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Insulin resistance appears to be responsible of approximately half of the cases of polycystic ovaries, the other half being probably provoked by an anomaly of the stimulation of ovaries by an excess of LH. Nevertheless, it is likely that in most cases the two factors conjugate. The excess of androgen production by the ovarian stroma is one of the major symptoms of this disease. Today, however, the diagnosis is carried mainly with the assistance of ultra-sounds which, besides the increased ovarian volume, have permitted to discover an increased ovarian stromal vascularity. Two essential datas derive from the whole works: the increased frequency of ovarian hyperstimulation syndrome and the great number of metabolic complications which requires an endocrinological supervision. But the most recent works focus on the extension to all ages of this form of pathology: from the intra-uterine life to the post menopause; and on the hereditary character of this disease. The mystery remains concerning the mechanism of the favourable effect in clomifene resistant PCOS, of surgical and laparoscopic methods of ovulation induction to which it may be useful to resort after mature consideration. More recently the benefit at the administration of metformine has been confirmed by several works.

The authors consider all the mechanisms through which a genital infection is able to affect fertility and fecundity. They conclude that a strict diagnosis and treatment must complement accurate information of the public by physicians.

A preliminary report is given on a new laparoscopic sterilization procedure. By a double-puncture method, a loop of tube is brought out of the abdomen through the suprapubic incision. The loop is then resected by a modified Pomeroy method. Between Octorber 1976 and June 1978, 75 sterilizations were performed without any major problem. Sterilization failed in one case when one tube could not be seen. All recoveries were uneventful. Safety, effectiveness, simplicity, and potential reversibility seem to be the qualities of this method.

The author reports a case of abdominal pregnancy in a woman with a malformed uterus after 30 weeks of amenorrhoes. The several different clinical abnormal features are detailed: threatened early labour, death in utero, inability to induce labour by several different methods, sub-acute obstruction and "rupture" of the membranes. Diagnosis was made only on laparotomy. Rupture of the uterine cornu had occurred in a bicornuate uterus with single cervix with secondary implantation of the oocyte in the abdominal cavity. The ruptured cornu was removed.

40 tubal sterilisations have been carried out in 5 years. The indications most often are for grand parity. The anatomical criteria for effective sterilisation by the vaginal route should be sought by gynaecological examination under general anaesthetic. The date for the operation, the technique and its difficulties have been described. The operation lasted on an average 30 minutes. The average stay in hospital was 8.2 days. Only one local complication using this techinque was noted. On one occasion the authors had to abandon the vaginal route to reach the tubes. This simple procedure without any aesthetic inconvenience seems to them to be the ideal route for tubal sterilisation.

Despite correct management of HMG and hCG, the margin between effective dose and overdose is narrow. Surveillance must be clinical, biochemical and echographic. Biochemistry and echography give information on follicle maturation. Echography is a particularly valuable means of monitoring the effect of administration of hypophyseal hormones on the development of follicles.

The statement of the definitive character of the menopause is not easy, save in the case of surgical castration. In all other cases one has seen the reappearance of the menstrual periods after several months of amenorrhoea. Although, in principle, amenorrhoea of an entire year's duration corresponds to the menopause, there are exceptions. In the case of women who are undergoing contraceptive treatment, the only means of knowing if they are menopausal consists of interruption of the oestro-progestational contraception and of advising the use of a local contraceptive for a period of several months.

A procedure of total vaginal hysterectomy without vaginectomy with a vaginal vault suspension to the anterior abdominal wall-- without laparotomy--is presented. The patient for whom this operation is indicated is the old sexually active women.

Systematic ultrasound examination made it possible to discover a placental angioma measuring 50 mm in diameter and situated in contact with the feral plaque. This angioma had reached 78 mm in size across its largest diameter by the 23rd week and appeared to become stable thereafter, getting in size towards the 35th week. This state of involution was confirmed when the placenta was examined and it was found there was a second angioma present, and that is was functional, and that there were several microangiomata. The pregnancy, clinically and biologically, was normal throughout and ended with the birth of a healthy girl, who in particular had no enlargement of her heart.