Service de Medecine de la Reproduction

Bondy, France

Service de Medecine de la Reproduction

Bondy, France
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Frydman R.,University Paris - Sud | Grynberg M.,Service de Medecine de la Reproduction | Grynberg M.,University of Paris 13 | Grynberg M.,University Paris Diderot
Fertility and Sterility | Year: 2016

Oocyte and ovarian tissue cryopreservation represents one of the most important advances in the field of reproductive medicine and biology. Preserving a woman's potential for becoming a genetic mother is now possible for numerous diseases that could impair female fertility either by themselves or as a result of their treatments. However, female fertility preservation is still at the pioneering level and is thus often considered an experimental treatment either from a technical standpoint or in the clinical situation in which it is discussed. As a consequence, many ethics issues are raised with fertility preservation treatment in infants, adolescents, and young women.

Barraud-Lange V.,University of Paris Descartes | Pont J.-C.,University of Paris Descartes | Ziyyat A.,University of Paris Descartes | Pocate K.,University of Paris Descartes | And 5 more authors.
Fertility and Sterility | Year: 2011

Objective: To assess the effect of leukocytospermia on assisted reproductive technology outcomes. Design: Retrospective analysis. Setting: University laboratory. Patient(s): Couples attending the infertiliy clinic and involved in ART program for IVF or ICSI. Intervention(s): During a 7-year follow-up in an assisted reproductive technology program, leukocytospermia was routinely determined using the peroxidase technique. Donor sperm were excluded from the study. Main Outcome Measure(s): Egg retrievals (N = 3,508) were distributed in 3 groups according to the leukocyte levels in semen from which fertilizing sperm were extracted: group 1, absence of leukocytes (n = 3,026); group 2, moderate leukocytospermia (<10 6/mL) (n = 344); or group 3, high leukocytospermia (≥10 6/mL) (n = 138). They resulted in 1,463 IVF and 2,045 intracytoplasmic sperm injection procedures that gave 802 clinical pregnancies. Result(s): Surprisingly, the fertilization rate, cleavage rate, clinical pregnancy rate, gestational age, and mean infant weight were significantly improved when seminal leukocytes were present, regardless of the technique used. The only negative side effects associated with a high level of seminal leukocytes (group 3) were an elevated rate of early pregnancy loss (from 26.6% to 40.5%) and a 3-fold increase in the percentage of ectopic pregnancies. Conclusion(s): At moderate levels (<10 6/mL), leukocytospermia appears to be physiologic. It is associated with improved sperm fertilization ability and pregnancy outcome. At higher concentrations, leukocytospermia alters neither sperm fertilization ability nor the probability of clinical pregnancy when compared with nonleukocytic patients with infertility. However, the pregnancy outcome is reduced. Copyright © 2011 American Society for Reproductive Medicine.

Frydman R.,University Paris - Sud | Grynberg M.,Service de Medecine de la Reproduction | Grynberg M.,University of Paris 13 | Grynberg M.,University Paris Diderot
Fertility and Sterility | Year: 2016

It is now well established that many benign or malignant diseases may by themselves or as result of treatment, impair male fertility. Therefore, preserving the potential of becoming a genetic father represents a major issue. Besides sperm cryopreservation, which is the most reliable method for male fertility preservation, other strategies have more recently emerged, especially in prepubertal boys. Prepubertal germ cell storage from testicular sperm extraction and derivation of male gametes from stem cells may represent a future hope, although raising many ethical issues. © 2016

Grange C.,Hopital Rangueil | Bonal M.,Service de Medecine de la Reproduction | Huyghe E.,Hopital Rangueil | Leguevaque P.,Service de Chirurgie Generale et Gynecologique | And 2 more authors.
Gynecologie Obstetrique Fertilite | Year: 2013

Objectives: Sexual dysfunction is currently the most common complication of cancer. Most of the time, patients who are concerned by locally advanced cervical cancer are in a period of sexual activity. The primary objective of this study was to assess the quality of life and sexual function of patients with locally advanced cervical cancer who were in remission. The secondary objective was to correlate the prognostic factor with sexual dysfunction. Patients and methods: This multicentric and prospective study included the patients with locally advanced cervical cancer diagnosis from three centres. Thirty-one patients with diagnosis of locally advanced cervical cancer were enrolled from February 2007 to October 2008. The mean age was 49 years old. Inclusion criteria were to have received the standard therapy by chemoradiotherapy and have been in remission for 2 years. Both self-administered questionnaires BISF-W and EORTC QLQ-CX24 allowed scoring quality of life and sexual function. Results: The rate of completion was 42%. The results confirmed that sexual function was impaired in accordance with sexual satisfaction. After therapy, the frequency of sexual activity was decreased. The functional quality of life was significantly correlated with sexual function. Marital status was a significant prognostic factor. Age, stage and the type of centre were not. Discussion and conclusion: This preliminary study suggests that after 2 years of remission of the disease after treatment, patients and their partners need to be helped as regards their sexual function. We propose to perform a prospective study on a larger cohort.© 2012 Elsevier Masson SAS. All rights reserved.

Grynberg M.,Service de Medecine de la Reproduction | Grynberg M.,University of Paris 13 | Grynberg M.,University Paris Diderot | Frydman R.,Service de Gynecologie Obstetrique
Minerva Ginecologica | Year: 2014

Conservative and functional surgery is increasingly used in surgical oncology. Although radical surgery remains the gold standard for treatment of cervical, endometrial and ovarian cancers, conservative approaches have been developed, aiming at preserving the potential of fertility of young patients. These procedures are proposed to selected patients, depending on histological parameters and prognostic factors as well. Therefore, a multidisciplinary approach is mandatory to weight the benefits and risks of fertility-sparing surgery.

Sonigo C.,Service de medecine de la reproduction | Sonigo C.,University of Paris 13 | Grynberg M.,Service de medecine de la reproduction | Grynberg M.,University of Paris 13
Gynecologie Obstetrique Fertilite | Year: 2014

Recovering immature oocytes from unstimulated ovaries, followed by in vitro maturation (IVM) was initially proposed to avoid the risks and side effects of exogenous gonadotropin administration. Therefore, during the past decades, IVM was mainly offered to patients with polycystic ovary syndrome at high risk of ovarian hyperstimulation syndrome. However, the development of fertility preservation has recently opened new perspectives in the field of IVM. The present review reports the possible indications of IVM, in the strategy of female fertility preservation. © 2014 Elsevier Masson SAS. All rights reserved.

PubMed | University of Paris 13, Service de cytogenetique et biologie de la reproduction, Service de medecine de la reproduction and University Paris Diderot
Type: Journal Article | Journal: Journal de gynecologie, obstetrique et biologie de la reproduction | Year: 2016

Advances on cryopreservation techniques now allow considering oocyte, embryo or ovarian tissue freezing for female fertility preservation. Originally developed for patients suffering from cancer, fertility preservation has rapidly invaded others medical fields, and represents now the standard of care for all young patient diagnosed with a disease that could impair fertility or having to receive possibly gonadotoxic treatment. As a result, autoimmune diseases, some genetic pathologies or iterative pelvic surgeries, at risk of premature ovarian failure, have become common indications of fertility preservation. In addition, the social egg freezing aiming at preventing the age-related fertility decline is still debated in France, although authorized in numerous countries. This review will discuss the different strategies of fertility preservation in young girls and women of reproductive age, regarding different medical or non-medical indications.

The French bio ethical law published in 2004 did not authorize the transfer of embryos submitted to a research program, or even issued from gametes concerned by an experimentation. Vitrification process was still considered as an "experimental" technique; thus it was impossible to vitrify either oocytes or embryos, whereas numerous international studies emphasized the interest of this technique for both oocytes and embryos, in particular if they were vitrified at the blastocyst stage. The new revised law (7/7/2011), clearly authorizes oocyte vitrification; moreover, studies intended to improve ART efficiency, are now permitted, enabling vitrification of embryos. © 2012 Elsevier Masson SAS. All rights reserved.

Weil E.,Service de Medecine de la Reproduction
Medecine Therapeutique Medecine de la Reproduction, Gynecologie et Endocrinologie | Year: 2011

The egg donation, illustrated by a clinical vignette and placed in the medicalization of reproduction addresses the separation of genetic and gestational parentage in the report to the status of "real" mother. Infantile sexual theories of prospective parents would find it revised? The construction of female identity seems to be repaired by the possible access to motherhood through pregnancy. As for the putative child, it would seem that psychoanalysis cannot provide a unique destiny before conception for those born using this technique. Oocyte donation is associated to a high degree of technical sophistication with an archaic gesture that is the gift from woman to woman, even remaining anonymous.

Dudkiewicz-Sibony C.,Service de medecine de la reproduction
Andrologie | Year: 2010

Based on the psychological interviews we had at CECOS with sperm donors and with requesting couples, and following the analysis of testimonials of children born through donations, we seek to outline that it is not mainly the anonymous donors who raise an issue, but the secret on the nature of the donation itself. It all becomes a family secret as the donation is not well received by the parents. This causes negative effects when the announcement is made lately and it is forbidden to talk about it. © Springer 2010.

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