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Infertility: HELP
Articles by Benoit Resch
Based on 4 articles published since 2008
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Between 2008 and 2019, B. Resch wrote the following 4 articles about Infertility.
 
+ Citations + Abstracts
1 Article Fertility Outcomes After Ablation Using Plasma Energy Versus Cystectomy in Infertile Women With Ovarian Endometrioma: A Multicentric Comparative Study. 2016

Mircea, Oana / Puscasiu, Lucian / Resch, Benoit / Lucas, Jerome / Collinet, Pierre / von Theobald, Peter / Merviel, Philippe / Roman, Horace. ·Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen, France; University of Medicine and Pharmacy, "Carol Davila" Bucharest, Romania. · Department of Gynecology and Obstetrics, University of Medicine and Pharmacy, Târgu Mureş, Romania. · Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen, France; Department of Gynecologic Surgery, Mathilde Clinic, Rouen, France. · Department of Gynecologic Surgery, Europe Clinic, Rouen, France. · Department of Gynecologic Surgery, "Jeanne de Flandre" University Hospital, Lille, France. · Department of Gynecologic Surgery, Caen University Hospital, Caen, France. · Department of Gynecologic Surgery, Amiens University Hospital, Amiens, France. · Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen, France; Research Group 4308 "Spermatogenesis and Gamete Quality", IHU Rouen Normandy, IFRMP23, Reproductive Biology Laboratory, Rouen University Hospital, Rouen, France. Electronic address: horace.roman@gmail.com. ·J Minim Invasive Gynecol · Pubmed #27553184.

ABSTRACT: STUDY OBJECTIVE: To compare the probability of postoperative pregnancy in infertile women with ovarian endometrioma larger than 3 cm in diameter, managed by either ablation using plasma energy or cystectomy. DESIGN: A multicentric case-control study (Canadian Task Force classification II-2). SETTING: Six surgical departments, affiliated with 4 university hospitals and 2 private facilities. PATIENTS: One hundred four infertile patients with ovarian endometrioma larger than 3 cm. INTERVENTIONS: Endometrioma ablation using plasma energy was performed in 64 patients (61.5%) and cystectomy in 40 patients (38.5%). MEASUREMENTS AND MAIN RESULTS: Patients were enrolled in the CIRENDO prospective cohort database (NCT02294825) from June 2009 to June 2014 and managed in 6 different facilities. The minimum length of follow-up was 1 year. Postoperative probabilities of pregnancy in patietns and control subjects were estimated using the Kaplan-Meier method with 95% confidence intervals (CIs) and compared using the log-rank test. The Cox model was used to assess independent predictive factors for pregnancy. Patients managed by plasma energy were significantly older than patients managed by cystectomy, had significantly higher overall revised American Fertility Society (rAFS) score, and had higher rate of Douglas pouch obliteration, deep endometriosis, and colorectal localizations. After a mean follow-up of 35.3 ± 17.5 months (range, 12-60), fertility outcomes were comparable between the groups. The probability of pregnancy at 24 and 36 months after surgery in plasma energy and cystectomy groups was, respectively, 61.3% (95% CI, 48.2%-74.4%) versus 69.3% (95% CI, 54.5%-83%) and 84.4% (95% CI, 72%-93.4%) versus 78.3% (95% CI, 63.8%-90%). The Cox's model revealed that the type of surgical procedure on ovarian endometrioma had no statistically significant impact on the probability of pregnancy, after adjustment for women's age, bilateral cysts larger than 3 cm, colorectal endometriosis, and rAFS stage of endometriosis. CONCLUSION: Postoperative pregnancy rates were comparable after management of ovarian endometrioma by either ablation using plasma energy or cystectomy despite an overall higher rate of unfavorable fertility predictive factors in women managed by ablation.

2 Article [Interstitial pregnancy: experience at Rouen's hospital]. 2014

Douysset, X / Verspyck, E / Diguet, A / Marpeau, L / Chanavaz-Lacheray, I / Rondeau, S / Resch, B / Sergent, F. ·Pôle gynécologique et obstétricale, CHU Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France; Clinique universitaire de gynécologie-obstétrique, université Joseph-Fourrier et CHU de Grenoble, boulevard de la Chantourne, 38700 La Tronche, France. Electronic address: xdouysset@gmail.com. · Pôle gynécologique et obstétricale, CHU Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France. · Maternité du Belvédère, 72, rue Louis-Pasteur, 76130 Mont Saint-Aignan, France. · Clinique pédiatrique, CHU Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France. · Clinique universitaire de gynécologie-obstétrique, université Joseph-Fourrier et CHU de Grenoble, boulevard de la Chantourne, 38700 La Tronche, France. ·Gynecol Obstet Fertil · Pubmed #23602139.

ABSTRACT: OBJECTIVE: Presenting our experience concerning interstitial pregnancies (IP) surgical management and to evaluate our patients' subsequent long-term fertility. PATIENTS AND METHOD: Twenty patients underwent surgical treatment of IP in our department over 15 years. In this retrospective study, we present symptoms that led to diagnosis, treatments, fertility and obstetrical outcome. RESULTS: Mean gestational age at diagnosis was 8SA, with a median BHCG rate of 7411 IU/L, and a patient mean age of 30 years. Ninety percent of patients had at least one risk factor for ectopic pregnancy. Pain or bleeding were the most common symptoms at admission, 4 patients were admitted in an hypovolemic shock status. Location of the interstitial ectopic pregnancy was discovered during surgery in 45 % of cases. Six patients had a large hemoperitoneum bigger than 1L, 5 patients had an IP of uterine stump after salpingectomy for a previous ectopic pregnancy. The most used surgical technique was in 60 % of cases the excision by Endo GIA stapling(®) with salpingectomy. Regarding fertility, 12 patients wished pregnancy in the aftermath of the intervention, 10 had at least one pregnancy, among them there is an ectopic contralateral ampullary pregnancy, and a contralateral recurrence of interstitial pregnancy. Four patients were delivered by cesarean section and 4 patients were delivered vaginally, some several times. No uterine rupture occured. DISCUSSION AND CONCLUSION: Interstitial pregnancy is a rare ectopic pregnancy. Its diagnosis is difficult and may involve maternal life-threatening and fertility. In subsequent pregnancies, the clinician has to be careful concerning the risks of interstitial pregnancy recurrence and uterine rupture.

3 Article Fertility after ectopic pregnancy: the DEMETER randomized trial. 2013

Fernandez, Hervé / Capmas, Perrine / Lucot, Jean Philippe / Resch, Benoit / Panel, Pierre / Bouyer, Jean / Anonymous3930752. ·Epidemiology of Reproduction and Child Development Team, Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, F94276 Le Kremlin Bicêtre, France. ·Hum Reprod · Pubmed #23482340.

ABSTRACT: STUDY QUESTION: Does treatment for the resolution of ectopic pregnancy (EP) affect subsequent spontaneous fertility [occurrence of an intrauterine pregnancy (IUP)]? SUMMARY ANSWER: There is no significant difference in 2 years subsequent fertility neither between methotrexate and conservative surgery for less active EP nor between conservative and radical surgery for the most active EP. WHAT IS KNOWN ALREADY: No randomized trial has compared radical and conservative surgery treatments. A recent review of the Cochrane database did not conclude about fertility due to insufficient data. Prospective studies from EP registries in two regions of France (Auvergne and Greater Lille) have suggested that fertility is similar after medical treatment and conservative surgery and lower after radical surgery. STUDY DESIGN, SIZE, DURATION: This randomized controlled trial included all women with an ultrasound-confirmed EP. Women were divided into two arms according to the activity of the EP (defined by Fernandez's score). In arm 1 (less active ectopic pregnancies, i.e. Fernandez's score <13 and no haemodynamic failure), medical treatment was considered practicable, and women were randomly allocated to conservative surgery with a systematic post-operative i.m. methotrexate injection within 24 h or to an i.m. methotrexate injection alone. In arm 2 (active ectopic pregnancies), medical treatment was considered impracticable, and, thus, all women had to undergo surgery; they were randomly allocated to either a radical or conservative procedure, the latter including a post-operative methotrexate injection. Sample sizes (n = 210 in arm 1 and n = 230 in arm 2) were computed to provide a statistical power of 80% to detect a 20% difference in subsequent cumulative fertility rates between treatments in each arm. The total duration of the trial was 5 years. PARTICIPANTS/MATERIALS, SETTINGS, METHODS: The trial took place in 17 centres in France from 2005 to 2009. Two hundred and seven women were included in arm 1 and 199 in arm 2. Cumulative fertility curves were drawn with the Kaplan-Meier method and compared with the log-rank test. Hazard ratios (HRs) were computed with the Cox model. Analysis was performed according to the intention-to-treat principle. MAIN RESULTS: Arm 1: cumulative fertility curves were not significantly different between medical treatment and conservative surgery. HR was 0.85 (0.59-1.22) P = 0.37. The 2-year rates of IUP were 67% after medical treatment and 71% after conservative surgery. Arm 2: cumulative fertility curves were not significantly different between conservative and radical surgery. HR was 1.06 (0.69-1.63) P = 0.78. The 2-year rates of IUP were 70% after conservative surgery and 64% after radical surgery. LIMITATIONS, REASONS FOR CAUTION: Inclusion in this trial was more difficult than expected, especially in arm 2 in which women were reluctant to radical surgery. In consequence, the sample size was slightly lower than planned. However, due to a lower proportion of lost to follow-up than expected (10% instead of 15%), the statistical power remained very close to 80%. WIDER IMPLICATIONS OF THE FINDINGS: As it is a multicentre randomized trial, the results may be generalized with satisfactory confidence. The results of this trial invite gynaecologists to reconsider the management of EP and to modify balance between considerations of initial recovery and preservation of fertility. TRIAL REGISTRATION NUMBER: NCT00137982 on the WHO International Clinical Trials Registry Platform.

4 Article Fertility and pregnancy following pelvic arterial embolisation for postpartum haemorrhage. 2010

Sentilhes, Loïc / Gromez, A / Clavier, E / Resch, B / Verspyck, E / Marpeau, L. ·Department of Obstetrics and Gynaecology, Rouen University Hospital, Charles Nicolle, Rouen, France. loicsentilhes@hotmail.com ·BJOG · Pubmed #19832826.

ABSTRACT: OBJECTIVES: To determine and compare the fertility and pregnancy outcomes following embolisation with or without uterine-sparing surgery for postpartum haemorrhage, and to attempt to identify specific risk factors associated with an increased likelihood of intrauterine synechia. DESIGN: Retrospective study. SETTING: University-affiliated tertiary referral centre. POPULATION: All consecutive women who had an embolisation with or without uterine-sparing surgery (vessel ligation and/or uterine compression) for postpartum haemorrhage between 1994 and 2007 were included. METHODS: Data were retrieved from medical files and telephone interviews. MAIN OUTCOME MEASURE(S): Fertility and pregnancy outcomes, synechia. RESULTS: Data were available for 68 of the 85 women (80%) included in the study. Among the 15 women who complained of amenorrhoea or decreased flow of menstruation, synechia was found in all those who decided to undergo an ambulatory hysteroscopy (n = 8). Seventeen women had 26 pregnancies with 19 term deliveries, one ectopic pregnancy, two abortions and four miscarriages. The clinical courses of the 19 complete gestations were uneventful, but postpartum haemorrhage recurred in six women (31.6%) (caused by placenta accreta in two women). Fertility and pregnancy outcomes did not differ between women who had undergone embolisation versus both embolisation and a uterine-sparing surgical procedure. The occurrence of synechia was significantly associated with a higher rate of placenta accreta/percreta (P < 0.001) and postpartum fever above 38.5 degrees C (P = 0.04). CONCLUSIONS: Embolisation, whether or not associated with a uterine-sparing surgical procedure, for postpartum haemorrhage does not appear to compromise a woman's subsequent fertility and obstetric outcome. Nevertheless, these women should be considered at high risk for postpartum haemorrhage during future deliveries.