Publique-Hôpitaux de Paris, Bondy, France. christophe.poncelet@jvr.aphp.fr ·Fertil Steril · Pubmed #20605145.

ABSTRACT: In this prospective comparative study, compared with fertile control subjects (n = 12), infertile patients with hydrosalpinx (n = 18) had lower E-cadherin and a trend toward decreased N-cadherin H-scores in the endometrium (3.6 ± 0.6 vs. 2.4 ± 0.8 and 0.57 ± 1.0 vs. 0.52 ± 0.5, respectively). In hydrosalpinx, epithelial N-cadherin expression was discontinuous and disappeared in atrophic patches.

25 Article [Fertility after endometrial osseous metaplasia elective hysteroscopic resection]. 2010

Creux, H / Hugues, J-N / Sifer, C / Cédrin-Durnerin, I / Poncelet, C. ·Pôle Femme et Enfant, services de gynécologie-obstétrique et médecine de la reproduction, CHU Jean-Verdier, AP-HP, Bondy, France. ·Gynecol Obstet Fertil · Pubmed #20579919.

ABSTRACT: OBJECTIVES: The endometrial osseous metaplasia is a rare disease which is characterized by the presence of osseous tissue in endometrium. It is often diagnosed in women with secondary infertility. The main objective of this work is to evaluate fertility after elective resection of osteoid metaplasia endometrial lesions by operative hysteroscopy in infertile women. PATIENTS AND METHOD: Retrospective and descriptive series of 7 cases observed in the Woman and Child department, CHU Jean-Verdier. The 7 women were in reproductive age, of African origin, with secondary infertility after abortions concerning 6 out of the 7 patients. RESULTS: In all cases, endovaginal pelvic ultrasound has raised endometrial calcification, and diagnostic hysteroscopy highlighted endometrial osteoid metaplasia. The operative hysteroscopic procedure consisted of elective diathermic resection to handle endometrial insertion of bone chips. A second diagnostic hysteroscopy was systematically done. It showed no recurrence. Six of the 7 patients began pregnancy, 3 spontaneously and 3 after IVF/ICSI in the first year following the hysteroscopic treatment. The evolution of pregnancies has been marked by 2 normal deliveries, 1 spontaneous miscarriage and then an ectopic pregnancy in one patient, 1 growth retardation intrauterine requiring caesarean at 38 SA, 1 HELLP syndrome in a twin pregnancy requiring ceasarean at 27 SA followed normal labor at term and 1 pregnancy lost sight. DISCUSSION AND CONCLUSION: Hysteroscopic elective resection seems to be the treatment of choice with a good prognosis on subsequent fertility.