Mozole Mirach Ceza Dissertation

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Liste des documents règlementaires indispensables à votre prise en charge (Arrêté du 03 août 2010) :

  • Photocopies des pièces identité (avec photo) des deux membres du couple.
  • Certificat de mariage (photocopie du livret de famille) ou attestation de vie commune (formulaire délivré par votre gynécologue) ou copie du PACS.
  • Demande d’AMP, signée après un délai de réflexion d’un mois.
  • Consentement à la technique, signé par les deux membres du couple et renouvelé avant chaque tentative d’AMP. Ce consentement devra impérativement être signé en présence d’un membre de l’équipe pluridisciplinaire pour tout transfert d’embryon(s) congelé(s).
  • Votre accord pour la transmission des résultats de votre tentative de façon nominative à l’agence de biomédecine (en cas de refus, la transmission se fait de façon non nominative).

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Liste des documents médicaux a indispensables à votre prise en charge

  • Résultats des sérologies datant de moins de 3 mois avant une première tentative, puis de moins d’un an pour les tentatives suivantes.
    • VIH,
    • Hépatite B (Ag HBs, Ac-Anti HBs, Ac Anti-HBc),
    • Hépatite C,
    • Syphilis (TPHA-VDRL).
  • Résultats d’un spermogramme avec un test de migration survie datant de moins de 6 mois pour une première tentative.
  • Résultats d’une spermoculture datant de moins de 6 mois pour une première tentative, puis de moins d’un an pour les tentatives suivantes.
  • Pour toute IIU (première et suivantes), les résultats doivent datés de moins de 6 mois.

Liste des démarches supplémentaires en cas de ponction ovocytaire (FIV & ICSI)

  • Prendre rendez-vous en consultation avec l’anesthésiste au 01 39 63 72 04.
  • Effectuer votre pré-admission d’hospitalisation (La date approximative correspondant a 15 jours après le début de vos règles sur lesquelles vous débuterez votre traitement de stimulation).

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