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Infertility: HELP
Articles by Antoine Torre
Based on 12 articles published since 2008
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Between 2008 and 2019, A. Torre wrote the following 12 articles about Infertility.
 
+ Citations + Abstracts
1 Guideline [Management of endometriosis: CNGOF-HAS practice guidelines (short version)]. 2018

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

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

2 Review [Quality of oocytes and embryos from women with polycystic ovaries syndrome: State of the art]. 2017

Fournier, A / Torre, A / Delaroche, L / Gala, A / Mullet, T / Ferrières, A / Hamamah, S. ·Département de biologie de la reproduction et du diagnostic pré-implantatoire, hôpital Arnaud-de-Villeneuve, CHU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France. · Département gynécologie-obstétrique, hôpital Arnaud-de-Villeneuve, CHU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France. · Clinique P. Cherest, centre de fécondation in vitro, 5, rue Pierre-Cherest, 92200 Neuilly-sur-Seine, France. · Département de biologie de la reproduction et du diagnostic pré-implantatoire, hôpital Arnaud-de-Villeneuve, CHU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France; Inserm U1203, institut de médecine régénérative et biothérapies (IRMB), hôpital Saint-Éloi, CHRU de Montpellier, 80, rue Augustin-Fliche, 34295 Montpellier, France. · Département de biologie de la reproduction et du diagnostic pré-implantatoire, hôpital Arnaud-de-Villeneuve, CHU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France; Inserm U1203, institut de médecine régénérative et biothérapies (IRMB), hôpital Saint-Éloi, CHRU de Montpellier, 80, rue Augustin-Fliche, 34295 Montpellier, France. Electronic address: s-hamamah@chu-montpellier.fr. ·Gynecol Obstet Fertil Senol · Pubmed #28757106.

ABSTRACT: The frequency of polycystic ovary syndrome (PCOS) and the consequent fertility disorders cause many difficulties in the management of the assisted reproductive technics. Some studies are focused on different additional treatments, stimulation protocols or techniques that could optimize the in vitro fertilization cycles. The quality of the oocytes and embryos of these patients is also an outstanding issue. They remain difficult to actually evaluate during management, and none of the few published studies on this subject demonstrated any inferiority, compared to control patients. However, many differences have been highlighted, studying intra- and extra-ovarian factors. The advent of new genetic techniques could allow a better understanding of the pathophysiological mechanisms of the syndrome, as well as refining the evaluation of oocytes and embryos, in order to better predict the results of in vitro fertilization attempts. Pregnancy and birth rates, however, appear to be comparable to those of the general population.

3 Review [Role of GnRH agonists in preserving female fertility]. 2014

Thomin, A / Torre, A / Daraï, É / Chabbert-Buffet, N. ·Service de gynécologie obstétrique, médecine de la reproduction, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France. Electronic address: anne.thomin@tnn.aphp.fr. · Service de gynécologie obstétrique, médecine de la reproduction, centre hospitalier intercommunal Poissy, 78300 Saint-Germain-en-Laye, France. · Service de gynécologie obstétrique, médecine de la reproduction, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France. ·J Gynecol Obstet Biol Reprod (Paris) · Pubmed #24321862.

ABSTRACT: The impact of cancer treatment on ovarian function and fertility has been known since the 70s. Preservation of fertility is now an important focus of care for patients of reproductive age with cancer. The beneficial role of GnRH agonists in fertility preservation is controversial since the early 2000s. Recent randomized studies come to overturn this role. The POEMS multicenter randomized trial with long-term follow-up is ongoing and will provide results that could help clarify the current uncertain indication of these compounds in this context.

4 Review Ovarian drilling for surgical treatment of polycystic ovarian syndrome: a comprehensive review. 2011

Fernandez, Hervé / Morin-Surruca, Michèle / Torre, Antoine / Faivre, Erika / Deffieux, Xavier / Gervaise, Amélie. ·Univ Paris-Sud, Bicêtre, France. herve.fernandez@bct.aphp.fr ·Reprod Biomed Online · Pubmed #21511534.

ABSTRACT: This systematic literature review is intended to clarify and evaluate the results obtained by ovarian drilling as surgical treatment for polycystic ovarian syndrome (PCOS). Four databases were consulted (Medline at the National Library of Medicine, USA; Cochrane Library, UK; National Guideline Clearinghouse, USA; and the Health Technology Assessment Database, Sweden) and searched for 'polycystic ovary syndrome' plus 'drilling' in the title or abstract. The assessment criteria used to define the efficacy of the procedure were the rates of ovulation, clinical pregnancy and early miscarriage. Alternatives to surgical ovarian drilling were evaluated. This search produced 147 references, 81 of which met the selection criteria. This review of infertility management in women with PCOS indicates that ovarian drilling is a second-line treatment when treatment with clomiphene citrate fails to lead to conception. The benefits of ovarian drilling are that it does not induce either hyperstimulation syndrome or multiple pregnancies. It is concluded that ovarian drilling is an option in the management of female infertility associated with PCOS, especially as a second-line treatment after the failure of clomiphene citrate treatment.

5 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.

6 Review [Statement: cancer treatments and ovarian reserve]. 2010

Basille, C / Torre, A / Grynberg, M / Gallot, V / Frydman, R / Fanchin, R. ·Université Paris-Sud, 92140 Clamart, France. ·J Gynecol Obstet Biol Reprod (Paris) · Pubmed #20674192.

ABSTRACT: PURPOSE OF REVIEW: The purpose of this review is to update the reader on the impact of cancer treatment on fertility, the options of fertility preservation, and the new markers to assess ovarian function. ESSENTIAL POINTS: The impact of chemotherapy and radiotherapy on fertility depends on the drugs and the doses used. It often affects ovarian reserve significantly, and the presence of menstruation is not a reliable reflection of it. Fertility preservation techniques, such as ovarian protection, and preferably cryopreservation combined with assisted reproductive medicine, should be individually discussed and possibly proposed to the patients. The use of new markers for ovarian reserve assessment will help to evaluate infraclinic chemotherapy and/or radiotherapy-induced effects on ovarian reserve, prior to clinical effects.

7 Article Uterine contractility and elastography as prognostic factors for pregnancy after intrauterine insemination. 2017

Swierkowski-Blanchard, Nelly / Boitrelle, Florence / Alter, Laura / Selva, Jacqueline / Quibel, Thibaud / Torre, Antoine. ·EA7404, Gamètes, Implantation, Gestation, Université de Versailles Saint Quentin en Yvelines, Montigny-le-Bretonneux, France; Service de Gynécologie Obstétrique, Hôpital de Poissy Saint Germain en Laye, Poissy, France. · EA7404, Gamètes, Implantation, Gestation, Université de Versailles Saint Quentin en Yvelines, Montigny-le-Bretonneux, France; Service de Biologie de la Reproduction, Hôpital de Poissy Saint Germain en Laye, Poissy, France. · Service de Gynécologie Obstétrique, Hôpital de Poissy Saint Germain en Laye, Poissy, France. · EA7404, Gamètes, Implantation, Gestation, Université de Versailles Saint Quentin en Yvelines, Montigny-le-Bretonneux, France; Service de Gynécologie Obstétrique, Hôpital de Poissy Saint Germain en Laye, Poissy, France. Electronic address: dr.antoine.torre@gmail.com. ·Fertil Steril · Pubmed #28283264.

ABSTRACT: OBJECTIVE: To determine the impact of the frequency and intensity of uterine contractions (UCs) at the time of IUI on subsequent fertility. DESIGN: Observational pilot study. SETTING: University hospital. PATIENT(S): One hundred volunteer women scheduled for IUI between April 2011 and July 2013, in whom UCs were assessed during the ultrasound before IUI. INTERVENTION(S): A two-dimensional sagittal uterus elastography was recorded for 5 minutes. The elasticity index, defined as the mean ratio of elastographic measurements between the subendometrial area (of interest) and the endometrial area (control), was computed. UC frequency, endometrial thickness and volume, and subendometrial vascularisztion were also measured. MAIN OUTCOME MEASURE(S): These parameters, along with characteristics of the IUI cycle, were entered into a logistic regression model for predicting ongoing pregnancy. RESULT(S): The elasticity index was significantly higher (2.4 ± 1.3 vs. 1.5 ± 0.7, i.e., with stiffer myometrium), and the endometrium was significantly less echogenic in future pregnant women. Factors closely reaching significance were age, previous fertility, day 3 hormonal assessments, number of inseminated spermatozoa, endometrial thickness, and UC count. In multivariate analysis, low UC frequency (<2.8/minute; odds ratio [OR] = 0.039), high elasticity index (>1.7; OR = 63.26), high endometrial thickness on the ovulation triggering day (>8 mm; OR = 28.21), and low patient age (<32 years; OR = 0.001) were predictive of pregnancy after IUI. CONCLUSION(S): A low frequency and high intensity of UCs at the day of IUI appears associated with a higher pregnancy rate. Elastography provides a promising innovative tool for IUI monitoring.

8 Article Fertility after uterine artery embolization for symptomatic multiple fibroids with no other infertility factors. 2017

Torre, Antoine / Fauconnier, Arnaud / Kahn, Vanessa / Limot, Olivier / Bussierres, Laurence / Pelage, Jean Pierre. ·EA7404, Gamètes, Implantation, Gestation, UFR des Sciences de la Santé Simone Veil, 2 Avenue de la Source de la Bièvre, 78180, Montigny-le-Bretonneux, France. · Service de Gynécologie Obstétrique, Hôpital de Poissy Saint Germain en Laye, 10 rue du Champ Gaillard, Poissy, France. · Service de Gynécologie Obstétrique, Hôpital de Poissy Saint Germain en Laye, 10 rue du Champ Gaillard, Poissy, France. afauconnier@chi-poissy-st-germain.fr. · EA7285, Risques cliniques et sécurité en santé des femmes et en santé périnatale, UFR des Sciences de la Santé Simone Veil, 2 Avenue de la Source de la Bièvre, 78180, Montigny-le-Bretonneux, France. afauconnier@chi-poissy-st-germain.fr. · Department of Obstetric Gynecology, Poissy-Saint Germain Hospital, 10 rue du Champ Gaillard, F-78303, Poissy, France. afauconnier@chi-poissy-st-germain.fr. · Service de Gynécologie Obstétrique, Hôpital Bichat Claude Bernard, 46 Rue Henri Huchard, 75018, Paris, France. · Service de Radiologie, Hôpital de Poissy Saint Germain en Laye, 10 rue du Champ Gaillard, Poissy, France. · URC Paris Descartes Necker Cochin, 149 Rue de Sèvres, 75015, Paris, France. ·Eur Radiol · Pubmed #27966042.

ABSTRACT: OBJECTIVES: To evaluate the fertility of women eligible for surgical multiple myomectomy, but who carefully elected a fertility-sparing uterine artery embolization (UAE). METHODS: Non-comparative open-label trial, on women ≤40 years, presenting with multiple symptomatic fibroids (at least 3, ≥3 cm), immediate pregnancy wish, and no associated infertility factor. Women had a bilateral limited UAE using tris-acryl gelatin microspheres ≥500 μm. Fertility, ovarian reserve, uterus and fibroid sizes, and quality of life questionnaires (UFS-QoL) were prospectively followed. RESULTS: Fifteen patients, aged 34.8 years (95%CI 32.2-37.5, median 36.0, q1-q3 29.4-39.5) were included from November 2008 to May 2012. During the year following UAE, 9 women actively attempting to conceive experienced 5 live-births (intention-to-treat fertility rate 33.3%, 95%CI 11.8%-61.6%). Markers of ovarian reserve remained stable. The symptoms score was reduced by 66% (95%CI 48%-85%) and the quality of life score was improved by 112% (95%CI 21%-204%). Uterine volume was reduced by 38% (95%CI 24%-52%). Women were followed for 43.1 months (95%CI 32.4-53.9), 10 live-births occurred in 8 patients, and 5 patients required secondary surgeries for fibroids. CONCLUSION: Women without associated infertility factors demonstrated an encouraging capacity to deliver after UAE. Further randomized controlled trials comparing UAE and myomectomy are warranted. KEY POINTS: • Women without infertility factors showed an encouraging delivery rate after UAE. • For women choosing UAE over abdominal myomectomy, childbearing may not be impaired. • Data are insufficient to definitively recommend UAE as comparable to myomectomy. • Further randomized trials comparing fertility after UAE or myomectomy are warranted.

9 Article A human morphologically normal spermatozoon may have noncondensed chromatin. 2015

Boitrelle, F / Pagnier, M / Athiel, Y / Swierkowski-Blanchard, N / Torre, A / Alter, L / Muratorio, C / Vialard, F / Albert, M / Selva, J. ·Department of Reproductive Biology and Cytogenetics, Poissy General Hospital, Poissy, France. · EA 2493, University of Saint-Quentin-en-Yvelines, France. ·Andrologia · Pubmed #25220830.

ABSTRACT: According to numerous assisted reproductive medicine practitioners, semen with normal characteristics might not require further investigation. However, on the scale of the individual spermatozoon, it is well known that normal morphology does not guarantee optimal nuclear quality. Here, for 20 patients with normal sperm characteristics and a high proportion of spermatozoa with noncondensed chromatin, we subsequently assessed chromatin condensation status (aniline blue staining) and morphology (Papanicolaou staining) of the same 3749 spermatozoa. Although the overall proportion of morphologically normal spermatozoa was not correlated with the overall proportion of spermatozoa with noncondensed chromatin, an individual spermatozoon's morphology appeared to be closely related to its chromatin condensation status. Morphologically normal spermatozoa with noncondensed chromatin were seen in all patients; the proportion averaged 23.3% [min 10.9%-max 44.4%]. Morphologically abnormal spermatozoa were more likely to have noncondensed chromatin than morphologically normal ones (P < 0.0001). Small-, large- or multiple-headed spermatozoa presented the highest degree of noncondensation (>80% for each type), and more than half the vacuolated spermatozoa also presented noncondensed chromatin. However, a morphologically normal spermatozoon may also have a noncondensed chromatin.

10 Article Uterine artery embolization for severe symptomatic fibroids: effects on fertility and symptoms. 2014

Torre, A / Paillusson, B / Fain, V / Labauge, P / Pelage, J P / Fauconnier, A. ·Paris Ile de France Ouest School of Medicine, Versailles Saint Quentin en Yvelines University, 2 avenue de la Source de la Bièvre, F-78180, Montigny-Le-Bretonneux, France. ·Hum Reprod · Pubmed #24430777.

ABSTRACT: STUDY QUESTION: Does uterine artery embolization (UAE) permit fertility in childbearing women who have extensive symptomatic fibroids and are not eligible for surgery? SUMMARY ANSWER: Although UAE was effective in improving bleeding, bulking and pain symptoms, and in sparing the ovarian reserve, no woman in this study delivered successfully after UAE. WHAT IS KNOWN ALREADY: Although pregnancies have been reported after UAE, the actual fertility rate after this treatment remains uncertain. STUDY DESIGN, SIZE, DURATION: This prospective cohort study included 66 women who desired a future pregnancy and were treated with UAE for symptomatic fibroids. PARTICIPANTS/MATERIALS, SETTING, METHODS: This cohort of consecutive patients had extensive symptomatic fibroids but were not eligible for abdominal myomectomy because of fibroid recurrence despite previous surgery, because of current risks of surgery, or because of patient refusal. The patients were enrolled in a tertiary referral center for fibroid treatment. All patients had a pre-operative ovarian function assessment and underwent bilateral superselective embolization of both uterine arteries using 500-1200 µm Tris acryl microspheres. MAIN RESULTS AND THE ROLE OF CHANCE: Fibroid symptoms including menorrhagia (OR 0.08, 95% CI 0.02-0.27), metrorrhagia (OR 0.05, 95% CI 0.01-0.39), pain (OR 0.08, 95% CI 0.03-0.22) and bulk syndrome (OR 0.02, 95% CI 0.01-0.07) were significantly improved after UAE. According to magnetic resonance imaging, the dominant fibroid volume decreased by 31.8% (95% CI 12.2-51.3%). Ovarian reserve demonstrated no change after embolization. Thereafter the women were prospectively followed, and 31 of them (aged 37.3 ± 3.5 years) were actively trying to conceive. In spite of 33.4 ± 14.5 months of attempts, only 1 in 31 women became pregnant and she finally miscarried (monthly fecundability rate 0.1% 95% CI 0-0.3%). LIMITATIONS, REASONS FOR CAUTION: The high rate of associated infertility factors in our population, and the high frequency of previous surgery, could in part explain these poor reproductive outcomes; however, they should not account for the total absence of ongoing pregnancy. Embolization might have had a negative impact on fertility in our population, which may not be related to ovarian function. WIDER IMPLICATIONS OF THE FINDINGS: The low reproductive outcomes reported in the present study suggest that UAE should not be performed routinely in young women of childbearing age with extensive fibroids. Although this finding was established in a population for whom abdominal myomectomy was declined, a possible adverse effect of UAE on fertility potential should be considered for woman of childbearing age scheduled for embolization. STUDY FUNDING/COMPETING INTEREST(S): No particular funding was obtained for this study and the authors have no conflict of interest.

11 Article Adiponectin and leptin systems in human endometrium during window of implantation. 2012

Dos Santos, Esther / Serazin, Valérie / Morvan, Corinne / Torre, Antoine / Wainer, Robert / de Mazancourt, Philippe / Dieudonné, Marie-Noëlle. ·Service de Biochimie et Biologie Moléculaire, Unité Propre de Recherche et de l'Enseignement Supérieur- Equipe d'Accueil 2493, Pôle de Recherche et de l'Enseignement Supérieur Universud Paris, Centre Hospitalier de Poissy-Saint Germain, Poissy Cedex, France. dossantos.esther@orange.fr ·Fertil Steril · Pubmed #22265003.

ABSTRACT: OBJECTIVE: To measure the expression of adiponectin, leptin, and their respective receptors in the human endometria of fertile women compared with women with unexplained recurrent implantation failure (IF) during the window of implantation. DESIGN: Controlled, prospective, clinical study. SETTING: Teaching hospital and university research laboratory. PATIENT(S): Thirty-one endometrial biopsies from women with IF and 19 fertile controls. INTERVENTION(S): Human endometrial biopsies. MAIN OUTCOME MEASURE(S): Gene and protein expression of endometrial biopsies. RESULT(S): Endometrial leptin expression was significantly lower in the IF group compared with fertile women. In contrast, leptin receptor (Ob-R) expression was higher in endometria of women with IF. Concerning the adiponectin system, adiponectin was expressed to the same extent in both groups. Conversely, the expression of its two receptors, AdipoR1 and AdipoR2, was reduced in endometria of women with IF compared with fertile women. CONCLUSION(S): Although progesterone resistance seems to be a common state of the endometrium in some human reproductive disorders, such as endometriosis or polycystic ovary syndrome, modification in leptin endometrial expression seems to be specific to IF. These results strongly suggest that changes in Ob-R and AdipoR expression profiles [1] should be implicated in the development of uterine receptivity, and [2] may therefore be potential new targets for prediction of IF.

12 Minor Reply: uterine artery embolization for severe symptomatic fibroids: effects on fertility and symptoms. 2014

Torre, Antoine / Paillusson, Bénédicte / Fain, V / Labauge, P / Pelage, J P / Fauconnier, A. ·Versailles Saint Quentin en Yvelines University, Versailles, France Department of Gynaecology and Obstetrics, Hospital of Poissy Saint Germain en Laye, Poissy, France antoinetorre@voila.fr. · Versailles Saint Quentin en Yvelines University, Versailles, France Department of Gynaecology and Obstetrics, Hospital of Poissy Saint Germain en Laye, Poissy, France. · Department of Gynaecology and Obstetrics, Hospital Bichat Claude Bernard, Paris, France. · Department of Radiology, Hospital of Poissy Saint Germain en Laye, Poissy, France. · Versailles Saint Quentin en Yvelines University, Versailles, France Department of Radiology, Hospital of Poissy Saint Germain en Laye, Poissy, France. ·Hum Reprod · Pubmed #24939959.

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