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Introduction: Infertility in developing countries are mainly due to tubal injuries, making essential IVF; IVF costs but this, should be reduced to be accessible to people, and not be seen as a luxury in this part of the world but rather an psycho-social emergency. Simplifying attempts monitoring means can decrease these costs, provided that the results are not altered. Patients: The authors, through this randomized survey led in the Academic Hospital Arnaud de Villeneuve in Montpellier, compare the results of 118 patients admitted to an IVF embryo transfer program. Agonist or antagonist protocols are used for ovarian stimulation. The study patients are followed up by traditional monitoring or single day monitoring. Results: Pregnancy rates are equals in both groups: traditional and unique monitoring. Single day monitoring is twice less expensive than the traditional one. Conclusion: single day monitoring doesn't affect IVF outcome and is less expensive. [ABSTRACT FROM AUTHOR]

Abstract: We report a case of ovarian hyperstimulation induced by a GnRH agonist (Decapeptyl®) in a patient aged of 23 years and having 3 years of primary infertility of male origin. Twelve days after agonist administration, several ovarian follicles, great-sized, and with a rate of elevated serum œstradiol have been noted. After triggering of the ovulation by 5000 IU of HCG, oocyte retrieval permitted the collection of 4 oocytes 3 of which were mature. Only one embryo with 4 cells has been transferred 48 hours after intracytoplasmic sperm injection fertilization (ICSI), but there was no pregnancy. Ovarian hyperstimulation induced by GnRH agonist is a rare event and only a few cases have been reported. The development of multiple follicles after the administration of an agonist is a paradoxal answer of the ovary to the pituitary desensitization without a clarified physiopathology. The hypothesis of a direct action of the agonist on the ovary is likeliest. Triggering of ovulation by human chorionic gonadotrophin (HCG) has been achieved by certain authors. Fertilization of oocytes and transfers of embryos have succeeded in certain cases, but only one pregnancy has been reported that led to a living birth. [Copyright &y& Elsevier]

Objectives: To evaluate pregnancy rates after randomized controlled trial (RCT) between ovarian drilling by fertiloscopy or ovarian hyperstimulation+insemination+metformine after clomifène citrate (cc) treatment fails., Patients and Methods: Randomized controlled trial with 126 patients in each arm in 9 university centers. After 6-9 months of stimulation by cc, 2 groups were randomized: group 1, ovarian drilling with bipolar energy versus group 2: 3 months treatment by metformine followed by 3 hyperstimulation by FSH+insemination. The success rate was pregnancy rate above 12 weeks., Results: RCT was stopped after the screening of 40 patients. In spite of the low number of patients, the pregnancy rate is significantly higher in medical group 8/16 versus 3/18 (p=0.04)., Conclusion: The causes of fail of RCT were in relationship with difficulties of inclusion, with absence of final agreement by team included. Moreover, RCT between medical and surgical management is often root of difficulties for patients who decline surgical strategy. However, medical treatment appeared better than drilling in this RCT., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Ischemic stroke is a very rare complication but classic ovarian hyperstimulation. We report the cases of three young women aged 35, 37 and 27 years. All three were victims of ischemic formed by proximal occlusion of the middle cerebral artery secondary to ovarian hyperstimulation. The first and the third had a proximal occlusion of the right middle cerebral artery occlusion and the second of the left middle cerebral artery. The last two have benefited from a patient intravenous thrombolysis. The first patient did not receive thrombolysis because it was out of time. Against by their evolution was different. The first has almost recovered its deficit, the second sequelae quite heavy after craniectomy and the third died despite her craniectomy., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)