La réceptivité endométriale en aide médicale à la procréation : Une piste à ne pas oublier devant un échec d’implantation

International audienceInfertility affects between 8 and 12% of reproductive-age couples worldwide. Despite improvements in assisted reproductive techniques (ART), live birth rates are still limited. In clinical practice, imaging and microscopy are currently widely used, but their diagnostic effectiveness remains limited. In research, the emergence of innovative techniques named OMICS would improve the identification of the implantation window, while progressing in the understanding of the pathophysiological mechanisms involved in embryo implantation failures. To date, transcriptomic analysis seems to be the most promising approach in clinical research. The objective of this review is to present the results obtained with the different approaches available in clinical practice and in research to assess endometrial receptivity in patients undergoing ART.L’infertilité touche entre 8 et 12 % des couples en âge de procréer à travers le monde. Malgré l’amélioration des techniques d’aide médicale à la procréation (AMP), les taux de naissances vivantes restent toujours limités. En pratique clinique, l’imagerie et la microscopie sont actuellement largement utilisées, mais leur efficacité diagnostique reste limitée. En recherche, l’émergence des techniques innovantes dites OMICS permettrait d’améliorer l’identification de la fenêtre implantatoire, tout en progressant dans la compréhension des mécanismes physiopathologiques impliqués dans les échecs d’implantation embryonnaire. À ce jour, l’approche transcriptomique semble être la piste la plus prometteuse en recherche clinique. L’objectif de cette revue est de faire un état des lieux des résultats obtenus à ce jour avec les différentes approches disponibles en pratique clinique et en recherche pour évaluer la réceptivité endométriale chez les patientes prises en charge en AMP

Poids de naissance et transfert d’embryon congelé : état de l’art

International audienceThe aim of this study was to update our acknowledgment if there is a link between assisted embryo cryopreservation and epigenetics in human? Animal studies have demonstrated epigenetics consequence and especially imprinting disorders due to in vitro culture. In human, it is important to note that after frozen embryo transfer birth weight is significantly increased by 81 to 250g. But these studies cannot identify the reasons of such difference. This review strongly suggests that embryo cryopreservation is responsible for birth weight variations but mechanisms not yet elucidated. Epigenetics is probably one of these but to date, none study is able to prove it. We have to be attentive on a possible link between assisted reproductive technology (ART) and epigenetics reprogrammation

Dichorio-Triamniotic Triplet Pregnancy after Day 3 Single Embryo Transfer

International audienceA 31 year-old woman had a single embryo transfer on day 3 after assisted hatching (AH) and intracytoplasmic sperm injection (ICSI) treatment. Ultrasound examination performed 6 weeks after oocyte retrieval revealed a triplet pregnancy combining monochorionic diamniotic twins and a singleton. If zygote splitting resulting in monochorionic triamniotic triplets following IVF has already been described, this case is about an incredibly rare phenomenon after single embryo transfer. Naturally, a concurrent spontaneous conception cannot be excluded. To our knowledge, this is the first time a dichorionic triplet pregnancy after single embryo transfer is reported

Programme de préservation de la fertilité féminine au CHRU de Montpellier 2ans après

International audienceOBJECTIVE:Female fertility preservation in the context of cancer management is crucial for patient's health care. The aim of this study was to evaluate the oncofertility practice at our university hospital of Montpellier since 2011.PATIENTS AND METHODS:The evaluation of management of young patients referred to Montpellier University Hospital from September 2011 to September 2013 for oncofertility counselling before cancer treatment.RESULTS:Seventy-one patients were referred to a specialized oncofertility center. Forty-two patients (59.1%) were included in the oncofertility program. Twenty-two patients (31%) were proposed for oocyte vitrification after COS protocol, eight patients (11.3%) for ovarian tissue cryoconservation, seven patients (9.9%) for GnRH injections, three patients (4.2%) ovarian transposition and two patients (2.8%) for embryo cryopreservation. Among the 42 indications of fertility preservation, only 18 will have finally taken place.CONCLUSION:Oncofertility counselling for young patients should now be part of the cancer management. It involves multidisciplinary teams. Further information of both oncologists and patients is needed to improve this new approach in the field of cancer treatments