Evolution au cours du temps des paramètres spermatiques d'hommes fertiles et subfertiles au cecos de Tours

Bien qu'une tendance au déclin de la qualité du sperme soit fortement suspectée, les résultats restent encore très controversés pour des raisons méthodologiques. Notre étude a pour objectif de vérifier si la qualité du sperme avait décliné au cours du temps au CECOS de Tours. Nous avons donc analysé rétrospectivement les paramètres spermatiques de deux populations homogènes : une population d'hommes fertiles (candidats au don de sperme), et une population d'hommes subfertiles (patients réalisant un spermogramme dans le cadre du bilan d'infertilité du couple). Les buts de cette étude étaient : (i) d'analyser les paramètres spermatiques des candidats au don du sperme ainsi que leurs variations au cours de la période 1976-2009, (ii) de comparer l'évolution de ces paramètres entre les candidats retenus ou non comme donneurs, (iii) d'analyser les paramètres spermatiques des hommes subfertiles ainsi que leurs variations au cours de la période 1985-2010, (iv) de comparer l'évolution de ces paramètres entre les populations fertiles et subfertiles de 1985 à 2010. Nous avons constaté une baisse significative de la numération totale (-32%), de la mobilité progressive (-38%) et du pourcentage de formes normales (passant de 62% à 12% entre 1976 et 2009) chez les hommes fertiles en association à une hausse de l'Index d'Anomalies Multiples (+42%). Les candidats retenus avaient des paramètres spermatiques supérieurs à ceux qui étaient récusés. Concernant les patients subfertiles, nous avons observé une diminution significative du volume (-6%), de la numération totale (-17%) ainsi que du pourcentage de formes normales (passant de 36% à 6% entre 1985 et 2010) mais une augmentation de la mobilité progressive (+10%) ; tous les paramètres spermatiques étant significativement plus bas que ceux des hommes fertiles. Notre étude met en évidence une diminution variable de la qualité du sperme au cours des dernières décennies à la fois chez des hommes fertiles et subfertiles originaires d'une même région géographique. De nombreuses hypothèses ont été émises pour expliquer ce phénomène en particulier des facteurs environnementaux mais aucune explication n'a été fermement validée jusqu'à présent.ANGERS-BU Médecine-Pharmacie (490072105) / SudocSudocFranceF

Evolution des paramètres spermatiques d'hommes fertiles de 1976 à 2010

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Effets de la durée d'ouverture des kits conventionnels de congélation/décongélation des blastocystes sur leur survie puis implantation

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Morphokinetic parameters in chromosomal translocation carriers undergoing preimplantation genetic testing

International audienceRESEARCH QUESTION: Can embryo morphokinetic parameters help identify unbalanced embryos in translocation carriers?DESIGN: This retrospective study was conducted in 67 translocation carriers undergoing 105 preimplantation genetic testing cycles for chromosomal structural rearrangements (PGT-SR) without aneuploidy screening (PGT-A). Using time-lapse imaging analysis, morphokinetic parameters of balanced and unbalanced embryos were compared, as well as the frequency of abnormal cellular events. The performance of a previously published prediction model of aneuploidy was also tested in this population.RESULTS: Significant differences were observed between balanced and unbalanced embryos for some morphokinetic parameters: t5 (P = 0.0067), t9+ (P = 0.0077), cc2 (P = 0.0144), s2 (P = 0.0003) and t5-t2 (P = 0.0028). Also, multinucleation at the two- or four-cell stages, abnormal division and cell exclusion at the morula stage were significantly (all P < 0.05) more frequent in unbalanced than in balanced embryos. None, however, could accurately predict embryo chromosomal status. A previously published morphokinetic prediction model for embryo aneuploidy did not adequately classify balanced and unbalanced embryos.CONCLUSIONS: No significant morphokinetic predictor of chromosomal status could be found. Time-lapse should not be used as a diagnostic tool for chromosomal status in translocation carriers

External validation of a time-lapse prediction model

International audienceOBJECTIVE:To study the performance of a previously published implantation prediction model based on morphokinetics in a different setting, in an unselected population and with various embryo transfer strategies.DESIGN:Retrospective monocentric study.SETTING:University-based assisted reproduction technology (ART) center.PATIENT(S):450 unselected couples undergoing intracytoplasmic sperm injection (ICSI) cycle with embryo culture in the EmbryoScope (Unisense Fertilitech), corresponding to 528 embryos with known implantation.INTERVENTION(S):None.MAIN OUTCOME MEASURE(S):Implantation rates (IR) in embryo categories defined by the model in the overall population and in subgroups according to the day of embryo transfer.RESULT(S):The distribution of IR among detailed morphokinetic categories in the overall population and in subgroups according to the day of embryo transfer was more heterogeneous than expected according to the published model. The distribution corresponded better to the original when a simplified version of the model was used, although it worked better in the cleavage-stage group than in the blastocyst-stage group.CONCLUSION(S):This study was unsuccessful in replicating the sensitivity of the previously published model for predicting implantation rate of embryos ranked according to morphokinetic categories. Further work is required to assess the utility of the model for embryo selection. Each team using time-lapse technology should build a center-specific prediction model based on its own data and transfer policy

Does sperm origin affect embryo morphokinetic parameters?

International audiencePurpose The purpose of our study was to use time-lapse in order to evaluate the impact of sperm origin (fresh ejaculate or surgically retrieved) on embryo morphokinetic parameters and clinical outcome in intracytoplasmic sperm injection (ICSI) cycles.Methods This retrospective monocentric study was conducted in 485 unselected couples undergoing 604 ICSI cycles with embryo culture in the Embryoscope®. Among them, 445 couples underwent ICSI cycle with fresh ejaculated sperm and 40 with surgically retrieved sperm (26 with testicular sperm and 14 with epididymal sperm). Embryo morphokinetic parameters and clinical cycle outcome were compared between fresh ejaculated sperm and surgically retrieved sperm. A subgroup analysis was also conducted between testicular and epididymal sperm ICSI cycles.Results Clinical outcome was comparable between groups according to sperm origin. Although most early morphokinetic parameters were comparable between ejaculated and surgical sperm groups, a few parameters were significantly different between both groups, but with a considerable overlap in their distribution. Late cellular events occurred significantly later in the surgical sperm group than in the ejaculated sperm group. Conclusions Morphokinetic analysis did not allow us to identify clinically relevant differences between fresh ejaculate and surgically retrieved sperm groups. Further studies are needed, especially concerning the relationship between sperm origin and late morphokinetic parameters, such as blastocyst development