MEDICALLY ASSISTED PROCREATION

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The reproductive medicine and biology department of the Poitiers CHU carries out its health care mission with the intervention of several specialists and application of all the techniques favoring medically assisted procreation.

The main activity of the department are :

  • the diagnosis and treatment of infertility
  • the preservation of male anf female fertility

The department strives to apply all current methods of medically assisted procreation and preservation of fertility : intrauterine insemination, classic in vitro fertilization and fertilization through intracytoplasmic sperm injection (ICSI)…

The three methods :

Intrauterine insemination

Its objective is to deposit spermatozoa, following selection of the most mobile ones, directly inside the woman’s uterine cavity, in view of increasing their chances of meeting an ovocyte egg.

In vitro fertilization (IVF)

When sperm parameters (concentration, mobility, morphology) are unsatisfactory or when the Fallopian tubes are altered, physicians have recourse to in vitro fertilization (IVF). The principle of IVF consists in carrying out ovarian puncture to collect the follicular fluid containing ovocytes (oocytes), which are then incubated along with spermatozoa to achieve fertilization. Transfer of the embryo into the patient’s uterus is performed a few days later.

Fertilization through intracytoplasmic sperm injection (ICSI)

When the sperm presents major anomalies (small number and/or low mobility), micro-injection or intracytoplasmic sperm injection (ICSI) can be considered as an option.  It starts out like a classic FIV, but instead of incubating ovocytes and spermatozoa and waiting for fertilization, a biologist with a microscope introduces a mobile spermatozoon to each punctured ovocyte.

Application of one (or another) of these techniques, which is decided upon collegially by clinicians and biologists, is by no means systematic.

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Stimulation, medical treatments or surgery at times suffice. But whatever the chosen option, medically assisted procreation (MAP) doctors are far from isolated. Theirs is a multidisciplinary activity necessitating the collaboration of one or several specialists: endocrinologists, geneticists, urologists and psychologists. They often intervene prior to the procreation process, particularly during the first consultation,which is dedicated to physiological evaluation.

Activity

Our activity derives benefit from a quality system and has been awarded ISO certification.

Since 2009, MAP activity has undergone an exponential increase; each year an average of 400 ovarian punctures preliminary to in vitro fertilization are carried out, as are 70 cycles for intrauterine insemination.

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o as to guarantee optimally effective treatment, the department works in close collaboration with other CHU departments: gynecology, obstetrics, internal medicine, urology and endocrinology. It also works with different public and private health establishments throughout the region.

A gynecologic ultrasound is not only quickly accessible for explorations triggered by fertilization problems; it is at the service of all other female patients.

A functional exploration area is available for men presenting with moderate to severe andrological and/or spermatic disorders. Clinical testing is carried out by a clinician/physician with the participation of a urologist and a sexologist. Due to the active involvement of the radiology department, further examinations (ultrasound and MRI) can simultaneously be organized, as can a genetic test and a semen biochemistry test.

Health care activities are provided by a team bringing together several specialties :

  • clinicians
  • gynecologists
  • biologists
  • midwives
  • laboratory technicians
  • psychologists
  • sexologist
  •  secretaries
  • anesthetists
  • surgeons

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Download the information booklet (in French)


Lire l’article “Faire reculer l’infertilité” paru dans le CHU magazine de juin 2018

Teaching

The practitioners in the reproductive medicine and biology unit provide classroom teaching and practical training for interns in reproductive medicine and biology, specialized clinical assistants in reproductive biology, midwifery students, medical students and clinical psychology (DESC) students. Future practitioners can also receive training while in direct contact with couples.

The training programs carried out in the unit are valid for the DESC (complementary degree) in reproductive medicine, and for master 2 in reproductive biology.

Practitioners are actively involved in MAP teaching at the medicine faculty, the midwifery school and the nursing school.

The unit is also involved in theoretical instruction: internal medicine DIU, obstetric gynecology DES.

Some of the practitioners have contributed to the recommendations of the Collège national des gynécologues-obstétriciens on the Turner Syndrome and pregnancy.

Most of the physicians are members of the following scholarly societies: ESHRE, SMR, FFER.

Contact : Centre d’assistance médicale à la procréation : tel. 05 49 44 39 56.