[Contraception during the perimenopause: indications, security, and non contraceptive benefits]. / Contraception en période de périménopause: indication, sécurité et avantages non contraceptifs.

Although patients' fertility is diminished in the period of perimenopause, they still need efficient contraception. Thorough knowledge of the physiological changes occuring during this period of transition is essential in order to provide optimal care. Until the age of 50, no contraceptive method is specifically considered unsuitable due to age alone. The choice of contraceptive needs to be adapted to the patient, assessing the individual risk factors and favouring the potential non-contraceptive advantages of the method selected. Long-term contraceptive methods (e.g., the copper intrauterine device (IUD), the Mirena IUD or a subcutaneous implant) offer an excellent solution on both levels.

[Results of in vitro fertilization in natural cycle or with mild stimulation]. / Résultats de la fécondation in vitro en cycle naturel ou avec une stimulation hormonale minimale.

Natural cycle, modified natural cycle and mild stimulation are different protocols which provide some advantages compared to conventional stimulation: lower medication cost, less injections, less invasive, low risk of ovarian hyperstimulation and multiple pregnancy. There main drawback is high cancellation rate due to premature ovulation and lack of egg recovery at the retrieval. When an embryo transfer can be performed, the cumulative pregnancy rate is similar to the results in con- ventional stimulation. Those protocols don't provide any advantage in term of results for woman with normal ovarian reserve, however it might be considered as a therapeutic alternative in poor responders.