Insémination intra-utérine: pourquoi continuer à stimuler l'ovulation?

Belaïsch-Allart, J.; Mayenga, J.-M.; Grefenstette, I.; Chouraqui, A; Serkine, A. M.; Abirached, F; Plachot, M.; Kulski, O.

doi:10.1016/j.gyobfe.2007.07.007

Cited by 9 publications

(4 citation statements)

References 20 publications

(18 reference statements)

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“…However, our data are in agreement with other studies that used other morphological sperm evaluation criteria. In fact, morphological sperm alterations seem to confer a significantly poorer outcome in IUI [37,47,48] and are reported to be a more relevant semen parameters than sperm concentration and sperm motility [49]. Karabinus and Gelety [50] stated that pregnancy rates per cycle after IUI were not different when the percentage of morphologically normal sperm (strict criteria) in raw semen was 5%, 5-9%, 10-19%, 20-29%, or ≥30% (with rates of 6.55 ± 3.9,13.6 ± 3.2, 8.8 ± 2.4, 7.1 ± 2.5, and 9.7 ± 3.3%, respectively).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of motile sperm organelle morphology examination (MSOME) for predicting pregnancy after intrauterine insemination

Akl¹,

Oliveira²,

Petersen³

et al. 2011

Fertility and Sterility

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Background: Although the motile sperm organelle morphology examination (MSOME) was developed merely as a selection criterion, its application as a method for classifying sperm morphology may represent an improvement in the evaluation of semen quality. The aim of this study was to determine the prognostic value of normal sperm morphology using MSOME with regard to clinical pregnancy (CP) after intrauterine insemination (IUI). Methods: A total of 156 IUI cycles that were performed in 111 couples were prospectively analysed. Each subject received 75 IU of recombinant FSH every second day from the third day of the cycle. Beginning on the 10th day of the cycle, follicular development was monitored by vaginal ultrasound. When one or two follicles measuring at least 17 mm were observed, recombinant hCG was administered, and IUI was performed 12-14 h and 36-40 h after hCG treatment. Prior to the IUI procedure, sperm samples were analysed by MSOME at 8400× magnification using an inverted microscope that was equipped with DIC/Nomarski differential interference contrast optics. A minimum of 200 motile spermatozoa per semen sample were evaluated, and the percentage of normal spermatozoa in each sample was determined. Results: Pregnancy occurred in 34 IUI cycles (CP rate per cycle: 21.8%, per patient: 30.6%). Based on the MSOME criteria, a significantly higher percentage of normal spermatozoa was found in the group of men in which the IUI cycles resulted in pregnancy (2.6+/-3.1%) compared to the group that did not achieve pregnancy (1.2+/-1.7%; P = 0.019). Logistic regression showed that the percentage of normal cells in the MSOME was a determining factor for the likelihood of clinical pregnancy (OR: 1.28; 95% CI: 1.08 to 1.51; P = 0.003). The ROC curve revealed an area under the curve of 0.63 and an optimum cut-off point of 2% of normal sperm morphology. At this cut-off threshold, using the percentage of normal sperm morphology by MSOME to predict pregnancy was 50% sensitive with a 40% positive predictive value and 79% specificity with an 85% negative predictive value. The efficacy of using the percentage of normal sperm morphology by MSOME in predicting pregnancy was 65%.

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Section: Discussionmentioning

confidence: 99%

Efficacy of motile sperm organelle morphology examination (MSOME) for predicting pregnancy after intrauterine insemination

Akl¹,

Oliveira²,

Petersen³

et al. 2011

Fertility and Sterility

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“…Onze pour cent des cycles sont annulés pour réponse excessive. Le nombre de follicules matures avant déclenchement est en moyenne de 1,3 et ne diffère pas entre IAC et RP alors qu'un objectif bifolliculaire est recommandé pour les patientes normo-ovulatoires [8][9][10] et qu'à l'inverse une stimulation monofolliculaire est souhaitable chez les patientes anovulatoires [11]. Le nombre de follicules de taille intermédiaire (10 à 14 mm) est plus élevé dans le groupe RP qu'en cas d'IAC reflétant probablement la plus grande proportion dans le groupe RP de patientes avec troubles de l'ovulation où il est plus difficile de maîtriser la croissance folliculaire.…”

Section: Discussionunclassified

Facteurs prédictifs de succès de l’induction d’ovulation par FSH recombinante : résultats de l’étude Indigo

Cédrin‐Durnerin

Belaïsch-Allart

Avril³

et al. 2010

Gynécologie Obstétrique & Fertilité

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“…En IIU, les taux de succès sont fonction certes des indications (les meilleurs résultats s'observant en cas d'infertilité cervicale) mais plus encore de l'âge de la femme. À Sèvres, notre taux de succès passe de 15,9 % de grossesse évolutive (ayant dépassé les 12 semaines d'aménorrhée) avant 35 ans à 4,8 % à partir de 40 ans [2]. Les résultats européens font état d'un taux d'accouchement de 5,5 % après 40 ans contre 10,5 % avant [3].…”

Section: Place De L'amp Intraconjugale Dans Le Désir D'enfant Après 4unclassified

Place de l’assistance médicale à la procréation et du don d’ovocyte

Belaïsch-Allart¹

2014

43es Journées Nationales De La Société Française De Médecine Périnatale (Monaco 13–15 Novembre 2013)

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Insémination intra-utérine: pourquoi continuer à stimuler l'ovulation?

Cited by 9 publications

References 20 publications

Efficacy of motile sperm organelle morphology examination (MSOME) for predicting pregnancy after intrauterine insemination

Efficacy of motile sperm organelle morphology examination (MSOME) for predicting pregnancy after intrauterine insemination

Facteurs prédictifs de succès de l’induction d’ovulation par FSH recombinante : résultats de l’étude Indigo

Place de l’assistance médicale à la procréation et du don d’ovocyte

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