D Molina Gomes

Hôpital de Poissy Saint Germain en Laye, Saint-Germain, Île-de-France, France

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Publications (34)84.66 Total impact

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    ABSTRACT: To study pericentric inversion segregation and interchromosomal effect on sperm for men heterozygous for inv(2)(p11q13), to assess the risk of miscarriage. Case report. Department of reproductive biology, cytogenetics, gynecology, and obstetrics. Seven patients heterozygous for inv(2)(p11q13) and five patients with normal karyotype with experience of recurrent spontaneous miscarriage. Fluorescence in situ hybridization on sperm with 2 p and 2q subtelomeric probes to screen for inversion segregation, and X, Y, and 18 centromeric probes to study interchromosomal effects. One thousand sperm were analyzed per experiment and per patient. Rate of unbalanced chromosomes and aneuploid sperm. The inv(2)(p11q13) patients showed a 0.3% rate of sperm with unbalanced chromosomes. For interchromosomal effects, a 0.6% aneuploid sperm rate was observed for patients heterozygous for inv(2)(p11q13). This is similar to the 0.5% rate observed for control patients. Inv(2)(p11q13) seems not to increase miscarriage for couples with men heterozygous for this inversion.
    Fertility and sterility 09/2009; 92(4):1497.e1-4. · 3.97 Impact Factor
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    ABSTRACT: Etiologic diagnosis of multiple congenital abnormalities (MCAs) is often lacking. Large chromosome abnormalities can be detected by conventional cytogenetic methods, but more subtle chromosome micro-rearrangements and/or de novo abnormalities require multi-FISH analysis, which is hampered by the amount of material available in prenatal testing. We used the comparative genomic hybridization (CGH) array, Genosensor Array 300, to screen for classic microdeletion syndromes and subtelomeric rearrangements in 39 consecutive fetuses with MCAs, after termination of pregnancy, in a prospective study. Thirty-seven of them had a normal karyotype, and two had a de novo unbalanced karyotype that could not be characterized with conventional cytogenetic methods. Two de novo unbalanced karyotypes were characterized by array CGH, and four additional abnormalities were diagnosed: an unbalanced inherited cryptic translocation, a deletion in band 22q11.2, a 1p36 deletion, and a 6p12.1-21.2 duplication. Chromosomal imbalances were therefore detected and/or characterized in 6 of 39 (15.4%) fetuses, indicating the value of routine array CGH in cases of MCAs and in uncharacterized chromosome rearrangements. Extension to all prenatal diagnoses may be warranted when copy number variation is identified and all FISH probes are commercially available.
    Fetal Diagnosis and Therapy 07/2009; 25(2):277-84. · 1.90 Impact Factor
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    ABSTRACT: The aim of this study was to analyse and compare the meiotic segregation of X-autosome translocation in two male carriers and to discuss couple-specific treatment modality before intracytoplasmic sperm injection (ICSI). Meiotic segregation was analysed by fluorescence in-situ hybridization (FISH) in spermatozoa of two men who were carriers of a X-autosome translocation: 46,Y,t(X;2)(p21;p25.3) (patient 1) and 46,Y,t(X;18)(qll;pl1.1) (patient 2). The results indicated a majority of unbalanced spermatozoa (62.05%) for patient 1, but normal or balanced spermatozoa (54.36%) for patient 2. Moreover, the unbalanced gametes resulted from adjacent I, adjacent II and 3:1 segregation, in decreasing frequencies, for patient 1 but from 3:1, adjacent I, adjacent II segregation for patient 2. The results of the meiotic segregation analysis had different treatment implications for assisted reproduction. Couple 1 were advised against ICSI, due to the results of the meiotic segregation in spermatozoa from patient 1 and the age of his wife. For couple 2, the clinic viewed favourably an attempt with ICSI followed by conventional prenatal diagnosis. A 46,XY child was born without malformations.
    Reproductive biomedicine online 07/2009; 18(6):850-5. · 2.68 Impact Factor
  • Prenatal Diagnosis 05/2009; 29(8):804-5. · 2.68 Impact Factor
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    ABSTRACT: To examine sperm meiotic segregation in a man with mosaic ring chromosome 21. Case report. Hospital departments of reproductive biology, cytogenetics, gynecology, and obstetrics. One patient referred for cryptozoospermia, heterozygous for a ring chromosome. Fluorescence in situ hybridization with chromosome 21-specific probes after sperm selection. A total of 169 spermatozoa were selected; 92.3% carried a normal 21 chromosome, 6.5% the ring chromosome, and 1.2% both. Ring chromosome frequency in mature sperm cells was low and may be due to preferential meiosis of normal spermatogonia,which could explain the cryptozoospermia and unexpected ratio in this case.
    Fertility and sterility 02/2009; 91(3):930.e13-5. · 3.97 Impact Factor
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    ABSTRACT: Preimplantation genetic diagnosis (PGD) is widely used for women heterozygous for a Robertsonian translocation. Preconceptional diagnosis (PCD), performed before fertilization, may be an alternative to PGD, especially in countries where PGD is restricted or prohibited, as in France. It could also give different information and clarify the influence of reproductive and obstetric history. In our study, translocation was diagnosed before ICSI in five cases (group A), and after newborn or fetal aneuploidy or miscarriage in two cases, (group B). First polar body (PB1) analysis using acrocentric centromeric probes was done for 85 PB1s, and aneuploidy rate was at 42.4%. Oocyte aneuploidy rate differed (p<0.0001) between groups A and B (30% vs 84%). Despite the small group sizes, we demonstrate a correlation (p=0.0358) of aneuploidy rate in polar bodies after 2 or more attempts. Three live births were recorded, all in group A. PCD could thus be an alternative to PGD. This pilot study also provides new prognostic information taking into account the women's natural history, but further confirmation is required.
    Journal of Assisted Reproduction and Genetics 01/2009; 26(2-3):113-7. · 1.82 Impact Factor
  • M Jaoul, D Molina Gomes, M Albert, M Bailly, M Bergere, J Selva
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    ABSTRACT: When one thinks of the failures of ART one naturally thinks of the suffering that they generate; but behind this pain, there is the suffering of infertility and, behind this latter, other distress we showed at the time of a recent research that they could play a part in infertility itself. The psychotherapy will help assume the failures, so that the traumatisms do not come to solidify in an impossible mourning, covering non elaborate former grieves. A sublimation of the desire of reproduction can make it possible for the unfertile man to peacefully consider other forms of paternity. For it to be possible, it is necessary that the subject should not be in the refusal of the psychic effraction, which the announcement of its infertility produces. When it is the case, to put on the couple on psychological assistance may help to restore a share of the narcissistic wounds; more particularly the one related to the suffering of the couple that often comes to be added to the wound of infertility.
    Gynécologie Obstétrique & Fertilité 01/2009; 37(11-12):921-5. · 0.55 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the stability of the aneuploidy rate of the first polar body. Knowing the stability of the oocyte aneuploidy rate for each patient would allow the first analysis to be used as a prognostic tool for further attempts at intracytoplasmic sperm injection (ICSI). After a first unsuccessful ICSI attempt with preconceptional screening, 24 women underwent a second attempt. First polar body aneuploidy rates were compared in the course of two successive ovarian stimulations. The first polar body was biopsied after laser dissection of the zona pellucida and five chromosomes were analysed using the MultiVysion polar body multicolour probe panel. A total of 200 polar bodies were analysed; 91 and 109 in the first and second ICSI attempts, respectively. The total aneuploidy rate was identical in the first and second attempts; 44.0% (40/91) and 44.0% (48/109), respectively. The first evaluation of the aneuploidy rate was statistically (P = 0.0007) correlated with the second, with a correlation coefficient, r = 0.707. The stability of the aneuploidy rate in different cohorts from the same patient, if confirmed in a larger series, makes this parameter a useful tool for counselling couples.
    Reproductive biomedicine online 09/2008; 17(2):213-9. · 2.68 Impact Factor
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    ABSTRACT: To clarify the mechanisms underlying oocyte abnormalities in meiosis: meiotic nondisjunction of a whole chromosome or premature separation of sister chromatids in two situations of increased chromosomal risk. Preconception diagnosis by first polar-body analysis in two situations of increased chromosomal risk. Departments of reproductive biology, cytogenetics, gynecology, and obstetrics. First polar body analysis was proposed to 76 patients (91 cycles) for advanced age (AMA; n = 30, 36 cycles), recurrent implantation failure (RIF; >10 embryos transferred without implantation; n = 32, 36 cycles), or both (AMA + RIF; n = 14, 19 cycles), before their intracytoplasmic sperm injection procedure. First polar-body analysis using fluorescence in situ hybridization. Mechanisms and frequency of aneuploidy. Three hundred eighty-four oocytes were analyzed by fluorescence in situ hybridization, 130 from women >38 years of age, 171 from women with RIF, and 83 from women with both indications. The oocyte abnormality rate was similar in the three groups, respectively, 38.5%, 40.4%, and 45.8%. The aneuploidy mechanisms were different for women >38 years of age who had no previous implantation failure (AMA) compared with women of whatever age who had implantation failure (P<.05 vs. RIF; P<.001 vs. AMA+RIF), with, respectively, for the AMA, RIF, and AMA+RIF groups, 72.2%, 56.6%, and 49.2% premature separation of sister chromatids and 27.8%, 43.4%, and 50.8% meiotic nondisjunction. In the two implantation-failure groups, we distinguished a subgroup (22% in the RIF group and 33% in AMA+RIF group) of patients with >2/3 abnormal oocytes, suggesting a meiosis alteration. The mechanisms accounting for oocyte aneuploidy differed in the two clinical situations of advanced maternal age and RIF. Advanced maternal-age aneuploidy was linked to a loss of sister chromatid cohesion that led to one single chromatid abnormality, whereas implantation failure is a much more heterogeneous situation.
    Fertility and sterility 07/2007; 87(6):1333-9. · 3.97 Impact Factor
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    ABSTRACT: Maternal ageing is the only aetiological factor unequivocally linked to aneuploidy. Two mechanisms seem to explain these abnormalities in oocytes: non-disjunction and premature unbalanced separation of sister chromatids (PSSC). Previous studies of unfertilized oocytes argue for a major role of PSSC in the aetiology of aneuploidy for women of advanced age, but in vitro ageing of the oocytes could influence the results. Owing to the high prevalence of aneuploidy in women of advanced age, chromosomal screening of the first polar body just before ICSI was offered to women (from 38 years of age) included in an assisted reproduction programme. Among 141 oocytes from 29 women (mean age 40 years and 2 months), 43 (30.5%) were abnormal. Sixty-five abnormalities were found and PSSC was involved in 80% of cases. These results are in accordance with previous studies and confirm, in 'fresh' oocytes, the major role of PSSC in the aetiology of aneuploidy in women of advanced age.
    Human Reproduction 06/2006; 21(5):1172-8. · 4.67 Impact Factor
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    ABSTRACT: We present a case of prenatal diagnosis of a de novo (7;19)(q11.2;q13.3) translocation associated with ultrasound features, including enlarged cisterna magna, normal vermis, thick corpus callosum, micrognathia, small and low-set ears and right hyperechogenic kidney. Karyotyping was performed at 24 weeks of gestation. Termination of pregnancy was accepted at the parents' request. Postmortem examination confirmed the prenatal findings, but revealed bilateral Wilms tumors of the kidneys. Parental karyotype was normal.
    Prenatal Diagnosis 11/2005; 25(10):876-8. · 2.68 Impact Factor
  • F Vialard, R Robyr, Y Hillion, D Molina Gomes, J Selva, Y Ville
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    ABSTRACT: 5p deletion syndrome commonly known as cri du chat is well described in affected neonates with catlike cry and hypotonia. Karyotyping will usually show a deletion of the short arm of one chromosome 5 with variable breakpoints. Only a few cases have been reported prenatally, and the fetal form of the syndrome has not been clearly individualised. We report a new case of 5p deletion syndrome diagnosed prenatally in association with Dandy-Walker syndrome and agenesis of the corpus callosum. Other brain anomalies have been reported previously, but this unusual association suggests the use of a specific probe in the investigation of these malformations.
    Prenatal Diagnosis 05/2005; 25(4):311-3. · 2.68 Impact Factor
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    ABSTRACT: To analyze the indications and the results of invasive testing for fetal karyotyping for ultrasound abnormality in the third trimester of pregnancy, when first- and second-trimester screening tests were negative. Retrospective study of 171 consecutive pregnancies that underwent invasive testing after 28 weeks of gestation in 2 institutions between January 1999 and December 2001. Forty-one patients did not have any form of screening for fetal aneuploidy beforehand. One hundred and thirty of them had a normal first-trimester scan and a low risk of fetal aneuploidy by nuchal translucency and/or maternal serum screening and were included in the statistical analysis. Mean maternal age, gestational age at diagnosis and at invasive testing were 30.5 years; 29.3 weeks and 32.5 weeks respectively. Amniocentesis and fetal blood sampling were performed in 97 and 33 cases respectively. The most frequent indications for invasive testing in the third trimester were major fetal malformations (51%) and intrauterine growth restriction (19%) detected on routine second- or third-trimester ultrasound examination. Ultrasound markers of aneuploidy and polyhydramnios accounted for 17 and 11% of the indications respectively. Fetal karyotype was normal in 121/130 cases. A gene mutation was found in one case. The karyotype was abnormal in nine cases, including seven cases of aneuploidy (one Turner syndrome, three trisomy 18, and three trisomy 21) and two cases of structural chromosomal abnormalities (46,XX, del 4 p16.1 and 46,XX, dup1). One hundred cases resulted in the delivery of a normal baby. Thirty cases led to termination of pregnancy or intrauterine death due to major fetal malformations (N = 25), abnormal karyotype in six of these, and severe IUGR (N = 5) with normal karyotype. Fetal US markers of aneuploidy and isolated polyhydramnios were associated with a favorable outcome in all cases.A significant increase in the risk of chromosomal anomaly was seen when two or more anomalies were found, rising from 2% with one anomaly to 21% when two or more anomalies were present. In low risk patients, fetal karyotyping in the third trimester may be justified when the diagnosis of fetal malformation is made in the third trimester of pregnancy. Two or more anomalies increase the risk of fetal aneuploidy even with a negative-screening test in the first and second trimester of pregnancy.
    Prenatal Diagnosis 01/2004; 23(13):1068-72. · 2.68 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: When one thinks of the failures of ART one naturally thinks of the suffering that they generate; but behind this pain, there is the suffering of infertility and, behind this latter, other distress we showed at the time of a recent research that they could play a part in infertility itself. The psychotherapy will help assume the failures, so that the traumatisms do not come to solidify in an impossible mourning, covering non elaborate former grieves. A sublimation of the desire of reproduction can make it possible for the unfertile man to peacefully consider other forms of paternity. For it to be possible, it is necessary that the subject should not be in the refusal of the psychic effraction, which the announcement of its infertility produces. When it is the case, to put on the couple on psychological assistance may help to restore a share of the narcissistic wounds; more particularly the one related to the suffering of the couple that often comes to be added to the wound of infertility.
    Gynécologie Obstétrique & Fertilité 37(s 11–12):921–925. · 0.55 Impact Factor

Publication Stats

178 Citations
84.66 Total Impact Points

Institutions

  • 2004–2014
    • Hôpital de Poissy Saint Germain en Laye
      Saint-Germain, Île-de-France, France
  • 2008–2013
    • Université de Versailles Saint-Quentin
      Versailles, Île-de-France, France
  • 2012
    • TOMA Advanced Biomedical Assays
      Ansizio, Lombardy, Italy
  • 2009
    • Computational Hydraulics Int.
      Guelph, Ontario, Canada