Preimplantation diagnosis with HLA typing: birth of the first double hope child in France

Preimplantation genetic diagnosis (PGD) is authorized in France since 1999. After 10 years, technical results are encouraging. With the development of new technologies, our team is able to diagnosis the large majority of chromosome translocations and 75 monogenic diseases. However, PGD remains limited because of the growing augmentation of demands causing an increasing delay for the first procedure of more than 18 months. Since 2006, 19 couples asked for a PGD with HLA typing. In January 2011, 11 couples have already been included in our PGD program. The birth of the first child after PGD with HLA typing offers new perspectives of treatment for these couples.     

Looking to Europe: something's changed in Italy

The new Italian law regulating the use of assisted reproduction technologies (ARTs) prohibits treatment widely practiced in Europe. The new regulations have already given rise to a humiliating form of "reproductive tourism" of Italian subfertile couples.     

When not to resuscitate the newborn baby

In the acute situation where an infant is born and needs resuscitation then the default should be to provide the necessary care. There may be situations where one would not want to initiate resuscitation as the consequences of initiating and sustaining resuscitation may result in an outcome that would not be desirable. Examples would be extreme prematurity beyond the margins of viability or where an infant has been given an antenatal diagnosis of a lethal condition. It is a prerequisite that the decision not to initiate resuscitation is the consensus of all those involved. In the absence of such a consensus the default would be to provide the care that is needed.     

Looking to Europe: Something's changed in Italy

The new Italian law regulating the use of assisted reproduction technologies (ARTs) prohibits treatment widely practiced in Europe. The new regulations have already given rise to a humiliating form of “reproductive tourism” of Italian subfertile couples.     

Ultrasonography in the differential diagnosis of "double" uteri

A total of 43 infertile patients with hysterosalpingographic diagnosis of bifid uterus underwent sonography and subsequent laparoscopy/hysteroscopy to evaluate the capacity of ultrasound to demonstrate the peritoneal profile of the malformed uteri correctly. Sonographic visualization was adequate in 39 cases (90.7%) and the following were identified correctly: 1 of 2 didelphic uteri, all of 11 bicornuate uteri, all of 4 complete septate uteri, and all of 22 partial septate uteri. The sensitivity of ultrasound in detecting the presence of a perimetrial fundal notch was 92.3% and its specificity 100%. Thus, a precise differential diagnosis of "double" uteri was possible with this technique, which may in some clinical situations provide an alternative to laparoscopy.