Contraception, fertilite, sexualite (1992)最新文献

The metabolism of iron and zinc during pregnancy is reported; their deficiency impairs foetal growth, and increases the rate of complications at delivery and of preterm births. Providing iron and zinc supplements must take into account their metabolic interactions which are likely to decrease their bioavailability. Supplementations should be prescribed only during at risk pregnancy and their dosage should be adapted to lessen these side effects and improve their efficiency.

Biomarkers are "keys" of oncogenesis. Many applications are soon possible as gene therapy and vaccination. Authors have reviewed different aspects of classical prognosis factors and examined new possibilities of prognosis and selection of precancerous lesions as ASCUS by biomarkers. Ag SCCTA4, HPV typing, microangiogenesis, are the main biomarkers in cervical cancers.

We received all conizations performed between 1986 and 1997. The incidence of positive margins conization for cervical intraepithelial neoplasia is 7.8% (23.8% in others studies). Persistent or recurrence disease occur only in 35% of cases; so new treatment is not always usefull and cytology and colposcopy are adequate for follow-up.

The recent identification of the BRCA1 and BRCA2 genes allows to understand in an increasing number of cases the origin of a breast/ovarian cancer family history and thereby to propose genetic testing to at risk women. However to know to be carrier of a predisposing germline mutation is at the present to deal with the difficult choice of different supportive cares: close follow up or prophylactic surgery. Numerous studies still have to be done to determine the better management of women at risk. The other challenges are the understanding of the origin of each breast or ovarian cancer case; to identify the factors which modify the tumor risks in predisposed women; and finally to win the social acceptance of genetic testing avoiding any discrimination.

Faced with the silence that follows an abortion, we have established an individual, post-abortion counseling program based on psychological interviews with women who have recently had an abortion. These interviews begin in the second week following the abortion when the woman returns to the hospital for a post-abortion medical examination. The point of these interviews is to listen to what has been experienced--notably a certain ambivalence that arises from the act of having the abortion, which is constructed as having been a decision freely taken. The aim of these sessions is to help the woman through the process of mourning. Whether due to the failure of a contraceptive or a failed relationship, the resulting sorrow is produced by an underlying wish to have children. The periodic interviews have, over the weeks, helped to restore a certain psychological balance.

Blastocyst transfer is highly recommended for the following indications to avoid repeated failure of implantation: related to maternal, paternal and cytogenetic aspects on the embryonic side and/or uterus motility. Sequential media have now replaced coculture in order to produce blastocysts. The basic idea of sequential media is to follow embryo's need. There are 2 phases during preimplantation period: the first one corresponds to a development through maternal stores, gathered during maturation, before genomic activation. This requires a complete protection against free radicals (through EDTA), and a decrease in the concentration of glucose and phosphate: mitocondrial function is impaired. Regulation of the endogenous pool is not perfect. Then at the time of genomic activation, there is an increased need for numerous metabolites. Insulin can be added as the I-Receptor appears at the 8-cell stage. The medium used during this phase has to be rich.

The French study group on oocyte donation, named GEDO, reports the results concerning the oocyte donation activity in France during 1998, including information from all the centers in effective operation except one. These data describe the recipients' and donors' situation and give the analysis of the results obtained.

Background: Couples where the male partner is HIV-infected but the female partner is not often express a desire for children. Assisted reproduction techniques (ART) with sperm "wash" can reduce the risk of acquisition of infection for the woman. The information about the characteristics of such couples coming to these clinics for advice and support is scant.

Objective: To describe the characteristics of a cohort of HIV-discordant couples seeking reproductive assistance in a referral clinic in Barcelona, Spain.

Methods: Demographic, social and HIV related information were collected prospectively according to a standard protocol. Blood tests, a full evaluation for STDs and sperm analysis were performed.

Results: Between April 1994 and February 1999, 140 couples contacted the clinic for reproductive advice, 100 couples were fully assessed and were offered reproductive assistance. The vast majority were white, with a history of injecting drug use. Nearly half of the men had been diagnosed during their present relationship. STDs were uncommon and abnormalities among sperm analysis were frequent.

Conclusion: An increasing number of HIIV infected individuals desire to have children. With the introduction of HAART and the safety of sperm wash in such cases, the need to have children is more frequently expressed. These couples are in general healthy and accept to be included in an ART program.

Sex determination relies on the translation of chromosomal sex established at fertilisation into gonadal sex (testis or ovary), and later into somatic sex (male or female) under the control of gonadal hormone secretions. The aim of the current review will be to highlight our knowledge of the key events which, in the presence of a Y chromosome, induce the organisation of the developing epithelial cells located inside the genital ridges into testicular cords. Many groups have tried to define the molecules relevant to this process, with a double goal: unravelling a molecular pathway which leads to cell fate decision (Sertoli cell in this particular case) during development; improving the establishment of a diagnosis and subsequent medical management in cases where chromosomal, gonadal and then somatic sexes are discordant. Recent progress made in this area will be depicted, with the introduction of several pieces to this developmental jigsaw puzzle.