Reçu le 19 mars 2005 ; accepté le 27 juillet 2005 Disponible sur internet le 21 octobre 2005 Résu... more Reçu le 19 mars 2005 ; accepté le 27 juillet 2005 Disponible sur internet le 21 octobre 2005 Résumé Objectif. -Évaluer les résultats d'un protocole d'insémination avec sperme de donneur, associant stimulation et monitorage de l'ovulation, préparation du sperme par migration ascendante et insémination intra-utérine, proposé aux patientes de moins de 39 ans. Apprécier l'influence de différents paramètres cliniques et biologiques sur les taux de grossesses. Patients et méthodes. -Analyse rétrospective de 249 cycles (106 couples) réalisés sur une période de quatre ans.
Due to their catalytic and oxidative properties, cerium dioxide nanoparticles (CeO 2 NPs) are wid... more Due to their catalytic and oxidative properties, cerium dioxide nanoparticles (CeO 2 NPs) are widely used as diesel additive or as promising therapy in cancerology; yet, scarce data are available on their toxicity, and none on their reproductive toxicity. We showed a significant decrease of fertilization rate, assessed on 1272 oocytes, during in vitro fertilization (IVF) carried out in culture medium containing CeO 2 NP at very low concentration (0.01 mg.l À1 ). We also showed significant DNA damage induced in vitro by CeO 2 NP on mouse spermatozoa and oocytes at 0.01 mg.l À1 using Comet assay. Transmission Electron Microscopy did not detect any nanoparticles in the IVF samples at 0.01 mg.l À1 , but showed, at high concentration (100 mg.l À1 ), their endocytosis by the cumulus cells surrounding oocytes and their accumulation along spermatozoa plasma membranes and oocytes zona pellucida. We did not observe any nanoparticles in the cytoplasm of spermatozoa, oocytes or embryos. This study demonstrates for the first time the impact of CeO 2 NP on in vitro fertilization, as well as their genotoxicity on mouse spermatozoa and oocytes, at low nanoparticle concentration exposure. Decreased fertilization rates may result from: (1) CeO 2 NP's genotoxicity on gametes; (2) a mechanical effect, disrupting gamete interaction and (3) oxidative stress induced by CeO 2 NP. These results add new and important insights with regard to the reproductive toxicity of nanomaterials requesting urgent evaluation, and support several publications on metal nanoparticles reprotoxicity. Our data highlight the need for in vivo studies after low-dose exposure.
To assess midwifery students' knowledge in the field of female fertility and to study their d... more To assess midwifery students' knowledge in the field of female fertility and to study their decision if they had diagnosis of diminished ovarian reserve (DOR). A prospective observational study by self-administered questionnaire was conducted among female midwifery students of seven French schools from June to December 2013. The questionnaire had three parts: (1) questions designed to gather information on the study population; (2) a questionnaire consisting of 10 items to test knowledge about female fertility and ovarian reserve; (3) a self-administered questionnaire simulating a DOR diagnosis and quantifying the decision that students would make using a Likert scale of 5 points. The participation rate was 72.5% (n=285/393). The average age was 22, 6 years±1.9. Among the 285 participants, the ovarian reserve concept was known by 93% of them (n=265) thanks to the midwifery studies (77%, n=204), the media (9%, n=24) and other sources of information. In total, 83.5% of midwifery s...
Our aim was to analyse the results of a donor insemination program using ovarian stimulation, swi... more Our aim was to analyse the results of a donor insemination program using ovarian stimulation, swim-up sperm preparation and intrauterine insemination proposed to women with a maximum age of 39. Incidence of several clinical and biological parameters on success rates was investigated. Retrospective analysis of the results of 249 cycles performed in 106 couples during a four-year period is reported. Overall pregnancy rate of 28.1% and delivery rate of 22% per cycle were achieved, with a multiple pregnancy rate of 11.4%. Most of the pregnancies (84%) were obtained before the fourth insemination. Among the different parameters studied the total number of motile sperm inseminated was found to be the most important factor for success rate: pregnancy rate per cycle reached 40.4% if more than 1.5 million progressive sperm were inseminated vs. 24.7% if they were less than 1.5 million (P<0.05). In precise conditions, outcome of inseminations with donor semen can reach satisfying pregnancy ...
Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine
The breastfeeding initiation rate is extremely disparate worldwide and remains low in France, wit... more The breastfeeding initiation rate is extremely disparate worldwide and remains low in France, with a breastfeeding initiation rate of 60.2%. Some studies have reported increased early parenting difficulties in women who conceived with in vitro fertilization (IVF). Our study had two main objectives: (1) to determine by a retrospective chart review the demographic and medical factors associated with breastfeeding versus formula feeding in women who had undergone IVF and (2) to assess by survey study the reasons for the infant feeding decision (breastfeeding versus formula feeding) for women who conceived by IVF. By telephone interviews, we conducted a longitudinal nonexperimental cohort study of French women who had a live birth after IVF. Fertility data and obstetric outcomes were collected from individual medical records. Among women who had a live birth after IVF (n=73), 63% (n=46) initiated breastfeeding for a mean duration of 6.2±6.2 months. In our IVF population, the breastfeedi...
Reçu le 19 mars 2005 ; accepté le 27 juillet 2005 Disponible sur internet le 21 octobre 2005 Résu... more Reçu le 19 mars 2005 ; accepté le 27 juillet 2005 Disponible sur internet le 21 octobre 2005 Résumé Objectif. -Évaluer les résultats d'un protocole d'insémination avec sperme de donneur, associant stimulation et monitorage de l'ovulation, préparation du sperme par migration ascendante et insémination intra-utérine, proposé aux patientes de moins de 39 ans. Apprécier l'influence de différents paramètres cliniques et biologiques sur les taux de grossesses. Patients et méthodes. -Analyse rétrospective de 249 cycles (106 couples) réalisés sur une période de quatre ans.
Un déclin des paramètres spermatiques au cours des dernières décennies est décrit dans la littéra... more Un déclin des paramètres spermatiques au cours des dernières décennies est décrit dans la littérature et l’on suspecte l’existence d’un lien entre ce déclin et l’exposition des hommes à des agents reprotoxiques d’origine professionnelle et/ou environnementale. De nombreuses études épidémiologiques se sont penchées sur l’effet des expositions professionnelles sur la fertilité. Il s’avère que les salariés du bâtiment et des travaux publics (BTP) sont particulièrement exposés aux agents reprotoxiques. Cet article a pour objectif de faire la revue des substances ayant un impact négatif sur les paramètres spermatiques, la fertilité et la descendance des hommes employés dans le BTP.Les principaux facteurs retrouvés dans ce secteur d’activité et susceptibles d’être impliqués dans l’altération de la qualité spermatique et/ou de la fertilité masculine sont les solvants (en particulier les éthers de glycol), les métaux (fumée de soudage, plomb), les hydrocarbures aromatiques polycycliques et la chaleur. Nous exposons ici, après un bref rappel de la physiologie de la spermatogenèse, les effets de ces différents facteurs sur la reproduction ainsi que leurs mécanismes d’action. Ces expositions professionnelles peuvent également avoir un retentissement sur la descendance des sujets avec un risque accru d’anomalies de fermeture du tube neural et de cancers (leucémies et tumeurs du système nerveux central).De ces données découlent des implications cliniques pour le médecin du travail et le médecin de la reproduction. En effet, environ 15 % des couples consultent pour infertilité dans les pays occidentaux. Il est important de prendre en compte l’environnement professionnel dans l’exploration de leur infertilité. La collaboration entre les médecins de la reproduction et les médecins du travail est donc à développer.A decline of semen parameters during the last decades is described in the literature; a link is suspected between this decline and human exposure to reprotoxic occupational and/or environmental agents. Numerous epidemiological studies examined the effect of occupational exposure on fertility and showed that employees in the building-trade are particularly exposed to reprotoxic agents. This article aims to review the substances having a negative impact on semen parameters, fertility and offspring of men employed in the building-trade.The main factors of reduced sperm parameters and/or male fertility found in this occupational sector are solvents (especially glycol ethers), metals (welding fumes, lead), Polycyclic Aromatic Hydrocarbons and heat. After a brief review of the physiology of spermatogenesis, we present the effects of these factors on reproduction and their mechanisms of action. These occupational exposures may also have an impact on the offspring of exposed subjects with an increased risk of neural tube defects and cancers (leukemias and tumors of the central nervous system).These data have clinical implications for the occupational physicians and reproductive medicine physicians. Indeed, about 15 % of couples consult for infertility in Western countries. Occupational exposures are of importance in their infertility exploration. Collaboration between occupational and reproductive medicine physicians is thus to developed.
Les bourgeons des membres supérieurs, constitués d'un axe mésenchymateux recouvert d'épiblaste, a... more Les bourgeons des membres supérieurs, constitués d'un axe mésenchymateux recouvert d'épiblaste, apparaissent à partir de la cinquième semaine de développement dans la région cervicale de l'embryon. Leur croissance proximo-distale dépend de facteurs diffusibles synthétisés par la crête apicale ectoblastique. D'autres facteurs, produits au niveau de la zone d'activité polarisante et de l'ectoderme, agissent en coordination pour assurer la croissance cranio-caudale et déterminer la polarité dorso-ventrale. Le développement des éléments squelettiques spécifiques des segments du membre est contrôlé par des facteurs de transcription appartenant à la famille HOX, exprimés dans une cascade de transcription dans le bourgeon. Les mécanismes embryologiques des principales malformations de la main sont évoqués, ainsi que certaines de leurs étiologies connues, de nature génétique ou mécanique. # 2008 Elsevier Masson SAS. Tous droits réservés.
to compare the options available for prostate cancer management and their consequences on fertili... more to compare the options available for prostate cancer management and their consequences on fertility on men, in order to best advise these men to choose their treatment, especially if they are young, with no child with their current partner. a literature review on prostate cancer and fertility over the last 26 years was carried out on Pubmed database. The literature was based on evidence and pratical considerations. Twenty nine articles were selected according to their relevance. after prostatectomy, there is an obstructive infertility in 100% of the cases. In external radiotherapy, doses more than 15 cGy induced reduction in sperm count. Direct irradiation between 15 and 35 cGy caused oligozoospermia and doses between 35 and 50 cGy caused reversible azoospermia. The calculated projected doses on testicles were 196 cGy (+/-145 cGy). The brachytherapy effects on fertility seems to be less harmful. The irradiation dose received by testicles is less important (less than 20 cGy) after brachytherapy than after external radiotherapy. Infertility induced by hormonal therapy alone should be reversible. Fertility and focal therapy haven&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;t been well evaluated yet. Active surveillance is the management of prostate cancer which allows to keep at best men&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s fertility. urologists should consider approaching the topic of infertility when discussing the pros and cons of various prostate cancer management with their younger patients. If a patient with prostate cancer expresses interest in future fertility, a semen analysis should be performed. Cryopreservation represents the only preemptive accompanying possibility to preserve fertility in young cancer patients.
Background: In couples presenting with retrograde ejaculation refractory to medical treatment, th... more Background: In couples presenting with retrograde ejaculation refractory to medical treatment, the first choice of fertility treatment should be Assisted Reproductive Techniques using rapidly purified spermatozoa retrieved from post-ejaculatory urine. The Hotchkiss technique and modified variants are simple and efficient for retrieving sperm from the bladder. We developed a new protocol, including a novel modified Hotchkiss technique involving sperm cryopreservation. The aim was to study the pregnancy rate and birth rate achieved by intra cytoplasmic sperm injection (ICSI) using frozen-thawed sperm retrieved from the bladder with this novel modified Hotchkiss technique in patients with refractory retrograde ejaculation. Results: In this descriptive retrospective, single-center study, we analyzed the local database of all patients who banked sperm at A total of 2171 patients banked sperm during this time, including 63 patients with retrograde ejaculation, of whom ten patients banked sperm that had been retrieved by the modified Hotchkiss technique. These ten couples underwent 26 ICSI cycles: nine clinical pregnancies were achieved in six couples, including eight after fresh embryo transfer and one after thawed embryo transfer, resulting in seven live births. The average live birth rate per transfer was 28 %. Conclusions: We report the largest series of births using frozen-thawed spermatozoa retrieved from post-ejaculatory urine by a modified Hotchkiss technique. This series of births demonstrates that this new modified Hotchkiss technique allows for successful association with sperm cryopreservation, leading to an efficient and easy management of couples with refractory retrograde ejaculation.
Men with spinal cord injury present a unique infertile population. Only 10 % of them can father c... more Men with spinal cord injury present a unique infertile population. Only 10 % of them can father children without medical assistance, owing to potential impairments in erection, ejaculation and semen quality. The algorithm typically followed is to retrieve semen by Penile Vibratory Stimulation, in case of failure by Electro Ejaculation. Most of these patients have normal sperm concentrations but abnormally low sperm motility and vitality in the ejaculate. The reasons for poor semen quality in spinal cord injured men are reviewed. If semen cannot be obtained by Electro Ejaculation, or if the ejaculate from Penile Vibratory Stimulation or Electro Ejaculation contains an insufficient quantity or quality of sperm for in vitro fertilization with intracytoplasmic sperm injection, then retrieval of sperm from reproductive tissues is attempted. Despite abnormal semen quality, successful pregnancies with sperm from spinal cord injured male partners have occurred by intravaginal insemination, ...
Journal de Gynécologie Obstétrique et Biologie de la Reproduction
An amendment to the French bioethics law allowing children conceived by gamete donation to know t... more An amendment to the French bioethics law allowing children conceived by gamete donation to know the identity of donors is proposed, while no study can assess the proportion of parents in France that disclose the nature of conception to their donor conceived offspring. The aim of our study was to know whether couples who wish to inform their offspring actually did it. We sent a questionnaire to parents who had expressed an intention to disclose the nature of conception to their future offspring conceived by sperm donation. This allowed us to evaluate the number of couples who inform their offspring, and the couple and offspring feelings when information was given. Among 38 questionnaires sent, 20 couples answered. Fourteen informed their offspring about the nature of conception, most having lived serenely this moment. 47% of offspring have reacted with indifference. While 19 couples informed their friends or family, six couples did not inform their offspring, and two of them no longe...
Due to their catalytic and oxidative properties, cerium dioxide nanoparticles (CeO 2 NPs) are wid... more Due to their catalytic and oxidative properties, cerium dioxide nanoparticles (CeO 2 NPs) are widely used as diesel additive or as promising therapy in cancerology; yet, scarce data are available on their toxicity, and none on their reproductive toxicity. We showed a significant decrease of fertilization rate, assessed on 1272 oocytes, during in vitro fertilization (IVF) carried out in culture medium containing CeO 2 NP at very low concentration (0.01 mg.l À1 ). We also showed significant DNA damage induced in vitro by CeO 2 NP on mouse spermatozoa and oocytes at 0.01 mg.l À1 using Comet assay. Transmission Electron Microscopy did not detect any nanoparticles in the IVF samples at 0.01 mg.l À1 , but showed, at high concentration (100 mg.l À1 ), their endocytosis by the cumulus cells surrounding oocytes and their accumulation along spermatozoa plasma membranes and oocytes zona pellucida. We did not observe any nanoparticles in the cytoplasm of spermatozoa, oocytes or embryos. This study demonstrates for the first time the impact of CeO 2 NP on in vitro fertilization, as well as their genotoxicity on mouse spermatozoa and oocytes, at low nanoparticle concentration exposure. Decreased fertilization rates may result from: (1) CeO 2 NP's genotoxicity on gametes; (2) a mechanical effect, disrupting gamete interaction and (3) oxidative stress induced by CeO 2 NP. These results add new and important insights with regard to the reproductive toxicity of nanomaterials requesting urgent evaluation, and support several publications on metal nanoparticles reprotoxicity. Our data highlight the need for in vivo studies after low-dose exposure.
Systems biology in reproductive medicine, Jan 30, 2015
Spermatozoa contain a complex population of RNAs including messenger RNAs (mRNAs) and small RNAs ... more Spermatozoa contain a complex population of RNAs including messenger RNAs (mRNAs) and small RNAs such as microRNAs (miRNA). It has been reported that these RNAs can be used to understand the mechanisms by which toxicological exposure affects spermatogenesis. The aim of our study was to compare mRNA and miRNA profiles in spermatozoa from eight smokers and eight non-smokers, and search for potential relationships between mRNA and miRNA variation. All men were selected based on their answers to a standard toxic exposure questionnaire, and sperm parameters. Using mRNA and miRNA microarrays, we showed that mRNAs from 15 genes were differentially represented between smokers and non-smokers (p < 0.01): five had higher levels and 10 lower levels in the smokers. For the microRNAs, 23 were differentially represented: 16 were higher and seven lower in the smokers (0.004 ≤ p < 0.01). Quantitative RT-PCR confirmed the lower levels in smokers compared to non-smokers for hsa-miR-296-5p, hsa-...
Does the live birth rate after IVF depend on the etiology of diminished ovarian reserve (DOR)? IV... more Does the live birth rate after IVF depend on the etiology of diminished ovarian reserve (DOR)? IVF outcome and live birth rate are significantly impaired in women with DOR caused by a previous cystectomy for endometrioma compared with women with idiopathic DOR. The safety of the surgical treatment of endometriomas is being discussed in terms of damage to ovarian reserve. Several studies have reported a poor response to controlled ovarian stimulation and a significantly impaired IVF outcome in women with DOR consecutive to an endometrioma cystectomy compared with women with tubal factor infertility. Retrospective case-control study conducted in women aged under 40 treated in our Reproductive Medicine Center between January 2010 and January 2014 for a DOR defined by anti-Müllerian hormone level <2 ng/ml. Two groups of patients were selected: group A included patients with a DOR diagnosed after cystectomy(s) for endometrioma(s), group B included patients with an idiopathic DOR. In e...
The aim of genotoxicity tests in germ cells is to assess the impact of exposure to environmental ... more The aim of genotoxicity tests in germ cells is to assess the impact of exposure to environmental mutagens that may represent a risk for the fertility or for the offspring of exposed subject. The comet assay on mature mouse oocytes is a simple, reproductive and rapid test to study primary DNA damage in oocytes. This test is used to complete toxicology assays applied in first line to somatic cells, and could find many applications in reproductive toxicology to study impact of environmental factors on female germ cells. We describe a practical application of comet assay in reproductive biology to assess the genotoxicity of cryoprotectants used at high concentrations in oocyte vitrification protocols. This test allowed us to demonstrate that dimethylsulfoxide and ethylene glycol are non-genotoxic for the mouse oocytes and led us to hypothesize a genotoxic effect of 1,2-propanediol (PrOH) at high concentrations after having observed induction of significant DNA damage on CHO cell line an...
With the improvement of the anticancerous treatments, the preservation of the feminine fertility ... more With the improvement of the anticancerous treatments, the preservation of the feminine fertility before gonadotoxic treatment tends at present to stand out as a legal obligation, with a duty of information to patients. When emergency IVF can be performed, the cryopreservation of embryos is the best mastered method which offers most chances to patients to obtain a pregnancy after cancer remission thanks to the transfer of frozen embryos. This article proposes an overview about the indications, the feasibility and the ethical and practical limitations of IVF emergency for embryo freezing before gonadotoxic anticancerous treatment.
Reçu le 19 mars 2005 ; accepté le 27 juillet 2005 Disponible sur internet le 21 octobre 2005 Résu... more Reçu le 19 mars 2005 ; accepté le 27 juillet 2005 Disponible sur internet le 21 octobre 2005 Résumé Objectif. -Évaluer les résultats d'un protocole d'insémination avec sperme de donneur, associant stimulation et monitorage de l'ovulation, préparation du sperme par migration ascendante et insémination intra-utérine, proposé aux patientes de moins de 39 ans. Apprécier l'influence de différents paramètres cliniques et biologiques sur les taux de grossesses. Patients et méthodes. -Analyse rétrospective de 249 cycles (106 couples) réalisés sur une période de quatre ans.
Due to their catalytic and oxidative properties, cerium dioxide nanoparticles (CeO 2 NPs) are wid... more Due to their catalytic and oxidative properties, cerium dioxide nanoparticles (CeO 2 NPs) are widely used as diesel additive or as promising therapy in cancerology; yet, scarce data are available on their toxicity, and none on their reproductive toxicity. We showed a significant decrease of fertilization rate, assessed on 1272 oocytes, during in vitro fertilization (IVF) carried out in culture medium containing CeO 2 NP at very low concentration (0.01 mg.l À1 ). We also showed significant DNA damage induced in vitro by CeO 2 NP on mouse spermatozoa and oocytes at 0.01 mg.l À1 using Comet assay. Transmission Electron Microscopy did not detect any nanoparticles in the IVF samples at 0.01 mg.l À1 , but showed, at high concentration (100 mg.l À1 ), their endocytosis by the cumulus cells surrounding oocytes and their accumulation along spermatozoa plasma membranes and oocytes zona pellucida. We did not observe any nanoparticles in the cytoplasm of spermatozoa, oocytes or embryos. This study demonstrates for the first time the impact of CeO 2 NP on in vitro fertilization, as well as their genotoxicity on mouse spermatozoa and oocytes, at low nanoparticle concentration exposure. Decreased fertilization rates may result from: (1) CeO 2 NP's genotoxicity on gametes; (2) a mechanical effect, disrupting gamete interaction and (3) oxidative stress induced by CeO 2 NP. These results add new and important insights with regard to the reproductive toxicity of nanomaterials requesting urgent evaluation, and support several publications on metal nanoparticles reprotoxicity. Our data highlight the need for in vivo studies after low-dose exposure.
To assess midwifery students' knowledge in the field of female fertility and to study their d... more To assess midwifery students' knowledge in the field of female fertility and to study their decision if they had diagnosis of diminished ovarian reserve (DOR). A prospective observational study by self-administered questionnaire was conducted among female midwifery students of seven French schools from June to December 2013. The questionnaire had three parts: (1) questions designed to gather information on the study population; (2) a questionnaire consisting of 10 items to test knowledge about female fertility and ovarian reserve; (3) a self-administered questionnaire simulating a DOR diagnosis and quantifying the decision that students would make using a Likert scale of 5 points. The participation rate was 72.5% (n=285/393). The average age was 22, 6 years±1.9. Among the 285 participants, the ovarian reserve concept was known by 93% of them (n=265) thanks to the midwifery studies (77%, n=204), the media (9%, n=24) and other sources of information. In total, 83.5% of midwifery s...
Our aim was to analyse the results of a donor insemination program using ovarian stimulation, swi... more Our aim was to analyse the results of a donor insemination program using ovarian stimulation, swim-up sperm preparation and intrauterine insemination proposed to women with a maximum age of 39. Incidence of several clinical and biological parameters on success rates was investigated. Retrospective analysis of the results of 249 cycles performed in 106 couples during a four-year period is reported. Overall pregnancy rate of 28.1% and delivery rate of 22% per cycle were achieved, with a multiple pregnancy rate of 11.4%. Most of the pregnancies (84%) were obtained before the fourth insemination. Among the different parameters studied the total number of motile sperm inseminated was found to be the most important factor for success rate: pregnancy rate per cycle reached 40.4% if more than 1.5 million progressive sperm were inseminated vs. 24.7% if they were less than 1.5 million (P<0.05). In precise conditions, outcome of inseminations with donor semen can reach satisfying pregnancy ...
Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine
The breastfeeding initiation rate is extremely disparate worldwide and remains low in France, wit... more The breastfeeding initiation rate is extremely disparate worldwide and remains low in France, with a breastfeeding initiation rate of 60.2%. Some studies have reported increased early parenting difficulties in women who conceived with in vitro fertilization (IVF). Our study had two main objectives: (1) to determine by a retrospective chart review the demographic and medical factors associated with breastfeeding versus formula feeding in women who had undergone IVF and (2) to assess by survey study the reasons for the infant feeding decision (breastfeeding versus formula feeding) for women who conceived by IVF. By telephone interviews, we conducted a longitudinal nonexperimental cohort study of French women who had a live birth after IVF. Fertility data and obstetric outcomes were collected from individual medical records. Among women who had a live birth after IVF (n=73), 63% (n=46) initiated breastfeeding for a mean duration of 6.2±6.2 months. In our IVF population, the breastfeedi...
Reçu le 19 mars 2005 ; accepté le 27 juillet 2005 Disponible sur internet le 21 octobre 2005 Résu... more Reçu le 19 mars 2005 ; accepté le 27 juillet 2005 Disponible sur internet le 21 octobre 2005 Résumé Objectif. -Évaluer les résultats d'un protocole d'insémination avec sperme de donneur, associant stimulation et monitorage de l'ovulation, préparation du sperme par migration ascendante et insémination intra-utérine, proposé aux patientes de moins de 39 ans. Apprécier l'influence de différents paramètres cliniques et biologiques sur les taux de grossesses. Patients et méthodes. -Analyse rétrospective de 249 cycles (106 couples) réalisés sur une période de quatre ans.
Un déclin des paramètres spermatiques au cours des dernières décennies est décrit dans la littéra... more Un déclin des paramètres spermatiques au cours des dernières décennies est décrit dans la littérature et l’on suspecte l’existence d’un lien entre ce déclin et l’exposition des hommes à des agents reprotoxiques d’origine professionnelle et/ou environnementale. De nombreuses études épidémiologiques se sont penchées sur l’effet des expositions professionnelles sur la fertilité. Il s’avère que les salariés du bâtiment et des travaux publics (BTP) sont particulièrement exposés aux agents reprotoxiques. Cet article a pour objectif de faire la revue des substances ayant un impact négatif sur les paramètres spermatiques, la fertilité et la descendance des hommes employés dans le BTP.Les principaux facteurs retrouvés dans ce secteur d’activité et susceptibles d’être impliqués dans l’altération de la qualité spermatique et/ou de la fertilité masculine sont les solvants (en particulier les éthers de glycol), les métaux (fumée de soudage, plomb), les hydrocarbures aromatiques polycycliques et la chaleur. Nous exposons ici, après un bref rappel de la physiologie de la spermatogenèse, les effets de ces différents facteurs sur la reproduction ainsi que leurs mécanismes d’action. Ces expositions professionnelles peuvent également avoir un retentissement sur la descendance des sujets avec un risque accru d’anomalies de fermeture du tube neural et de cancers (leucémies et tumeurs du système nerveux central).De ces données découlent des implications cliniques pour le médecin du travail et le médecin de la reproduction. En effet, environ 15 % des couples consultent pour infertilité dans les pays occidentaux. Il est important de prendre en compte l’environnement professionnel dans l’exploration de leur infertilité. La collaboration entre les médecins de la reproduction et les médecins du travail est donc à développer.A decline of semen parameters during the last decades is described in the literature; a link is suspected between this decline and human exposure to reprotoxic occupational and/or environmental agents. Numerous epidemiological studies examined the effect of occupational exposure on fertility and showed that employees in the building-trade are particularly exposed to reprotoxic agents. This article aims to review the substances having a negative impact on semen parameters, fertility and offspring of men employed in the building-trade.The main factors of reduced sperm parameters and/or male fertility found in this occupational sector are solvents (especially glycol ethers), metals (welding fumes, lead), Polycyclic Aromatic Hydrocarbons and heat. After a brief review of the physiology of spermatogenesis, we present the effects of these factors on reproduction and their mechanisms of action. These occupational exposures may also have an impact on the offspring of exposed subjects with an increased risk of neural tube defects and cancers (leukemias and tumors of the central nervous system).These data have clinical implications for the occupational physicians and reproductive medicine physicians. Indeed, about 15 % of couples consult for infertility in Western countries. Occupational exposures are of importance in their infertility exploration. Collaboration between occupational and reproductive medicine physicians is thus to developed.
Les bourgeons des membres supérieurs, constitués d'un axe mésenchymateux recouvert d'épiblaste, a... more Les bourgeons des membres supérieurs, constitués d'un axe mésenchymateux recouvert d'épiblaste, apparaissent à partir de la cinquième semaine de développement dans la région cervicale de l'embryon. Leur croissance proximo-distale dépend de facteurs diffusibles synthétisés par la crête apicale ectoblastique. D'autres facteurs, produits au niveau de la zone d'activité polarisante et de l'ectoderme, agissent en coordination pour assurer la croissance cranio-caudale et déterminer la polarité dorso-ventrale. Le développement des éléments squelettiques spécifiques des segments du membre est contrôlé par des facteurs de transcription appartenant à la famille HOX, exprimés dans une cascade de transcription dans le bourgeon. Les mécanismes embryologiques des principales malformations de la main sont évoqués, ainsi que certaines de leurs étiologies connues, de nature génétique ou mécanique. # 2008 Elsevier Masson SAS. Tous droits réservés.
to compare the options available for prostate cancer management and their consequences on fertili... more to compare the options available for prostate cancer management and their consequences on fertility on men, in order to best advise these men to choose their treatment, especially if they are young, with no child with their current partner. a literature review on prostate cancer and fertility over the last 26 years was carried out on Pubmed database. The literature was based on evidence and pratical considerations. Twenty nine articles were selected according to their relevance. after prostatectomy, there is an obstructive infertility in 100% of the cases. In external radiotherapy, doses more than 15 cGy induced reduction in sperm count. Direct irradiation between 15 and 35 cGy caused oligozoospermia and doses between 35 and 50 cGy caused reversible azoospermia. The calculated projected doses on testicles were 196 cGy (+/-145 cGy). The brachytherapy effects on fertility seems to be less harmful. The irradiation dose received by testicles is less important (less than 20 cGy) after brachytherapy than after external radiotherapy. Infertility induced by hormonal therapy alone should be reversible. Fertility and focal therapy haven&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;t been well evaluated yet. Active surveillance is the management of prostate cancer which allows to keep at best men&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s fertility. urologists should consider approaching the topic of infertility when discussing the pros and cons of various prostate cancer management with their younger patients. If a patient with prostate cancer expresses interest in future fertility, a semen analysis should be performed. Cryopreservation represents the only preemptive accompanying possibility to preserve fertility in young cancer patients.
Background: In couples presenting with retrograde ejaculation refractory to medical treatment, th... more Background: In couples presenting with retrograde ejaculation refractory to medical treatment, the first choice of fertility treatment should be Assisted Reproductive Techniques using rapidly purified spermatozoa retrieved from post-ejaculatory urine. The Hotchkiss technique and modified variants are simple and efficient for retrieving sperm from the bladder. We developed a new protocol, including a novel modified Hotchkiss technique involving sperm cryopreservation. The aim was to study the pregnancy rate and birth rate achieved by intra cytoplasmic sperm injection (ICSI) using frozen-thawed sperm retrieved from the bladder with this novel modified Hotchkiss technique in patients with refractory retrograde ejaculation. Results: In this descriptive retrospective, single-center study, we analyzed the local database of all patients who banked sperm at A total of 2171 patients banked sperm during this time, including 63 patients with retrograde ejaculation, of whom ten patients banked sperm that had been retrieved by the modified Hotchkiss technique. These ten couples underwent 26 ICSI cycles: nine clinical pregnancies were achieved in six couples, including eight after fresh embryo transfer and one after thawed embryo transfer, resulting in seven live births. The average live birth rate per transfer was 28 %. Conclusions: We report the largest series of births using frozen-thawed spermatozoa retrieved from post-ejaculatory urine by a modified Hotchkiss technique. This series of births demonstrates that this new modified Hotchkiss technique allows for successful association with sperm cryopreservation, leading to an efficient and easy management of couples with refractory retrograde ejaculation.
Men with spinal cord injury present a unique infertile population. Only 10 % of them can father c... more Men with spinal cord injury present a unique infertile population. Only 10 % of them can father children without medical assistance, owing to potential impairments in erection, ejaculation and semen quality. The algorithm typically followed is to retrieve semen by Penile Vibratory Stimulation, in case of failure by Electro Ejaculation. Most of these patients have normal sperm concentrations but abnormally low sperm motility and vitality in the ejaculate. The reasons for poor semen quality in spinal cord injured men are reviewed. If semen cannot be obtained by Electro Ejaculation, or if the ejaculate from Penile Vibratory Stimulation or Electro Ejaculation contains an insufficient quantity or quality of sperm for in vitro fertilization with intracytoplasmic sperm injection, then retrieval of sperm from reproductive tissues is attempted. Despite abnormal semen quality, successful pregnancies with sperm from spinal cord injured male partners have occurred by intravaginal insemination, ...
Journal de Gynécologie Obstétrique et Biologie de la Reproduction
An amendment to the French bioethics law allowing children conceived by gamete donation to know t... more An amendment to the French bioethics law allowing children conceived by gamete donation to know the identity of donors is proposed, while no study can assess the proportion of parents in France that disclose the nature of conception to their donor conceived offspring. The aim of our study was to know whether couples who wish to inform their offspring actually did it. We sent a questionnaire to parents who had expressed an intention to disclose the nature of conception to their future offspring conceived by sperm donation. This allowed us to evaluate the number of couples who inform their offspring, and the couple and offspring feelings when information was given. Among 38 questionnaires sent, 20 couples answered. Fourteen informed their offspring about the nature of conception, most having lived serenely this moment. 47% of offspring have reacted with indifference. While 19 couples informed their friends or family, six couples did not inform their offspring, and two of them no longe...
Due to their catalytic and oxidative properties, cerium dioxide nanoparticles (CeO 2 NPs) are wid... more Due to their catalytic and oxidative properties, cerium dioxide nanoparticles (CeO 2 NPs) are widely used as diesel additive or as promising therapy in cancerology; yet, scarce data are available on their toxicity, and none on their reproductive toxicity. We showed a significant decrease of fertilization rate, assessed on 1272 oocytes, during in vitro fertilization (IVF) carried out in culture medium containing CeO 2 NP at very low concentration (0.01 mg.l À1 ). We also showed significant DNA damage induced in vitro by CeO 2 NP on mouse spermatozoa and oocytes at 0.01 mg.l À1 using Comet assay. Transmission Electron Microscopy did not detect any nanoparticles in the IVF samples at 0.01 mg.l À1 , but showed, at high concentration (100 mg.l À1 ), their endocytosis by the cumulus cells surrounding oocytes and their accumulation along spermatozoa plasma membranes and oocytes zona pellucida. We did not observe any nanoparticles in the cytoplasm of spermatozoa, oocytes or embryos. This study demonstrates for the first time the impact of CeO 2 NP on in vitro fertilization, as well as their genotoxicity on mouse spermatozoa and oocytes, at low nanoparticle concentration exposure. Decreased fertilization rates may result from: (1) CeO 2 NP's genotoxicity on gametes; (2) a mechanical effect, disrupting gamete interaction and (3) oxidative stress induced by CeO 2 NP. These results add new and important insights with regard to the reproductive toxicity of nanomaterials requesting urgent evaluation, and support several publications on metal nanoparticles reprotoxicity. Our data highlight the need for in vivo studies after low-dose exposure.
Systems biology in reproductive medicine, Jan 30, 2015
Spermatozoa contain a complex population of RNAs including messenger RNAs (mRNAs) and small RNAs ... more Spermatozoa contain a complex population of RNAs including messenger RNAs (mRNAs) and small RNAs such as microRNAs (miRNA). It has been reported that these RNAs can be used to understand the mechanisms by which toxicological exposure affects spermatogenesis. The aim of our study was to compare mRNA and miRNA profiles in spermatozoa from eight smokers and eight non-smokers, and search for potential relationships between mRNA and miRNA variation. All men were selected based on their answers to a standard toxic exposure questionnaire, and sperm parameters. Using mRNA and miRNA microarrays, we showed that mRNAs from 15 genes were differentially represented between smokers and non-smokers (p < 0.01): five had higher levels and 10 lower levels in the smokers. For the microRNAs, 23 were differentially represented: 16 were higher and seven lower in the smokers (0.004 ≤ p < 0.01). Quantitative RT-PCR confirmed the lower levels in smokers compared to non-smokers for hsa-miR-296-5p, hsa-...
Does the live birth rate after IVF depend on the etiology of diminished ovarian reserve (DOR)? IV... more Does the live birth rate after IVF depend on the etiology of diminished ovarian reserve (DOR)? IVF outcome and live birth rate are significantly impaired in women with DOR caused by a previous cystectomy for endometrioma compared with women with idiopathic DOR. The safety of the surgical treatment of endometriomas is being discussed in terms of damage to ovarian reserve. Several studies have reported a poor response to controlled ovarian stimulation and a significantly impaired IVF outcome in women with DOR consecutive to an endometrioma cystectomy compared with women with tubal factor infertility. Retrospective case-control study conducted in women aged under 40 treated in our Reproductive Medicine Center between January 2010 and January 2014 for a DOR defined by anti-Müllerian hormone level <2 ng/ml. Two groups of patients were selected: group A included patients with a DOR diagnosed after cystectomy(s) for endometrioma(s), group B included patients with an idiopathic DOR. In e...
The aim of genotoxicity tests in germ cells is to assess the impact of exposure to environmental ... more The aim of genotoxicity tests in germ cells is to assess the impact of exposure to environmental mutagens that may represent a risk for the fertility or for the offspring of exposed subject. The comet assay on mature mouse oocytes is a simple, reproductive and rapid test to study primary DNA damage in oocytes. This test is used to complete toxicology assays applied in first line to somatic cells, and could find many applications in reproductive toxicology to study impact of environmental factors on female germ cells. We describe a practical application of comet assay in reproductive biology to assess the genotoxicity of cryoprotectants used at high concentrations in oocyte vitrification protocols. This test allowed us to demonstrate that dimethylsulfoxide and ethylene glycol are non-genotoxic for the mouse oocytes and led us to hypothesize a genotoxic effect of 1,2-propanediol (PrOH) at high concentrations after having observed induction of significant DNA damage on CHO cell line an...
With the improvement of the anticancerous treatments, the preservation of the feminine fertility ... more With the improvement of the anticancerous treatments, the preservation of the feminine fertility before gonadotoxic treatment tends at present to stand out as a legal obligation, with a duty of information to patients. When emergency IVF can be performed, the cryopreservation of embryos is the best mastered method which offers most chances to patients to obtain a pregnancy after cancer remission thanks to the transfer of frozen embryos. This article proposes an overview about the indications, the feasibility and the ethical and practical limitations of IVF emergency for embryo freezing before gonadotoxic anticancerous treatment.
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Papers by Jeanne Perrin