The 2nd World Congress on Controversies in Obstetrics Gynecology & Infertility

Paris, France,
September 6-9, 2001


1 Volume for the Invited Speakers and 1 Cdrom for the Free Papers

Monduzzi Editore International Proceedings Division Home Page



This is the 2nd book of proceedings of Controversies in Obstetrics, Gynecology & Infertility which summarizes the 2nd World Congress in Paris. This book, like the congress, is solely devoted to controversial issues in the field and represents a unique source of cutting edge knowledge for the general practitioner as well as for the expert.

Over the years the field of Obstetrics and Gynecology has witnessed an enormous expansion in clinical and basic data as well as tremendous growth in field-related technology. This growth has also created a greater need to debate the many controversial issues that have subsequently arisen.

As evident from the content of this book the controversies presented encompass the main unresolved issues of our profession. The various chapters presented here consolidate the knowledge through evidence based medicine but also indicate the gaps and lack of evidence to support certain clinical practices.

We believe that readers will find the chapters stimulating as a source for updating their knowledge and helpful for practical handling of their patients.

Zion Ben-Rafael
Rene Frydman
Zeev Shoham




Volume of the Invited Speakers




The Enigma of PCO

Do PCOS Features Predict Ovulation Induction Outcome
B.C.J.M. Fauser

Should Insulin Resistance Be Controlled and How Can it Be Done Safely?
S. Franks

Improving Ovarian Response and Success Rate in Art

Do All Women Need LH for Stimulation?
M. Filicori

Do All Women Need LH for Ovarian Stimulation?
E. Loumaye

Is Inhibin B a Static or Dynamic Test of Ovarian Reserve?
D. Seifer

Assessing Uterine Blood Perfusion in 2001
R. Fanchin

Individualized Treatment in Reproductive Medicine

New Options in Hormonal Contraception: To Bleed or Not to Bleed – Is That Your Question?
U. Karck

Individualized Treatment Improving Outcome and Convenience in Assisted Reproduction
G. Trew

Human-derived Versus Recombinant Gonadotropins

Human-derived Vs. Recombinant Gonadotropins in Assisted Reproduction: What Makes the Difference?
M. Filicori

Cryopreservation and Gamete Maturation

Vitrification – Is It Going to Replace Conventional Freezing Techniques?
D.K. Gardner and M. Lane

Freezing the Embryo? What Stage?
M.J. Torelló, A. Veiga and Y. Ménézo

Oocyte In-vitro Maturation and Ovarian Transplantation
S.L. Tan and T.J. Child

Ovarian Cancer: Screening and Prophylactic Oophorectomy

Incidental Prophylactic Oophorectomy During Abdominal Surgery
P.E. Schwartz and M. Chu

Ovarian Cancer Screening
B. Rufford, U. Menon and I. Jacobs

The Current Place of Laparoscopic Surgery in Gineco-oncology

Should Laparoscopy Be Used for Surgical Staging in Cervical Cancer
D. Dargent and R. Enria

Urogenital Aging

Incontinence and Prolapse: Benefits of Laparoscopic Access
T. Falcone

Multiple Gestation: How Do We Cope?

Genetic Testing - Before or After Multiple Pregnancy Reduction?
Y. Ville and A. Rafii

When and How to Deliver Twins?
I. Blickstein

Birth Weight Discordance – A Normal Variation or IUGR?
J.O. Gardosi

How to Avoid Multiple Pregnancy - Who Is Responsible?
L. Hamberger Lars and N. Simberg

Thrombophilia in Obstetrics and Gynecology

Thrombophilia in Obstetrics and Gynecology: Introduction
D. Blickstein

Thrombophilic Risk of HRT, OC and ART
I. Walker

Pregnancy and Thrombophila: Are They Related? Can the Complications Be Prevented?
B. Brenner

Risks and Benefits of Low Molecular Weight Heparins in Obstetrics and Gynecology
J.C. Gris

Fetal Malformations

MRI / 3D for the Detection of Fetal Anomalies
A. Kurjak, S. Kupesic and M. Kos

Prenatal Informed Consent for Sonogram: The Time for First Trimester Nuchal Translucency Has Come
S.T. Chasen, D.W. Skupski, L.B. McCullough and F.A. Chervenak

Fetal Monitoring

Is There a Place for Electronic Fetal Monitoring in Low Risk Pregnancy?
O. Tamizian and S. Arulkumaran

Does Electronic Fetal Monitoring Increase CS Rate?
O. Tamizian and S. Arulkumaran

Does Fetal ECG Affect Detection of Fetal Distress?
K.G. Rosén, R Luzietti and H Norén for the EU Innovation Project "FECG"

Diagnosis and Surgical Procedures

Hysterosalpingography vs Hysteroscopy vs Hydrosonography
F.M. Severi, C. Bocchi, P. Florio, L. Cobellis, R. La Rosa, M.G. Ricci and F. Petraglia

Laparoscopy Vs Minilaparoscopy Vs Transvaginal Hydrolaparoscopy (THL)
H.C. Verhoeven

Myomectomy: It’s Role in Infertility
J.-B. Dubuisson, A. Fauconnier, P.-Y. Ancel and C. Chapron

Hydrosalpinx – To Treat or Not
A. Strandell

Ovulation Induction and Insemination

Should Treatment with Clomiphene Continue?
H.J. Out

Is IUI Mandatory Before IVF? Natural or Stimulated Cycle
P.G. Crosignani

Cervical, Intrauterine or Tubal Insemination What Is the Evidence?
P.-N. Barri, R. Tur, B. Coroleu and R. Buxaderas

Forget About Ovulation Induction! Proceed Directly to IVF
N. Gleicher and V. Karande

When Should We Proceed to IVF and ICSI?
M. Germond, R. Laganara, M.C. Fadda, D. Wirthner,
A. Chanson and A. Senn

IVF - Can We Increase the Success Rate?

Can We Improve the Embryo Quality? Improving Art Efficacy: Biologist’s Role
Y. Ménézo, MJ. Torelló and A. Veiga

Can We Improve the Embryo Quality – The Clinician’s Role
M. Germond, M.C. Fadda, D. Wirthner, A. Chanson and A. Senn

Improving Endometrial Receptivity in Assisted Reproduction (AR)
A. Pellicer, J.A. García-Velasco, A. Ruiz, D. Valbuena and C. Simón

Assisted Hatching – Is It a Serious Alternative?
N. Laufer

Embryo Transfer: Techniques and Variables Affecting Success
W.B. Schoolcraft and D.K. Gardner

Blastocysts Vs. Day 2-3 ET – How Strong Is the Evidence?
D.K. Gardner and W.B. Schoolcraft

Birth Control

Oral Contraceptives- Very Low Estrogen Dosages: Pros and Cons
G. Creatsas and A. Elsheikh

Oral Contraception in a Patient with a First Degree Relative with Breast Cancer
P. Spinola

Menopausal Health - Treatment

Oestrogen - P.O. or Nasal Administration
F. Al-Azzawi

The Role for Supplemental Androgens in Men and Women
J. Studd, W. Cronje and A. Vashisht

DHEA: A New Challenge in Menopausal Health
A.R. Genazzani, M. Stomati, F. Bernardi, E. Casarosa, S. Luisi, M. Pieri and M. Luisi

The Future of Global Endometrial Ablation Technology, Today

NovaSure GEA Technology Overview
P. Laberge

NovaSure™ GEA Technology Overview. Analysis of Worldwide Clinical Results
J. Cooper

Menopause and HRT

Does HRT Enhance Quality of Life?
W.H. Utian


The Spectrum of Preterm Birth
G.C. Di Renzo, R. Luzietti, M. Mignosa, F. Taddei, G. Clerici and A. Cutuli

Can We Establish a Universal Lower Limit of Viability?
M. Carrapato and F. Menezes

Cesarean Section - Mode of Delivery

Delivery after Caesarean Section: One or More
O. Tamizian and S. Arulkumaran

What is the Optimal C/S Rate?
D. Farine

Management of Preterm Labour: the Way Forward

Treatment with the Oxytocin Receptor Antagonist Atosiban in Patients with Risk of Preterm Delivery – The Vienna Experience
P. Husslein

Second Trimester Miscarriage - Diagnosis of Cervical Incompetence

Cervical Funneling – False Positive and False Negative Observations
B. Arabin

Uterine Anomalies – When To Treat?, When To Circle?
E. Shalev


Can Surgery Relieve Pain and Improve Sexual Activity
C. Sutton

How to Prevent Endometriosis?
A. Audebert

Fertility Preserving in Gineco-oncology

Chemotherapy and Conization for Preserving Fertility in Stage IB1 Cervical Cancer
F. Landoni, A. Maneo, A. Villa and T. dell’Anna

Abdominal Radical Trachelectomy
L. Ungar and J.R. Smith

Laparoscopic Vaginal Radical Trachelectomy (LVRT) in the Management of Early Cervical Cancer
D. Dargent and R. Enria

Endometrial Carcinoma – Can Fertility Be Preserved?
T. Levy

Endometrial Ablation - Critical Evaluation of 5 New Techniques

A Safe and Effective Method of Controlling Abnormal Uterine Bleeding
D.E. Townsend for the Endometrial Ablation Study Group

Thermachoice Balloon Ablation: Long-Term Follow-up Studies
N.N. Amso, B. Blanc, M. Bongers, H. Fernandez, C. Fortin, P. McFaul, B. Sanders, M. Schaffer, P. Van der Heijden and G. Vilos

A Unique Form of Endometrial Ablation Utilizing Direct Visualization; Hydro ThermAblator® (HTA®) FDA 12-Month Registration Trial Results
P. Brooks

Laparoscopic and Advanced Procedure

RCT-Laparotomy Vs. Laparoscopic Hysterectomy
T. Falcone

Fertiloscopy or Laparoscopy for Pelvic Examination
A. Watrelot and C. Racinet


Limitations of Uterine Artery Embolisation
W.J. Walker

Pelvic Pain

Laparoscopy Versus Mini-endoscopy. When To Do It?
R. Campo, S. Gordts and I. Brosens

Painful Retroversion Does It Exists?
A. Fauconnier, J.-B. Dubuisson, H. Foulot, C. Deyrolle, G. Bréart and C. Chapron

C. Sutton

Effective Treatment for Chronic Pelvic Pain
R.W. Stones

Evidence-Based Medicine

Randomized Controlled Trial – When and Why We Need It
S. Daya

Evidenced Based Medicine Will Influence the Number of Publications in Journals
A.H. Decherney

Ethical Dimensions of Obstetrics and Gynecological Controversies
F.A. Chervenak and L.B. McCullough

Meta-analysis – The Role of Cochrane Collaboration. Will it Change Future Medical Studies?
E. Hughes






Cdrom of the Free Papers





Controversies in Embryological Development of Fallopian Tubes
B.K. Chakrabarti

Reasons For Low Uptake of Amniocentesis in a Multi-ethnic Population
Y. Chua, F.M. Lai and G.S.H. Yeo

Research of Intervention on Prolonged Pregnancy
Faramarzi Mahbobeh

Vaginal Delivery after Previous Cesarean Section: An Analysis of Maternal and Fetal Outcome
O. Kontic-Vucinic, J. Opalic, Z. Bogdanovic, I. Likic and P. Momcilov

Improving Pregnancy Rates by Means of Polarized Maca Based Phytoterapy and Intratubal Insemination
G. Menaldo, S. Serrano and B. Lopez

Is Repeat Cesarean Really Necessary For a Breech Delivery?
E. Ophir, M. Oettinger, H. Kreutzer, A. Priborkin, S. Hutova and V. Fait

Misoprostol for Prevention of Postpartum Hemorrhage: An Evidence-based Review by U.S. Pharmacopeia (USP)
J. Primo Carpenter

External Cephalic Version with Tocolysis in Late Pregnancy
W. Ruangchainikom, C. Chareonpron and S. Sarapak

Severe Obstetric Bleeding Treated with Recombinant Activated Factor VII (rFVIIa)
S. Segal, IY. Shemesh, R. Blumental, B. Yoffe, N. Laufer, Y. Ezra, I. Levy, M. Mazor and U. Martinowitz

Low Dose Aspirin in the Management of Idiopathic Recurrent Miscarriage
A.Y.K. Wong and L.C.H. Tang


Controlled Ovarian Stimulation Using a Single Dose GnRH Antagonists (Cetrotide® 3 mg)
J.M. Antoine, J.D. Alby, P. Merviel, B. Boutlane, J. Mandelbaum and S. Uzan

Different Concentrations of IL-12 and IL-13 in Follicular Fluid of Women with and without PCOS
A. Gallinelli, M. Salvatori, T. Marsella, L. Giannella, I. Ciaccio, S. Giulini and A. Volpe

The Effect of Serum Prolactin on the Day of Oocyte Retrieval on Pregnancy Rate in Patients Undergoing Invitrofertilization and Embryo Transfer (IVF-ET)
B.H. Rashidi

Leptin Attenuates the Insulin-like Growth Factor I Augmentation of Follicle Stimulating Hormone-Stimulated [Ca2+]i in Human Granulosa Cells
H.F. Huang and J.Z. Sheng

Early Transvaginal Embryo Aspiration For Selective Reduction in High Orders Multiple Gestations: The Experience From China
H. Huang, Y. Zhu, Y. Ye and M. Jin

To Correct a Defective Endometrium…
A. Husulak, D. Vazquez, C. Tajer and R. Marcomini

What Is the Role of Proinflammatory Cytokines in Follicular Fluid During In Vitro Fertilization
A. Ljubić, M. Cvetković, V. Šulović, V. Jelušić, T. Zdravković and T. Motrenko

How Safe Is Reduction To One?
T. Mardesic and P. Muller

GnRH Antagonists and Poor Responders: Results of a Preliminary Study
T. Papageorgiou, J. Guibert, Y. Janssens and J.-R. Zorn

A Phase III Trial to Study the Efficacy and Safety of Highly Purified Menotrophin (Menopurä) Versus Recombinant FSH (Follitrophin Alpha) in Female Patients in an IVF/ICSI Programme
The European Study Group on highly purifed hMG versus rFSH

Hysterosonosalpingography (HSSG) – Diagnostic Procedure in Infertility Work-up
V. Radić, S. Ciglar and V. Kukura

Xenoesterogens and Male Reproductive Failure: Is There a Casual Role?
R. Rozati, P.P. Reddy, P. Reddanna and R. Mujtaba

Blastocyst Transfer As an Alternative Art Treatment
V. Šulović, A. Ljubić, A. Stanković, Z. Stanković, T. Zdravković, V. Vlaisavljević and B. Kovačić

The Role of Free Radicals Regarding the Effectivness of Assisted Reproductive Cycles
A. Török, J. Belágyi, P. Németh, B. Török, T. Berki, J. Bódis and H.R. Tinneberg


CavatermTM Balloon Ablation
A. Alaily and Y. Diab

Evaluating the Risk of Tumor Aneuploidy on the Basis of Preoperative Blood Flow Resistance Index (RI) Measurements in Patients with Serous Ovarian Tumors
I. But and I. Takač

Computer Assisted Vaginal Hysterectomy
R Canales de la F., J.L. Mosso, V. Lara V., A. Minor M. and J.M. Grosso E.

Uterine Polyps and Pelvic Inflammatory Disease the Missing Link
S.M. Eldurrija, O.I. Abusnena and I.A. Al. Arbah

NovaSure™ Impedance Controlled Endometrial Ablation System. Long-term Follow-up Results
T. Fulop, I. Rakoczi and I. Barna

Estimate of Endometrium During Tibolone Treatment in Postmenopausal Women
L. Marianowski, B. Grzechocińska and H. Gadomska

A Case Report of Breast Hamartoma
I.A. Maruccio, M. Marziali and R. Maruccio

LigaSure versus Sutures in Total Abdominal Hysterectomy: A Prospective Randomized Study

R. McLellan, C. Anania, M. Birdsall, R. Bruno, J.K. Hurd and P. Prakash

Culdolaparoscopy: When and Why
D.A. Tsin

Uterine Sarcomas: Clinical Study in Five Years Period
S. Vrzic, V. Kesic, S. Petkovic and M. Petronijevic

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