Evaluation des principaux paramètres influençant la stratégie du transfert embryonnaire à J2 ou J3

Afin de pallier aux faibles taux d'implantation, il est devenu commun de transférer plusieurs embryons lors de la même tentative. Mais l'incidence des complications obstétricales augmente de façon significative avec le nombre de fœtus. La limitation du nombre d'embryons transférés est donc recommandée pour éviter les problèmes médicaux, sociaux et financiers associés aux naissances de haut rang. L'objectif de ce travail est d'évaluer l'impact des principaux facteurs dépendants à la fois de la patiente et de la tentative en cours, sur la survenue des grossesses simples et multiples. Pour cela, nous avons réalisé un travail rétrospectif sur 3574 transferts embryonnaires effectués à J2 ou J3 au centre de Fécondation In Vitro du CHU d'Amiens durant 9 ans. Les données de notre étude suggèrent une stratégie de transfert personnalisée, principalement en fonction de l'âge de la patiente, du rang de tentative et de la qualité des embryons disponibles. Ainsi, il apparaît clairement qu'une politique systématique garante d'un nombre limité de grossesses multiples ne donne pas autant de chance de succès à tous les couples.AMIENS-BU Santé (800212102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Is There an Association of Being Breastfed as an Infant and Fertility Status as an Adult?

International audienceBackground: Breastfeeding has many short-term and long-term health benefits for infants. Short-term benefits include protection against childhood infections and mortality in low-income countries. The adult long-term effects usually emphasized are a reduction of excess weight and type 2 diabetes. However, there is a lack of available data on the impact of having been breastfed on adult fertility. Indeed, infertility probably has a multifactorial origin, including an environmental origin. The aim of this study was to investigate whether having been breastfed could be associated with unexplained infertility. Materials and Methods: This research is an ancillary study of the case-control study ALIFERT, for which both fertile and infertile couples were recruited. Breastfeeding statuses, collected from childhood health records, were compared among fertile and infertile individuals. Anthropometrics parameters were also used for analysis. Results: About 65.6% of infertile women and 63.3% of fertile women were breastfed, and 69% of infertile men and 67.4% of fertile men were breastfed. There was no statistically significant difference between fertile and infertile groups. Nevertheless, infertile women who were not breastfed had a significantly higher body mass index than those who were breastfed (25.8 kg/m2 vs. 23.2 kg/m2). Conclusion: In our study, we did not observe any association between having been breastfed and fertility in adulthood. However, we observed that, in infertile women, having not been breastfed may influence weight in adulthood. Trial registration: NCT01093378 ALIFERT. Registered: March 25, 2010

Sedentary behavior, physical inactivity and body composition in relation to idiopathic infertility among men and women

International audienceBackground Physical activity (PA) and sedentary behavior have inconsistent effects on fertility. High body mass index is associated with infertility but to our knowledge, very few studies have explored body composition in association to fertility. Objective To assess the association between physical inactivity, sedentary behavior, body composition and idiopathic infertility in French men and women. Design We conducted a case-control multicentric observational study. 159 infertile (79 men and 80 women) and 143 fertile (72 men and 71 women) were recorded in four fertility centers. Main outcome measures Participants completed self-administered questionnaires on sociodemographic and lifestyle characteristics, dietary intake, physical activity and sedentary behavior. Anthropometrics were measured, and bioelectrical impedance analysis was used to estimate body composition. Multivariable logistic regression was used to analyze the association of fertility with PA level and sedentary behavior. Results In men, being physically inactive (Odd ratio [OR] 2.20; 95% confidence interval [CI], 1.06, 4.58) and having fat mass greater than the reference values for their age (OR 2.83; 95% CI, 1.31, 6.10) were positively associated with infertility. Sedentary behavior and fat-free mass were not related to infertility in men. In women, sedentary behavior (OR 3.61; 95% CI, 1.58, 8.24), high body fat (OR 3.16; 95% CI, 1.36, 7.37) and low fat-free mass (OR 2.65; 95% CI, 1.10, 6.37) were associated with infertility. PA level was not associated with fertility in women. Conclusions This study suggests that sedentary behavior and physical inactivity would represent two independent risk factors associated with infertility. The various elements that make up physical activity (frequency, intensity, time, and type of exercise) and the interrupting time spent sitting should be considered. Body composition variation should be explored further in relation to the biological pathways involved in idiopathic infertility. Moreover, the improvement of lifestyle factors should be considered in infertility treatment