Motivations and personality characteristics of candidate sperm and oocyte donors according to parenthood status: a national study from the French CECOS network.

STUDY QUESTION: In a non-commercial national gamete donation programme, do the motivations and personality characteristics of candidate sperm and oocyte donors differ according to their parenthood status? SUMMARY ANSWER: Moderate differences exist between non-parent and parent candidate donors in motivations for gamete donation and representations as well as in personality characteristics. WHAT IS KNOWN ALREADY: Several studies have analysed the motivations and experiences of oocyte or sperm donors, but mainly in countries where gamete donation is a commercial transaction, and very few studies have reported results of personality traits using personality inventory tests. No study has specifically investigated the motivations and personality characteristics of candidate gamete donors according to parenthood status. STUDY DESIGN SIZE DURATION: A prospective study was carried out including 1021 candidate donors from 21 centres (in university hospitals) of the national sperm and egg banking network in France between November 2016 and December 2018. PARTICIPANTS/MATERIALS SETTING METHODS: In total, 1021 candidate gamete donors were included in the study. During their first visit, male (n = 488) and female candidate donors (n = 533) completed a questionnaire on sociodemographic characteristics, their motivations for donation and their representations of donation, infertility and family. Secondly, a NEO Personality Inventory (NEO-PI-R) exploring the Big Five personality traits was completed online. Results were compared between parent and non-parent candidate donors. MAIN RESULTS AND THE ROLE OF CHANCE: Altruistic values were the principal motive for donation irrespective of parenthood status. Reassurance about their fertility or preservation of sperm for future use was more often reported in non-parent than in parent candidate donors. With regard to representation of gamete donation or of the family, independently of their parenthood status, candidate donors more frequently selected social rather than biological representations. Mean personality characteristics were in the normal range. Non-parent candidate donors had higher scores on openness and depression than parents, while parent candidate donors appeared more social than non-parents. LIMITATIONS REASONS FOR CAUTION: The personality characteristics inventory was not completed by all candidate donors included in the study. However, family status did not differ between the two groups (NEO-PI-R completed (n = 525) or not), while the group who completed the NEO-PI-R had a higher educational level. This national study was performed in a country where gamete donation is subject to strict legislation. WIDER IMPLICATIONS OF THE FINDINGS: In a global context where reproductive medicine is commercialized and gamete donor resources are limited, this study found that altruism and social representations of gamete donation and family are the main motivations for gamete donation in a country which prohibits financial incentive. These findings are relevant for health policy and for gamete donation information campaigns. STUDY FUNDING/COMPETING INTERESTS: Grant from the Agence de la Biomédecine, France. The authors have nothing to disclose related to this study. TRIAL REGISTRATION NUMBER: N/A.

Follicular flushing versus direct aspiration in poor responder IVF patients: a randomized prospective study.

OBJECTIVE: To compare follicular flushing with a double-lumen needle with direct aspiration on the number of oocytes collected in a poor responder population in IVF. STUDY DESIGN: We conducted a randomized controlled prospective single-center study between March 2011 and June 2016 at the ART center in the Medico-Surgical and Obstetric Center in Schiltigheim, France. Patients undergoing IVF who had ≤ 4 follicles ≥ 14 mm on the day of HCG administration were recruited and then randomized to one of two groups : simple aspiration group (= NO FLUSH) with a single-lumen 17-gauge needle or follicular flushing group (= FLUSH) which underwent oocyte puncture with aspiration and follicular flushing with a double-lumen 17-gauge needle. The primary end-point was the number of oocytes collected. Secondary assessment criteria were the fertilization rate, the number of transferable embryos, the number of clinical pregnancies and their outcome. RESULTS: 252 patients were included: 127 in the Flush group and 125 in the No flush The number of oocytes retrieved per patient was significantly lower in the FLUSH group: 2.41 than in the NO FLUSH group: 3.42 (p < 0.001). The number of transferable embryos, fertilization rate (68.8 % in the FLUSH group versus 75 % p = 0.682), or pregnancy rate weren't different but (15 versus 13). However the number of failed punctures was significantly higher in the FLUSH group (11 % versus 3.2 % p = 0.016) and the duration of oocyte retrieval was significantly longer in the FLUSH group where the median time was 10 min whereas it was only 7 min in the NO FLUSH group, p < 0.001 CONCLUSION: Follicular flushing in poor responders is not beneficial and could be detrimental with an increasing procedure time and less oocytes retrieved.

Diagnosis of primary ciliary dyskinesia: When and how?

INTRODUCTION: Primary ciliary dyskinesia (PCD) is a rare congenital disorder involving permanent ubiquitous structural and/or functional ciliary abnormalities. METHODS: A single-center retrospective study included 56 cases of PCD (respiratory form) out of a cohort of 280 patients with suspected PCD. The main features of history-taking and clinical examination were analyzed, to formulate a pragmatic diagnostic procedure, easy to implement in clinical practice. RESULTS: Chronic respiratory tract infectious symptoms are sensitive but non-specific for the diagnosis of PCD. Nasal brushing for phase-contrast microscopy study of ciliary morphology and activity proved to be a fast, easy, non-invasive, cost-effective and age-independent diagnostic method. In doubtful cases, depending on local availability, further tests are indicated: nasal nitric oxide level, electronic microscopy, genetic study and cell culture. CONCLUSIONS: In suspected PCD, there being no gold standard method of screening and early diagnosis, nasal brushing with ciliary study is contributive, alongside numerous other complementary tests, on condition that the clinician is experienced and results are interpreted in the light of clinical examination and history-taking.

[Complications of pregnancy after oocyte donation]. / Pathologies des grossesses issues de don d'ovocytes.

Oocyte donation is a remarkably effective method of treatment even in difficult cases, which encourages couples. However the data in literature express an increased risk of complications in pregnancies particularly for older women. Maternal-fetal outcome is fortunately usually favorable. Medical teams must respect the autonomy of informed couples, but also be able to deny access to oocyte donation when age is exceeded or where there are risk factors.