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STUDY QUESTION How do oocyte donors and recipients perceive the genetic link related to the transfer of nuclear DNA between donors and offspring? SUMMARY ANSWER Whether they are donors or recipients, individuals attach great importance to the transmission of their genetic heritage, since 94.5% would opt for the pronuclear transfer method to preserve this genetic link in the context of oocyte donation. WHAT IS KNOWN ALREADY Since 1983, the use of oocyte donation has increased worldwide. Performed in France since the late 1980s and initially offered to women with premature ovarian insufficiency, its indications have progressively expanded and now it is proposed in many indications to prevent the transmission of genetically inherited diseases. This has resulted in an increase in the waiting time for access to oocyte donation due to the difficulty in recruiting oocyte donors in French ART centres. Several articles have discussed how to fairly distribute donor oocytes to couples, but few have interviewed women in the general population to record their feelings about oocyte donation, as either the donor or recipient and the importance given to the genetic link between the oocyte donors and the children born. Mitochondrial replacement therapy (MRT) is a technique originally developed for women at risk of transmitting a mitochondrial DNA mutation. Recently, MRT has been considered for embryo arrest and oocyte rejuvenation as it could help females to reproduce with their own genetic material through the transfer of their oocyte nucleus into a healthy donor oocyte cytoplasm. STUDY DESIGN, SIZE, DURATION We conducted an opinion survey from January 2021 to December 2021, during which 1956 women completed the questionnaire. Thirteen participants were excluded from the analysis due to incomplete responses to all the questions. Consequently, 1943 women were included in the study. PARTICIPANTS/MATERIALS, SETTING, METHODS We specifically developed a questionnaire for this study, which was created and distributed using the Drag'n Survey® software. The questionnaire consisted of 21 items presented alongside a video created with whiteboard animation software. The aim was to analyse whether certain factors, such as age, education level, marital status, number of children, use of ART for pregnancy, video viewing, and knowledge about oocyte donation, were associated with feelings towards oocyte donation, by using a univariate conditional logistic regression model. This statistical method was also used to assess whether women would be more inclined to consider oocyte donation with the pronuclear transfer technique rather than the whole oocyte donation. All parameters found to be statistically significant in the univariate analysis were subsequently tested in a multivariate model using logistic regression. MAIN RESULTS AND THE ROLE OF CHANCE Most women were concerned about the biological genetic contribution of the donated oocyte (94.8%). The most common reason for a women's reluctance to donate their oocytes was their unwillingness to pass on their genetic material (33.3%). Nearly 70% of women who were initially hesitant to donate their oocytes indicated that they would reconsider their decision if the oocyte donation was conducted using donated cytoplasm and the pronuclear transfer technique. Concomitantly, >75% of the respondents mentioned that it would be easier to receive a cytoplasm donation. The largest proportion of the population surveyed (94.5%) expressed their support for its legalization. LIMITATIONS, REASONS FOR CAUTION In this study, a substantial portion of the responses came from individuals with medical or paramedical backgrounds, potentially introducing a recruitment bias among potential donors. The rate of missing responses to the question regarding the desire to become an oocyte donor was 13.6%, while the question about becoming an oocyte cytoplasm donor had a missing response rate of 23%. These missing responses may introduce a bias in the interpretation of the data. WIDER IMPLICATIONS OF THE FINDINGS This study was the first to demonstrate that, for the French population studied, the combination of oocyte cytoplasm donation with pronuclear transfer could offer a promising approach to enhance the acceptance of oocyte donation for both the donor and the recipient. STUDY FUNDING/COMPETING INTEREST(S) No external funding was used for this study. The authors have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

In vitro fertilization is strongly regulated in France. An agreement is needed for the clinicians and the embryologists; and the activity is under the control of CNMBRDP, a governmental commission. PGD is even more controlled; an agreement is needed for embryo biopsy and for genetic/FISH testing. Only three centers are allowed to perform PGD. All the agreements are given for five years and submitted to renewal. Regulations are under the "Ethical" law which should have been re-examined in 1999, but still not redone. This leads to problems, especially in relation with the research on embryos. Evolution of the techniques and indications necessitates a follow-up by the representatives on a regular basis. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the reproductive competence of oocytes obtained by follicular flushing in poor responder patients. This prospective comparative study, at the University of Paris XI, Assistance Publique des Hopitaux de Paris, INSERM Unit 782, was performed on 165 infertile IVF embryo transfer candidates. A total of 271 consecutive minimal stimulation IVF cycles were studied. Oocyte retrieval was performed 34 h after human chorionic gonadotrophin administration and oocytes were allocated into two groups according to their retrieval method: oocytes obtained in the first follicular aspiration (FA, n = 127); and oocytes retrieved in the subsequent follicular flushing (FF, n = 102). The principal outcome was to evaluate clinical pregnancy and embryo implantation rates. Thus, patient characteristics, fertilization rate and clinical pregnancy rate per oocyte were comparable in both of groups. In contrast, embryo morphology (41 versus 59%, P < 0.01) and implantation rates (20.4 versus 34.8%, P < 0.04) were better in the FF group. In conclusion, an optimal reproductive competence was observed in oocytes retrieved by follicular flushing in minimal stimulation IVF in poor responder patients. [ABSTRACT FROM AUTHOR]

How do carriers of pathogenic mitochondrial DNA (mtDNA) respond to ovarian stimulation? A single-centre, retrospective study conducted between January 2006 and July 2021 in France. Ovarian reserve markers and ovarian stimulation cycle outcomes were compared for couples undergoing preimplantation genetic testing (PGT) for maternally inherited mtDNA disease (n = 18) (mtDNA-PGT group) with a matched-control group of patients undergoing PGT for male indications (n = 96). The PGT outcomes for the mtDNA-PGT group and the follow-up of these patients in case of unsuccessful PGT was also reported. For carriers of pathogenic mtDNA, parameters of ovarian response to FSH and ovarian stimulation cycle outcomes were not different from those of matched-control ovarian stimulation cycles. The carriers of pathogenic mtDNA needed a longer ovarian stimulation and higher dose of gonadotrophins. Three patients (16.7%) obtained a live birth after the PGT process, and eight patients (44.4%) achieved parenthood through alternative methods: oocyte donation (n = 4), natural conception with prenatal diagnosis (n = 2) and adoption (n = 2). To the best of our knowledge, this is the first study of women carrying a mtDNA variant who have undergone a PGT for monogenic (single gene defects) procedure. It is one of the possible options to obtain a healthy baby without observing an impairment in ovarian response to stimulation. [ABSTRACT FROM AUTHOR]

Objective: The aims of this study were to follow up the monitoring, health and anxiety from women who became pregnant after an embryo transfer or a intrauterine insemination during the COVID-19 epidemic in France STUDY DESIGN: This is a single centre, retrospective study from December 2019 to March 2020 based on a phone call interview using a specific questionnaire sheet specially developed for this study. Questionnaires from 104 pregnant women were completed and descriptive data are then analyzed.Results: Women with ongoing pregnancies (n = 88) did not change their physician visits. The COVID-19 outbreak has created no or few additional stresses for 77 % of pregnant women since the lockdown started. We report a miscarriage rate of 14.4 % (n = 15) and documented 10 patients (11.3 %) who had symptoms related to COVID-19. No severe symptoms and no hospitalization in intensive care unit were identified.Conclusion: The epidemic context did not disrupt the medical monitoring of pregnancies and we did not recover an increased rate of miscarriage after ART. None of the patients who had COVID-related symptoms presented with severe clinical manifestations. Surprisingly, pregnant women were psychologically able to experience the lockdown. [ABSTRACT FROM AUTHOR]

Objective: To establish a French national cohort of children born after PGD and study their outcome and development. Materials/Methods: All children born in any of the three centres authorized to carry out PGD (preimplantation genetic diagnosis) in France since November 2000 are included in a prospective open-ended cohort study. They will be compared with a control group composed of children born after ICSI, matched on centre, maternal age, gestational age and singleton or twins. Follow-up includes a clinical examination (1 year), a questionnaire addressed to the parents (2 and 5 years) and a clinical and psychological examination (8 years). Results: Slightly more than 100 children have been born in France since PGD and 89 were examined at 1 year of age. The average age of the mothers was 33 years (range 24 to 38 years). For 57% of the mothers, the included child was their first born; and 64% of the pregnancies ended in singletons. Average gestational age was 38 weeks. Average weight at birth was 2.9 kg. Of the children, 56% were breast-fed and 15% were hospitalized during their first year of life. No significant difference has been noticed to date, based on the results at 1 and 2 years. The observed malformation rate is similar in the PDG group and in the general population. Conclusion: At a time when assisted reproductive technologies are being used with increasing frequency, PGD represents an alternative to prenatal diagnosis for couples at risk of transmission of incurable genetic disease. Although it is a more invasive procedure, our preliminary results are encouraging but need to be confirmed over time as the cohort grows up. [ABSTRACT FROM AUTHOR]

Objectives – This study has two objectives: firstly, to find out what are the women’s views about home birth, and secondly to perform a review of the perinatal risk associated with home birth.Patients and methods – A questionnaire was sent to 121 women in three maternity hospitals and a Medline® search was performed using the following keywords: home delivery, hospital delivery, risk factor, perinatal transfer.Results – Fifty two percent of these women think that home delivery “should or could be offered” (group I), 22% think that it “should never be offered” (group II); finally 26% “do not know” whether it should or not be offered (group III). The level of maternity care, educational standards, nationality, parity, annual income, age, location of the place of residence, do not modify the rate of women belonging to group I. Thirty four percent of women who have heard about complications happening during delivery think that home delivery “should never be offered” while 13% of women who have never heard of complications during delivery stated that it should never be offered (p=0.024). Even if it is not significant the number of women belonging to group II increases with educational standards and maternal age. Most women believed that hospital delivery is safer, more restful, that pain relief is better, but also stated that it is more impersonal than home delivery.Conclusion – In this study more than one out of two women believed that home delivery “should or could be offered”. Nevertheless, 22% stated that home delivery “should never be offered”. The level of opposition to home delivery seems to increase with the level of information about potential obstetrical complications. A study should be designed to confirm this statement. The analysis of perinatal risks related to home delivery shows that two conditions should be fulfilled in order to allow home delivery: a careful selection, with validated risk factor, to eliminate high risk pregnancies, and clear and complete information on the small but real risk of perinatal transfer. [ABSTRACT FROM AUTHOR]