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Hesters L, Sermondade N, Lambert C, Pouly JL, Pereira B, Lucas C, Levy R, Brugnon F. Is large for gestational age in singletons born after frozen embryo transfer associated with freezing technique or endometrial preparation protocol? A longitudinal national French study. Hum Reprod 2024; 39:724-732. [PMID: 38384249 DOI: 10.1093/humrep/deae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 01/28/2024] [Indexed: 02/23/2024] Open
Abstract
STUDY QUESTION Is large for gestational age (LGA) observed in babies born after frozen embryo transfer (FET) associated with either the freezing technique or the endometrial preparation protocol? SUMMARY ANSWER Artificial cycles are associated with a higher risk of LGA, with no difference in rate between the two freezing techniques (vitrification versus slow freezing) or embryo stage (cleaved embryo versus blastocyst). WHAT IS KNOWN ALREADY Several studies have compared neonatal outcomes after fresh embryo transfer (ET) and FET and shown that FET is associated with improved neonatal outcomes, including reduced risks of preterm birth, low birthweight, and small for gestational age (SGA), when compared with fresh ET. However, these studies also revealed an increased risk of LGA after FET. The underlying pathophysiology of this increased risk remains unclear; parental infertility, laboratory procedures (including embryo culture conditions and freezing-thawing processes), and endometrial preparation treatments might be involved. STUDY DESIGN, SIZE, DURATION A multicentre epidemiological data study was performed through a retrospective analysis of the standardized individual clinical records of the French national register of IVF from 2014 to 2018, including single deliveries resulting from fresh ET or FET that were prospectively collected in fertility centres. Complementary data were collected from the participating fertility centres and included the vitrification media and devices, and the endometrial preparation protocols. PARTICIPANTS/MATERIALS, SETTING, METHODS Data were collected from 35 French ART centres, leading to the inclusion of a total of 72 789 fresh ET, 10 602 slow-freezing FET, and 39 062 vitrification FET. Main clinical outcomes were presented according to origin of the transferred embryos (fresh, slow frozen, or vitrified embryos) and endometrial preparations for FET (ovulatory or artificial cycles), comparing five different groups (fresh, slow freezing-ovulatory cycle, slow freezing-artificial cycle, vitrification-ovulatory cycle, and vitrification-artificial cycle). Foetal growth disorders were defined in live-born singletons according to gestational age and sex-specific weight percentile distribution: SGA and LGA if <10th and ≥90th percentiles, respectively. Analyses were performed using linear mixed models with the ART centres as random effect. MAIN RESULTS AND THE ROLE OF CHANCE Transfers led to, respectively, 19 006, 1798, and 9195 deliveries corresponding to delivery rates per transfer of 26.1%, 17.0%, and 23.5% after fresh ET, slow-freezing FET, and vitrification FET, respectively. FET cycles were performed in either ovulatory cycles (n = 21 704) or artificial cycles (n = 34 237), leading to 5910 and 10 322 pregnancies, respectively, and corresponding to pregnancy rates per transfer of 31.6% and 33.3%. A significantly higher rate of spontaneous miscarriage was observed in artificial cycles when compared with ovulatory cycles (33.3% versus 21.4%, P < 0.001, in slow freezing groups and 31.6% versus 21.8%, P < 0.001 in vitrification groups). Consequently, a lower delivery rate per transfer was observed in artificial cycles compared with ovulatory cycles both in slow freezing and vitrification groups (15.5% versus 18.9%, P < 0.001 and 22.8% versus 24.9%, P < 0.001, respectively). Among a total of 26 585 live-born singletons, 16 413 babies were born from fresh ET, 1644 from slow-freezing FET, and 8528 from vitrification FET. Birthweight was significantly higher in the FET groups than in the fresh ET group, with no difference between the two freezing techniques. Likewise, LGA rates were higher and SGA rates were lower in the FET groups compared with the fresh ET group whatever the method used for embryo freezing. In a multivariable analysis, the risk of LGA following FET was significantly increased in artificial compared with ovulatory cycles. In contrast, the risk of LGA was not associated with either the freezing procedure (vitrification versus slow freezing) or the embryo stage (cleaved embryo versus blastocyst) at freezing. Regarding the vitrification method, the risk of LGA was not associated with either the vitrification medium used or the embryo stage. LIMITATIONS, REASONS FOR CAUTION No data were available on maternal context, such as parity, BMI, infertility cause, or maternal comorbidities, in the French national database. In particular, we cannot exclude that the increased risk of LGA observed following FET with artificial cycles may, at least partially, be associated with a confounding effect of some maternal factors. No information about embryo culture and incubation conditions was available. Most of the vitrification techniques were performed using the same device and with two main vitrification media, limiting the validity of a comparison of risk for LGA according to the device or vitrification media used. WIDER IMPLICATIONS OF THE FINDINGS Our results seem reassuring, since no potential foetal growth disorders following embryo vitrification in comparison with slow freezing were observed. Even if other factors are involved, the endometrial preparation treatment seems to have the greatest impact on LGA risk following FET. FET during ovulatory cycles could minimize the risk for foetal growth disorders. STUDY FUNDING/COMPETING INTEREST(S) This work has received funding from the French Biomedicine Agency (Grant number: 19AMP002). None of the authors has any conflict of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Laetitia Hesters
- Department of Reproductive Biology CECOS, Hôpital Antoine Béclère, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Clamart, France
| | - Nathalie Sermondade
- Department of Reproductive Biology CECOS, Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Céline Lambert
- Biostatistics Unit, Department of Clinical Research and Innovation, Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Clermont-Ferrand, France
| | - Jean-Luc Pouly
- Department of Reproductive Biology CECOS, Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics Unit, Department of Clinical Research and Innovation, Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Clermont-Ferrand, France
| | - Cécily Lucas
- Department of Reproductive Biology CECOS, Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Clermont-Ferrand, France
| | - Rachel Levy
- Department of Reproductive Biology CECOS, Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Florence Brugnon
- Department of Reproductive Biology CECOS, Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Clermont-Ferrand, France
- University of Clermont Auvergne, IMoST, INSERM 1240, Faculté de Médecine, Clermont-Ferrand, France
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Sonigo C, Ahdad-Yata N, Pirtea P, Solignac C, Grynberg M, Sermondade N. Do IVF culture conditions have an impact on neonatal outcomes? A systematic review and meta-analysis. J Assist Reprod Genet 2024; 41:563-580. [PMID: 38246922 PMCID: PMC10957805 DOI: 10.1007/s10815-024-03020-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
PURPOSE Are embryo culture conditions, including type of incubator, oxygen tension, and culture media, associated with obstetric or neonatal complications following in vitro fertilization (IVF)? METHODS A systematic search of MEDLINE, EMBASE, and Cochrane Library was performed from January 01, 2008, until October 31, 2021. The studies reporting quantitative data on at least one of the primary outcomes (birthweight and preterm birth) for the exposure group and the control group were included. For oxygen tension, independent meta-analysis was performed using Review Manager, comparing hypoxia/normoxia. For culture media, a network meta-analysis was carried out using R software, allowing the inclusion of articles comparing two or more culture media. RESULTS After reviewing 182 records, 39 full-text articles were assessed for eligibility. A total of 28 studies were kept for review. Meta-analysis about the impact of incubator type on perinatal outcomes could not be carried out because of a limited number of studies. For oxygen tension, three studies were included. The pairwise meta-analysis comparing hypoxia/normoxia did not show any statistical difference for birthweight and gestational age at birth. For culture media, 18 studies were included. The network meta-analysis failed to reveal any significant impact of different culture media on birthweight or preterm birth. CONCLUSION No difference was observed for neonatal outcomes according to the embryo culture conditions evaluated in this review. Further research is needed about the safety of IVF culture conditions as far as future children's health is concerned.
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Affiliation(s)
- Charlotte Sonigo
- Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Antoine Béclère, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France
| | - Naouel Ahdad-Yata
- Unité d'Assistance Médicale à la Procréation, Hôpital Américain, Neuilly-sur-Seine, France
| | - Paul Pirtea
- Service de Gynécologie-Obstétrique et Reproduction, Hôpital Foch, Université Paris Ouest, Suresnes, France
| | | | - Michael Grynberg
- Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Antoine Béclère, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France
| | - Nathalie Sermondade
- Service de Biologie de la Reproduction-CECOS, Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique-Hôpitaux de Paris, 4 rue de la Chine, 75020, Paris, France.
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Rivet-Danon D, Ly A, Prades-Borio M, Berthaut I, Ogouma-Aworet L, Panissard C, Bachelot G, Lévy R, Dupont C, Sermondade N. [The revision of the Bioethics Act, two years on: major principles and consequences for practice in the reproductive biology laboratory]. Ann Biol Clin (Paris) 2024; 81:621-627. [PMID: 38189359 DOI: 10.1684/abc.2023.1847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Since 1994, in France, bioethics law has set the regulatory framework for Medically Assisted Reproduction (MAR). The latest revision of the law of August 2, 2021, is characterized by major upheavals in the field of MAR and intervenes in several areas: the purpose and conditions to access to MAR, access to origins in the case of gamete or embryo donation, and gametes cryopreservation without medical indication. Indeed, the law authorizes, because of a strong societal demand, the extension of sperm donation to couples of women and unmarried women, as well as the possibility for any person to preserve his/her gametes if he/she meets the age criteria defined by decree. Finally, the law opens the possibility for people born following gamete or embryo donation to have access, from their 18th anniversary, to identifying and/or non-identifying data. These new measures have led to a very important number of MAR requests to fertility and donation centers, and have required the implementation of new circuits in order to harmonize care, without discrimination or prioritization.
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Sonigo C, Robin G, Boitrelle F, Fraison E, Sermondade N, Mathieu d'Argent E, Bouet PE, Dupont C, Creux H, Peigné M, Pirrello O, Trombert S, Lecorche E, Dion L, Rocher L, Arama E, Bernard V, Monnet M, Miquel L, Birsal E, Haïm-Boukobza S, Plotton I, Ravel C, Grzegorczyk-Martin V, Huyghe E, Dupuis HGA, Lefevre T, Leperlier F, Bardet L, Lalami I, Robin C, Simon V, Dijols L, Riss J, Koch A, Bailly C, Rio C, Lebret M, Jegaden M, Fernandez H, Pouly JL, Torre A, Antoine JM, Courbiere B. [First-line management of infertile couple. Guidelines for clinical practice of the French College of Obstetricians and Gynecologists 2022]. Gynecol Obstet Fertil Senol 2024:S2468-7189(24)00037-0. [PMID: 38311310 DOI: 10.1016/j.gofs.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 01/25/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To update the 2010 CNGOF clinical practice guidelines for the first-line management of infertile couples. MATERIALS AND METHODS Five major themes (first-line assessment of the infertile woman, first-line assessment of the infertile man, prevention of exposure to environmental factors, initial management using ovulation induction regimens, first-line reproductive surgery) were identified, enabling 28 questions to be formulated using the Patients, Intervention, Comparison, Outcome (PICO) format. Each question was addressed by a working group that had carried out a systematic review of the literature since 2010, and followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE®) methodology to assess the quality of the scientific data on which the recommendations were based. These recommendations were then validated during a national review by 40 national experts. RESULTS The fertility work-up is recommended to be prescribed according to the woman's age: after one year of infertility before the age of 35 and after 6months after the age of 35. A couple's initial infertility work-up includes a single 3D ultrasound scan with antral follicle count, assessment of tubal permeability by hysterography or HyFOSy, anti-Mullerian hormone assay prior to assisted reproduction, and vaginal swabbing for vaginosis. If the 3D ultrasound is normal, hysterosonography and diagnostic hysteroscopy are not recommended as first-line procedures. Chlamydia trachomatis serology does not have the necessary performance to predict tubal patency. Post-coital testing is no longer recommended. In men, spermogram, spermocytogram and spermoculture are recommended as first-line tests. If the spermogram is normal, it is not recommended to check the spermogram. If the spermogram is abnormal, an examination by an andrologist, an ultrasound scan of the testicles and hormonal test are recommended. Based on the data in the literature, we are unable to recommend a BMI threshold for women that would contraindicate medical management of infertility. A well-balanced Mediterranean-style diet, physical activity and the cessation of smoking and cannabis are recommended for infertile couples. For fertility concern, it is recommended to limit alcohol consumption to less than 5 glasses a week. If the infertility work-up reveals no abnormalities, ovulation induction is not recommended for normo-ovulatory women. If intrauterine insemination is indicated based on an abnormal infertility work-up, gonadotropin stimulation and ovulation monitoring are recommended to avoid multiple pregnancies. If the infertility work-up reveals no abnormality, laparoscopy is probably recommended before the age of 30 to increase natural pregnancy rates. In the case of hydrosalpinx, surgical management is recommended prior to ART, with either salpingotomy or salpingectomy depending on the tubal score. It is recommended to operate on polyps>10mm, myomas 0, 1, 2 and synechiae prior to ART. The data in the literature do not allow us to systematically recommend asymptomatic uterine septa and isthmoceles as first-line surgery. CONCLUSION Based on strong agreement between experts, we have been able to formulate updated recommendations in 28 areas concerning the initial management of infertile couples.
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Affiliation(s)
- Charlotte Sonigo
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Antoine-Béclère, 157, rue de la Porte-Trivaux, 92140 Clamart, France; Faculté de médecine, université Paris-Sud Saclay, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France
| | - Geoffroy Robin
- Service d'assistance médicale à la procréation et préservation de la fertilité, CHU de Lille, Lille, France
| | - Florence Boitrelle
- Service de biologie de la reproduction, préservation de fertilité, CECOS, CHI de Poissy, Poissy, France; INRAe, ENVA, BREED, UVSQ, université Paris Saclay, Jouy-en Josas, France
| | - Eloïse Fraison
- Département médecine de la reproduction, CHU Lyon, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69500 Bron, France
| | - Nathalie Sermondade
- Service de biologie de la reproduction CECOS, hôpital Tenon, AP-HP, Sorbonne université, 75020 Paris, France; Inserm US938, centre de recherche Saint-Antoine, Sorbonne université, 75012 Paris, France
| | - Emmanuelle Mathieu d'Argent
- Service de gynécologie-obstétrique et médecine de la reproduction, Dmu Origyne, hôpital Tenon, GHU Sorbonne université, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - Pierre-Emmanuel Bouet
- Service de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49000 Angers, France
| | - Charlotte Dupont
- Service de biologie de la reproduction - CECOS, hôpital Tenon, AP-HP, Sorbonne université, 75012 Paris, France
| | - Hélène Creux
- Centre AMP, polyclinique Saint-Roch, 550, avenue du Colonel-André-Pavelet, 34070 Montpellier cedex, France
| | - Maeliss Peigné
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Jean-Verdier-Béclère, avenue du 14-Juillet, Bondy, France
| | - Olivier Pirrello
- Service d'aide médicale à la procréation, centre médicochirurgical obstétrique (CMCO), CHU de Strasbourg, 19, rue Louis-Pasteur, 67303 Schiltigheim, France
| | - Sabine Trombert
- Laboratoire Cerba, 6-11, rue de l'Équerre, 95310 Saint-Ouen L'Aumône, France
| | - Emmanuel Lecorche
- Laboratoire Cerba, 6-11, rue de l'Équerre, 95310 Saint-Ouen L'Aumône, France
| | - Ludivine Dion
- Département de gynécologie-obstétrique et reproduction humaine - CECOS, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France
| | - Laurence Rocher
- Service de radiologie diagnostique et interventionnelle, site Bicêtre, hôpitaux Paris Sud, 94270 Le Kremlin-Bicêtre, France; Université Paris Sud, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France; Service hospitalier Frédéric-Joliot, imagerie par résonance magnétique médicale et multimodalités, CNRS UMR8081, université Paris Sud, 4, place du Gal-Leclerc, 91401 Orsay cedex, France
| | - Emmanuel Arama
- Service de radiologie diagnostique et interventionnelle, site Bicêtre, hôpitaux Paris Sud, 94270 Le Kremlin-Bicêtre, France; Université Paris Sud, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France; Service hospitalier Frédéric-Joliot, imagerie par résonance magnétique médicale et multimodalités, CNRS UMR8081, université Paris Sud, 4, place du Gal-Leclerc, 91401 Orsay cedex, France
| | - Valérie Bernard
- Service de chirurgie gynécologique, gynécologie médicale et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU Pellegrin, Bordeaux, France
| | - Margaux Monnet
- Département de gynécologie médicale, maternité régionale de Nancy, hôpitaux universitaires de Nancy, Nancy, France
| | - Laura Miquel
- Service d'assistance médicale à la procréation, pôle Femmes-Parents-Enfants, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France
| | - Eva Birsal
- Service d'assistance médicale à la procréation, pôle Femmes-Parents-Enfants, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France
| | | | - Ingrid Plotton
- Service d'hormonologie, endocrinologie moléculaire et maladies rares, CPBE, groupement hospitalier Lyon-Est, Lyon-Bron, France; Université Claude-Bernard, Lyon 1, Lyon, France; Unité Inserm 1208, Lyon, France
| | - Célia Ravel
- Département de gynécologie-obstétrique et reproduction humaine - CECOS, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France
| | - Véronika Grzegorczyk-Martin
- Centre d'assistance médicale à la procréation et de préservation de la fertilité, clinique Mathilde, 76100 Rouen, France
| | - Eric Huyghe
- Département d'urologie, hôpital de Rangueil, CHU de Toulouse, Toulouse, France; Service de médecine de la reproduction, hôpital Paule-de-Viguier, CHU de Toulouse, Toulouse, France; Inserm 1203, UMR DEFE, université de Toulouse, université de Montpellier, Montpellier, France
| | - Hugo G A Dupuis
- Service d'urologie et d'andrologie, CHU - hôpitaux de Rouen, CHU Charles-Nicolle, 76031 Rouen, France
| | - Tiphaine Lefevre
- Service de médecine et biologie de la reproduction - gynécologie médicale, centre hospitalier universitaire de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes, France
| | - Florence Leperlier
- Service de médecine et biologie de la reproduction - gynécologie médicale, centre hospitalier universitaire de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes, France
| | - Léna Bardet
- Service de gynécologie-obstétrique et médecine de la reproduction, Dmu Origyne, hôpital Tenon, GHU Sorbonne université, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - Imane Lalami
- Service de gynécologie-obstétrique et de médecine de la reproduction, grand hôpital de l'Est Francilien - site de Meaux, 6-8, rue Saint-Fiacre, 77100 Meaux, France
| | - Camille Robin
- Service d'assistance médicale à la procréation et préservation de la fertilité, CHU de Lille, Lille, France
| | - Virginie Simon
- Unité fonctionnelle de gynécologie endocrinienne, service de gynécologie médicale, orthogénie et sexologie, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - Laura Dijols
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Bretonneau, CHU de Tours, Tours, France
| | - Justine Riss
- Service d'aide médicale à la procréation, centre médicochirurgical obstétrique (CMCO), CHU de Strasbourg, 19, rue Louis-Pasteur, 67303 Schiltigheim, France
| | - Antoine Koch
- Service d'aide médicale à la procréation, centre médicochirurgical obstétrique (CMCO), CHU de Strasbourg, 19, rue Louis-Pasteur, 67303 Schiltigheim, France
| | - Clément Bailly
- Service de biologie de la reproduction CECOS, hôpital Tenon, AP-HP, Sorbonne université, 75020 Paris, France; Inserm US938, centre de recherche Saint-Antoine, Sorbonne université, 75012 Paris, France
| | - Constance Rio
- Service de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49000 Angers, France
| | - Marine Lebret
- Service de gynécologie-obstétrique, CHU Charles-Nicolle, 37, boulevard Gambetta, 76000 Rouen, France
| | - Margaux Jegaden
- Faculté de médecine, université Paris-Sud Saclay, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France; Département de chirurgie gynécologique et obstétrique, hôpital Bicêtre, GHU-Sud, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Hervé Fernandez
- Faculté de médecine, université Paris-Sud Saclay, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France; Département de chirurgie gynécologique et obstétrique, hôpital Bicêtre, GHU-Sud, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Jean-Luc Pouly
- Service de gynécologie chirurgicale, CHU Estaing, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France
| | - Antoine Torre
- Centre d'assistance médicale à la procréation clinicobiologique, centre hospitalier Sud Francilien Corbeil-Essonnes, 40, avenue Serge-Dassault, 91106 Corbeil-Essonnes, France
| | - Jean-Marie Antoine
- Service de gynécologie-obstétrique et médecine de la reproduction, Dmu Origyne, hôpital Tenon, GHU Sorbonne université, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - Blandine Courbiere
- Service d'assistance médicale à la procréation, pôle Femmes-Parents-Enfants, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France; IMBE, CNRS, IRD, Aix-Marseille université, Avignon université, Marseille, France.
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Dupont C, Stathopoulou MG, Illy PJ, Sermondade N, Levy R, Trabucchi M, Prades M, Haj Hamid R, Berthaut I, Grandjean V. Impact of testicular cancer on sperm small non-coding RNA signature: a pilot study. Epigenetics 2023; 18:2241009. [PMID: 37515809 PMCID: PMC10388827 DOI: 10.1080/15592294.2023.2241009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 07/09/2023] [Accepted: 07/11/2023] [Indexed: 07/31/2023] Open
Abstract
Testicular germ cell tumours (TGCTs) are the most common tumours in young adults of European ancestry. The high heritability and the constantly increased incidence, which has doubled over the last 20 years, strongly suggest that both genetic and environmental factors are likely to shape the TGCT susceptibility. While genome-wide association studies have identified loci associated with TGCT susceptibility, the role played by environmental molecular vectors in TGCT susceptibility remains unclear. Evidence shows that sperm non-coding RNAs provide a good vision of the environmental stresses experienced by men. Here, to determine whether TGCT impacts the abundance of specific non-coding RNAs in sperm, small RNA deep sequencing analysis of sperm of 25 men aged between 19 and 42 years, diagnosed with (n = 16) or without (n = 9) TGCT was performed. The primary analysis showed no statistical significance in the sncRNA population between the TGCT and non-TGCT groups. However, when sperm physiological parameters were considered to look for differentially expressed sncRNA, we evidenced 11 differentially expressed sncRNA between patients and control which allow a clear discrimination between control and TGCT samples after Hierarchical Clustering analysis. Together, these findings indicate that sperm small non-coding RNAs abundance may have the potential for diagnosing men with TGCT. However, specific care should be taken regarding sperm physiological parameters of the TGCT patients. Hence, larger studies are needed to confirm our findings and to determine whether such a signature associates with the risks to develop TGCT.
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Affiliation(s)
- Charlotte Dupont
- Sorbonne Université, INSERM, Centre de Recherche St-Antoine, CRSA, Paris, France
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP. Sorbonne-Université, Paris, France
| | | | | | - Nathalie Sermondade
- Sorbonne Université, INSERM, Centre de Recherche St-Antoine, CRSA, Paris, France
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP. Sorbonne-Université, Paris, France
| | - Rachel Levy
- Sorbonne Université, INSERM, Centre de Recherche St-Antoine, CRSA, Paris, France
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP. Sorbonne-Université, Paris, France
| | | | - Marie Prades
- Sorbonne Université, INSERM, Centre de Recherche St-Antoine, CRSA, Paris, France
| | - Rahaf Haj Hamid
- Sorbonne Université, INSERM, Centre de Recherche St-Antoine, CRSA, Paris, France
| | - Isabelle Berthaut
- Sorbonne Université, INSERM, Centre de Recherche St-Antoine, CRSA, Paris, France
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP. Sorbonne-Université, Paris, France
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Chabbert-Buffet N, Sermondade N, Moreau E, Cristofari S, Johnson N, Mathieu d'Argent E, Levy R, Dupont C. [Transition, fertility and options for preservation of fertility]. ANN CHIR PLAST ESTH 2023; 68:484-490. [PMID: 37423825 DOI: 10.1016/j.anplas.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Oftentimes ignored or infrequently expressed, some transgender persons harbor a desire for parenthood. Given the evolution of medical techniques and the enacting of legislative reforms, it is henceforth possible to propose fertility preservation strategies in the overall context of gender transidentity. During the "female to male" (FtM) transition pathway, androgen therapy has an impact on gonadic function, generally inducing blockage of the ovarian function, with amenorrhea. Even though these events may be reversed on cessation of treatment, the possible long-term effects on future fertility and on the health of children yet to be born are little known. Moreover, transition surgeries definitively compromise the possibility of pregnancy insofar as they involve bilateral adnexectomy and/or hysterectomy. Options for fertility preservation in the framework of FtM transition are premised on cryopreservation of oocytes and/or ovarian tissue. In a comparable manner, even though relevant documentation is lacking, hormonal treatments for persons transitioning from male to female (MtF) can have an impact on future fertility. In the event of surgery involving bilateral orchidectomy in which spermatozoid cryopreservation has not been carried out, fertility is definitively impossible. In both cases and under present-day legislation, numerous legal and regulatory barriers render highly problematic the reutilization of cryopreserved gametes. Given these different constraints, it is indispensable to closely supervise these types of treatment by proposing psychological support.
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Affiliation(s)
- N Chabbert-Buffet
- Centre de fertilité Tenon, hôpital Tenon, Sorbonne université, AP-HP, Paris, France.
| | - N Sermondade
- Centre de fertilité Tenon, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - E Moreau
- Centre de fertilité Tenon, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - S Cristofari
- Centre de fertilité Tenon, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - N Johnson
- Centre de fertilité Tenon, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - E Mathieu d'Argent
- Centre de fertilité Tenon, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - R Levy
- Centre de fertilité Tenon, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - C Dupont
- Centre de fertilité Tenon, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
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Santulli P, Dupont C, Achour-Chneiweiss N, Drouineaud V, Grynberg M, Eustache F, Peigné M, Sifer C, Llabador MA, Sermondade N, Rivet Danon D, Lévy R, Epelboin S, d'Argent EM, Patrat C. [News in assisted reproductive technologies after French Bioethic law of 2021 August]. Gynecol Obstet Fertil Senol 2023; 51:428-433. [PMID: 37331510 DOI: 10.1016/j.gofs.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 06/16/2023] [Indexed: 06/20/2023]
Affiliation(s)
- Pietro Santulli
- Université Paris Cité, AP-HP Cochin, AP-HP.Centre, Paris, France
| | | | | | | | - Michael Grynberg
- Université Paris Saclay, Antoine-Béclère et Jean-Verdier, AP-HP, Paris, France
| | | | - Maëliss Peigné
- Université de Bobigny, Jean-Verdier, AP-HP, Paris, France
| | | | | | | | | | - Rachel Lévy
- Université Paris Sorbonne, AP-HP Tenon, Paris, France
| | - Sylvie Epelboin
- Université Paris Cité, AP-HP Bichat, AP-HP.Nord, Paris, France
| | | | - Catherine Patrat
- Université Paris Cité, AP-HP Cochin, AP-HP.Centre, Paris, France; Hôpitaux universitaires Paris Centre, Port royal, 123, boulevard de Port-Royal, 75679 Paris 14, France.
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8
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Bachelot G, Dhombres F, Sermondade N, Haj Hamid R, Berthaut I, Frydman V, Prades M, Kolanska K, Selleret L, Mathieu-D'Argent E, Rivet-Danon D, Levy R, Lamazière A, Dupont C. A Machine Learning Approach for the Prediction of Testicular Sperm Extraction in Nonobstructive Azoospermia: Algorithm Development and Validation Study. J Med Internet Res 2023; 25:e44047. [PMID: 37342078 DOI: 10.2196/44047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/19/2023] [Accepted: 04/07/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Testicular sperm extraction (TESE) is an essential therapeutic tool for the management of male infertility. However, it is an invasive procedure with a success rate up to 50%. To date, no model based on clinical and laboratory parameters is sufficiently powerful to accurately predict the success of sperm retrieval in TESE. OBJECTIVE The aim of this study is to compare a wide range of predictive models under similar conditions for TESE outcomes in patients with nonobstructive azoospermia (NOA) to identify the correct mathematical approach to apply, most appropriate study size, and relevance of the input biomarkers. METHODS We analyzed 201 patients who underwent TESE at Tenon Hospital (Assistance Publique-Hôpitaux de Paris, Sorbonne University, Paris), distributed in a retrospective training cohort of 175 patients (January 2012 to April 2021) and a prospective testing cohort (May 2021 to December 2021) of 26 patients. Preoperative data (according to the French standard exploration of male infertility, 16 variables) including urogenital history, hormonal data, genetic data, and TESE outcomes (representing the target variable) were collected. A TESE was considered positive if we obtained sufficient spermatozoa for intracytoplasmic sperm injection. After preprocessing the raw data, 8 machine learning (ML) models were trained and optimized on the retrospective training cohort data set: The hyperparameter tuning was performed by random search. Finally, the prospective testing cohort data set was used for the model evaluation. The metrics used to evaluate and compare the models were the following: sensitivity, specificity, area under the receiver operating characteristic curve (AUC-ROC), and accuracy. The importance of each variable in the model was assessed using the permutation feature importance technique, and the optimal number of patients to include in the study was assessed using the learning curve. RESULTS The ensemble models, based on decision trees, showed the best performance, especially the random forest model, which yielded the following results: AUC=0.90, sensitivity=100%, and specificity=69.2%. Furthermore, a study size of 120 patients seemed sufficient to properly exploit the preoperative data in the modeling process, since increasing the number of patients beyond 120 during model training did not bring any performance improvement. Furthermore, inhibin B and a history of varicoceles exhibited the highest predictive capacity. CONCLUSIONS An ML algorithm based on an appropriate approach can predict successful sperm retrieval in men with NOA undergoing TESE, with promising performance. However, although this study is consistent with the first step of this process, a subsequent formal prospective multicentric validation study should be undertaken before any clinical applications. As future work, we consider the use of recent and clinically relevant data sets (including seminal plasma biomarkers, especially noncoding RNAs, as markers of residual spermatogenesis in NOA patients) to improve our results even more.
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Affiliation(s)
- Guillaume Bachelot
- Saint Antoine Research Center, L'Institut national de la santé et de la recherche médicale UMR 938, Sorbonne Université, Paris, France
- Service de Biologie de La Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
- Laboratory in Medical Informatics and Knowledge Engineering in e-Health, L'Institut national de la santé et de la recherche médicale, Sorbonne University, Paris, France
| | - Ferdinand Dhombres
- Laboratory in Medical Informatics and Knowledge Engineering in e-Health, L'Institut national de la santé et de la recherche médicale, Sorbonne University, Paris, France
| | - Nathalie Sermondade
- Saint Antoine Research Center, L'Institut national de la santé et de la recherche médicale UMR 938, Sorbonne Université, Paris, France
- Service de Biologie de La Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Rahaf Haj Hamid
- Service de Biologie de La Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Isabelle Berthaut
- Service de Biologie de La Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Valentine Frydman
- Service d'Urologie, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Marie Prades
- Service de Biologie de La Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Kamila Kolanska
- Saint Antoine Research Center, L'Institut national de la santé et de la recherche médicale UMR 938, Sorbonne Université, Paris, France
- Service de Gynécologie Obstétrique et Médecine de la Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Lise Selleret
- Service d'Urologie, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Emmanuelle Mathieu-D'Argent
- Saint Antoine Research Center, L'Institut national de la santé et de la recherche médicale UMR 938, Sorbonne Université, Paris, France
- Service de Gynécologie Obstétrique et Médecine de la Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Diane Rivet-Danon
- Service de Biologie de La Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Rachel Levy
- Saint Antoine Research Center, L'Institut national de la santé et de la recherche médicale UMR 938, Sorbonne Université, Paris, France
- Service de Biologie de La Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Antonin Lamazière
- Saint Antoine Research Center, L'Institut national de la santé et de la recherche médicale UMR 938, Sorbonne Université, Paris, France
- Département de Métabolomique Clinique, Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Charlotte Dupont
- Saint Antoine Research Center, L'Institut national de la santé et de la recherche médicale UMR 938, Sorbonne Université, Paris, France
- Service de Biologie de La Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
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Epelboin S, Labrosse J, De Mouzon J, Devaux A, Gervoise-Boyer MJ, Hesters L, Jonveaux P, Levy R, Sermondade N, Fauque P, Pessione F. Higher risk of pre-eclampsia and other vascular disorders with artificial cycle for frozen-thawed embryo transfer compared to ovulatory cycle or to fresh embryo transfer following in vitro fertilization. Front Endocrinol (Lausanne) 2023; 14:1182148. [PMID: 37284215 PMCID: PMC10240394 DOI: 10.3389/fendo.2023.1182148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/04/2023] [Indexed: 06/08/2023] Open
Abstract
Background Risks of maternal morbidity are known to be reduced in pregnancies resulting from frozen embryo transfer (FET) compared to fresh-embryo transfer (fresh-ET), except for the risk of pre-eclampsia, reported to be higher in FET pregnancies compared to fresh-ET or natural conception. Few studies have compared the risk of maternal vascular morbidities according to endometrial preparation for FET, either with ovulatory cycle (OC-FET) or artificial cycle (AC-FET). Furthermore, maternal pre-eclampsia could be associated with subsequent vascular disorders in the offspring. Methods A 2013-2018 French nationwide cohort study comparing maternal vascular morbidities in 3 groups of single pregnancies was conducted: FET with either OC or AC preparation, and fresh-ET. Data were extracted from the French National Health System database. Results were adjusted for maternal characteristics and infertility (age, parity, smoking, obesity, history of diabetes or hypertension, endometriosis, polycystic ovary syndrome and premature ovarian insufficiency). Results A total of 68025 single deliveries were included: fresh-ET (n=48152), OC-FET (n=9500), AC-FET (n=10373). The risk of pre-eclampsia was higher in AC-FET compared to OC-FET and fresh-ET groups in univariate analysis (5.3% vs. 2.3% and 2.4%, respectively, P<0.0001). In multivariate analysis the risk was significantly higher in AC-FET compared to fresh-ET: aOR=2.43 [2.18-2.70], P<0.0001). Similar results were observed for the risk of other vascular disorders in univariate analysis (4.7% vs. 3.4% and 3.3%, respectively, P=0.0002) and in multivariate analysis (AC-FET compared to fresh-ET: aOR=1.50 [1.36-1.67], P<0.0001). In multivariate analysis, the risk of pre-eclampsia and other vascular disorders were comparable in OC-FET and fresh-ET: aOR=1.01 [0.87-1.17, P= 0.91 and aOR=1.00 [0.89-1.13], P=0.97, respectively).Within the group of FET, the risks of pre-eclampsia and other vascular disorders in multivariate analysis were higher in AC-FET compared to OC-FET (aOR=2.43 [2.18-2.70], P<0.0001 and aOR=1.5 [1.36-1.67], P<0.0001, respectively). Conclusion This nationwide register-based cohort study highlights the possibly deleterious role of prolonged doses of exogenous estrogen-progesterone supplementation on gestational vascular pathologies and the protective role of the corpus luteum present in OC-FET for their prevention. Since OC-FET has been demonstrated not to strain the chances of pregnancy, OC preparation should be advocated as first-line preparation in FET as often as possible in ovulatory women.
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Affiliation(s)
- Sylvie Epelboin
- Department of Reproductive Medicine, Gynecology and Obstetrics, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris Nord, Université de Paris, Paris, France
| | - Julie Labrosse
- Department of Reproductive Medicine, Gynecology and Obstetrics, American Hospital of Paris, Neuilly-sur-Seine, France
| | - Jacques De Mouzon
- Department of Reproductive Biology, Unilabs, Direction médicale, Clichy La Garenne, France
| | - Aviva Devaux
- Department of Reproductive Biology, Centre Hospitalier Universitaire, Amiens, France
| | | | - Laetitia Hesters
- Department of Reproductive Biology, Hôpital Antoine Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique - Hôpitaux de Paris, Clamart, France
| | - Philippe Jonveaux
- Department of Procreation, Agence de la biomédecine, La Plaine Saint Denis, France
| | - Rachel Levy
- Department of Reproductive Biology, Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Nathalie Sermondade
- Department of Reproductive Biology, Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Patricia Fauque
- Department of Reproductive Biology, Université Bourgogne Franche-Comté - INSERM UMR1231, Dijon, France
| | - Fabienne Pessione
- Department of Procreation, Agence de la biomédecine, La Plaine Saint Denis, France
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Coudert A, Cazin C, Amiri-Yekta A, Ben Mustapha SF, Zouari R, Bessonat J, Zoghmar A, Clergeau A, Metzler-Guillemain C, Triki C, Lejeune H, Sermondade N, Pipiras E, Prisant N, Cedrin I, Koscinski I, Keskes L, Lestrade F, Hesters L, Rives N, Dorphin B, Guichet A, Patrat C, Dulioust E, Feraille A, Robert F, Brouillet S, Morel F, Perrin A, Rougier N, Bieth E, Sorlin A, Siffroi JP, Ben Khelifa M, Boiterelle F, Hennebicq S, Satre V, Arnoult C, Coutton C, Barbotin AL, Thierry-Mieg N, Kherraf ZE, Ray PF. Genetic causes of macrozoospermia and proposal for an optimized genetic diagnosis strategy based on sperm parameters. J Genet Genomics 2023:S1673-8527(23)00094-2. [PMID: 37116580 DOI: 10.1016/j.jgg.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/14/2023] [Accepted: 04/16/2023] [Indexed: 04/30/2023]
Affiliation(s)
- Alicia Coudert
- Genetic Epigenetic and Therapies of Infertility team, Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université Grenoble Alpes, 38000 Grenoble, France; CHU Grenoble Alpes, UM GI-DPI, Grenoble, 38000, France; CHU Grenoble Alpes, UM de Génétique Chromosomique, 38000 Grenoble, France
| | - Caroline Cazin
- Genetic Epigenetic and Therapies of Infertility team, Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université Grenoble Alpes, 38000 Grenoble, France; CHU Grenoble Alpes, UM GI-DPI, Grenoble, 38000, France
| | - Amir Amiri-Yekta
- Genetic Epigenetic and Therapies of Infertility team, Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université Grenoble Alpes, 38000 Grenoble, France; CHU Grenoble Alpes, UM GI-DPI, Grenoble, 38000, France; Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | | | - Raoudha Zouari
- Polyclinique les Jasmins, Centre d'Aide Médicale à la Procréation, Centre Urbain Nord, 1003 Tunis, Tunisia
| | - Julien Bessonat
- CHU Grenobles Alpes, UF de Biologie de la Procréation, 38000 Grenoble, France
| | - Abdelali Zoghmar
- Reproduction Sciences and Surgery Clinique, Ibn Rochd, Constantine, Algeria
| | - Antoine Clergeau
- CHU Caen, CECOS de Caen, Département de Biologie, Unité de Biologie de la Reproduction, 14033 Caen, France
| | - Catherine Metzler-Guillemain
- Assistance-Publique des Hôpitaux de Marseille (AP-HM), Pôle Femmes-Parents-Enfants, Centre Clinico-biologique AMP-CECOS, Marseille, France and Aix Marseille Univ, INSERM, MMG, UMR 1251, Marseille, France
| | - Chema Triki
- Clinique Hannibal, Centre d'AMP, les berges du lac, 1053 Tunis, Tunisia
| | - Hervé Lejeune
- Reproductive Medicine Department, Hospices Civil de Lyon, Lyon, France
| | | | - Eva Pipiras
- Hôpital Jean Verdier, Université Sorbonne Paris Nord, Paris, France
| | | | - Isabelle Cedrin
- Service de Médecine de la Reproduction, CHU Jean Verdier, Paris, France
| | | | | | - Florence Lestrade
- CHR Metz-Thionville, Service d'Assistance Médicale à la Procréation, 57530 Ars-Laquenexy, France
| | - Laetitia Hesters
- Laboratoire de Fécondation in vitro, Hôpital Antoine Béclère, France
| | - Nathalie Rives
- Univ Rouen Normandie, Inserm U1239, NorDIC, Adrenal and Gonadal Pathophysiology, Reproductive Biology Laboratory-CECOS, Rouen University Hospital, 76031 Rouen cedex, France
| | - Béatrice Dorphin
- CHAL Centre Hospitalier Alpes Léman, Centre AMP74, 74130 Contamine-sur-Arve
| | - Agnes Guichet
- CHU Angers, Service de Génétique, 49933 Angers, INSERM U1083 France
| | - Catherine Patrat
- Service de Biologie de la Reproduction - CECOS Hopital Cochin, 74014, Paris
| | - Emmanuel Dulioust
- Service de Biologie de la Reproduction - CECOS Hopital Cochin, 74014, Paris
| | - Aurélie Feraille
- Univ Rouen Normandie, Inserm U1239, NorDIC, Adrenal and Gonadal Pathophysiology, Reproductive Biology Laboratory-CECOS, Rouen University Hospital, 76031 Rouen cedex, France
| | - François Robert
- IRH Médicentre, Clinique du Val d'Ouest, 39 chemin de la Vernique, 69 130 Ecully, France
| | - Sophie Brouillet
- CHU Arnaud De Villeneuve, Biologie de la Reproduction, 34000 Montpellier, France
| | - Frédéric Morel
- Faculté de médecine et des sciences de la santé, Université de Brest, EFS, UMR1078, GGB, Brest, France; Service de Génétique Médicale et Biologie de la Reproduction, CHU de Brest, Brest, France
| | - Aurore Perrin
- Faculté de médecine et des sciences de la santé, Université de Brest, EFS, UMR1078, GGB, Brest, France; Service de Génétique Médicale et Biologie de la Reproduction, CHU de Brest, Brest, France
| | - Nathalie Rougier
- CHRU Nîmes, Laboratoire d'Assistance Médicale à la Procréation, 30029 Nîmes, France
| | - Eric Bieth
- CHU Toulouse, Service de Génétique, 31059 Toulouse, France
| | - Arthur Sorlin
- Laboratoire national de santé, 1 Rue Louis Rech, L-3555 Dudelange, Luxembourg
| | - Jean-Pierre Siffroi
- Sorbonne Université, INSERM, UMRS_933, AP-HP, Hôpital Armand Trousseau, F-75012 Paris, France
| | | | - Florence Boiterelle
- Service d'assistance médicale à la procréation-Biologie de la reproduction, hôpital de Poissy, 78300 Poissy, France; EA 7404-GIG, UFR des sciences de la santé Simone-Veil, université de Versailles-Saint-Quentin-en-Yvelines, Paris Saclay, 78180 Montigny-le-Bretonneux, France
| | - Sylvianne Hennebicq
- Genetic Epigenetic and Therapies of Infertility team, Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université Grenoble Alpes, 38000 Grenoble, France; CHU Grenobles Alpes, UF de Biologie de la Procréation, 38000 Grenoble, France
| | - Veronique Satre
- Genetic Epigenetic and Therapies of Infertility team, Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université Grenoble Alpes, 38000 Grenoble, France; CHU Grenoble Alpes, UM de Génétique Chromosomique, 38000 Grenoble, France
| | - Christophe Arnoult
- Genetic Epigenetic and Therapies of Infertility team, Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université Grenoble Alpes, 38000 Grenoble, France
| | - Charles Coutton
- Genetic Epigenetic and Therapies of Infertility team, Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université Grenoble Alpes, 38000 Grenoble, France; CHU Grenoble Alpes, UM de Génétique Chromosomique, 38000 Grenoble, France
| | - Anne-Laure Barbotin
- CHU Lille, Hôpital Jeanne De Flandre, Laboratoire de Biologie de la Reproduction-Spermiologie, 59037 Lille, France
| | | | - Zine-Eddine Kherraf
- Genetic Epigenetic and Therapies of Infertility team, Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université Grenoble Alpes, 38000 Grenoble, France; CHU Grenoble Alpes, UM GI-DPI, Grenoble, 38000, France
| | - Pierre F Ray
- Genetic Epigenetic and Therapies of Infertility team, Institute for Advanced Biosciences, Inserm U 1209, CNRS UMR 5309, Université Grenoble Alpes, 38000 Grenoble, France; CHU Grenoble Alpes, UM GI-DPI, Grenoble, 38000, France.
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Sermondade N, Hesters L, De Mouzon J, Devaux A, Epelboin S, Fauque P, Gervoise-Boyer MJ, Labrosse J, Viot G, Bergère M, Devienne C, Jonveaux P, Levy R, Pessione F. Fetal growth disorders following medically assisted reproduction: due to maternal context or techniques? A national French cohort study. Reprod Biomed Online 2023; 46:739-749. [PMID: 36906455 DOI: 10.1016/j.rbmo.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/08/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023]
Abstract
RESEARCH QUESTION What part do maternal context and medically assisted reproduction (MAR) techniques play in the risk of fetal growth disorders? DESIGN This retrospective nationwide cohort study uses data available in the French National Health System database and focuses on the period from 2013 to 2017. Fetal growth disorders were divided into four groups according to the origin of pregnancy: fresh embryo transfer (n = 45,201), frozen embryo transfer (FET, n = 18,845), intrauterine insemination (IUI, n = 20,179) and natural conceptions (n = 3,412,868). Fetal growth disorders were defined from the percentiles of the weight distribution according to gestational age and sex: small and large for gestational age (SGA and LGA) if <10th and >90th percentiles, respectively. Analyses were performed using univariate and multivariate logistic models. RESULTS Compared with births following natural conception, multivariate analysis showed that the risk of SGA was higher for births following fresh embryo transfer and IUI (adjusted odds ratio [aOR] 1.26 [1.22-1.29] and 1.08 [1.03-1.12], respectively) and significantly lower following FET (aOR 0.79 [0.75-0.83]). The risk of LGA was higher for births following FET (aOR 1.32 [1.27-1.38]), especially in artificial cycles when compared with ovulatory cycles (aOR 1.25 [1.15-1.36]). In the subgroup of births without any obstetrical or neonatal morbidity, the same increased risk of SGA and LGA were observed following fresh embryo transfer or IUI and FET (aOR 1.23 [1.19-1.27] or 1.06 [1.01-1.11] and aOR 1.36 [1.30-1.43], respectively). CONCLUSIONS An effect of MAR techniques on the risks for SGA and LGA is suggested independently from maternal context and obstetrical or neonatal morbidities. Pathophysiological mechanisms remain poorly understood and should be further evaluated, as well as the influence of embryonic stage and freezing techniques.
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Affiliation(s)
- Nathalie Sermondade
- Department of Reproductive Biology, Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique-Hôpitaux de Paris, Paris, France.
| | - Laetitia Hesters
- Department of Reproductive Biology, Hôpital Antoine Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France
| | | | - Aviva Devaux
- Department of Reproductive Biology, Centre Hospitalier Universitaire, Amiens, France
| | - Sylvie Epelboin
- Department of Reproductive Medicine, Gynecology and Obstetrics, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris Nord, Université de Paris, Paris, France
| | - Patricia Fauque
- Université Bourgogne Franche-Comté-INSERM UMR1231, Dijon, France
| | | | - Julie Labrosse
- Department of Reproductive Medicine, Gynecology and Obstetrics, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris Nord, Université de Paris, Paris, France
| | | | | | | | | | - Rachel Levy
- Department of Reproductive Biology, Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique-Hôpitaux de Paris, Paris, France
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Aworet LO, Hamid RH, Danon DR, Berthaut I, Ly A, Bachelot G, Prades M, Kolanska K, Frydman V, Lévy R, Sermondade N, Dupont C. Successful testicular sperm extraction after hematopoietic stem cell transplantation. Asian J Androl 2023; 25:539-540. [PMID: 36537381 PMCID: PMC10411262 DOI: 10.4103/aja202294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 10/31/2022] [Indexed: 12/16/2022] Open
Affiliation(s)
- Ludmilla Ogouma Aworet
- Reproductive Biology and CECOS, Tenon Hospital (AP-HP), Sorbonne-Université, Paris 75020, France
| | - Rahaf Haj Hamid
- Reproductive Biology and CECOS, Tenon Hospital (AP-HP), Sorbonne-Université, Paris 75020, France
| | - Diane Rivet Danon
- Reproductive Biology and CECOS, Tenon Hospital (AP-HP), Sorbonne-Université, Paris 75020, France
- Reproductive Biology and CECOS, Cochin Hospital (AP-HP), Université Paris Centre, Paris 75014, France
| | - Isabelle Berthaut
- Reproductive Biology and CECOS, Tenon Hospital (AP-HP), Sorbonne-Université, Paris 75020, France
- Sorbonne University, Research Center Saint-Antoine, Inserm US938, Paris 7501, France
| | - Anna Ly
- Reproductive Biology and CECOS, Tenon Hospital (AP-HP), Sorbonne-Université, Paris 75020, France
| | - Guillaume Bachelot
- Reproductive Biology and CECOS, Cochin Hospital (AP-HP), Université Paris Centre, Paris 75014, France
| | - Marie Prades
- Reproductive Biology and CECOS, Tenon Hospital (AP-HP), Sorbonne-Université, Paris 75020, France
| | - Kamila Kolanska
- Reproductive Biology and CECOS, Tenon Hospital (AP-HP), Sorbonne-Université, Paris 75020, France
| | - Valentine Frydman
- Department of Urology, Hôpital Tenon (AP-HP), Sorbonne-Université, Paris 75020, France
| | - Rachel Lévy
- Reproductive Biology and CECOS, Tenon Hospital (AP-HP), Sorbonne-Université, Paris 75020, France
- Sorbonne University, Research Center Saint-Antoine, Inserm US938, Paris 7501, France
| | - Nathalie Sermondade
- Reproductive Biology and CECOS, Tenon Hospital (AP-HP), Sorbonne-Université, Paris 75020, France
- Sorbonne University, Research Center Saint-Antoine, Inserm US938, Paris 7501, France
| | - Charlotte Dupont
- Reproductive Biology and CECOS, Tenon Hospital (AP-HP), Sorbonne-Université, Paris 75020, France
- Sorbonne University, Research Center Saint-Antoine, Inserm US938, Paris 7501, France
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13
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Grateau S, Dupont C, Rivet-Danon D, Béranger A, Johnson N, Mathieu d'Argent E, Chabbert-Buffet N, Sermondade N. [Fertility preservation for transmen]. Gynecol Obstet Fertil Senol 2022; 50:797-804. [PMID: 36183988 DOI: 10.1016/j.gofs.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/23/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
The evolution of medical techniques as well as legislative changes currently allow to propose fertility preservation strategies in the context of transidentity. During "female to male" transition, androgen therapy has an impact on gonadal function since it usually induces a blockage of ovulation with amenorrhea. Although this effect is reversible when treatment is stopped, the possible long-term effects of testosterone treatment on future fertility or health of future children are poorly known. In addition, transitional surgeries definitely compromise fecundity when they include bilateral ovariectomy and/or hysterectomy. Yet, although long ignored or poorly expressed, the desire for parenthood is a reality in transgender men. Fertility preservation options in FtM transition rely on oocyte or ovarian tissue cryopreservation. The purpose of this review is to provide an overview of the literature regarding fertility preservation in transgender men. Although series remain limited, the increase in the number of recently published articles reflects the interest in improving the management of fertility issues in transgender men.
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Affiliation(s)
- S Grateau
- Service de biologie de la reproduction - CECOS, Sorbonne université, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - C Dupont
- Service de biologie de la reproduction - CECOS, Sorbonne université, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - D Rivet-Danon
- Service de biologie de la reproduction - CECOS, Sorbonne université, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - A Béranger
- Service de biologie de la reproduction - CECOS, Sorbonne université, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - N Johnson
- Service de gynécologie-obstétrique-médecine de la reproduction, Sorbonne université, hôpital Tenon, AP-HP, Paris, France
| | - E Mathieu d'Argent
- Service de gynécologie-obstétrique-médecine de la reproduction, Sorbonne université, hôpital Tenon, AP-HP, Paris, France
| | - N Chabbert-Buffet
- Service de gynécologie-obstétrique-médecine de la reproduction, Sorbonne université, hôpital Tenon, AP-HP, Paris, France
| | - N Sermondade
- Service de biologie de la reproduction - CECOS, Sorbonne université, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France.
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Bachelot G, Haj Hamid R, Sermondade N, Dhombres F, Isabelle B, Frydman V, Borio-Prades M, Kolanska K, Selleret L, Levy R, Lamaziere A, Dupont C. P-057 Machine learning-based prediction of testicular sperm extraction: comparison of different preprocessing and models, required sample size and relevance of input biomarkers. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Can advanced machine learning applied to the preoperative assessment predict the testicular sperm extraction outcome in azoospermic context and how many patients are required?
Summary answer
Despite encouraging results (AUC = 92.0%, sensitivity = 83.9% and specificity = 84.2%), integrating new biomarkers would probably be more relevant than enrolling additional patients.
What is known already
Testicular sperm extraction (TESE) is an essential therapeutic tool for the male infertility management and is often the “last hope” before gamete donation for these patients. However, it is an invasive procedure and is successful in up to 50%. Until now, no model is sufficiently powerful to accurately predict the success of sperm retrieval in TESE. Among the few models already developed, the findings are highly disparate despite having common input data (preoperative assessment). Moreover, only few types of machine learning models and procedures have been investigated. Performances were mostly capped despite the inclusion sometimes of more than 1000 patients.
Study design, size, duration
Data of 175 patients who underwent TESE between 2012 and 2021 were retrospectively analyzed. The performances of a wide range of preprocessing methods and machine learning models (state-of-the-art methods in machine learning) we explored, evaluated, and compared. The objective was to predict the presence or absence of spermatozoa, using 17 parameters (clinical, hormonal, genetic, history) from the preoperative assessment. The study protocol was approved by a local ethics committee (IRB CER-2021-041).
Participants/materials, setting, methods
After data preprocessing (standardization…), Machine Learning models (Bayesian Naive Classification, logistic regression, k-nearest neighbor classifier, support vector machine, random forests, GradientBoosting and XGBoost) and Deep Learning models were tested. The validation procedure consisted of splitting the dataset into a training set and test set. Beyond the standard metrics (sensitivity, specificity, AUC-ROC), the identification of the most relevant variables and the learning curve to determine the optimal patient number to be included were performed.
Main results and the role of chance
At least one live spermatozoon was found in the testicular tissue of 104 (59.4%) patients (positive TESE) out of 175. The best performing model (Random Forest with appropriate preprocessing) obtained the following results on the test set: AUC = 92.0%, sensitivity = 83.9% and specificity = 84.2%, leading to an efficient tool, which gives additional and more relevant information than the different variables taken separately. Inhibin B, FSH and history of cryptorchidism were the variables with the most discriminating power. However, a plateau in the model performance was observed (beyond 110 patients), whatever the approach or the preprocessing used. A trend curve shows that beyond 110 patients, no improvement can be observed and cast doubt about the power of the traditional preoperative parameters assessed before TESE. The classic preoperative assessment can probably not fully predict the TESE outcomes. Further work is needed to be enhance with new hypothesis and the use of new biomarkers to be integrated into the models.
Limitations, reasons for caution
The main limitation was the monocentric design and the use of retrospective data.
Wider implications of the findings
Machine learning models can provide the basis for an enhanced decision support system tool in the context of azoospermia. Indefinitely increasing the number of participants is not likely to be the solution: further hypotheses and biomarkers integration into the models will probably be necessary to improve performance.
Trial registration number
not applicable
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Affiliation(s)
- G Bachelot
- Sorbonne Université- Saint Antoine Research center, INSERM équipe Lipodystrophies génétiques et acquises , PARIS, France
- Service de Biologie de la reproduction - CECOS Hôpital Tenon, AP-HP Sorbonne Université , Paris, France
| | - R Haj Hamid
- Service de Biologie de la reproduction - CECOS Hôpital Tenon, AP-HP Sorbonne Université , Paris, France
| | - N Sermondade
- Service de Biologie de la reproduction - CECOS Hôpital Tenon, AP-HP Sorbonne Université , Paris, France
| | - F Dhombres
- Médecine foetale - Hôpital Armand-Trousseau, AP-HP Sorbonne Université , Paris, France
| | - B Isabelle
- Service de Biologie de la reproduction - CECOS Hôpital Tenon, AP-HP Sorbonne Université , Paris, France
| | - V Frydman
- Service d'urologie Hôpital Tenon, AP-HP Sorbonne Université , Paris, France
| | - M Borio-Prades
- Service de Biologie de la reproduction - CECOS Hôpital Tenon, AP-HP Sorbonne Université , Paris, France
| | - K Kolanska
- Service de Gynécologie-obstétrique et médecine de la reproduction - Hôpital Tenon, AP-HP Sorbonne Université , Paris, France
| | - L Selleret
- Service de Gynécologie-obstétrique et médecine de la reproduction - Hôpital Tenon, AP-HP Sorbonne Université , Paris, France
| | - R Levy
- Service de Biologie de la reproduction - CECOS Hôpital Tenon, AP-HP Sorbonne Université , Paris, France
| | - A Lamaziere
- Service de Métabolomique - Hôpital Saint-Antoine, AP-HP Sorbonne Université , Paris, France
| | - C Dupont
- Service de Biologie de la reproduction - CECOS Hôpital Tenon, AP-HP Sorbonne Université , Paris, France
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Sermondade N, Dupont C, Faure C, Léger D, Czernichow S, Lévy R, Caetano G. P-687 Sleep parameters and sleep disorders in male and female subjects presenting idiopathic infertility: the ALIFERT case-control study. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
To evaluate the association between sleep parameters, sleep disorders and idiopathic infertility.
Summary answer
Some sleep parameters, such as bedtime, sleep latency and chronotypes, might be associated with male and female fertility.
What is known already
Some studies suggested that sleep might play an important role in reproductive health. Short sleep duration might interfere with the menstrual cycle, sperm parameters or natural fertility. The biological clock chronotype was found to be associated with fertility, with altered sperm parameters in the “evening” type and more reproductive troubles in the “intermediate” type when compared to the “morning” type. Irregular and night work schedules were also associated with some degree of fertility dysfunction, such as irregular menstrual cycles, a longer time to pregnancy, or male infertility. However, the interrelations between sleep and fertility are not fully elucidated.
Study design, size, duration
Fertile and infertile couples were recruited in the ALIFERT cross-sectional case–control multicentric study, between September 2009 and December 2013. The study group consisted of 94 infertile men and 95 infertile women, presenting with a primary idiopathic infertility of more than 12 months. The control group consisted in 85 fertile men and 86 fertile women who had a spontaneously conceived child under 2 years of age with a time to pregnancy less than 12 months.
Participants/materials, setting, methods
Male and female participants answered the French version of the Pittsburgh Sleep Quality Index, including questions about sleep timing and duration and symptoms of sleep disorders. Sleep parameters were compared between infertile and fertile participants for each sex, and between partners. The Wilcoxon-Mann-Whitney test was used to compare differences in sleep parameters due to a non-normal distribution, and the Fisher's exact test was used for qualitative variables.
Main results and the role of chance
Bedtime was significantly later for infertile compared to fertile male participants (p = 0.03). Infertile female participants had significantly later wake time, greater sleep latency and sleep apnea symptoms compared to fertile female participants (p ≤ 0.02). Fertile participants of both sexes were more frequently moderate morning types compared to infertile participants (p ≤ 0.04). No differences were observed regarding total sleep time, time spent in bed, sleep efficacy, insomnia, hypersomnia, or periodic leg movement symptoms. Infertile couples had more frequently different chronotypes than fertile couples (p = 0.02). Differences in wake time between partners were significantly greater among infertile couples (p < 0.01), but no differences were observed for bedtime, time spent in bed and total sleep time (p ≥ 0.22).
Limitations, reasons for caution
Sleep parameters were evaluated based on self-reported questionnaire. Further studies including objective measures of sleep will be needed to allow a more objective determination of sleep parameters. A discussion about mechanistic hypothesis should also be considered to better understand the links between sleep and fertility.
Wider implications of the findings
Sleep could be an original and innovative parameter to consider in the reproduction field. Further investigation is needed to elucidate how sleep and reproductive functions are interrelated and how sleep might constitute a useful modifiable target in infertility management.
Trial registration number
NCT01093378
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Affiliation(s)
- N Sermondade
- Hopital Tenon- AP-HP, Biologie de la Reproduction - CECOS , Paris, France
| | - C Dupont
- Hopital Tenon- AP-HP, Biologie de la Reproduction - CECOS , Paris, France
| | - C Faure
- Hopital Tenon- AP-HP, Biologie de la Reproduction - CECOS , Paris, France
| | - D Léger
- Hôtel-Dieu- AP-HP, Centre du sommeil et de la vigilance , Paris, France
| | - S Czernichow
- Hôpital Européen Georges Pompidou- AP-HP , Service de Nutritio, Paris, France
| | - R Lévy
- Hopital Tenon- AP-HP, Biologie de la Reproduction - CECOS , Paris, France
| | - G Caetano
- Hôtel-Dieu- AP-HP, Centre du sommeil et de la vigilance , Paris, France
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Dupont C, Illy P, Sermondade N, Stathopoulou M, Lévy R, Prades M, Hamid RH, Berthaut I, Grandjean V. P-079 Impact of Testicular Cancer on Sperm Small Non-Coding RNA signature. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
To evaluate if the sperm small non-coding RNA (sncRNA) signature can be alterated in patients suffering from testicular cancer.
Summary answer
Sperm sncRNA profile is influenced by testicular cancer.
What is known already
Environmentally induced pathologies are associated with sperm sncRNA profile modifications which could have consequences on sperm quality but also on the offspring health. While this mechanism has been widely described in the case of metabolic and psycho-traumatic diseases, its relevance in testicular cancer needs to be assessed. Testicular cancer affects young men for which both genetic and environmental factors are known contributors.
Study design, size, duration
This pilot study aimed to compare sperm sncRNA profiles of 15 men suffering from testicular cancer with sperm sncRNA profile of 10 controle men. Semen samples were collected and stored in Tenon Hospital between 1999 and 2017 and donated to research (GERMETHEQUE biobank). Consent to use their samples was obtained from each patient (CPP 2.15.27) and the study protocol was approved by a local ethics committee (IRB CLEA-2021- 171).
Participants/materials, setting, methods
Sperm small RNA raw sequencing data was processed by the computational framework SPORTS1.0, which allows the annotation and quantification of small non-coding RNAs (tsRNAs, rsRNAs, ysRNA and miRNAs). DEseq 2 was used to identify sequences differentially expressed between patients and control samples. We also carried out a Gene Ontology analysis using miRNA targets according to the Metascape and DisGeNET Database.
Main results and the role of chance
In total, 77 deregulated sequences were found in sperm samples from testicular tumor patients compared to control men, including 17 that were down-regulated and 60 that were up-regulated. These sequences corresponded to 22 miRNAs, 25rsRNA, 11 tsRNA, 10 snRNA, 4 SnoRNA, 4 RNYs and 1 lncRNA sequences. Hierarchical Clustering of Differentially Expressed Genes using up and down regulation discriminates between control and testicular cancer samples. Gene Ontology analyses highlighted enriched processes including Neurodevelopmental Disorders, Adult and Childhood Medulloblastoma and Tumor initiation.
Limitations, reasons for caution
The current study was limited by the small patient number and the unavailability of the complete biological and oncogenic patient data.
Wider implications of the findings
Deciphering and validating the role of sperm sncRNAs may be a promising tool in testicular cancer diagnosis and may facilitate our understanding of the initiation and development of cancer in young adults.
Trial registration number
not applicable
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Affiliation(s)
- C Dupont
- Hôpital Tenon, Service de biologie de la reproduction-CECOS , Paris, France
| | - P.J Illy
- Université Cote d’Azur, Inserm U1065- Team Control of Gene Expression , Nice, France
| | - N Sermondade
- Hôpital Tenon, Service de biologie de la reproduction-CECOS , Paris, France
| | - M Stathopoulou
- Université Cote d’Azur, Inserm U1065- Team Control of Gene Expression , Nice, France
| | - R Lévy
- Hôpital Tenon, Service de biologie de la reproduction-CECOS , Paris, France
| | - M Prades
- Hôpital Tenon, Service de biologie de la reproduction-CECOS , Paris, France
| | - R. Haj Hamid
- Hôpital Tenon, Service de biologie de la reproduction-CECOS , Paris, France
| | - I Berthaut
- Hôpital Tenon, Service de biologie de la reproduction-CECOS , Paris, France
| | - V Grandjean
- Université Cote d’Azur, Inserm U1065- Team Control of Gene Expression , Nice, France
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Ogouma L, Berthaut I, Lévy R, Hamid RH, Prades M, Audouin M, Sermondade N, Dupont C. Testicular sperm extraction (TESE) outcomes in the context of malignant disease: a systematic review. Asian J Androl 2022; 24:584-590. [PMID: 35259785 PMCID: PMC9809488 DOI: 10.4103/aja2021129] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Advances in the oncology field have led to improved survival rates. Consequently, quality of life after remission is anticipated, which includes the possibility to conceive children. Since cancer treatments are potentially gonadotoxic, fertility preservation must be proposed. Male fertility preservation is mainly based on ejaculated sperm cryopreservation. When this is not possible, testicular sperm extraction (TESE) may be planned. To identify situations in which TESE has been beneficial, a systematic review was conducted. The search was carried out on the PubMed, Scopus, Google Scholar, and CISMeF databases from 1 January 2000 to 19 March 2020. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations were followed in selecting items of interest. Thirty-four articles were included in the systematic review, including 15 articles on oncological testicular sperm extraction (oncoTESE), 18 articles on postgonadotoxic treatment TESE and 1 article on both oncoTESE and postgonadotoxic treatment TESE. Testicular sperm freezing was possible for 42.9% to 57.7% of patients before gonadotoxic treatment and for 32.4% to 75.5% of patients after gonadotoxic treatment, depending on the type of malignant disease. Although no formal conclusion could be drawn about the chances to obtain sperm in specific situations, our results suggest that TESE can be proposed before and after gonadotoxic treatment. Before treatment, TESE is more often proposed for men with testicular cancer presenting with azoospermia since TESE can be performed simultaneously with tumor removal or orchiectomy. After chemotherapy, TESE may be planned if the patient presents with persistent azoospermia.
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Affiliation(s)
- Ludmilla Ogouma
- Fertility Center (Service de Biologie de la Reproduction CECOS), Tenon Hospital (AP-HP, Sorbonne-Université), Paris F-75020, France
| | - Isabelle Berthaut
- Fertility Center (Service de Biologie de la Reproduction CECOS), Tenon Hospital (AP-HP, Sorbonne-Université), Paris F-75020, France,Sorbonne University, Saint Antoine Research Center, Inserm US938, Paris F-75012, France
| | - Rachel Lévy
- Fertility Center (Service de Biologie de la Reproduction CECOS), Tenon Hospital (AP-HP, Sorbonne-Université), Paris F-75020, France,Sorbonne University, Saint Antoine Research Center, Inserm US938, Paris F-75012, France
| | - Rahaf Haj Hamid
- Fertility Center (Service de Biologie de la Reproduction CECOS), Tenon Hospital (AP-HP, Sorbonne-Université), Paris F-75020, France
| | - Marie Prades
- Fertility Center (Service de Biologie de la Reproduction CECOS), Tenon Hospital (AP-HP, Sorbonne-Université), Paris F-75020, France
| | - Marie Audouin
- Fertility Center, Diaconesses Hospital, Paris F-75012, France
| | - Nathalie Sermondade
- Fertility Center (Service de Biologie de la Reproduction CECOS), Tenon Hospital (AP-HP, Sorbonne-Université), Paris F-75020, France,Sorbonne University, Saint Antoine Research Center, Inserm US938, Paris F-75012, France
| | - Charlotte Dupont
- Fertility Center (Service de Biologie de la Reproduction CECOS), Tenon Hospital (AP-HP, Sorbonne-Université), Paris F-75020, France,Sorbonne University, Saint Antoine Research Center, Inserm US938, Paris F-75012, France,
Correspondence: Dr. C Dupont ()
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18
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Epelboin S, Labrosse J, De Mouzon J, Fauque P, Gervoise-Boyer MJ, Levy R, Sermondade N, Hesters L, Bergère M, Devienne C, Jonveaux P, Ghosn J, Pessione F. Obstetrical outcomes and maternal morbidities associated with COVID-19 in pregnant women in France: A national retrospective cohort study. PLoS Med 2021; 18:e1003857. [PMID: 34847147 PMCID: PMC8631654 DOI: 10.1371/journal.pmed.1003857] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 10/28/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND To the best of our knowledge, no study has exhaustively evaluated the association between maternal morbidities and Coronavirus Disease 2019 (COVID-19) during the first wave of the pandemic in pregnant women. We investigated, in natural conceptions and assisted reproductive technique (ART) pregnancies, whether maternal morbidities were more frequent in pregnant women with COVID-19 diagnosis compared to pregnant women without COVID-19 diagnosis during the first wave of the COVID-19 pandemic. METHODS AND FINDINGS We conducted a retrospective analysis of prospectively collected data in a national cohort of all hospitalizations for births ≥22 weeks of gestation in France from January to June 2020 using the French national hospitalization database (PMSI). Pregnant women with COVID-19 were identified if they had been recorded in the database using the ICD-10 (International Classification of Disease) code for presence of a hospitalization for COVID-19. A total of 244,645 births were included, of which 874 (0.36%) in the COVID-19 group. Maternal morbidities and adverse obstetrical outcomes among those with or without COVID-19 were analyzed with a multivariable logistic regression model adjusted on patient characteristics. Among pregnant women, older age (31.1 (±5.9) years old versus 30.5 (±5.4) years old, respectively, p < 0.001), obesity (0.7% versus 0.3%, respectively, p < 0.001), multiple pregnancy (0.7% versus 0.4%, respectively, p < 0.001), and history of hypertension (0.9% versus 0.3%, respectively, p < 0.001) were more frequent with COVID-19 diagnosis. Active smoking (0.2% versus 0.4%, respectively, p < 0.001) and primiparity (0.3% versus 0.4%, respectively, p < 0.03) were less frequent with COVID-19 diagnosis. Frequency of ART conception was not different between those with and without COVID-19 diagnosis (p = 0.28). When compared to the non-COVID-19 group, women in the COVID-19 group had a higher frequency of admission to ICU (5.9% versus 0.1%, p < 0.001), mortality (0.2% versus 0.005%, p < 0.001), preeclampsia/eclampsia (4.8% versus 2.2%, p < 0.001), gestational hypertension (2.3% versus 1.3%, p < 0.03), postpartum hemorrhage (10.0% versus 5.7%, p < 0.001), preterm birth at <37 weeks of gestation (16.7% versus 7.1%, p < 0.001), <32 weeks of gestation (2.2% versus 0.8%, p < 0.001), <28 weeks of gestation (2.4% versus 0.8%, p < 0.001), induced preterm birth (5.4% versus 1.4%, p < 0.001), spontaneous preterm birth (11.3% versus 5.7%, p < 0.001), fetal distress (33.0% versus 26.0%, p < 0.001), and cesarean section (33.0% versus 20.2%, p < 0.001). Rates of pregnancy terminations ≥22 weeks of gestation, stillbirths, gestational diabetes, placenta praevia, and placenta abruption were not significantly different between the COVID-19 and non-COVID-19 groups. The number of venous thromboembolic events was too low to perform statistical analysis. A limitation of this study relies in the possibility that asymptomatic infected women were not systematically detected. CONCLUSIONS We observed an increased frequency of pregnant women with maternal morbidities and diagnosis of COVID-19 compared to pregnant women without COVID-19. It appears essential to be aware of this, notably in populations at known risk of developing a more severe form of infection or obstetrical morbidities and in order for obstetrical units to better inform pregnant women and provide the best care. Although causality cannot be determined from these associations, these results may be in line with recent recommendations in favor of vaccination for pregnant women.
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Affiliation(s)
- Sylvie Epelboin
- Centre d’Assistance Médicale à la Procréation, gynécologie obstétrique, médecine de la reproduction, hôpital Bichat Claude-Bernard, AP–HP, Nord, Université de Paris, Paris, France
| | - Julie Labrosse
- Centre d’Assistance Médicale à la Procréation, gynécologie obstétrique, médecine de la reproduction, hôpital Bichat Claude-Bernard, AP–HP, Nord, Université de Paris, Paris, France
| | | | - Patricia Fauque
- Université Bourgogne Franche-Comté—INSERM UMR1231, Dijon, France
| | | | - Rachel Levy
- Inserm, équipe lipodystrophies génétiques et acquises, service de biologie de la reproduction-CECOS, Saint-Antoine research center, Sorbonne université, Paris, France
- Hôpital Tenon, AP–HP, Sorbonne université, Paris, France
| | | | - Laetitia Hesters
- Hôpital Antoine Béclère, AP–HP, Université de Paris, Clamart, France
| | | | | | | | - Jade Ghosn
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude-Bernard, AP–HP, Nord, Université de Paris, Paris, France
- INSERM U1137, IAME, Faculté de Médecine site Bichat, Université de Paris, Paris, France
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Sermondade N, Sonigo C, Ahdad-Yata N, Fraison E, Grynberg M. WHAT IS THE RELATIONSHIP BETWEEN THE NUMBER OF OOCYTES AND LIVE BIRTH RATES FOLLOWING IN VITRO FERTILIZATION? A SYSTEMATIC REVIEW WITH META-ANALYSIS. Fertil Steril 2021. [DOI: 10.1016/j.fertnstert.2021.07.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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20
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Epelboin S, Labrosse J, Fauque P, Levy R, Mouzon JD, Boyer M, Vienne CD, Bergere M, Valentin M, Devaux A, Hester L, Sermondade N, Jonveaux P, Pessione1 F. O-182 Higher risk of preeclampsia and pregnancy-induced hypertension with artificial cycle for Frozen-thawed Embryo Transfer compared to ovulatory cycle or fresh transfer following In Vitro Fertilization. Hum Reprod 2021. [DOI: 10.1093/humrep/deab127.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Is there an increased risk of preeclampsia after Frozen-thawed Embryo Transfer(FET) compared to In Vitro Fertilization-fresh transfer(IVF-fresh-ET) according to endometrial type of preparation for FET?
Summary answer
The frequency of preeclampsia and hypertension were significantly higher in the group of artificial cycle (AC-FET) compared to ovulatory cycle (OC-FET) and fresh-ET (P < 0.0001).
What is known already
Risks of maternal morbidity are known to be reduced in pregnancies resulting from FET compared to fresh-ET except for the risk of preeclampsia, that was reported to be significantly higher in pregnancies resulting from FET compared to fresh-ET or spontaneous conception. Most recent studies demonstrate an equal live birth rate with either OC-FET or AC-FET preparation. Few studies compared the maternal vascular morbidities with the two hormonal environments that preside over the early stages of embryonic development: OC (major role of the corpus luteum) and AC (prolonged hormone replacement with high doses of estrogen and progesterone).
Study design, size, duration
We conducted a 2013-2018 French nationwide cohort study comparing maternal vascular morbidities in 3 groups of single pregnancies> 22 weeks of gestation (WG): FET with AC or OC preparation, and IVF (conventional or ICSI)-fresh-ET.Data were extracted from the French National Health System database (>99% of national deliveries) in which all hospitalizations are registered, containing information on patient characteristics, diagnoses and treatments. Records were merged anonymously. Access to the database was legally approved.
Participants/materials, setting, methods
68 025 deliveries were included: fresh-ET(n = 48 152), OC-FET(n = 9 500), AC-FET(n = 10 373). In OC-FET, a luteal phase support with progesterone was administered for maximum 6 WG if pregnancy. In AC-FET, progesterone was co-administered with estrogen until 12 WG. Embryos were transferred at cleavage or blastocyst stage.
Vascular disorders were recorded if hospitalization for preeclampsia/eclampsia or hypertension (history of hypertension excluded). Maternal characteristics were included in multivariate analysis. Adjusted odds ratios(aOR) and 95% confidence intervals(CI) were estimated.
Main results and the role of chance
Maternal characteristics: In multivariate analysis, patients in the FET groups were older (33.4 years (std=4.3) vs. 33.2 years (std=4.4) for fresh-ET, respectively, P < 0.0001), less often primiparous (aOR=0.68[0.66-0.71], P < 0.0001) or smokers (aOR=0.84[0.75-0.95]) or with premature ovarian insufficiency (POI) (aOR=0.68 [0.58-0.79]), more frequently with polycystic ovaries (PCOS) (aOR=1.25[1.12-1.39]) and comparable for obesity or diabetes.
In FET groups, 52.2% were AC-FET. There was no difference for maternal age, parity, obesity, smoking, history of diabetes between AC and OC-FET. Endometriosis (aOR=1.26[1.16-1.38]), PCOS (aOR=1.79[1.50-2.15]) and POI (aOR=2.0[1.48-2.72]) were more frequent in AC-FET.
Risks of vascular disorders
The rate of preeclampsia (5.3% vs. 2.3% vs. 2.4%, respectively, P < 0.0001) and hypertension (4.7% vs. 3.4% vs. 3.3%, respectively, P = 0.0002) was significantly higher in AC-FET versus OC-FET and fresh-ET.
In multivariate analysis, the risk of preeclampsia increased with age, primiparity, obesity, diabetes and POI. The risk was higher in AC-FET versus OC-FET (aOR=2.42 [2.06-2.85]) and fresh-ET (aOR=2.43[2.2-2.7]), P < 0.00001. No difference was found between OC-FET and fresh-ET (P = 0.91). The risk of pregnancy-induced hypertension increased with age >40, primiparity, smoking, obesity and diabetes and was higher in AC-FET versus OC-FET (aOR=1.50[1.29-1.74], P < 0.0001) and fresh-ET (aOR=1.50[1.35-1.67], P < 0.0001) and not different between OC-FET and fresh-ET (P = 0.86).
Limitations, reasons for caution
While the strength of this study relies in the number and exhaustiveness of subjects analysed, its limitations are its retrospective and register-based nature that did not enable to refine the risk according to details of techniques and treatments in each group.
Wider implications of the findings
This large nationwide cohort study highlights 2 important information for physicians : i) the possible deleterious role of high supra-physiological and prolonged doses of estrogen-progesterone supplementation on vascular pathologies ii) the protective role of the corpus luteum present in stimulated or spontaneous OC for their prevention.
Trial registration number
Not applicable
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Affiliation(s)
- S Epelboin
- Assistance Publique Hôpitaux de Paris Hôpital Bichat-Claude Bernard, Gynecology Obstetrics Reproductive Medecine, Paris, France
| | - J Labrosse
- Assistance Publique Hôpitaux de Paris Hôpital Jean Verdier, Gynecology Obstetrics Reproductive Medecine, Paris, France
| | - P Fauque
- Université Bourgogne Franche-Comté - INSERM UMR1231- 2 Rue Angélique Ducoudray- F-21000 Dijon- France, Embryology, Dijon, France
| | - R Levy
- Assistance Publique Hôpitaux de Paris Hôpital Tenon, Embryology, Paris, France
| | | | - M Boyer
- Hôpital Saint-Joseph- Marseille, reproductive medecine, Marseille, France
| | - C. De Vienne
- Agence de la Biomédecine, Epidemiology, Saint-Denis, France
| | - M Bergere
- Agence de la Biomédecine, Epidemiology, Saint-Denis, France
| | - M Valentin
- Assistance Publique Hôpitaux de Paris Hôpital Bichat-Claude Bernard, Gynecology Obstetrics Prenatal diagnosis, Paris, France
| | - A Devaux
- Assistance Publique Hôpitaux de Paris, Embryology, Paris, France
| | - L Hester
- Assistance Publique Hôpitaux de Paris Hôpital Antoine Beclere, Embryology, Paris, France
| | - N Sermondade
- Assistance Publique Hôpitaux de Paris Hôpital Tenon, Embryology, Paris, France
| | - P Jonveaux
- Agence de la Biomédecine, Epidemiology genetics, Saint-Denis, France
| | - F Pessione1
- Assistance Publique Hôpitaux de Paris Hôpital Jean Verdier, Gynecology Obstetrics Reproductive Medecine, Paris, France
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21
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Sermondade N, Sonigo C, Pasquier M, Yata-Ahdad N, Fraison E, Grynberg M. O-107 Searching for the optimal number of oocytes to reach a life birth following in vitro fertilization: a systematic review with meta-analysis. Hum Reprod 2021. [DOI: 10.1093/humrep/deab126.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
To investigate the relationship between the number of oocytes and both the live birth rate after fresh embryo transfer and the cumulative live birth rate.
Summary answer
Above a 15-oocyte threshold, live birth rate (LBR) following fresh transfer plateaus, whereas a continuous increase in cumulative live birth rate (CLBR) is observed.
What is known already
Several lines of evidence indicate that number of oocytes represents a key point for in vitro fertilization (IVF) success. However, consensus is lacking regarding the optimal number of oocytes for expecting a live birth. This is a key question because it might impact the way practitioners initiate and adjust COS regimens.
Study design, size, duration
A systematic review and meta-analysis was performed. MEDLINE, EMBASE, and Cochrane Library were searched for studies published between January 01, 2004, and August 31, 2019 using the search terms: “(intracytoplasmic sperm injection or icsi or ivf or in vitro fertilization or fertility preservation)” and “(oocyte and number)” and “(live birth)”.
Participants/materials, setting, methods
Two independent reviewers carried out study selection, quality assessment using the adapted Newcastle-Ottawa Quality Assessment Scales, bias assessment using ROBIN-1 tools, and data extraction according to Cochrane methods. Independent analyses were performed according to the outcome (LBR and CLBR). The mean-weighted threshold of optimal oocyte number was estimated from documented thresholds, followed by a one-stage meta-analysis on articles with documented or estimable relative risks.
Main results and the role of chance
After reviewing 843 records, 64 full-text articles were assessed for eligibility. A total of 36 studies were available for quantitative syntheses. Twenty-one and 18 studies were included in the meta-analyses evaluating the relationship between the number of retrieved oocytes and LBR or CLBR, respectively. Given the limited number of investigations considering mature oocytes, association between the number of metaphase II oocytes and IVF outcomes could not be investigated. Concerning LBR, 7 (35.0%) studies reported a plateau effect, corresponding to a weighted mean of 14.4 oocytes. The pooled dose-response association between the number of oocytes and LBR showed a non-linear relationship, with a plateau beyond 15 oocytes. For CLBR, 4 (19.0%) studies showed a plateau effect, corresponding to a weighted mean of 19.3 oocytes. The meta-analysis of the relationship between the number of oocytes and CLBR found a non-linear relationship, with a continuous increase in CLBR, including for high oocyte yields.
Limitations, reasons for caution
Statistical models show a high degree of deviance, especially for high numbers of oocytes. Further investigations are needed to assess the generalization of those results to frozen mature oocytes, especially in a fertility preservation context, and to evaluate the impact of female age.
Wider implications of the findings
Above a 15-oocyte threshold, LBR following fresh transfer plateaus, suggesting that the freeze-all strategy should probably be performed. In contrast, the continuous increase in CLBR suggests that high numbers of oocytes could be offered to improve the chances of cumulative live births, after evaluating the benefit–risk balance.
Trial registration number
Not applicable
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Affiliation(s)
- N Sermondade
- Hopital TENON, Service de Biologie de la Reproduction - CECOS, PARIS, France
| | - C Sonigo
- Hopital Antoine Béclère, Médecine de la Reproduction et Préservation de la Fertilité, Clamart, France
| | - M Pasquier
- Centre Hospitalier Intercommunal de Créteil, Médecine de la Reproduction, Créteil, France
| | - N Yata-Ahdad
- Centre Hospitalier de Meaux, Médecine de la Reproduction, Meaux, France
| | - E Fraison
- Hospices Civils de Lyon, Médecine de la Reproduction, Lyon, France
| | - M Grynberg
- Hopital Antoine Béclère, Médecine de la Reproduction et Préservation de la Fertilité, Clamart, France
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22
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Boumerdassi Y, Bennan. Smires B, Sarandi S, Sadoun M, Laup L, Labrosse J, Herbemont C, Vinolas C, Cedrin-Durnerin I, Peigné M, Sermondade N, Grynberg M, Sifer C. P–440 Seven years’ experience using oocyte vitrification/warming from in vitro maturation or controlled ovarian hyperstimulation cycles to preserve fertility for oncologic indications. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Do oocytes vitrified following in vitro maturation (IVM) or controlled ovarian hyperstimulation (COH) for oncologic fertility preservation (FP), lead to similar biological/clinical outcomes after thawing?
Summary answer
IVM is a valid option when chemotherapy is urgent or COH is contraindicated. We report the second live-birth worldwide after IVM in a cancer patient.
What is known already
FP aims at maintaining in cancer survivors, the possibility of childbearing using their own gametes. Currently, oocyte vitrification after COH remains the gold standard but IVM has recently emerged as an option for young women seeking FP, when COH is contraindicated or when cancer therapy is urgent. However, the actual competence of oocyte vitrified after IVM in cancer patients is not established. To date, only one live birth has been reported following frozen/warmed oocytes from an IVM cycle and no data is available comparing biological/clinical outcomes of warmed oocytes resulting either from IVM or COH cycles in cancer survivors.
Study design, size, duration
This retrospective cohort study from a single IVF unit aimed to analyze outcomes of all oocyte warming cycles in 38 cancer survivors having undergone oocyte vitrification for FP after COH or IVM. All of them had oocyte retrieval before administration of gonadotoxic treatment and returned after being cured for assisted reproduction treatments with their oncologist agreement, between January 2014 and December 2020.
Participants/materials, setting, methods
Thirty-eight oocytes warming cycles followed by ICSI respectively from 18 COH and 22 IVM cycles were analyzed. Survival, degeneration following ICSI, fertilization, top-quality and good-quality embryos, defined at day–2 respectively as 4 and 3–5 adequate-sized blastomeres, without multinucleation and containing <20% of cytoplasmic fragments, implantation, biochemical (hCG>100 UI/mL), clinical (intrauterine sac with fetal heart beat) and live birth rates were compared between IVM and COH cycles using appropriate statistical tests. Significance was set at 5%.
Main results and the role of chance
The indications for FP were breast cancer (n = 32), hematologic malignancies (n = 3), BRCA1 mutation (n = 2), borderline ovarian tumor (n = 1). The mean age and antral follicle count (AFC) at the time of FP was similar in both groups. The number of cryopreserved oocytes was significantly lower in the IVM group (5.7 ± 9.1) when compared with the COH group (11.4 ± 3.3; p = 0.009). Oocyte survival rates were similar in IVM (70 ± 24%) and COH groups (73 ± 28%). Although not significant, we reported a trend to better results in the COH group when compared with those of IVM group in terms of degeneration rate following ICSI (6 ± 10% vs. 14 ± 20%; p = 0.16), fertilization (72 ± 35% vs. 54 ± 27%; p = 0.08), day 2 top-quality (38 ± 32% vs. 21 ± 31%; p = 0.15) and good-quality embryo (46 ± 30% vs. 25 ± 30%; p = 0.06), implantation (18 ± 35% vs. 14 ± 36%; p = 0.79), biochemical (28 (5/18) vs. 14% (3/22); p = 0.26), clinical (22% (4/18) vs. 9% (2/22); p = 0.24), live birth rates (22% (4/18) vs. 5% (1/22); p = 0.06).
Limitations, reasons for caution
Caution is needed when interpreting these retrospective data obtained from a limited number of frozen-thawed cycles. Statistical power to compare IVF outcomes after COH and IVM is limited by the few women who return for oocyte reutilization.
Wider implications of the findings: The present investigation is the largest evaluating the IVM-oocyte frozen-thawed cycles in a oncologic population. It suggests that a higher oocyte yield may be necessary in IVM, since fertilization/embryo-quality rates seem lower. Success rates and limiting factors of oocyte vitrification in this context is needed for providing proper oncofertility counseling.
Trial registration number
Not applicable
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Affiliation(s)
- Y Boumerdassi
- Hôpital Jean-Verdier, Cytogenetic and Reproductive Biology, Bondy, France
| | - B Bennan. Smires
- Hôpital Jean-Verdier, Cytogenetic and Reproductive Biology, Bondy, France
| | - S Sarandi
- Hôpital Jean-Verdier, Cytogenetic and Reproductive Biology, Bondy, France
| | - M Sadoun
- Hôpital Jean-Verdier, Reproductive Medicine and Fertility Preservation, Bondy, France
| | - L Laup
- Hôpital Jean-Verdier, Reproductive Medicine and Fertility Preservation, Bondy, France
| | - J Labrosse
- Hôpital Jean-Verdier, Reproductive Medicine and Fertility Preservation, Bondy, France
| | - C Herbemont
- Hôpital Jean-Verdier, Cytogenetic and Reproductive Biology, Bondy, France
| | - C Vinolas
- Hôpital Jean-Verdier, Reproductive Medicine and Fertility Preservation, Bondy, France
| | - I Cedrin-Durnerin
- Hôpital Jean-Verdier, Reproductive Medicine and Fertility Preservation, Bondy, France
| | - M Peigné
- Hôpital Jean-Verdier, Reproductive Medicine and Fertility Preservation, Bondy, France
| | - N Sermondade
- Hôpital Jean-Verdier, Cytogenetic and Reproductive Biology, Bondy, France
| | - M Grynberg
- Hôpital Jean-Verdier, Reproductive Medicine and Fertility Preservation, Bondy, France
| | - C Sifer
- Hôpital Jean-Verdier, Cytogenetic and Reproductive Biology, Bondy, France
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Dupont C, Didon S, Ciangura C, Selleret L, Bachelot A, Lévy R, Sermondade N. Impact of Bariatric Surgery-Induced Weight Loss on Ovarian Reserve in Women with Obesity: A Systematic Review. Bariatr Surg Pract Patient Care 2021. [DOI: 10.1089/bari.2021.0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Charlotte Dupont
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne-Université, Paris, France
- Sorbonne Université, Centre de Recherche Saint-Antoine, Paris, France
| | - Samia Didon
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne-Université, Paris, France
| | - Cécile Ciangura
- Service de Nutrition, Institute of Cardiometabolism and Nutrition, ICAN, Hôpital Pitié-Salpêtrière (AP-HP), Sorbonne Université, Paris, France
| | - Lise Selleret
- Service de Gynécologie, Obstétrique et Médecine de la Reproduction, Hôpital Tenon (AP-HP), Sorbonne-Université, Paris, France
| | - Anne Bachelot
- Service d'Endocrinologie et Médecine de la Reproduction, IE3M, Centre de Référence des Maladies Endocriniennes Rares de la Croissance et du Développement, Centre de Maladies Gynécologiques Rares, Institute of Cardiometabolism and Nutrition, ICAN, Hôpital Pitié-Salpêtrière (AP-HP), Sorbonne Université, Paris, France
| | - Rachel Lévy
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne-Université, Paris, France
- Sorbonne Université, Centre de Recherche Saint-Antoine, Paris, France
| | - Nathalie Sermondade
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne-Université, Paris, France
- Sorbonne Université, Centre de Recherche Saint-Antoine, Paris, France
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Ly A, Sermondade N, Brioude F, Berthaut I, Bachelot A, Hamid RH, Khattabi LE, Prades M, Lévy R, Dupont C. Fertility preservation in young men with Klinefelter syndrome: A systematic review. J Gynecol Obstet Hum Reprod 2021; 50:102177. [PMID: 34087451 DOI: 10.1016/j.jogoh.2021.102177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 04/13/2021] [Accepted: 05/31/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Klinefelter syndrome (KS) is the most common cause of genetic male infertility, as most patients present azoospermia. In the testis, a massive decrease in the number of germinal cells is observed and this can begin early in childhood. Thus, it is possible to collect spermatozoa after sperm collection or thanks to testicular sperm extraction (TESE), but the chances finding spermatozoa are decreasing with the age. Sperm collection or TESE should be performed as early as possible. When KS is diagnosed during childhood or teens, fertility preservation could be beneficial. The minimal age for proposing fertility preservation remains controversial and there is no current recommendation about fertility preservation in young men with KS. DESIGN In this context, we have conducted a systematic review of the results of fertility preservation in young patients with KS to discuss the optimal age range for offering fertility preservation, including or not a TESE. RESULTS Six articles were included in the systematic review, with patients between 13 and 24 years-old. Except for one, all young men agreed for sperm collection following masturbation. Azoospermia was diagnosed in all patients presenting homogenous KS. One study reported the presence of spermatozoa in the ejaculate of a young man with mosaic KS. Fifty-eight young man for whom ejaculated sperm collection was unsuccessful have benefited from TESE. Testicular spermatozoa were found and frozen in 27 patients out of the 58 (46.5%). The chances of freezing viable testicular sperm between 14 and 23 years of age do not appear to depend on age. CONCLUSION Fertility preservation should be proposed in young men, but the optimal age for proposing the first sperm collection could be adapted according to the medical context and the psychological maturity of the young man.
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Affiliation(s)
- Anna Ly
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne-Université, 75020 Paris, France
| | - Nathalie Sermondade
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne-Université, 75020 Paris, France; Sorbonne Université, Centre de recherche Saint-Antoine, Inserm US938, 75012 Paris, France
| | - Frederic Brioude
- Explorations Fonctionnelles endocriniennes, Hôpital Trousseau, APHP. Sorbonne Université, Paris 75012, France
| | - Isabelle Berthaut
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne-Université, 75020 Paris, France; Sorbonne Université, Centre de recherche Saint-Antoine, Inserm US938, 75012 Paris, France
| | - Anne Bachelot
- Service d'Endocrinologie et Médecine de la Reproduction, Centre de Référence des Maladies Endocriniennes Rares de la Croissance et du Développement, Hôpital Pitié Salpêtrière (APHP), Sorbonne Université, 75013 Paris, France
| | - Rahaf Haj Hamid
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne-Université, 75020 Paris, France
| | - Laila El Khattabi
- Service de cytogénétique, AP-HP.centre, Hôpital Cochin, Université de Paris, Faculté de Médecine, Institut Cochin INSERM U1016, F-75014 Paris, France
| | - Marie Prades
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne-Université, 75020 Paris, France
| | - Rachel Lévy
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne-Université, 75020 Paris, France; Sorbonne Université, Centre de recherche Saint-Antoine, Inserm US938, 75012 Paris, France
| | - Charlotte Dupont
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne-Université, 75020 Paris, France; Sorbonne Université, Centre de recherche Saint-Antoine, Inserm US938, 75012 Paris, France.
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25
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Talla P, Faure C, Rigourd V, Czernichow S, Sermondade N, Lévy R, Dupont C. Is There an Association of Being Breastfed as an Infant and Fertility Status as an Adult? Breastfeed Med 2021; 16:414-418. [PMID: 33781087 DOI: 10.1089/bfm.2020.0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: 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.
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Affiliation(s)
- Perrine Talla
- Sorbonne Université, Saint Antoine Research Center, INSERM Équipe Lipodystrophies Génétiques et Acquises US938, Service de Biologie de la Reproduction-CECOS, AP-H, Hôpital Tenon, Paris, France
| | - Céline Faure
- Service de Biologie de la Reproduction-CECOS, AP-H, Hôpital Tenon, Paris, France
| | - Virginie Rigourd
- Service de Néonatalogie, Hôpital Necker Enfants Malades, Paris, France.,Banque de Lait, Ile de France, Hôpital Necker Enfants Malades, Paris, France
| | - Sébastien Czernichow
- Université Paris Descartes, Paris, France.,APHP, Service de Nutrition, Hôpital Européen Georges-Pompidou, Paris, France
| | - Nathalie Sermondade
- Sorbonne Université, Saint Antoine Research Center, INSERM Équipe Lipodystrophies Génétiques et Acquises US938, Service de Biologie de la Reproduction-CECOS, AP-H, Hôpital Tenon, Paris, France
| | - Rachel Lévy
- Sorbonne Université, Saint Antoine Research Center, INSERM Équipe Lipodystrophies Génétiques et Acquises US938, Service de Biologie de la Reproduction-CECOS, AP-H, Hôpital Tenon, Paris, France
| | - Charlotte Dupont
- Sorbonne Université, Saint Antoine Research Center, INSERM Équipe Lipodystrophies Génétiques et Acquises US938, Service de Biologie de la Reproduction-CECOS, AP-H, Hôpital Tenon, Paris, France
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26
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Sermondade N, Benaloun E, Berthaut I, Moreau E, Prades M, Béranger A, Chabbert-Buffet N, Johnson N, Lévy R, Dupont C. Reproductive functions and fertility preservation in transgender women: a French case series. Reprod Biomed Online 2021; 43:339-345. [PMID: 34144898 DOI: 10.1016/j.rbmo.2021.04.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/14/2021] [Accepted: 04/20/2021] [Indexed: 11/30/2022]
Abstract
RESEARCH QUESTION The reproductive potential of transgender people may be impaired by gender-affirming hormone treatment (GAHT) and is obviously suppressed by gender-affirming surgery involving bilateral orchiectomy. The evolution of medical support for transgender people has made fertility preservation strategies possible. Fertility preservation in transgender women mainly relies on sperm cryopreservation. There are few studies on this subject, and the sample sizes are small, and so it difficult to know whether fertility preservation procedures are feasible and effective in trans women. DESIGN This retrospective study reports the management of fertility preservation in transgender women referred to the study centre for sperm cryopreservation, and the semen parameters of trans women were compared with those of sperm donors. RESULTS Ninety-six per cent of transgender women who had not started treatment benefitted from sperm cryopreservation, compared with 80% of those who attempted a therapeutic window and 50% of those receiving hormonal treatment at the time of sperm collection. No major impairment of semen parameters was observed in transgender women who had not started GAHT compared with sperm donors. However, even though the frequency of oligozoospermia was no different, two transgender women presented azoospermia. Some transgender women who had started GAHT could benefit from sperm freezing. None of them were treated with gonadotrophin-releasing hormone (GnRH) analogues. CONCLUSIONS Parenthood strategies for transgender people have long been ignored, but this is an important issue to consider, especially because medical treatments and surgeries may be undertaken in adolescents or very young adults. Fertility preservation should ideally be offered prior to initiation of GAHT.
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Affiliation(s)
- Nathalie Sermondade
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne Université, Paris 75020, France; Sorbonne Université, Centre de Recherche Saint-Antoine, Inserm US938, Paris 75012, France
| | - Emmanuelle Benaloun
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne Université, Paris 75020, France
| | - Isabelle Berthaut
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne Université, Paris 75020, France
| | - Emilie Moreau
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne Université, Paris 75020, France
| | - Marie Prades
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne Université, Paris 75020, France
| | - Alix Béranger
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne Université, Paris 75020, France
| | - Nathalie Chabbert-Buffet
- Service de Gynécologie, Obstétrique et Médecine de la Reproduction, Hôpital Tenon (AP-HP), Sorbonne Université, 75020 Paris, France
| | - Nicolaï Johnson
- Service de Gynécologie, Obstétrique et Médecine de la Reproduction, Hôpital Tenon (AP-HP), Sorbonne Université, 75020 Paris, France
| | - Rachel Lévy
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne Université, Paris 75020, France; Sorbonne Université, Centre de Recherche Saint-Antoine, Inserm US938, Paris 75012, France
| | - Charlotte Dupont
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne Université, Paris 75020, France; Sorbonne Université, Centre de Recherche Saint-Antoine, Inserm US938, Paris 75012, France.
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Geoffron S, Lier A, de Kermadec E, Sermondade N, Varinot J, Thomassin-Naggara I, Bendifallah S, Daraï E, Chabbert-Buffet N, Kolanska K. Fertility preservation in women with malignant and borderline ovarian tumors: Experience of the French ESGO-certified center and pregnancy-associated cancer network (CALG). Gynecol Oncol 2021; 161:817-824. [PMID: 33812696 DOI: 10.1016/j.ygyno.2021.03.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 03/27/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To describe strategy and results of fertility preservation (FP) in patients with malignant and borderline ovarian tumors. METHODS Consecutive cohort study of 43 women with malignant or borderline ovarian tumors who underwent FP between February 2013 and July 2019. The study was conducted in national expert center in Tenon University Hospital, Sorbonne University: French ESGO-certified ovarian cancer center and pregnancy-associated cancer network (CALG). Main outcome measure was FP technique proposed by multidisciplinary committee, FP technique used, time after surgery, number of fragments, histology and follicle density (if ovarian tissue freezing), number of expected, retrieved and frozen oocytes (if ovarian stimulation). RESULTS Pathological diagnosis was malignant epithelial ovarian tumor in five women (11.6%), rare malignant ovarian tumor in 14 (32.6%), borderline in 24 (55.8%), and mostly unilateral (79.1%) and stage I (76.7%). Mean age at diagnosis was 26.8 ± 6.9 years and mean tumor size 109.7 ± 61 mm. Before FP, mean AFC was 11.0 ± 6.1 and AMH levels were 2.7 ± 4.6 ng/mL. Six ovarian tissue-freezing procedures were performed (offered to 13). Twenty-four procedures of ovarian stimulation and oocyte freezing were performed after surgical treatment for 19 women (offered to 28) with a median interval of 188 days. The mean number of mature oocytes retrieved per stimulation was 12.4 ± 12.8. At least 10 mature oocytes were frozen for 52.6% of the women. No FP was offered to five women. CONCLUSION Oocyte and ovarian tissue cryopreservation should be offered to patients with malignant and borderline ovarian tumors. More data are needed to confirm ovarian stimulation and ovarian tissue grafting safety.
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Affiliation(s)
- S Geoffron
- Department of Gynaecology, Obstetrics and Reproductive Medicine, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, University Institute of Cancer, Paris, France; Jossigny Hospital, France
| | - A Lier
- Department of Gynaecology, Obstetrics and Reproductive Medicine, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, University Institute of Cancer, Paris, France; Department of Gynaecology and Obstetrics, Pregnancy associated cancer network (CALG), Paris, France
| | | | - N Sermondade
- Department of Reproductive biology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, University Institute of Cancer, Paris, France
| | - J Varinot
- INSERM UMR S 938, Biology and therapy of cancer, St Antoine research center, Paris, France; Department of Pathology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, University Institute of Cancer, Paris, France
| | - I Thomassin-Naggara
- INSERM UMR S 938, Biology and therapy of cancer, St Antoine research center, Paris, France; Department of Radiology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, University Institute of Cancer, Paris, France
| | - S Bendifallah
- Department of Gynaecology, Obstetrics and Reproductive Medicine, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, University Institute of Cancer, Paris, France; Department of Gynaecology and Obstetrics, Pregnancy associated cancer network (CALG), Paris, France; INSERM UMR S 938, Biology and therapy of cancer, St Antoine research center, Paris, France
| | - E Daraï
- Department of Gynaecology, Obstetrics and Reproductive Medicine, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, University Institute of Cancer, Paris, France; Department of Gynaecology and Obstetrics, Pregnancy associated cancer network (CALG), Paris, France; INSERM UMR S 938, Biology and therapy of cancer, St Antoine research center, Paris, France
| | - N Chabbert-Buffet
- Department of Gynaecology, Obstetrics and Reproductive Medicine, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, University Institute of Cancer, Paris, France; Department of Gynaecology and Obstetrics, Pregnancy associated cancer network (CALG), Paris, France; INSERM UMR S 938, Biology and therapy of cancer, St Antoine research center, Paris, France.
| | - K Kolanska
- Department of Gynaecology, Obstetrics and Reproductive Medicine, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, University Institute of Cancer, Paris, France; Department of Gynaecology and Obstetrics, Pregnancy associated cancer network (CALG), Paris, France; INSERM UMR S 938, Biology and therapy of cancer, St Antoine research center, Paris, France
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Benaloun E, Sermondade N, Moreau E, Chabbert-Buffet N, Cristofari S, Johnson N, Lévy R, Dupont C. [Fertility preservation for transwomen]. ACTA ACUST UNITED AC 2021; 49:547-552. [PMID: 33434749 DOI: 10.1016/j.gofs.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Indexed: 11/19/2022]
Abstract
The evolution of medical care for transgender people currently makes it possible to propose fertility preservation. Fertility preservation should be initiated before the start of hormonal treatments and/or surgical procedures. The "reproductive" aspect and the desire for parenthood among transgender people have long been ignored. However, these aspects are important to consider and fertility preservation should be discussed before the start of the physical transition. The aim of this review is to assess the literature on fertility preservation for transgender women ("male to female"). Many uncertainties remain regarding the impact of hormonal treatments on the reproductive functions of transgender women and their reversibility. However, the significant increase in the number of recently published articles is evidence of the improvement in the conditions of access to these procedures for women starting a transition process. Nevertheless, there are still a number of barriers that can prevent or delay this process.
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Affiliation(s)
- E Benaloun
- Service de biologie de la reproduction CECOS, AP-HP, hôpital Tenon, Paris, France
| | - N Sermondade
- Service de biologie de la reproduction-CECOS, AP-HP, hôpital Tenon, Sorbonne université, Saint-Antoine Research centre, Inserm équipe lipodystrophies génétiques et acquises, Paris, France
| | - E Moreau
- Service de biologie de la reproduction CECOS, AP-HP, hôpital Tenon, Paris, France
| | - N Chabbert-Buffet
- Service de gynécologie-obstétrique et médecine de la reproduction, AP-HP, hôpital Tenon, Paris, France
| | - S Cristofari
- Service de chirurugie plastique reconstructrice et esthétique, AP-HP, hôpital Tenon, Sorbonne université, Paris, France
| | - N Johnson
- Service de gynécologie-obstétrique et médecine de la reproduction, AP-HP, hôpital Tenon, Paris, France
| | - R Lévy
- Service de biologie de la reproduction-CECOS, AP-HP, hôpital Tenon, Sorbonne université, Saint-Antoine Research centre, Inserm équipe lipodystrophies génétiques et acquises, Paris, France
| | - C Dupont
- Service de biologie de la reproduction-CECOS, AP-HP, hôpital Tenon, Sorbonne université, Saint-Antoine Research centre, Inserm équipe lipodystrophies génétiques et acquises, Paris, France.
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29
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Sermondade N, Grynberg M, Comtet M, Valdelievre C, Sifer C, Sonigo C. Double-in vitro maturation increases the number of vitrified oocytes available for fertility preservation when ovarian stimulation is unfeasible. Sci Rep 2020; 10:18555. [PMID: 33122722 PMCID: PMC7596087 DOI: 10.1038/s41598-020-75699-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 10/19/2020] [Indexed: 12/22/2022] Open
Abstract
When ovarian stimulation is unfeasible, in vitro maturation (IVM) represents an alternative option for fertility preservation (FP). This retrospective study aims to evaluate the feasibility of performing within a short time frame two IVM cycles for FP. Seventeen women with breast cancer, 18-40 years of age, having undergone 2 cycles of IVM followed by oocyte vitrification were included. Non parametric analyses were used. No difference was observed between IVM1 and IVM2 outcomes. No complication was reported. The respective contributions of IVM1 and IVM2 for the number of cryopreserved oocytes were comparable irrespective of the delay between both procedures, even when performed during the same menstrual cycle. Those findings suggest that repeating IVM cycles may constitute a safe option for increasing the number of vitrified mature oocytes for FP. These two retrievals may be performed during the same cycle, providing additional argument for a physiologic continuous recruitment during follicular development.
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Affiliation(s)
- Nathalie Sermondade
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris, 93143, Bondy, France. .,Department of Reproductive Biology, Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique-Hôpitaux de Paris, 75020, Paris, France.
| | - Michaël Grynberg
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris, 93143, Bondy, France.,Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, 92140, Clamart, France.,Université Paris-Sud, Université Paris Saclay, 94276, Le Kremlin Bicêtre, France.,Inserm U1133, Université Paris Diderot, 75013, Paris, France
| | - Marjorie Comtet
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris, 93143, Bondy, France
| | - Constance Valdelievre
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris, 93143, Bondy, France
| | - Christophe Sifer
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris, 93143, Bondy, France
| | - Charlotte Sonigo
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris, 93143, Bondy, France.,Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, 92140, Clamart, France.,Inserm U1185 Université Paris-Sud, Université Paris Saclay, 94276, Le Kremlin Bicêtre, France
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30
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Celse T, Cazin C, Mietton F, Martinez G, Martinez D, Thierry-Mieg N, Septier A, Guillemain C, Beurois J, Clergeau A, Mustapha SFB, Kharouf M, Zoghmar A, Chargui A, Papaxanthos A, Dorphin B, Foliguet B, Triki C, Sifer C, Lauton D, Tachdjian G, Schuler G, Lejeune H, Puechberty J, Bessonnat J, Pasquier L, Mery L, Poulain M, Chaabouni M, Sermondade N, Cabry R, Benbouhadja S, Veau S, Frapsauce C, Mitchell V, Achard V, Satre V, Hennebicq S, Zouari R, Arnoult C, Kherraf ZE, Coutton C, Ray PF. Genetic analyses of a large cohort of infertile patients with globozoospermia, DPY19L2 still the main actor, GGN confirmed as a guest player. Hum Genet 2020; 140:43-57. [PMID: 33108537 DOI: 10.1007/s00439-020-02229-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/15/2020] [Indexed: 12/28/2022]
Abstract
Globozoospermia is a rare phenotype of primary male infertility inducing the production of round-headed spermatozoa without acrosome. Anomalies of DPY19L2 account for 50-70% of all cases and the entire deletion of the gene is by far the most frequent defect identified. Here, we present a large cohort of 69 patients with 20-100% of globozoospermia. Genetic analyses including multiplex ligation-dependent probe amplification, Sanger sequencing and whole-exome sequencing identified 25 subjects with a homozygous DPY19L2 deletion (36%) and 14 carrying other DPY19L2 defects (20%). Overall, 11 deleterious single-nucleotide variants were identified including eight novel and three already published mutations. Patients with a higher rate of round-headed spermatozoa were more often diagnosed and had a higher proportion of loss of function anomalies, highlighting a good genotype phenotype correlation. No gene defects were identified in patients carrying < 50% of globozoospermia while diagnosis efficiency rose to 77% for patients with > 50% of globozoospermia. In addition, results from whole-exome sequencing were scrutinized for 23 patients with a DPY19L2 negative diagnosis, searching for deleterious variants in the nine other genes described to be associated with globozoospermia in human (C2CD6, C7orf61, CCDC62, CCIN, DNAH17, GGN, PICK1, SPATA16, and ZPBP1). Only one homozygous novel truncating variant was identified in the GGN gene in one patient, confirming the association of GGN with globozoospermia. In view of these results, we propose a novel diagnostic strategy focusing on patients with at least 50% of globozoospermia and based on a classical qualitative PCR to detect DPY19L2 homozygous deletions. In the absence of the latter, we recommend to perform whole-exome sequencing to search for defects in DPY19L2 as well as in the other previously described candidate genes.
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Affiliation(s)
- Tristan Celse
- Institute for Advanced Biosciences, Team Genetics Epigenetics and Therapies of Infertility, Université Grenoble Alpes, INSERM U1209, CNRS UMR 5309, 38000, Grenoble, France.,CHU Grenoble Alpes, UM GI-DPI, 38000, Grenoble, France
| | - Caroline Cazin
- Institute for Advanced Biosciences, Team Genetics Epigenetics and Therapies of Infertility, Université Grenoble Alpes, INSERM U1209, CNRS UMR 5309, 38000, Grenoble, France.,CHU Grenoble Alpes, UM GI-DPI, 38000, Grenoble, France
| | - Flore Mietton
- CHU Grenoble Alpes, UM GI-DPI, 38000, Grenoble, France
| | - Guillaume Martinez
- Institute for Advanced Biosciences, Team Genetics Epigenetics and Therapies of Infertility, Université Grenoble Alpes, INSERM U1209, CNRS UMR 5309, 38000, Grenoble, France.,CHU Grenoble Alpes, UM de Génétique Chromosomique, 38000, Grenoble, France
| | | | | | - Amandine Septier
- Université Grenoble Alpes, CNRS, TIMC-IMAG, 38000, Grenoble, France
| | - Catherine Guillemain
- Pôle Femmes-Parents-Enfants, Centre Clinico-Biologique AMP-CECOS, Plateforme Cancer et Fertilité ONCOPACA-Corse, Assistance-Publique des Hôpitaux de Marseille (AP-HM), Marseille, France.,Aix Marseille University, INSERM, MMG, UMR_S 1251, Marseille, France
| | - Julie Beurois
- Institute for Advanced Biosciences, Team Genetics Epigenetics and Therapies of Infertility, Université Grenoble Alpes, INSERM U1209, CNRS UMR 5309, 38000, Grenoble, France
| | | | | | - Mahmoud Kharouf
- Polyclinique les Jasmins, Centre d'Aide Médicale à la Procréation, Centre Urbain Nord, 1003, Tunis, Tunisia
| | - Abdelali Zoghmar
- Reproduction Sciences and Surgery Clinique, Ibn Rochd, Constantine, Algeria
| | - Ahmed Chargui
- Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Service d'Histologie-Embryologie-Biologie de la Reproduction, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Aline Papaxanthos
- Department of Obstetrics, Gynecology and Reproductive Medicine, Bordeaux University Hospital, Bordeaux, France
| | | | - Bernard Foliguet
- Toxicology and Molecular Biology, Institute Jean Lamour UMR 7198 du CNRS, Université de Lorraine, 54000, Nancy, France
| | - Chema Triki
- Centre d'AMP, Clinique Hannibal, Les Berges du Lac, 1053, Tunis, Tunisia
| | - Christophe Sifer
- Service de Biologie de la Reproduction, d'Histo-Embryologie et Cytogénétique, Hôpital Jean-Verdier, Avenue du 14 Juillet, 93140, Bondy, France
| | - Dominique Lauton
- Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, Montpellier, France
| | - Gérard Tachdjian
- UMR 967, INSERM, Service d'Histologie Embryologie et Cytogénétique, Hôpitaux Universitaires Paris-Sud, AP-HP, Clamart, France
| | | | - Hervé Lejeune
- Reproductive Medicine Department, Hospices Civils de Lyon, Lyon, France
| | - Jacques Puechberty
- Département de Génétique Médicale, Maladies Rares et Médecine Personnalisée, Hôpital Arnaud de Villeneuve, CHU de Montpellier, Université Montpelier, Montpellier, France
| | - Julien Bessonnat
- CHU de Grenoble, UF de Biologie de la Procréation, 38000, Grenoble, France
| | - Laurent Pasquier
- Service de Génétique Clinique, CLAD Ouest, CHU Rennes, Rennes, France
| | - Lionel Mery
- Service de Médecine de la Reproduction, CHU de Saint-Étienne, Hôpital Nord, 42055, Saint-Étienne Cedex 2, France
| | - Marine Poulain
- Department of Obstetrics and Gynecology, Hôpital Foch, Université de Paris Ouest (UVSQ), Suresnes, France
| | - Myriam Chaabouni
- Polyclinique les Jasmins, Centre d'Aide Médicale à la Procréation, Centre Urbain Nord, 1003, Tunis, Tunisia
| | - Nathalie Sermondade
- Service de Biologie de la Reproduction-CECOS, Hôpital Tenon, AP-HP, 75020, Paris, France
| | - Rosalie Cabry
- Department of Obstetrics, Gynaecology and Reproductive Medicine, Picardie University Jules Verne, Amiens University Medical Centre, Amiens, France
| | - Sebti Benbouhadja
- Reproduction Sciences and Surgery Clinique, Ibn Rochd, Constantine, Algeria
| | - Ségolène Veau
- CHU, Centre d'AMP-CECOS, University Rennes, 16 Boulevard de Bulgarie, 35000, Rennes, France
| | - Cynthia Frapsauce
- CHU Bretonneau, Médecine et Biologie de la Reproduction-CECOS, Tours, France
| | - Valérie Mitchell
- EA 4308, Department of Reproductive Biology and Spermiology-CECOS Lille, University Medical Center, 59037, Lille, France
| | - Vincent Achard
- CECOS-Laboratoire de Biologie de la Reproduction, Pôle de Gynécologie Obstétrique et Reproduction (Gynépôle), Assistance Publique-Hôpitaux de Marseille (AP-HM) la Conception, 13005, Marseille, France.,Centre Clinico-Biologique d'Assistance Médicale à la Procréation, Pôle de Gynécologie Obstétrique et Reproduction (Gynépôle), Assistance Publique-Hôpitaux de Marseille (AP-HM) la Conception, 13005, Marseille, France.,Faculté de Médecine, Institut Méditerranéen de Biodiversité et d'Écologie (IMBE UMR 7263), Equipe Biogénotoxicologie, Santé Humaine et Environnement, Aix Marseille Université, CNRS, IRD, Université Avignon, 27, Boulevard Jean-Moulin, 13385, Marseille Cedex 5, France
| | - Veronique Satre
- Institute for Advanced Biosciences, Team Genetics Epigenetics and Therapies of Infertility, Université Grenoble Alpes, INSERM U1209, CNRS UMR 5309, 38000, Grenoble, France.,CHU Grenoble Alpes, UM de Génétique Chromosomique, 38000, Grenoble, France
| | - Sylviane Hennebicq
- Institute for Advanced Biosciences, Team Genetics Epigenetics and Therapies of Infertility, Université Grenoble Alpes, INSERM U1209, CNRS UMR 5309, 38000, Grenoble, France.,CHU de Grenoble, UF de Biologie de la Procréation, 38000, Grenoble, France
| | - Raoudha Zouari
- Pôle Femmes-Parents-Enfants, Centre Clinico-Biologique AMP-CECOS, Plateforme Cancer et Fertilité ONCOPACA-Corse, Assistance-Publique des Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Christophe Arnoult
- Institute for Advanced Biosciences, Team Genetics Epigenetics and Therapies of Infertility, Université Grenoble Alpes, INSERM U1209, CNRS UMR 5309, 38000, Grenoble, France
| | - Zine-Eddine Kherraf
- Institute for Advanced Biosciences, Team Genetics Epigenetics and Therapies of Infertility, Université Grenoble Alpes, INSERM U1209, CNRS UMR 5309, 38000, Grenoble, France.,CHU Grenoble Alpes, UM GI-DPI, 38000, Grenoble, France
| | - Charles Coutton
- Institute for Advanced Biosciences, Team Genetics Epigenetics and Therapies of Infertility, Université Grenoble Alpes, INSERM U1209, CNRS UMR 5309, 38000, Grenoble, France.,CHU Grenoble Alpes, UM de Génétique Chromosomique, 38000, Grenoble, France
| | - Pierre F Ray
- Institute for Advanced Biosciences, Team Genetics Epigenetics and Therapies of Infertility, Université Grenoble Alpes, INSERM U1209, CNRS UMR 5309, 38000, Grenoble, France. .,CHU Grenoble Alpes, UM GI-DPI, 38000, Grenoble, France.
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Sermondade N, Sonigo C, Ahdad-Yata N, Pasquier M, Fraison E, Grynberg M. SEARCHING FOR THE OPTIMAL NUMBER OF OOCYTES TO REACH A LIFE BIRTH AFTER IN VITRO FERTILIZATION: A SYSTEMATIC REVIEW WITH META-ANALYSIS. Fertil Steril 2020. [DOI: 10.1016/j.fertnstert.2020.08.787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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32
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Sonigo C, Le Conte G, Boubaya M, Ohanyan H, Pressé M, El Hachem H, Cedrin-Durnerin I, Benoit A, Sifer C, Sermondade N, Grynberg M. Priming Before In Vitro Maturation Cycles in Cancer Patients Undergoing Urgent Fertility Preservation: a Randomized Controlled Study. Reprod Sci 2020; 27:2247-2256. [PMID: 32617881 DOI: 10.1007/s43032-020-00244-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/09/2020] [Accepted: 06/22/2020] [Indexed: 12/16/2022]
Abstract
In vitro maturation (IVM) of oocytes retrieved at germinal vesicle stage, followed by vitrification of mature oocytes, has emerged as a fertility preservation (FP) option. This technique was first developed for patients with polycystic ovarian syndrome. In this population, providing LH activity prior to oocyte collection has been associated with better IVM outcomes. However, the benefit of this treatment in normo-ovulatory breast cancer (BC) patients undergoing IVM for FP purpose has never been investigated. To assess if the absence of therapeutic intervention prior to oocyte retrieval for IVM modifies IVM outcomes in BC patients undergoing urgent FP, we performed a non-inferiority, randomized controlled trial. The main outcome was the total number of mature oocytes obtained and cryopreserved after IVM. A total of 172 normo-ovulatory women, suffering from BC, 18 to 39 years of age received no injection or a subcutaneous injection of hCG or GnRH agonist (GnRHa) 36 h before oocytes retrieval according to randomized allocation. The total number of cryopreserved oocytes were 5.1 ± 3.8, 5.4 ± 3.8, and 6.0 ± 4.2 oocytes, respectively in the without, hCG and GnRHa groups. Mean differences were not significant between the three groups (- 0.5; CI 97.5% [- 2.03:1.02] and - 0.22; CI 97.5% [- 1.75:1.32], respectively). Intention to treat analyses failed to show non-inferiority in the "without injection group" in comparison with hCG or GnRHa groups. Our results are not conclusive enough to modify our practices and to stop administering hCG or GnRHa before IVM cycles for FP. The study was retrospectively registered to clinical trial (ID NCT03954197) in May 2019.
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Affiliation(s)
- Charlotte Sonigo
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Université Paris saclay, Assistance Publique - Hôpitaux de Paris, 92140, Clamart, France.,Inserm, UMR-S 1185 physiologie et physiopathologie endocrienne, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Grégoire Le Conte
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Université Paris saclay, Assistance Publique - Hôpitaux de Paris, 92140, Clamart, France
| | - Marouane Boubaya
- Clinical Research Unit and Clinical Research Center, Avicenne Hospital, APHP, Bobigny, France
| | - Haykanush Ohanyan
- Clinical Research Unit and Clinical Research Center, Avicenne Hospital, APHP, Bobigny, France
| | - Marion Pressé
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Université Paris saclay, Assistance Publique - Hôpitaux de Paris, 92140, Clamart, France
| | - Hady El Hachem
- Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada; Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada
| | - Isabelle Cedrin-Durnerin
- Department of Reproductive Medicine & Fertility Preservation, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140, Bondy, France
| | - Alexandra Benoit
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Université Paris saclay, Assistance Publique - Hôpitaux de Paris, 92140, Clamart, France
| | - Christophe Sifer
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140, Bondy, France
| | - Nathalie Sermondade
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140, Bondy, France
| | - Michaël Grynberg
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Université Paris saclay, Assistance Publique - Hôpitaux de Paris, 92140, Clamart, France. .,Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada; Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada. .,Unité Inserm U1133, Université Paris-Diderot, 75013, Paris, France.
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Grynberg M, Dagher Hayeck B, Papanikolaou EG, Sifer C, Sermondade N, Sonigo C. BRCA1/2 gene mutations do not affect the capacity of oocytes from breast cancer candidates for fertility preservation to mature in vitro. Hum Reprod 2020; 34:374-379. [PMID: 30561604 DOI: 10.1093/humrep/dey358] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 12/07/2018] [Indexed: 12/14/2022] Open
Abstract
STUDY QUESTION Are the maturation rates of oocytes recovered from small antral follicles different between breast cancer patients presenting with or without a BRCA 1/2 gene mutation? SUMMARY ANSWER BRCA 1/2 gene mutations do not affect the capacity of oocytes from breast cancer candidates for fertility preservation to mature in vitro. WHAT IS KNOWN ALREADY Mutations in the BRCA1 and BRCA2 genes are associated with an increased risk for developing breast and ovarian cancer. Controversy exists about fertility and ovarian reserve in BRCA mutation carriers. Studies suggest that these patients may have low ovarian reserve and poor response to ovarian stimulation. The impaired ability of the mutated BRCA gene to repair double-strand breaks in DNA may prompt oocyte aging, apoptosis and meiotic errors. IVM of oocytes retrieved at germinal vesicle stage, followed by vitrification of metaphase II (MII) oocytes has recently emerged as an option for young women seeking fertility preservation, when ovarian stimulation is unfeasible. STUDY DESIGN, SIZE, DURATION Retrospective cohort study involving 329 breast cancer candidates for fertility preservation using IVM between January 2014 and December 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS Inclusion criteria were: age 18-40 years; two ovaries present; no history of chemotherapy; test for BRCA 1/2 mutations performed. Before immature oocyte retrieval, all follicles measuring 2-9 mm in diameter were precisely counted on both ovaries and serum anti-Müllerian hormone (AMH) was measured irrespective of the phase of the cycle. Number of cumulus oocyte complexes (COC) retrieved, maturation rate and number of MII oocytes cryopreserved were compared according to BRCA mutation status. MAIN RESULTS AND THE ROLE OF CHANCE Overall, BRCA-mutated women (n = 52) and BRCA-negative women (n = 277) were comparable in terms of age (31.7 ± 3.9 versus 32.3 ± 3.8 years, respectively, P = 0.3), BMI (23.4 ± 4.7 versus 22.6 ± 3.7 kg/m2, respectively, P = 0.3) and ovarian reserve tests (antral follicle count: 20.5 ± 11.4 versus 21.7 ± 12.1 follicles, P = 0.5; serum AMH levels: 3.6 ± 2.9 versus 4.1 ± 3.6 ng/ml, P = 0.3, respectively). The number of COCs retrieved did not differ significantly between both groups (8.9 ± 6.9 versus 9.9 ± 8.1 oocytes, P = 0.5). After similar IVM rates (67 ± 24 versus 62 ± 23%, P = 0.2), the number of MII oocytes cryopreserved was similar in patients presenting BRCA mutation or not (5.1 ± 3.8 versus 6.1 ± 5.1, P = 0.1, respectively). LIMITATIONS, REASONS FOR CAUTION Given the low incidence of the mutation, these preliminary findings should be confirmed by further multi-center studies. WIDER IMPLICATIONS OF THE FINDINGS Although BRCA mutations are known to alter DNA repair mechanism, it does not seem to impair oocyte capacity to mature in vitro. STUDY FUNDING/COMPETING INTEREST(s) None.
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Affiliation(s)
- Michaël Grynberg
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Hôpitaux Universitaires Paris Sud, Assistance Publique - Hôpitaux de Paris, Clamart, France.,Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique- Hôpitaux de Paris, Bondy, France.,Université Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, France.,Inserm U1133 Université Paris Diderot, Paris, France
| | - Bénédicte Dagher Hayeck
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique- Hôpitaux de Paris, Bondy, France
| | | | - Christophe Sifer
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique - Hôpitaux de Paris, Bondy, France
| | - Nathalie Sermondade
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique - Hôpitaux de Paris, Bondy, France
| | - Charlotte Sonigo
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Hôpitaux Universitaires Paris Sud, Assistance Publique - Hôpitaux de Paris, Clamart, France.,Inserm U1185 Université Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, France
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Sermondade N, Huberlant S, Bourhis-Lefebvre V, Arbo E, Gallot V, Colombani M, Fréour T. Female obesity is negatively associated with live birth rate following IVF: a systematic review and meta-analysis. Hum Reprod Update 2020; 25:439-451. [PMID: 30941397 DOI: 10.1093/humupd/dmz011] [Citation(s) in RCA: 190] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/19/2019] [Accepted: 02/28/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND A worldwide increase in the prevalence of obesity has been observed in the past three decades, particularly in women of reproductive age. Female obesity has been clearly associated with impaired spontaneous fertility, as well as adverse pregnancy outcomes. Increasing evidence in the literature shows that obesity also contributes to adverse clinical outcomes following in vitro fertilization (IVF) procedures. However, the heterogeneity of the available studies in terms of populations, group definition and outcomes prevents drawing firm conclusions. A previous meta-analysis published in 2011 identified a marginal but significant negative effect of increased female body mass index (BMI) on IVF results, but numerous studies have been published since then, including large cohort studies from national registries, highlighting the need for an updated review and meta-analysis. OBJECTIVE AND RATIONALE Our systematic review and meta-analysis of the available literature aims to evaluate the association of female obesity with the probability of live birth following IVF. Subgroup analyses according to ovulatory status, oocyte origin, fresh or frozen-embryo transfer and cycle rank were performed. SEARCH METHODS A systematic review was performed using the following key words: ('obesity', 'body mass index', 'live birth', 'IVF', 'ICSI'). Searches were conducted in MEDLINE, EMBASE, Cochrane Library, Eudract and clinicaltrial.gov from 01 January 2007 to 30 November 2017. Study selection was based on title and abstract. Full texts of potentially relevant articles were retrieved and assessed for inclusion by two reviewers. Subsequently, quality was assessed using the Newcastle-Ottawa Quality Assessment Scales for patient selection, comparability and assessment of outcomes. Two independent reviewers carried out study selection and data extraction according to Cochrane methods. Random-effect meta-analysis was performed using Review Manager software on all data (overall analysis), followed by subgroup analyses. OUTCOMES A total of 21 studies were included in the meta-analysis. A decreased probability of live birth following IVF was observed in obese (BMI ≥ 30 kg/m2) women when compared with normal weight (BMI 18.5-24.9 kg/m2) women: risk ratio (RR) (95% CI) 0.85 (0.82-0.87). Subgroups analyses demonstrated that prognosis was poorer when obesity was associated with polycystic ovary syndrome, while the oocyte origin (donor or non-donor) did not modify the overall interpretation. WIDER IMPLICATIONS Our meta-analysis clearly demonstrates that female obesity negatively and significantly impacts live birth rates following IVF. Whether weight loss can reverse this deleterious effect through lifestyle modifications or bariatric surgery should be further evaluated.
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Affiliation(s)
- Nathalie Sermondade
- Service de Biologie de la Reproduction, Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique-Hôpitaux de Paris, PARIS, France
| | - Stéphanie Huberlant
- Département de Gynécologie Obstétrique et Médecine de la Reproduction, CHU Carémeau, NIMES, France
| | | | | | - Vanessa Gallot
- Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Antoine Béclère, Assistance Publique-Hôpitaux de Paris, Clamart, France
| | | | - Thomas Fréour
- Service de biologie et médecine de la reproduction, CHU de Nantes, NANTES 44093, France-Faculté de médecine, Université de Nantes, France-INSERM UMR1064, Nantes, France
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Sonigo C, Bajeux J, Boubaya M, Eustache F, Sifer C, Lévy V, Grynberg M, Sermondade N. In vitro maturation is a viable option for urgent fertility preservation in young women with hematological conditions. Hematol Oncol 2020; 38:560-564. [PMID: 32065670 DOI: 10.1002/hon.2724] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/04/2020] [Accepted: 02/12/2020] [Indexed: 12/19/2022]
Abstract
Fertility preservation embraces different techniques developed to improve young women chances of becoming mothers after healing. Among them, in vitro maturation (IVM) procedure is based on oocyte retrieval without any gonadotropin treatment, feasible under locoregional or local anesthesia, with very low operative complications. The present retrospective analysis of a preliminary case series of 25 women diagnosed with Hodgkin or non-Hodgkin lymphoma aims to evaluate the feasibility of IVM for urgent fertility preservation purposes in hematological context. A median of five mature oocytes was cryopreserved after one cycle of IVM, performed without delaying the start of the chemotherapy (median delay from histological diagnosis to start of the chemotherapy 17.5 days). No association was found between lymphomas' characteristics and the number of recovered or frozen oocytes. Although experimental, this technique could be relevant when fertility preservation has to be performed within a short time frame and without additional surgery nor any risk of malignant cells reintroduction.
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Affiliation(s)
- Charlotte Sonigo
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique - Hôpitaux de Paris, Bondy, France.,Inserm U1185 Université Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Jeanne Bajeux
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique - Hôpitaux de Paris, Bondy, France
| | - Marouane Boubaya
- Département de recherche clinique, Groupe Hospitalier Paris Seine Saint Denis, Assistance Publique -Hôpitaux de Paris, Université Paris 13, Bobigny et INSERM U1153, Paris, France
| | - Florence Eustache
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique - Hôpitaux de Paris, Bondy, France
| | - Christophe Sifer
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique - Hôpitaux de Paris, Bondy, France
| | - Vincent Lévy
- Département de recherche clinique, Groupe Hospitalier Paris Seine Saint Denis, Assistance Publique -Hôpitaux de Paris, Université Paris 13, Bobigny et INSERM U1153, Paris, France
| | - Michaël Grynberg
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique - Hôpitaux de Paris, Bondy, France.,Inserm U1185 Université Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, France.,Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d'Universités et Etablissements Sorbonne Paris Cité, Paris, France Inserm U1133 Université Paris Diderot, Paris, France
| | - Nathalie Sermondade
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique - Hôpitaux de Paris, Bondy, France
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Abstract
Over the past decades, progresses in oncology have improved the recovery rates after numerous malignant diseases, including breast cancer, that strike young adults in childbearing age. Quality of life of young cancer survivors has become a major issue. However, anticancer therapies can have a detrimental impact on fertility. It is now well-established that all patients should receive information about the fertility risks associated with their cancer treatment and the fertility preservation options available. These techniques aim to limit the negative impact of chemotherapy on the ovaries or to preserve gametes before treatment. Currently, oocyte or embryo freezing after controlled ovarian hyperstimulation represents the most effective method for preserving female fertility. Over the past years innovative protocols of ovarian stimulation have been developed to enable breast cancer patients to undergo oocyte or embryo cryopreservation irrespective of the phase of the cycle or without exogenous follicle-stimulating hormone related increase in serum estradiol levels. When controlled ovarian hyperstimualtion cannot be implemented, other techniques such as cryopreservation of ovarian cortex, in vitro maturation or the use of GnRH agonists may be proposed. However, it is important to inform patients that all these fertility preservation techniques do not represent a guarantee of pregnancy.
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Affiliation(s)
- Charlotte Sonigo
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Antoine-Béclère, 92140 Clamart, France; INSERM U1185, Université Paris-Sud, Université Paris-Saclay, 94276 Le Kremlin-Bicêtre, France
| | - Michaël Grynberg
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Antoine-Béclère, 92140 Clamart, France; INSERM U1133, Université Paris-Diderot, 75013 Paris, France; Université Paris-Sud, Université Paris-Saclay, 94276 Le Kremlin-Bicêtre, France.
| | - Sophie Bringer
- Service de gynécologie-obstétrique et médecine de la reproduction, CHRU, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France
| | - Nathalie Sermondade
- Service de biologie de la reproduction - CECOS, hôpital Tenon, 75020 Ap-HP, Paris, France
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Benoit A, Grynberg M, Morello R, Sermondade N, Grandazzi G, Moutel G. Does a web-based decision aid improve informed choice for fertility preservation in women with breast cancer (DECISIF)? Study protocol for a randomised controlled trial. BMJ Open 2020; 10:e031739. [PMID: 32047010 PMCID: PMC7044978 DOI: 10.1136/bmjopen-2019-031739] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 01/29/2023] Open
Abstract
INTRODUCTION Chemotherapy may cause infertility in young survivors of breast cancer. Various fertility preservation techniques increase the likelihood of survivors becoming genetic mothers. Disclosure of cancer diagnosis may impact decision making about fertility preservation. This protocol will develop and test the effectiveness of a web-based decision aid for helping women with breast cancer to make well-informed choices about fertility preservation. METHODS AND ANALYSIS This study will be conducted in three phases using mixed methods. In phase I, the aim is to develop a web-based patient decision aid (PDA) in French with a steering committee and using a focus group of five women already treated for breast cancer. In phase II, the face validity of the decision aid will be assessed using questionnaires. In phase III, the PDA will be assessed by a two-arm randomised controlled trial. This will involve a quantitative evaluation of the PDA in clinical practice comparing the quality of the decision-making process between usual care and the PDA. The primary outcome will be informed choice and its components. The secondary outcomes will be decisional conflict and anxiety. Data will be collected during and after an oncofertility consultation. Phase III is underway. Since September 2018, 52 participants have been enrolled in the study and have completed the survey. We expect to have results by February 2020 for a total of 186 patients. ETHICS AND DISSEMINATION This study protocol was approved by the Ouest V Research Ethics Board. Results will be spread through peer-reviewed publications, and reported at suitable meetings. TRIAL REGISTRATION NUMBER The ClinicalTrials.gov registry .(NCT03591848).
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Affiliation(s)
- Alexandra Benoit
- UNICAEN, Inserm U1086, ANTICIPE, Normandie Université, Caen, France
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine-Béclère, Clamart, France
| | - Michael Grynberg
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine-Béclère, Clamart, France
- U1133, Université Paris Diderot, Paris, France
| | - Rémy Morello
- UNICAEN, Inserm U1086, ANTICIPE, Normandie Universite, Caen, France
- Biostatistics and Clinical Research Unit, CHU Caen, Caen, France
| | - Nathalie Sermondade
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Bondy, France
| | - Guillaume Grandazzi
- UNICAEN, Inserm U1086, ANTICIPE, Normandie Universite, Caen, France
- Espace Régional de Réflexion éthique, CHU Caen, Caen, France
| | - Grégoire Moutel
- UNICAEN, Inserm U1086, ANTICIPE, Normandie Universite, Caen, France
- Espace Régional de Réflexion éthique, CHU Caen, Caen, France
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Abstract
The term 'fertility preservation' embraces techniques that are actually mostly based on gamete and gonadal tissue cryopreservation. While the efficiency of these techniques in terms of live births remains difficult to establish, it is remarkable that this ambiguous terminology is routinely used and seems currently well accepted. In order to limit false hopes about the real chances of truly preserving fertility, our medical community should discuss qualifying the term 'fertility preservation'. 'Gamete or gonadal tissue cryopreservation' could appear as a more unambiguous and realistic term. However, it probably captures only a segment of a more global 'fertility preservation' process. Discussing how and when to use which terminology, and even finding a more realistic and unifying term, should be further explored.
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Affiliation(s)
- Michaël Grynberg
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France.,Université Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Nathalie Sermondade
- Department of Reproductive Biology, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France.,Sorbonne Universités, UPMC Université Paris 6, INSERM UMRS 938, Centre de Recherche Saint Antoine, Paris, France
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Sonigo C, Sermondade N, Calvo J, Benard J, Sifer C, Grynberg M. Impact of letrozole supplementation during ovarian stimulation for fertility preservation in breast cancer patients. Eur J Obstet Gynecol Reprod Biol X 2019; 4:100049. [PMID: 31673686 PMCID: PMC6817658 DOI: 10.1016/j.eurox.2019.100049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/09/2019] [Accepted: 05/10/2019] [Indexed: 12/11/2022] Open
Abstract
Objectives Oocyte and/or embryo vitrification after controlled ovarian stimulation (COS) represents the most established method of fertility preservation (FP) before cancer treatment. However, traditional COS regimens are associated with supraphysiologic serum estradiol and are therefore not recommended in estrogen-sensitive diseases such as breast cancer (BC). To protect the patients from the potential deleterious effects of elevated estrogen levels during COS for FP, protocols using aromatase inhibitors (letrozole) were developed. The present study aims at investigating whether COS with letrozole supplementation (COSTLES) modifies ovarian response in BC patients. Study design One hundred and seventy-seven BC patients candidates for FP using oocyte and/or embryo vitrification following COS referred to our center between July 2013 and December 2016 were included in this retrospective case-control study. 94 patients underwent COSTLES while 83 had standard GnRH antagonist protocol. The number of oocytes retrieved, oocyte maturation rates, number of oocytes vitrified and follicle responsiveness to FSH assessed by the Follicular Output Rate (FORT) were assessed. Results Women in both groups were comparable in terms of age and ovarian reserve tests leading to a similar number of oocyte recovered (13.1 ± 10.0 vs. 12.2 ± 8.0 oocytes, respectively, NS). However, oocyte maturation rates were significantly lower in COSTLES compared to standard protocol (64.9 ± 22.8 vs. 77.4 ± 19.3%, p < 0.001). As a result, the number of mature oocyte vitrified was lower in COSTLES group (7.8 ± 5.3 vs. 10.3 ± 8.5 oocytes, p < 0.001 respectively) Conclusion Despite similar response to exogenous FSH, BC patients having undergone COSTLES show reduced oocyte maturation rates in comparison with those having received standard stimulation regimen.
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Affiliation(s)
- Charlotte Sonigo
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, 157, rue de la Porte de Trivaux, 92140 Clamart, France.,Inserm U1185, Univ Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, 94276, France
| | - Nathalie Sermondade
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - Jéremy Calvo
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140, Bondy, France
| | - Julie Benard
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140, Bondy, France
| | - Christophe Sifer
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - Michaël Grynberg
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, 157, rue de la Porte de Trivaux, 92140 Clamart, France.,Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140, Bondy, France.,Univ Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, 94276, France.,Unité Inserm U1133, Université Paris-Diderot, 75013 Paris, France
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Sermondade N, Sonigo C, Sifer C, Valtat S, Ziol M, Eustache F, Grynberg M. Serum antimüllerian hormone is associated with the number of oocytes matured in vitro and with primordial follicle density in candidates for fertility preservation. Fertil Steril 2018; 111:357-362. [PMID: 30527837 DOI: 10.1016/j.fertnstert.2018.10.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/11/2018] [Accepted: 10/18/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To assess whether serum antimüllerian hormone (AMH) levels and antral follicle count (AFC) can predict primordial follicle density within ovarian cortex and the number of oocytes cryopreserved after in vitro maturation (IVM). DESIGN Retrospective analysis of a case series of patients. SETTING University hospital. PATIENT(S) Fifty-four women, 18 to 35 years of age, with breast cancer who were candidates for fertility preservation (FP) using ovarian tissue cryopreservation (OTC) associated with oocyte vitrification after unstimulated IVM between July 2013 and December 2016. INTERVENTION(S) Serum AMH levels and transvaginal AFC evaluated before FP, cumulus-oocyte complexes (COC) recovered under ultrasound guidance and incubated for IVM, and ovarian tissue laparoscopically harvested and cryopreserved. MAIN OUTCOME MEASURE(S) Univariate and multivariate analysis between ovarian reserve tests, number of recovered and in vitro matured oocytes, and primordial follicle density histologically obtained within ovarian cortex. RESULT(S) Univariate analysis showed a statistically significant correlation between AMH or AFC and primordial follicle density. Multivariate analysis showed a predominant statistically significant correlation of serum AMH with density. Antimüllerian hormone also correlated with the number of COC and in vitro matured oocytes. CONCLUSION(S) Serum AMH levels may reflect the primordial follicle stockpile and may predict outcomes of IVM and OTC when performed for FP. Further analyses are required to evaluate the relevance of performing such procedures in young women who have low values on ovarian reserve tests.
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Affiliation(s)
- Nathalie Sermondade
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France.
| | - Charlotte Sonigo
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France; Inserm U1185, Université Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Christophe Sifer
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France
| | - Sophie Valtat
- Inserm UMR1169, Université Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Marianne Ziol
- Service d'Anatomie Pathologique, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France; Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d'Universités et Etablissements Sorbonne Paris Cité, Paris, France
| | - Florence Eustache
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France
| | - Michaël Grynberg
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France; Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d'Universités et Etablissements Sorbonne Paris Cité, Paris, France; Inserm U1133 Université Paris Diderot, Paris, France
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Zeghari F, Sonigo C, Raad J, Sermondade N, Grynberg M. impact of breast cancer prognostic factors on the response to controlled ovarian stimulation patients undergoing fertility preservation. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Herbemont C, Dahoun M, Sermondade N, Cedrin-Durnerin I, Grynberg M, Sifer C. Does oxygen tension influence in vitro maturation of human oocytes in a fertility preservation program? preliminary results of a prospective auto-controlled study. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Raad J, Sonigo C, Sermondade N, Zeghari F, Sifer C, Grynberg M. Influence of breast cancer prognostic factors on in-vitro maturation outcomes in patients seeking urgent fertility preservation. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Therapeutic advances in many medical fields have led to the need to consider patient quality of life after curative medico-surgical treatments for malignancy. Thus, it has become a major issue for young patients to preserve the ability to become "genetic" parents, with their own gametes. While the preservation of male fertility has been an established technique for more than 30 years, it is only in the last decade that progress in cryopreservation techniques has allowed surgeons to offer successful oocyte and ovarian tissue cryobanking. However, in addition to the still experimental nature of some fertility preservation techniques, this practice also raises many ethical and moral questions.
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Affiliation(s)
- C Vinolas
- Service de Médecine de la Reproduction & Préservation de la Fertilité, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - J Raad
- Service de Médecine de la Reproduction & Préservation de la Fertilité, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - C Sonigo
- Service de Médecine de la Reproduction & Préservation de la Fertilité, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - C Sifer
- Service de Cytogénétique et Biologie de la Reproduction, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - N Sermondade
- Service de Cytogénétique et Biologie de la Reproduction, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - M Grynberg
- Service de Médecine de la Reproduction & Préservation de la Fertilité, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France; Université Paris XIII, 93000 Bobigny, France; Unité Inserm U1133, Université Paris-Diderot, 75013 Paris, France.
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Abstract
Recent advances in fertility preservation (FP) techniques have led to a wide spread of indications. FP should now be discussed not only for young girls having to receive gonadotoxic treatments for cancer, but also for those with genetic or endocrine disorders, as well as benign ovarian diseases at risk of premature ovarian insufficiency. For premenarchal girls, ovarian tissue cryopreservation is still the only available technique. Oocyte cryopreservation after ovarian stimulation could be offered to postmenarchal girls. Whenever possible, the parents and the young patient should be informed of the benefits to be expected, as well as of the risks and limits of FP for children.
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Herbemont C, Sarandi S, Boujenah J, Cedrin-Durnerin I, Sermondade N, Vivot A, Poncelet C, Grynberg M, Sifer C. Should we consider day-2 and day-3 embryo morphology before day-5 transfer when blastocysts reach a similar good quality? Reprod Biomed Online 2017; 35:521-528. [DOI: 10.1016/j.rbmo.2017.07.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 07/06/2017] [Accepted: 07/25/2017] [Indexed: 10/19/2022]
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Grynberg M, Raad J, Sifer C, Sermondade N, Sonigo C. BRCA 1/2 gene mutations do not affect the capacity of cumulo-oocyte-complexes to mature in vitro in breast cancer candidates for fertility preservation. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pocate-Cheriet K, Heilikman I, Porcher R, Barraud-Lange V, Sermondade N, Herbemont C, Wolf JP, Sifer C. Predicting the clinical outcome of ICSI by sperm head vacuole examination. Syst Biol Reprod Med 2016; 63:29-36. [DOI: 10.1080/19396368.2016.1261203] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Ilan Heilikman
- Jean Verdier University Hospital, IVF Laboratory Unit, Bondy, France
| | - Raphael Porcher
- Saint-Louis University Hospital, Bio-statistical analysis unit, Paris, France
| | | | | | | | - Jean Philippe Wolf
- Cochin-Port Royal University Hospital, IVF Laboratory Unit, Paris, France
| | - Christophe Sifer
- Jean Verdier University Hospital, IVF Laboratory Unit, Bondy, France
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Sonigo C, Sermondade N, Grynberg M. Letter in reply to "Fertility preservation before an ABVD protocol: no new evidence to support changing the recommendations". Future Oncol 2016; 13:591-592. [PMID: 27928934 DOI: 10.2217/fon-2016-0507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Charlotte Sonigo
- Department of Reproductive Medicine & Fertility Preservation, Hôpital Jean-Verdier, Avenue du 14 Juillet, 93140 Bondy, France.,Université Paris XIII, 93000 Bobigny, France
| | - Nathalie Sermondade
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean-Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - Michaël Grynberg
- Department of Reproductive Medicine & Fertility Preservation, Hôpital Jean-Verdier, Avenue du 14 Juillet, 93140 Bondy, France.,Université Paris XIII, 93000 Bobigny, France.,Unité Inserm U1133, Université Paris-Diderot, 75013 Paris, France
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Sifer C, Sellam-Chokron O, Sermondade N, Cedrin-Durnerin I, Sonigo C, Herbemont C, Grynberg M. Should metaphase 1 and 2 stages oocytes be vitrified in the same time for fertility preservation? Future Oncol 2016; 12:2297-305. [DOI: 10.2217/fon-2016-0096] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Aims: Could metaphase 1 (M1) and 2 (M2) stages oocytes from in vitro maturation (IVM) cycles and controlled-ovarian hyperstimulation (COH) cycles be frozen at the same time without any adverse effect of vitrification on further survival (SR) and maturation rates (MR)? Materials & methods: M1 from cancer patients were prospectively included in IVM/COH groups, and in study or control subgroups if they were vitrified or not. In each study subgroup, SR were compared with that of M2 oocytes vitrified/warmed from egg donors. MR were compared with those of fresh-M1 oocytes from control IVM/COH subgroups. Results: SR were not different between groups. MR compared respectively between survived- and fresh-M1 oocytes were similar when resulting from COH (85.2 vs 81.1%) but significantly lower after IVM (39.1 vs 73.3%). Conclusion: Simultaneous freezing of M1/M2 oocytes could be applied to COH but not to IVM during the course of fertility preservation.
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Affiliation(s)
- Christophe Sifer
- Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique – Hôpitaux de Paris, 93143 Bondy, France
- UFR de Santé, Médecine et Biologie Humaine, Université Paris 13, 93017 Bobigny Cedex, France
- Unité de Recherche en Epidémiologie Nutritionnelle, UMR U557 Inserm; U1125 Inra; Cnam; Université Paris 13, CRNH IdF, 93017 Bobigny, France
| | - Olivia Sellam-Chokron
- Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique – Hôpitaux de Paris, 93143 Bondy, France
| | - Nathalie Sermondade
- Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique – Hôpitaux de Paris, 93143 Bondy, France
| | - Isabelle Cedrin-Durnerin
- Service de Médecine de la Reproduction, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique – Hôpitaux de Paris, 93143 Bondy, France
| | - Charlotte Sonigo
- UFR de Santé, Médecine et Biologie Humaine, Université Paris 13, 93017 Bobigny Cedex, France
- Service de Médecine de la Reproduction, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique – Hôpitaux de Paris, 93143 Bondy, France
| | - Charlène Herbemont
- Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique – Hôpitaux de Paris, 93143 Bondy, France
- UFR de Santé, Médecine et Biologie Humaine, Université Paris 13, 93017 Bobigny Cedex, France
| | - Michael Grynberg
- UFR de Santé, Médecine et Biologie Humaine, Université Paris 13, 93017 Bobigny Cedex, France
- Service de Médecine de la Reproduction, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique – Hôpitaux de Paris, 93143 Bondy, France
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