Papers by sylvie epelboin
Gynécologie Obstétrique Fertilité & Sénologie
Human Reproduction
Study question Identify the genetic cause of a cohort of patients with unexplained Diminished ova... more Study question Identify the genetic cause of a cohort of patients with unexplained Diminished ovarian reserve (DOR) by next-generation sequencing and compare with pregnancy outcome. Summary answer A high-yield positive genetic diagnosis was obtained: 27% of cases. Defects of genes involved in DNA repair/meiosis appeared to have an unfavorable prognosis. What is known already Ten percent of women undergoing Medically Assisted Procreation-MAP have a DOR defined by an AMH level <1.2 and an antral follicle count (AFC) <5. However, most causes of DOR are unknown. There is no known criteria of success in MAP. Primary ovarian insufficiency (POI) corresponds to a complete cessation of ovarian function in 1-4% of women under 40 years. We have very recently shown in a large cohort of POI that a custom-made target next-generation sequencing (NGS) POI panel allowed a genetic diagnosis in 30% of unexplained POI and leads to personalized medicine (Heddar et al., EBioMedicine. 2022 doi: 10.1...
Reproductive BioMedicine Online
Reproductive BioMedicine Online
Gynécologie Obstétrique Fertilité & Sénologie
SSRN Electronic Journal
Background Primary Ovarian Insufficiency (POI), a public health problem, affects 1-3.7% of women ... more Background Primary Ovarian Insufficiency (POI), a public health problem, affects 1-3.7% of women under 40 yielding infertility and a shorter lifespan. Most causes are unknown. Recently, genetic causes were identified, mostly in single families. We studied an unprecedented large cohort of POI to unravel its molecular pathophysiology. Methods 375 patients with 70 families were studied using targeted (88 genes) or whole exome sequencing with pathogenic/likely-pathogenic variant selection. Mitomycin-induced chromosome breakages were studied in patients' lymphocytes if necessary. Findings A high-yield of 29.3% supports a clinical genetic diagnosis of POI. In addition, we found strong evidence of pathogenicity for nine genes not previously related to a Mendelian phenotype or POI: ELAVL2, NLRP11, CENPE, SPATA33, CCDC150, CCDC185, including DNA repair genes: C17orf53(HROB), HELQ, SWI5 yielding high chromosomal fragility. We confirmed the causal role of BRCA2,
International audienceWe present in this "ETHNOBOTANIQUE MEDICINALE DES FULBE BANDES AND NYO... more International audienceWe present in this "ETHNOBOTANIQUE MEDICINALE DES FULBE BANDES AND NYOKHOLONKE" of the Eastern Senegal, some 150 plants and a few hundreds of therapeutic uses. These do not constitute an exhaustive list of the knowledge of the FulBe bande (PL) and the Nyokholonke (NK) in this field. It is understood that the terms "therapeutic" or "medicine" are taken in the sense that they. Gives the indigenous thought: lekki (PL), booro (NK), the remedy, can be a crushed bark to relieve a cough or a scholarly preparation intended to win his case to a plaintiff. It is sometimes a propitiatory ritual aimed at ensuring the success of the cultivation of a newly cleared field. Preparations that protect thieves are also included under this term. Most of the time, they are meant to repair or protect health, but they may themselves cause illness or unhappiness either because it is a malicious action, In defending himself from illness or misfortune, he is...
AKOS (Traite de Medecine) - Epreuve corrigee par l'auteur. Disponible en ligne depuis le 25/0... more AKOS (Traite de Medecine) - Epreuve corrigee par l'auteur. Disponible en ligne depuis le 25/04/2018
EMC - Tratado de Medicina, 2018
Gynécologie Obstétrique Fertilité & Sénologie , 2019
Pour citer cet article : Ninive C, et al. Prise en charge des couples porteurs du VIH en assistan... more Pour citer cet article : Ninive C, et al. Prise en charge des couples porteurs du VIH en assistance mé dicale à la procré ation : quels ré sultats et quelle straté gie en France en 2019 ? Gyné cologie Obsté trique Fertilité & Sé nologie (2019),
Journal De Gynecologie Obstetrique Et Biologie De La Reproduction, Oct 1, 2005
But. Présentation d'une technique de cerclage prophylactique au début du second trimestre de la g... more But. Présentation d'une technique de cerclage prophylactique au début du second trimestre de la grossesse, dérivée de la méthode de McDonald et adaptée aux cols hypoplasiques après exposition au DES in utero. Matériels et méthodes. Étude prospective incluant 20 patientes enceintes exposées in utero au DES et présentant un col hypoplasique. Étude de la localisation de la bandelette de cerclage dans le massif cervical ainsi que des variations de longueur du col avant et après cerclage par mesure clinique et par échographie endovaginale. Résultats. Le col est cliniquement et échographiquement plus long après cerclage. La bandelette est localisée à proximité de l'orifice cervical interne, sa portion postérieure est plus proche de l'orifice cervical interne que sa portion antérieure. Conclusion. Cette technique de cerclage des cols hypoplasiques de réalisation simple permet de positionner la bandelette à proximité de l'orifice cervical interne sans colpotomie, sans recours à la voie abdominale tout en permettant l'accouchement par voie vaginale. Mots-clés : Cerclage • Col hypoplasique • Diéthylstilboestrol • DES. SUMMARY: Early prophylactic cervical cerclage for hypoplastic cervix following exposure to DES in utero. Aim. Presentation of a prophylactic cerclage technique, placed in the beginning of second trimester of the pregnancy, derived from McDonald cerclage and adapted to hypoplastic cervix following exposure to DES in utero. Materials and methods. Prospective study including 20 pregnant patients exposed to DES in utero and presenting a hypoplastic cervix. Study of the location of the cerclage tape in the cervix and of changes in cervical length (before and after cerclage) assessed by physical examination of the cervix and by transvaginal ultrasonography. Results. The cervix was longer after cerclage as shown by physical examination and by ultrasound. The tape was localized near the internal cervical os, its posterior portion nearer the internal cervical os than its anterior portion. Conclusion. This easy-to-perform technique of cerclage of hypoplastic cervix allows the tape to be localized near the internal cervical os without colpotomy and without use of the transabdominal approach, while allowing vaginal delivery.
Contraception, Mar 1, 1990
ABSTRACT RU486, a potent antiprogesterone steroid was administered to 124 women requesting therap... more ABSTRACT RU486, a potent antiprogesterone steroid was administered to 124 women requesting therapeutic abortion. All were less than 49 days from their last menstrual period. Ten of these subjects (Group I) received high doses of RU486 in a decremental dose regimen (400, 300, 200 and 100 mg/day) over 4 successive days and 14 received 50 mg/day for 7 days (Group II). A further 50 subjects (Group III) received 100 mg/day for seven days and the remaining 50 subjects (Group IV) received 450 mg in a single dose. In the first three groups, half the daily dose was given in the morning and the remainder in the evening. Blood was collected before, and on Days 4 and 7 and then once a week after commencing therapy until disappearance of circulating beta HCG. In addition to beta HCG, estradiol-17 beta (E2), progesterone (P), cortisol, and various metabolic and hematological parameters were measured. Plasma RU486 concentrations were also assayed in Group II, III and IV subjects on Day 7 of therapy and in some cases on Days 14 and 21. Ultrasonography was performed in all cases on Day 1 and on Day 14. All the patients bled within five days following RU486 administration, for 1 to 21 days. A complete abortion occurred in 60% in Group I, 50% in Group II, 86% in Group III, and 80% in Group IV. The difference between the last two groups and the first two was significant at p less than 0.01. The non-responders were submitted to a uterine vacuum aspiration. A stepwise discriminant analysis was performed and indicated that the best predictors of the outcome of therapy were beta HCG values and the gestational sac diameter. With these criteria, the prediction was accurate in 86.4% of the cases. The best results were obtained in the cases where the ultrasonic measurement of gestational sac was under 10 mm in diameter and the initial beta HCG values under 15,000 mIU/ml. Among the observed side effects were moderate pelvic cramps (20.9%), nausea (27%), fainting (4.8%); 61.3% of the women complained of fatigue. Heavy bleeding occurred in 15.3% of the women but only one of them required blood transfusion. In the patients with complete abortion, beta HCG values decreased to below 500 mIU/ml by Day 14 (but in 11 cases values fell below 2,000 mIU/ml only by Day 21). Plasma estradiol and progesterone also fell. Cortisol levels increased during therapy especially in subjects of Group I, but returned to basal values after termination of treatment.(ABSTRACT TRUNCATED AT 400 WORDS)
Frontiers in Endocrinology
BackgroundRisks of maternal morbidity are known to be reduced in pregnancies resulting from froze... more BackgroundRisks of maternal morbidity are known to be reduced in pregnancies resulting from frozen embryo transfer (FET) compared to fresh-embryo transfer (fresh-ET), except for the risk of pre-eclampsia, reported to be higher in FET pregnancies compared to fresh-ET or natural conception. Few studies have compared the risk of maternal vascular morbidities according to endometrial preparation for FET, either with ovulatory cycle (OC-FET) or artificial cycle (AC-FET). Furthermore, maternal pre-eclampsia could be associated with subsequent vascular disorders in the offspring.MethodsA 2013-2018 French nationwide cohort study comparing maternal vascular morbidities in 3 groups of single pregnancies was conducted: FET with either OC or AC preparation, and fresh-ET. Data were extracted from the French National Health System database. Results were adjusted for maternal characteristics and infertility (age, parity, smoking, obesity, history of diabetes or hypertension, endometriosis, polycys...
Nous presentons dans cette "ETHNOBOTANIQUE MEDICINALE DES FULBE BANDE ET DES NYOKHOLONKE&quo... more Nous presentons dans cette "ETHNOBOTANIQUE MEDICINALE DES FULBE BANDE ET DES NYOKHOLONKE" du Senegal oriental quelques 150 plantes et quelques centaines d'usages therapeutiques. Ceux- ci ne constituent pas une liste exhaustive des connaissances des FulBe bande (PL) et des Nyokholonke (NK) dans ce domaine. Il est bien entendu que les termes "therapeutique"ou "medecine" sont pris dans l'acception que leur. donne la pensee autochtone : lekki (PL), · booro (NK), le remede, peut etre une ecorce croquee pour soulager une toux ou une preparation savante destinee a faire gagner son proces a un plaignant. C'est parfois un rituel propitiatoire visant a assurer la reussite de la culture d'un champ nouvellement defriche . Sont englobees aussi sous ce terme des preparations qui protegent des voleurs. La plupart du temps, elles ont pour but de reparer ou de proteger la sante, mais elles peuvent etre elles-memes causes de rnaladi~s ou de malheur soit q...
La Revue Sage-Femme, 2019
Resume Avec l’utilisation des traitements antiretroviraux, la transmission du VIH entre partenair... more Resume Avec l’utilisation des traitements antiretroviraux, la transmission du VIH entre partenaires sexuels et de la mere au fœtus s’est considerablement reduite, autorisant successivement la grossesse, puis l’assistance medicale a la procreation, puis les rapports sexuels non proteges cibles chez les couples vivant avec le VIH. Depuis le premier rapport Morlat en France en 2013, la procreation naturelle est desormais envisageable sous certaines conditions pour ces couples vivant avec le VIH et le recours a l’AMP se limite de plus en plus au traitement d’une infertilite. Si les resultats en IIU semblent satisfaisants pour les couples serodiscordants pour le VIH, les resultats en FIV sont plus defavorables lorsque la femme est infectee par le VIH. Par contre, ils semblent comparables a ceux de la population generale lorsque l’homme uniquement est infecte par le VIH. On peut supposer une alteration ovarienne chez les femmes infectees, liee au traitement et/ou au virus. Le desir de grossesse doit etre aborde precocement chez ces couples et l’orientation vers un centre d’AMP doit etre rapide si necessaire.
Contraception Fertilite Sexualite, 1989
Sur les 403 grossesses obtenues de septembre 1983 a decembre 1988 au centre de PMA Baudelocque-Sa... more Sur les 403 grossesses obtenues de septembre 1983 a decembre 1988 au centre de PMA Baudelocque-Saint-Vincent-de-Paul, 99 grossesses furent multiples. L'analyse du devenir obstetrical de ces grossesses met en evidence une difference nette entre grossesses gemellaires et triples en ce qui concerne la precocite des MAP, la severite de la prematurite, le poids de naissance des enfants, la prise en charge pediatrique. Les jumeaux peuvent etre consideres sans reserve comme un succes des PMA. Les grossesses de rang superieur, quelle que soit la qualite de la prise en charge obstetricale, doivent absolument etre evitees
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Papers by sylvie epelboin