暂无摘要。

OBJECTIVE: The aim of this study was to establish the spermiological profile of patients treated for infertility at Sikasso Hospital.
METHODS: This was a prospective descriptive cross-sectional study, which took place from January to December 2022 at Sikasso Hospital. Interpretation of spermiological parameters was based on standards established by the World Health Organization in 2010.
RESULTS: We enrolled 41 patients, 51.22% of whom had disturbed spermiological parameters. The abnormalities were azoospermia (21.92%), asthenooligozoospermia (12.20%), asthenozoospermia (7.32%), oligozoospermia (7.32%) and asthenonecrozoospermia (2.44%). These anomalies were mainly observed in the 34-44 age group (47.62%).
CONCLUSIONS: This study revealed significant disturbances in spermiological parameters, with azoospermia being the most frequent abnormality.
UNASSIGNED: L\'objectif de cette étude était d\'établir le profil spermiologique des patients suivis pour infertilité à l\'hôpital de Sikasso.
UNASSIGNED: Il s\'agissait d\'une étude transversale prospective descriptive, qui s\'est déroulée de janvier à décembre 2022 à l\'hôpital de Sikasso. L\'interprétation des paramètres spermiologique a fait recours aux normes établies par l\'Organisation mondiale de la santé en 2010.
RESULTS: Nous avons colligé 41 patients dont 51,22% avaient ses paramètres spermiologiques perturbés. Les anomalies étaient l\'azoospermie (21,92%), l\'asthénooligozoospermie (12,20%), l\'asthénozoospermie (7,32%), l\'oligozoospermie (7,32 %) et l\'asthénonécrozoospermie (2,44 %). Ces anomalies étaient observées majoritairement dans la tranche d\'âge 34-44 ans avec 47,62%.
CONCLUSIONS: cette étude a révélé des perturbations importantes des paramètres spermiologiques et l\'azoospermie a constitué l\'anomalie la plus fréquente.

Endometriosis is a chronic disease defined by the presence of endometrial cells outside the uterus. Research is ongoing to better understand its etiologies, the anatomopathological forms it takes and the associated symptoms, which often have pain in common.

暂无摘要。

OBJECTIVE: To update the 2010 CNGOF clinical practice guidelines for the first-line management of infertile couples.
METHODS: Five major themes (first-line assessment of the infertile woman, first-line assessment of the infertile man, prevention of exposure to environmental factors, initial management using ovulation induction regimens, first-line reproductive surgery) were identified, enabling 28 questions to be formulated using the Patients, Intervention, Comparison, Outcome (PICO) format. Each question was addressed by a working group that had carried out a systematic review of the literature since 2010, and followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE®) methodology to assess the quality of the scientific data on which the recommendations were based. These recommendations were then validated during a national review by 40 national experts.
RESULTS: The fertility work-up is recommended to be prescribed according to the woman\'s age: after one year of infertility before the age of 35 and after 6months after the age of 35. A couple\'s initial infertility work-up includes a single 3D ultrasound scan with antral follicle count, assessment of tubal permeability by hysterography or HyFOSy, anti-Mullerian hormone assay prior to assisted reproduction, and vaginal swabbing for vaginosis. If the 3D ultrasound is normal, hysterosonography and diagnostic hysteroscopy are not recommended as first-line procedures. Chlamydia trachomatis serology does not have the necessary performance to predict tubal patency. Post-coital testing is no longer recommended. In men, spermogram, spermocytogram and spermoculture are recommended as first-line tests. If the spermogram is normal, it is not recommended to check the spermogram. If the spermogram is abnormal, an examination by an andrologist, an ultrasound scan of the testicles and hormonal test are recommended. Based on the data in the literature, we are unable to recommend a BMI threshold for women that would contraindicate medical management of infertility. A well-balanced Mediterranean-style diet, physical activity and the cessation of smoking and cannabis are recommended for infertile couples. For fertility concern, it is recommended to limit alcohol consumption to less than 5 glasses a week. If the infertility work-up reveals no abnormalities, ovulation induction is not recommended for normo-ovulatory women. If intrauterine insemination is indicated based on an abnormal infertility work-up, gonadotropin stimulation and ovulation monitoring are recommended to avoid multiple pregnancies. If the infertility work-up reveals no abnormality, laparoscopy is probably recommended before the age of 30 to increase natural pregnancy rates. In the case of hydrosalpinx, surgical management is recommended prior to ART, with either salpingotomy or salpingectomy depending on the tubal score. It is recommended to operate on polyps>10mm, myomas 0, 1, 2 and synechiae prior to ART. The data in the literature do not allow us to systematically recommend asymptomatic uterine septa and isthmoceles as first-line surgery.
CONCLUSIONS: Based on strong agreement between experts, we have been able to formulate updated recommendations in 28 areas concerning the initial management of infertile couples.

OBJECTIVE: We decided to conduct a study based on these multidisciplinary team (MDT) in order to investigate their impact at the University Hospitals of Strasbourg and look for ways to improve this MDT.
METHODS: This is a retrospective study of the 682 patients presented to endometriosis MDT from its inception in March 2017 to December 2020.
RESULTS: The MDT decision was different from that initially proposed by the patient\'s referent for 406 patients (60%). Surgery was chosen for 417 patients (61%) and assisted reproduction for 261 patients (38%). A review of the MRI by a referring radiologist was carried out for 348 cases (51%), with a modification of the results for 255 patients (73%). Initial underestimation of lesions was noted in 198 cases.
CONCLUSIONS: Our study has shown the importance of MDT in endometriosis since the therapeutic proposal was modified in 60% of cases. In addition, we supported the importance of radiologists specializing in this field since they made a modification in two-thirds of the MRIs reread. These results show the importance of collegial discussions, which can modify the decisions of medical teams. This underlines the importance of setting up endometriosis networks.

BACKGROUND: Following on from the Rapport vers une stratégie nationale de lutte contre l\'infertilité (Report on a national strategy to combat infertility) submitted to the French Minister of Health in 2022, whose objective 13 is: to better identify and diagnose male infertility, we wanted to clarify with reproductive specialists what role the urologist should play in the management of the infertile couple.
METHODS: An expert consensus was reached with the Pedagogical Committee and pilots of the Transversal Specialized Training in Reproductive Medicine and Biology - Andrology, and with the presidents, board and scientific council of the French Federation for Reproductive Study (FFER).
RESULTS: In the case of infertility in a couple, the fertility of both partners should be assessed from the outset, and in the event of abnormality or failure of ART, the patient should be referred to a uro-andrologist for expert management. The uro-andrologist will set up medical or surgical treatments to improve the prognosis of the man\'s fertility, in conjunction with the entire ART team. It is also important for the urologist/andrologist to take charge of the man\'s health before conception, because of the benefits for the patient himself and for his offspring.
CONCLUSIONS: This expert consensus has shed light on the role of the uro-andrologist in the ART pathway, on the need for training in Andrology and on the medical demography required.

BACKGROUND: The subinguinal microsurgical varicocelectomy is considered as the gold standard surgical technique for the treatment of varicocele. The objective of this study is to evaluate the results of this technique on the resolution of pain and the parameters of sperm analysis.
METHODS: Single-center, retrospective study that includes 22 patients who have been operated over a period of six months for a clinically palpable varicocele via the microsurgical subinguinal technique. Nine patients were operated for pain and 13 patients for infertility with an abnormality of their sperm analysis.
RESULTS: All the patients operated for pain had a complete resolution of pain at the postoperative follow-up (3 months). Concerning the patients operated for infertility, 76.92% of the patients had a normal sperm analysis, 7.69% of the patients presented a partial improvement, and 15.39% of the patients without any improvement. Analysis of sperm\'s parameters at 3 months showed a significant improvement in the morphology (4.3% vs 6.69% of typical forms according to Kruger ; P<0.05) and mobility (progressive mobility 15.6% vs 23% postoperatively; P<0.01). A non-significant improvement (low sample) in the concentration was noted (21.58 million/mL preoperative vs 34.9 million/mL postoperative, P=0.08). Pregnancies are noted in 38.5% of patients. A postoperative complication was noted with surgical site infection resolved with antibiotics.
CONCLUSIONS: This single-center study confirms that the treatment of varicocele by subinguinal microsurgical route is an effective therapeutic strategy on symptomatic varicocele and in infertile men. This technique is associated with few complications.
METHODS:

In certain family configurations, the secrecy of origins is fiercely maintained. The revelation can then occur suddenly, causing a radical upheaval for the person concerned. This is what happened to Alexandre Mercier, who agreed to share his experience with us.

Évaluer les risques et bénéfices de la chirurgie minimalement invasive dans la prise en charge des patientes atteintes d\'infertilité et fournir des conseils aux gynécologues qui prennent en charge les problèmes les plus fréquents chez ces patientes.
Patientes atteintes d\'infertilité (incapacité à concevoir après 12 mois de rapports sexuels non protégés) en processus diagnostique ou sous traitement. BéNéFICES, RISQUES ET COûTS: On peut recourir à la chirurgie de la reproduction minimalement invasive pour traiter l\'infertilité, améliorer les résultats des traitements de fertilité ou préserver la fertilité. Toutes les interventions chirurgicales comportent des risques et des complications associées. La chirurgie de la reproduction n\'améliore pas toujours la fertilité et peut, dans certains cas, compromettre la réserve ovarienne. Toutes les interventions entraînent des coûts, lesquels sont assumés par la patiente ou son assureur. DONNéES PROBANTES: Des recherches ont été faites dans les bases de données PubMed-Medline, Embase, Science Direct, Scopus et Cochrane Library pour répertorier les articles publiés en anglais dans la période de janvier 2010 à mai 2021 (voir les termes de recherche MeSH à l\'annexe A). MéTHODES DE VALIDATION: Les auteurs ont évalué la qualité des données probantes et la force des recommandations en utilisant le cadre méthodologique GRADE (Grading of Recommendations Assessment, Development and Evaluation). Voir l\'annexe B en ligne (tableau B1 pour les définitions et tableau B2 pour l\'interprétation des recommandations fortes et conditionnelles [faibles]). PROFESSIONNELS CONCERNéS: Gynécologues qui prennent en charge les affections courantes chez les patientes atteintes d\'infertilité. DÉCLARATIONS SOMMAIRES: RECOMMANDATIONS.