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Infertility: HELP
Articles by Jean-Luc Pouly
Based on 25 articles published since 2009
(Why 25 articles?)
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Between 2009 and 2019, J. L. Pouly wrote the following 25 articles about Infertility.
 
+ Citations + Abstracts
1 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.

2 Guideline [Management by assisted reproductive technology in women with endometriosis: CNGOF-HAS Endometriosis Guidelines]. 2018

Chauffour, C / Pouly, J-L / Gremeau, A-S. ·Département de gynécologie-obstétrique et de reproduction humaine, CHU Estaing, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France. Electronic address: candicechauffour@gmail.com. · Département de gynécologie-obstétrique et de reproduction humaine, CHU Estaing, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France. ·Gynecol Obstet Fertil Senol · Pubmed #29523480.

ABSTRACT: Should the presence of endometriosis change the management of assisted reproductive technology? There is no difference in pregnancy rate after IVF between an agonist or antagonist protocol in patients with endometriosis, so the choice between one or the other of these protocols is free. But the review of the literature has shown an improvement in the chances of pregnancy in case of prolonged ovulation suppression before stimulation for IVF with a GnRH agonist analogue or with oral contraception, especially in cases of severe endometriosis. Endometriosis, regardless of the stage and type of lesions, would have no effect on the IVF results in terms of pregnancy rate and live birth rate, but with a lower number of oocytes collected, especially in cases of severe endometriosis. In a context of superficial endometriosis without pain and of infertility, surgical treatment of superficial endometriosis is not recommended just to increase the chances of pregnancy in IVF. Surgery may have a place in case of failure of IVF to improve the results of the ART. In case of recurrence of endometriosis, surgery is not better than IVF, a medico-surgical concertation is recommended. In addition, studies on ovulation stimulation for IVF do not show any aggravation of the symptoms associated with endometriosis lesions, or an acceleration of its progression, or an increase in the rate of recurrence of the disease.

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 [In vitro fertilization and intracystoplasmic sperm injection]. 2014

Pouly, Jean-Luc. · ·Rev Prat · Pubmed #24649557.

ABSTRACT: In vitro fertilization with or without microinjection has revolutionized the treatment of infertility. It is useful in almost all causes of sterility. But these results are still modest and far from the expectations of couples since 25% patients deliver after an attempt and 40 to 50% after several attempts. There is a risk of immediate complications but it is today well control. The long-term studies on the children development and the women health are very reassuring.

7 Review [Postoperative abdominal adhesions and their prevention in gynaecological surgery: I. What should you know?]. 2012

Audebert, A / Darai, E / Bénifla, J-L / Yazbeck, C / Déchaud, H / Wattiez, A / Crowe, A / Pouly, J-L. ·Service d'endoscopie gynécologique, polyclinique de Bordeaux, 145, rue du Tondu, 33000 Bordeaux, France. audebert@alienor.fr ·Gynecol Obstet Fertil · Pubmed #22129851.

ABSTRACT: Adhesions are the most frequent complications of abdominopelvic surgery, causing important short- and long-term problems, including infertility, chronic pelvic pain and a lifetime risk of small bowel obstruction. They also complicate future surgery with increased morbidity and mortality risk. They pose serious quality of life issues for many patients with associated social and healthcare costs. Despite advances in surgical techniques, including laparoscopy, the healthcare burden of adhesion-related complications has not changed in recent years. Adhesiolysis remains the main treatment although adhesions reform in many patients. The extent of the problem of adhesions has been underestimated by surgeons and the health authorities. There is rising evidence however that surgeons can take important steps to reduce the impact of adhesions. As well as improvements in surgical technique, developments in adhesion-reduction strategies and new agents offer a realistic possibility of reducing adhesion formation and improving outcomes for patients. This paper is the first of a two-part publication providing a comprehensive overview of the evidence on adhesions to allow gynaecological surgeons to be best informed on adhesions, their development, impact on patients, health systems and surgical outcomes. In the second paper we review the various strategies to reduce the impact of adhesions and improve surgical outcomes to assist fellow surgeons in France to consider the adoption of adhesion reduction strategies in their own practice.

8 Review [Reproductive surgery]. 2010

Yazbeck, C / Fauconnier, A / Pouly, J-L. ·Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Bichat Claude Bernard, APHP, 46 rue Henri Huchard, 75018 Paris, France. chadi.yazbeck@bch.aphp.fr ·J Gynecol Obstet Biol Reprod (Paris) · Pubmed #21185489.

ABSTRACT: The place of surgery in the management of an infertile couple is still under debate. Good pregnancy outcomes in assisted reproductive technologies have led to a decrease in surgical indications. In this evidence based review, we updated our data of high powered articles in order to establish national guidelines for clinical practice about the role and benefits of surgery in principal etiologies of female infertility.

9 Review [Anatomic evaluation of the female of the infertile couple]. 2010

Torre, A / Pouly, J-L / Wainer, B. ·Faculté de médecine Paris-Ouest, Université de Versailles Saint-Quentin en Yvelines, 9 boulevard d'Alembert, 78280 Guyancourt, France. antoinetorre@voila.fr ·J Gynecol Obstet Biol Reprod (Paris) · Pubmed #21185484.

ABSTRACT: One third of infertility cases are due to anatomical abnormalities of the female reproductive tract: endometrial polyps (33%), bilateral tubal blockage (12%), hydrosalpinx (7%), sub-mucosal fibroids (3%) and pelvic endometriosis. These may need surgical correction which could restore fertility. This review aim to determine which examinations should be performed first. Hysterosalpingography shows sensitivity of only 65% but it increases the achievement of spontaneous pregnancy by three times. Office hysteroscopy has an excellent sensitivity (>95%) for diagnosing intra-uterine lesions. Pelvic ultrasound, whose good sensitivity is improved by adding 3D imaging and hysterosonography, seems as efficient as office hysteroscopy in diagnosing uterine cavity abnormalities. Moreover, it also efficiently diagnoses pelvic diseases such as hydrosalpinx or endometrioma without laparoscopy. A first line laparoscopy is indicated in for woman suspected of endometriosis or tubal pathology (history of complicated appendicitis, previous pelvic surgery, pelvic inflammatory disease). For the others straight forward cases, the majority of patients, hysterosalpingography and pelvic ultrasound seem to be sufficient as primary diagnostic tool.

10 Article Long-term evaluation of painful symptoms and fertility after surgery for large rectovaginal endometriosis nodule: a retrospective study. 2018

Bourdel, Nicolas / Comptour, Aurélie / Bouchet, Paméla / Gremeau, Anne-Sophie / Pouly, Jean-Luc / Slim, Karem / Pereira, Bruno / Canis, Michel. ·Gynecological Surgery Service, CHU University Hospital Clermont-Ferrand, Clermont-Ferrand, France. · Service of Hepato Gastro Enterology, CHU University Hospital Clermont-Ferrand, Clermont-Ferrand, France. · Biostatistics Units (DRCI), CHU University Hospital Clermont-Ferrand, Clermont-Ferrand, France. ·Acta Obstet Gynecol Scand · Pubmed #29143306.

ABSTRACT: INTRODUCTION: Optimal surgical treatment of rectovaginal endometriosis remains a controversial topic. The objective of this study was to evaluate long-term postoperative outcomes after rectal shaving or colorectal resection for rectovaginal endometriosis. MATERIAL AND METHODS: 195 patients underwent surgery (172 managed by shaving, 23 by colorectal resection) between January 2000 and June 2013 for rectovaginal endometriosis (>2 cm) involving at least the serosa of the rectum. Primary outcome measures were pain and fertility. Secondary outcome measures were complications, recurrence rates and quality of life. RESULTS: Mean follow-up was 60 ± 42 months in the shaving group and 67 ± 47 months in the resection group. The mean VAS score for pelvic pain between the pre and postoperative period decreased from 5.5 ± 3.5 (shaving group) and 7.3 ± 2.9 (resection group) to 2.3 ± 2.4 (p < 0.001) and 2.0 ± 1.8 (p < 0.001), respectively. For dysmenorrhea, the mean baseline VAS score fell postoperatively from 7.7 ± 2.8 (shaving group) and 8.2 ± 2.6 (resection group) to 3.3 ± 2.9 (p < 0.001) and 2.7 ± 2.7 (p < 0.001), respectively. Pregnancy rates were 73% for shaving and 69% for resection. Major complications occurred in 4% of patients in the shaving group and in 26% in the resection group (p = 0.001). Thirteen patients (7.6%) from the shaving group and none from the resection group were reoperated for suspicion of endometriosis recurrence (p = 0.37). Postoperative quality of life scores revealed no differences between the two groups. CONCLUSION: Our study demonstrates that rectal shaving, when feasible for rectovaginal nodule (>2 cm) infiltrating the digestive serosa, has equal impact on pain and pregnancy rates compared with colorectal resection at long-term follow-up, with low complication and favorable pregnancy rates.

11 Article Effects of U0126 and MK2206 on cell growth and re-growth of endometriotic stromal cells grown on substrates of varying stiffness. 2017

Matsuzaki, Sachiko / Pouly, Jean-Luc / Canis, Michel. ·CHU Clermont-Ferrand, CHU Estaing, Chirurgie Gynécologique, Clermont-Ferrand, France. · Clermont Université, Université d'Auvergne, ISIT UMR6284, Clermont-Ferrand, France. · CNRS, ISIT UMR6284, Clermont-Ferrand, France. ·Sci Rep · Pubmed #28218307.

ABSTRACT: Endometriosis is a common gynecological disorder responsible for infertility and pelvic pain. A complete cure for patients with endometriosis awaits new targets and strategies. Here we show that U0126 (a MEK inhibitor) and MK2206 (an AKT inhibitor) synergistically inhibit cell growth of deep endometriotic stromal cells (DES) grown on polyacrylamide gel substrates (PGS) of varying stiffness (2 or 30 kilopascal [kPa]) or plastic in vitro. No significant differences in cell proliferation were observed among DES, endometrial stromal cells of patients with endometriosis (EES) from the proliferative phase (P), EES-S (secretory phase) and EES-M (menstrual phase) compared to cells grown on a substrate of the same stiffness at both higher (U0126 [30 μM] and MK2206 [9 μM]) and lower (U0126 [15 μM] and MK2206 [4.5 μM]) combined doses. However, cell re-growth of DES after drug discontinuation was higher than that of EES-P and EES-S when cells were grown on rigid substrates at both combined doses. Combination U0126 and MK2206 treatment is more effective than each drug alone in cell growth inhibition of DES. However, further studies are required to investigate the mechanisms underlying high cell survival and proliferation after drug discontinuation for developing target therapies that prevent recurrence.

12 Article [About a case of uterine per-partum rupture, 37months after resection of a rectovaginal endometriosis nodule]. 2016

Delépine, O / Curinier, S / Agar, N / Piquier-Perret, G / Gallot, D / Houlle, C / Canis, M / Pouly, J-L. ·Service de gynécologie-obstétrique des hôpitaux de Clermont-Ferrand, CHU Estaing, place Lucie-Aubrac, 63003 Clermont-Ferrand, France. Electronic address: orian2110@hotmail.com. · Service de gynécologie-obstétrique et biologie de la reproduction, CHU Estaing, place Lucie-Aubrac, 63003 Clermont-Ferrand, France. ·J Gynecol Obstet Biol Reprod (Paris) · Pubmed #27496570.

ABSTRACT: Endometriosis is a common condition in women, whose main repercussions are painful symptoms. In addition, it was shown that endometriosis was a major cause of infertility and various obstetric complications could be related to this pathology. Uterine rupture is a rare but serious complication whose incidence tends to decrease with the screening of women at risk, however, its fetal, maternal morbidity and mortality causes remains important. We were confronted with a case of posterior uterine rupture in a patient of 36 years, primipare term exceeded in immediate postpartum period. The patient's primary antecedent of uterine surgery torus was responsible for infertility endometriosis. The outcome was favorable for the mother, after a surgical treatment by laparotomy, and for the child. In the literature, two cases have been reported of uterine rupture after endometriosis surgery, which is why we found it interesting to report this rare case. Given the increase in surgical management of this disease, it seems relevant to ask whether, in the future, we should be more vigilant in monitoring pregnancy for these women.

13 Article Soft matrices inhibit cell proliferation and inactivate the fibrotic phenotype of deep endometriotic stromal cells in vitro. 2016

Matsuzaki, Sachiko / Canis, Michel / Pouly, Jean-Luc / Darcha, Claude. ·CHU Clermont-Ferrand, CHU Estaing, Chirurgie Gynécologique, 1, Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand, France Clermont Université, Université d'Auvergne, ISIT UMR6284, Clermont-Ferrand, France CNRS, ISIT UMR6284, Clermont-Ferrand, France sachikoma@aol.com. · CHU Clermont-Ferrand, CHU Estaing, Chirurgie Gynécologique, 1, Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand, France Clermont Université, Université d'Auvergne, ISIT UMR6284, Clermont-Ferrand, France CNRS, ISIT UMR6284, Clermont-Ferrand, France. · CHU Clermont-Ferrand, CHU Estaing, Chirurgie Gynécologique, 1, Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand, France. · CHU Clermont-Ferrand, Service d'Anatomie et Cytologie Pathologiques, Clermont-Ferrand, France. ·Hum Reprod · Pubmed #26762314.

ABSTRACT: STUDY QUESTION: Can deep infiltrating endometriotic stromal cells (DES) sense changes in extracellular matrix (ECM) stiffness and respond to them? SUMMARY ANSWER: Soft matrices inhibit cell proliferation and inactivate the fibrotic phenotype of DES in vitro. WHAT IS KNOWN ALREADY: Deep infiltrating endometriosis (DIE) is characterized histologically by dense fibrous tissue. Tissue stiffening is a hallmark of fibrosis. Studies show that matrix stiffness is involved in the progression of numerous diseases, including cancer and fibrosis. However, no studies to date have investigated whether tissue stiffening could influence cell behavior in DIE. Previous in vitro studies typically analyzed cells grown on rigid plastic or glass substrates with stiffness in the gigapascal (gPa) range, which is much stiffer than that occurring in vivo. To investigate how changes in ECM stiffness affect the behavior of DES, it is critical to model in vivo tissue compliance conditions in vitro. STUDY DESIGN, SIZE, DURATION: For this laboratory study, paired endometrial and endometriotic samples from 40 patients who had histological evidence of DIE and endometrial samples from 23 patients without endometriosis were analyzed (uterine fibroma: n = 10, tubal infertility: n = 13). PARTICIPANTS/MATERIALS, SETTING, METHODS: All participants were 20-37 years old and had regular menstrual cycles of 26-32 days. The abundance of F-actin, alpha smooth muscle actin (αSMA), Ki67, and procollagen type I in DES and endometrial stromal cells (EES) on polyacrylamide gel substrates of varying stiffness (2, 4, 8, 16 and/or 30 kPa) was determined by immunofluorescence confocal microscopy. mRNA level of type I collagen, matrix metalloproteinase-1 (MMP-1), MMP-14 and cyclin D1 was measured by real-time PCR. The cellular proliferation index (CPI), assessed as the percentage of Ki67-positive cells among the total number of nuclei stained by 4',6-diamidino-2-phenylindole (DAPI) was determined. MAIN RESULTS AND THE ROLE OF CHANCE: Increased matrix stiffness induced F-actin stress fiber formation in both EES and DES, whereas αSMA-containing stress fibers were induced only in DES. Furthermore, increased stiffness increased the CPI in both EES (16 or 30 kPa versus 2 kPa, P < 0.05) and DES (16 or 30 kPa versus 2, 4 or 8 kPa, P < 0.05). Increased stiffness increased the percentage of procollagen I-positive cells as well as mRNA levels of type I collagen in both EES and DES in a matrix stiffness-dependent manner (2, 8 and 30 kPa) (P < 0.05). Increased stiffness also increased MMP-14 mRNA levels in EES (30 versus 2 kPa, P < 0.05), but decreased MMP-1 mRNA levels in DES in a matrix stiffness-dependent manner (2, 8 and 30 kPa; P < 0.05). Treatment with transforming growth factor (TGF)-β1 further increased type I collagen mRNA levels in both EES and DES when compared with cells grown on a substrate of the same stiffness (2, 8 or 30 kPa, with versus without TGF-β1, P < 0.05). Treatment with TGF-β1 also increased MMP-1 (8 or 30 kPa, P < 0.05 versus no TGF-β1) and MMP-14 mRNA levels (2, 8 or 30 kPa, P < 0.05 versus no TGF-β1) in EES, but decreased MMP-1 mRNA levels (2, 8 or 30 kPa, P < 0.05 versus no TGF-β1) in DES. On a soft substrate (2 kPa), both EES and DES exhibited a small rounded morphology with diffuse labeling for F-actin. No F-actin-positive stress fibers were observed in either EES or DES grown on 2 kPa substrates. There were more Ki67-positive EES when grown on 2, 4 or 8 kPa compared with Ki67-positive DES (P < 0.05). LIMITATIONS, REASONS FOR CAUTION: A tremendous gap exists between the present in vitro model and in vivo deep endometriotic tissues. Cell culture systems that more closely mimic the cellular complexity typical of in vivo endometriotic tissues are required to develop novel strategies for treatment of DIE. A disadvantage of polyacrylamide is its cytotoxicity but in the two-dimensional culture models used here, where cells are seeded above the polyacrylamide gel, this should not have a major impact. Finally, the soft substrates we used in vitro (2 and 4 kPa) may represent the elasticity of the endometrium in vivo, however, currently there are no data regarding tissue stiffness in DIE in vivo. WIDER IMPLICATIONS OF THE FINDINGS: Hormonal suppressive therapy is not usually effective for treating DIE. Interrupting the mechanical interactions between endometriotic fibroblasts and aberrant ECM may be a novel strategy for treatment of DIE. STUDY FUNDING/COMPETING INTERESTS: This study was supported in part by Karl Storz Endoscopy & GmbH (Tuttlingen, Germany). No competing interests are declared.

14 Article Targeting the Wnt/β-catenin pathway in endometriosis: a potentially effective approach for treatment and prevention. 2014

Matsuzaki, Sachiko / Botchorishvili, Revaz / Pouly, Jean Luc / Canis, Michel. ·CHU Clermont-Ferrand, CHU Estaing, Chirurgie Gynécologique, 1, Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand, France ; Clermont Université, Université d'Auvergne, ISIT UMR6284, Clermont-Ferrand, France ; CNRS, ISIT UMR6284, Clermont-Ferrand, France. · CHU Clermont-Ferrand, CHU Estaing, Chirurgie Gynécologique, 1, Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand, France. ·Mol Cell Ther · Pubmed #26056600.

ABSTRACT: Endometriosis is a chronic, estrogen-dependent disease associated with infertility and pelvic pain. Endometriosis is defined by the presence of extra-uterine endometrial tissue. It affects approximately 10% of reproductive-aged women. However, the underlying etiology, pathogenesis and pathophysiology remain to be fully elucidated. Knowledge of these factors is indispensable for the development of targeted therapies for prevention and treatment of endometriosis. Several studies, including those from our laboratory, have suggested that aberrant activation of the Wnt/β-catenin pathway may be involved in the pathophysiology of endometriosis. This is a review of the literature focused on the aberrant activation of the Wnt/β-catenin pathway in patients with endometriosis, and on how targeting the Wnt/targeting pathway may be a potentially effective approach for treating and/or preventing endometriosis.

15 Article [Cryoconservation of ovarian tissue: indications and outcome of the patients]. 2014

Desvignes, F / Pouly, J L / Janny, L / Canis, M / Sanfilippo, S / Kanold, J / Lebouedec, G / Brugnon, F. ·Pôle de gynécologie-obstétrique-reproduction humaine, médecine de la reproduction, CHU de Clermont-Ferrand, CHU d'Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France. Electronic address: desvignes.fanny@neuf.fr. · Pôle de gynécologie-obstétrique-reproduction humaine, médecine de la reproduction, CHU de Clermont-Ferrand, CHU d'Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France. · Laboratoire AMP, CECOS, pôle de gynécologie-obstétrique-reproduction humaine, CHU de Clermont-Ferrand, CHU d'Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France. · Centre régional de cancérologie et thérapie cellulaire pédiatrique, CHU d'Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France. · Département de chirurgie oncologique, centre Jean-Perrin, 58, rue Montalembert, 63000 Clermont-Ferrand, France. ·Gynecol Obstet Fertil · Pubmed #24792707.

ABSTRACT: OBJECTIVES: Ovarian Tissue Cryopreservation (OTC) is a very promising approach of fertility preservation for women and young patients who have to follow gonadotoxic treatments (chemotherapy, radiotherapy…). The aim of this study was to analyse the indications and the outcomes of the patients who had OTC in our center during the last 17 years. PATIENTS AND METHODS: The study is retrospective. Forty-six patients, who underwent OTC in the Laboratory of Reproductive Biology of the University Hospital of Clermont-Ferrand, between January 1997 and December 2009, were included. RESULTS: The average age on the day of ovarian tissue harvesting was 19.5 years. Fifty-two percent of the patients were minor. In order of decreasing frequency, the diseases for which OTC has been proposed were hematologic, ovarian tumors, sarcoma ou PNET and breast neoplasia. In 93.5 %, the harvesting of ovarian cortex was performed by laparoscopy. After OTC, 82.6 % of the patients were treated by chemotherapy. A bone marrow transplant was performed for 48 % of the study patients. At the time of data collection, 57 % of the patients who had evaluation of their ovarian function presented premature ovarian failure. Eight patients had one or more pregnancies after treatment. It was a natural pregnancy for five of them. The three others were obtained by medically assisted procreation (in vitro fertilization and oocyte donation). DISCUSSION AND CONCLUSION: We report a long-term follow-up of patients treated in our center for OTC. The originality of our study is to evaluate all aspects of OTC from the decision to propose the patients an OTC to their outcomes several years after the ovarian tissue harvesting. It is therefore a multidisciplinary approach both oncology, gynecological and pediatric whereas OTC is often considered restrictively in the literature. Finally, it seems to be essential to establish a specific medical care for these patients. This monitoring will allow an adequate assessment of pubertal development and ovarian function, management of estrogen deficiency and secondary infertility, supporting patients in their desire for motherhood.

16 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.

17 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.

18 Article Fertility after tubal ectopic pregnancy: results of a population-based study. 2012

de Bennetot, Marianne / Rabischong, Benoît / Aublet-Cuvelier, Bruno / Belard, Fabien / Fernandez, Hervé / Bouyer, Jean / Canis, Michel / Pouly, Jean-Luc. ·Department of Obstetrics and Gynecology, Pôle de Gynécologie-Obstétrique, Centre Hospitalier Universitaire Estaing, Clermont-Ferrand, France. ·Fertil Steril · Pubmed #22818285.

ABSTRACT: OBJECTIVE: To assess the reproductive outcome after an ectopic pregnancy (EP) based on the type of treatment used, and to identify predictive factors of spontaneous fertility. DESIGN: Observational population based-study. SETTING: Regional sistry. PATIENT(S): One thousand sixty-four women registered from 1992 to 2008. INTERVENTION(S): Laparoscopic (radical or conservative), or medical treatment. MAIN OUTCOME MEASURE(S): Epidemiologic characteristics, clinical presentation, treatments performed, reproductive outcome, recurrence. RESULT(S): The 24-month cumulative rate of intrauterine pregnancy (IUP) was 67% after salpingectomy, 76% after salpingostomy, and 76% after medical treatment. IUP rate was lower after radical treatment compared with conservative treatments in univariable analysis. In multivariate analysis, IUP rate was significantly lower for patients >35 years old or with history of infertility or tubal disease. For them, IUP rate was significantly higher after conservative treatment compared with salpingectomy. The 2-year cumulative rate of recurrences was 18.5% after salpingostomy or salpingectomy and 25.5% after medical treatment. History of infertility or of previous live birth would be protective, in contrast to history of voluntary termination of pregnancy. CONCLUSION(S): Conservative strategy seems to be preferred, whenever possible, to preserve patients' fertility without increasing the risk of recurrence. The choice between conservative treatments does not rely on subsequent fertility, but more likely on their own indications and therapeutic effectiveness. Risk factors of recurrence could be considered for secondary prevention.

19 Article Is There a Relationship between Ovarian Epithelial Dysplasia and Infertility? 2012

Chene, Gautier / Penault-Llorca, Frédérique / Tardieu, Anne / Cayre, Anne / Lagarde, Nicole / Jaffeux, Patricia / Aublet-Cuvelier, Bruno / Dechelotte, Pierre / Felloni, Bertrand / Pouly, Jean-Luc / Dauplat, Jacques. ·Department of Histopathology, Centre Jean Perrin, Clermont-Ferrand 63000, France. ·Obstet Gynecol Int · Pubmed #22496700.

ABSTRACT: Aim. Ovarian epithelial dysplasia was initially described in material from prophylactic oophorectomies performed in patients at genetic risk of ovarian cancer. Similar histopathological abnormalities have been revealed after ovulation stimulation. Since infertility is also a risk factor for ovarian neoplasia, the aim of this study was to study the relationship between infertility and ovarian dysplasia. Methods. We blindly reviewed 127 histopathological slides of adnexectomies or ovarian cystectomies according to three groups-an exposed group to ovulation induction (n = 30), an infertile group without stimulation (n = 35), and a spontaneously fertile control group (n = 62)-in order to design an eleven histopathological criteria scoring system. Results. The ovarian dysplasia score was significantly higher in exposed group whereas dysplasia score was low in infertile and control groups (resp., 8.21 in exposed group, 3.69 for infertile patients, and 3.62 for the controls). In the subgroup with refractory infertility there was a trend towards a more severe dysplasia score (8.53 in ovulation induction group and 5.1 in infertile group). Conclusion. These results raise questions as to the responsibility of drugs used to induce ovulation and/or infertility itself in the genesis of ovarian epithelial dysplasia.

20 Article [Factors affecting the cumulative live birth rate in IVF cycles. Retrospective analysis of a 1001 couples cohort]. 2012

Pouly, J-L / Ouziel, L / Gremeau, A S / De Mouzon, J / Janny, L / Vignancour, S / Dejou, L / Brugnon, F. ·Centre d'Assistance médicale à la procréation, CHU de Clermont-Ferrand, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France. jlpouly@chu-clermontferrand.fr ·Gynecol Obstet Fertil · Pubmed #22326180.

ABSTRACT: OBJECTIVE: To analyze the different factors influencing real and theoretical cumulative live birth rates following in vitro fertilization. PATIENTS AND METHODS: Retrospective study of 1001 couples starting an IVF/ICSI cycle between 2004 and 2006 that were followed-up after all their attempts. All abandoned cycles were taken in account. RESULTS: For all couples, the theoretical cumulative live birth rates after n attempts were 23.9%, 40.5%, 51.4%, 62.2%. The real cumulative live birth rates were 23.9%, 36%, 41.2% and 44.4%. With reference to age, success rates were better for women less than 35 (58,8%) and were reduced for women older than 38 (18,0%). Looking at the ovarian reserve, in the 35 to 38 years age group, the actuarial rates were satisfactory as long as the ovarian response resulted in five or more oocytes. Among older patients, success rates were influenced by the number of oocytes collected and only acceptable when more than eight oocytes were obtained. Multivariate analysis has demonstrated that women's age was determinant on the live birth rate (OR=0.17 [0.09-0.32] in the 38 to 39 group versus less than 30 group). In ovulatory disease, the success rates were the best compared to other infertility aetiology (OR=1.61[1.05-2.47]). Moreover, the number of embryos transferred had a strong impact on live birth rate with an OR of 1.62 [1.32-1.99] per extra embryo. DISCUSSION AND CONCLUSION: Live birth rates are dependent on the women' age. For women older than 38 years, the ovarian response to the stimulation and the number of embryos transferred are important factors for success.

21 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.

22 Article [Risk factors for recurrence of ectopic pregnancy]. 2012

De Bennetot, M / Rabischong, B / Aublet-Cuvelier, B / Belard, F / Fernandez, H / Bouyer, J / Mage, G / Pouly, J-L. ·Service de gynécologie-obstétrique et reproduction humaine, CHU de Clermont-Ferrand, CHU Estaing, 1, place Lucie-Aubrac, 63100 Clermont-Ferrand, France. ·J Gynecol Obstet Biol Reprod (Paris) · Pubmed #22018441.

ABSTRACT: OBJECTIVES: Investigate and identify the risk factors influencing the recurrence of ectopic pregnancies. PATIENTS AND METHODS: The Auvergne ectopic pregnancy registry data were analyzed from 1992 to 2008. The appearance of a recurrence was studied among 1108 women from 18 to 44 years old, who attempted to conceive again. RESULTS: One hundred and sixteen repeated ectopic pregnancies occurred (10.5 %) during the period under study. The rate of recurrence was significantly higher among women who had a history of voluntary termination of pregnancy (P=0.01). Conversely, fewer recurrences (P=0.01 and 0.0478) occurred among women having a history of infertility or previous live birth. The treatment for ectopic pregnancy, whether it is conservative or radical laparoscopic, or medical with methotrexate did not significantly influence the recurrence rate (P=0.86). CONCLUSION: Reproductive history appears to involve the risk of repeated ectopic pregnancy and must be taken into account in their secondary prevention. As for the choice of treatment, the risk of recurrence does not seem to constitute a decisive argument.

23 Article [Predictive factors of success in ovulation induction with recombinant FSH: results of Indigo study]. 2010

Cédrin-Durnerin, I / Belaisch-Allart, J / Avril, C / Pouly, J-L. ·Service de médecine de la reproduction, hôpital Jean-Verdier, avenue du 14-Juillet, 93143 Bondy cedex, France. isabelle.cedrin-durnerin@jvr.aphp.fr ·Gynecol Obstet Fertil · Pubmed #20106707.

ABSTRACT: INTRODUCTION: Although ovulation induction is commonly used to treat infertility, few data are available concerning this treatment. Therefore, the aim of this prospective observational study was to describe medical practices and to identify predictive outcome factors of ovarian stimulation by recombinant FSH (r-hFSH), administrated with a self-injector pen. PATIENTS AND METHODS: At the time of the prescription of ovarian stimulation followed by sexual intercourse (SI) or artificial insemination (HAI) with a normal husband sperm, 370 gynaecologists consecutively sent from January to November 2005, for a maximum of six patients (1398 patients in total), a form dealing with the assessment of infertility factors prior to stimulation (n=1340), then a monitoring form of the treated cycle (n=1227) and when a pregnancy was obtained, a follow-up form at 12 weeks of amenorrhea (n=254). Each patient had to complete an autoquestionnaire about the use of the pen (n=1044). RESULTS: Seventy percent of the contributing gynaecologists had only a private practice. The mean age of patients was 31.9+/-4.8 years. Dealing with infertility exploration prior to stimulation, 9% did not have tubal assessment. Although it was the first stimulation attempt for 52% of cases, 91% of patients found the pen easy to manipulate. The mean duration of r-hFSH administration was 8.8+/-3.7 days and the mean daily dose was 75.4+/-29.4 IU. Ultrasound and hormonal monitoring was performed for 88% of patients. The cycle cancellation rate was 11%. The hCG administration was performed on cycle day 13+/-3. An HAI was programmed in 60% of patients and SI in 40%. The pregnancy rates for positive betahCG, ongoing and multiple pregnancies were, respectively, 22.7, 18 and 16% (twins 14%; 2% of triplets or more 2%). Three prognosis factors were independently related to ongoing pregnancy rate: age<35 years, previous pregnancy obtained by treatment and presence of ovulatory disorders. DISCUSSION AND CONCLUSION: This observatory of ovarian stimulation out of FIV allowed to describe medical practices of gynaecologists: infertility assessment prior to ovarian stimulation, used FSH doses, ultrasound and hormonal monitoring, and it outlined three predictive factors of outcome: age, previous pregnancy obtained by treatment and presence of ovulatory disorders.

24 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.

25 Unspecified [Fourteenth congress of the Fédération française d'étude de la reproduction (Clermont-Ferrand, 18 - 20th November 2009)]. 2009

Janny, L / Pouly, J-L / Brugnon, F. ·Biologie du développement et de la reproduction, CECOS Auvergne, pôle gynécologie-obstétrique et reproduction humaine, Hôtel-Dieu, 63058 Clermont-Ferrand cedex 1, France. ljanny@clermontferrand.fr ·Gynecol Obstet Fertil · Pubmed #19836285.

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