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Gambini S, Sonigo C, Robin G, Cedrin-Durnerin I, Vinolas C, Sifer C, Boumerdassi Y, Mayeur A, Gallot V, Grynberg M, Peigné M. Risk factors for poor oocyte yield and oocyte immaturity after GnRH agonist triggering. Hum Reprod 2024; 39:963-973. [PMID: 38452353 DOI: 10.1093/humrep/deae041] [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: 06/21/2023] [Revised: 12/20/2023] [Indexed: 03/09/2024] Open
Abstract
STUDY QUESTION What are the potential risk factors for poor oocyte recuperation rate (ORR) and oocyte immaturity after GnRH agonist (GnRHa) ovulation triggering? SUMMARY ANSWER Lower ovarian reserve and LH levels after GnRHa triggering are risk factors of poor ORR. Higher BMI and anti-Müllerian hormone (AMH) levels are risk factors of poor oocyte maturation rate (OMR). WHAT IS KNOWN ALREADY The use of GnRHa to trigger ovulation is increasing. However, some patients may have a suboptimal response after GnRHa triggering. This suboptimal response can refer to any negative endpoint, such as suboptimal oocyte recovery, oocyte immaturity, or empty follicle syndrome. For some authors, a suboptimal response to GnRHa triggering refers to a suboptimal LH and/or progesterone level following triggering. Several studies have investigated a combination of demographic, clinical, and endocrine characteristics at different stages of the treatment process that may affect the efficacy of the GnRHa trigger and thus be involved in a poor endocrine response or efficiency but no consensus exists. STUDY DESIGN, SIZE, DURATION Bicentric retrospective cohort study between 2015 and 2021 (N = 1747). PARTICIPANTS/MATERIALS, SETTING, METHODS All patients aged 18-43 years who underwent controlled ovarian hyperstimulation and ovulation triggering by GnRHa alone (triptorelin 0.2 mg) for ICSI or oocyte cryopreservation were included. The ORR was defined as the ratio of the total number of retrieved oocytes to the number of follicles >12 mm on the day of triggering. The OMR was defined as the ratio of the number of mature oocytes to the number of retrieved oocytes. A logistic regression model with a backward selection method was used for the analysis of risk factors. Odds ratios (OR) are displayed with their two-sided 95% confidence interval. MAIN RESULTS AND THE ROLE OF CHANCE In the multivariate analysis, initial antral follicular count and LH level 12-h post-triggering were negatively associated with poor ORR (i.e. below the 10th percentile) (OR: 0.61 [95% CI: 0.42-0.88]; P = 0.008 and OR: 0.86 [95% CI: 0.76-0.97]; P = 0.02, respectively). A nonlinear relationship was found between LH level 12-h post-triggering and poor ORR, but no LH threshold was found. A total of 25.3% of patients suffered from oocyte immaturity (i.e. OMR < 75%). In the multivariate analysis, BMI and AMH levels were negatively associated with an OMR < 75% (OR: 4.34 [95% CI: 1.96-9.6]; P < 0.001 and OR: 1.22 [95% CI: 1.03-1.12]; P = 0.015, respectively). Antigonadotrophic pretreatment decreased the risk of OMR < 75% compared to no pretreatment (OR: 0.72 [95% CI: 0.57-0.91]; P = 0.02). LIMITATIONS, REASONS FOR CAUTION Our study is limited by its retrospective design and by the exclusion of patients who had hCG retriggers. However, this occurred in only six cycles. We were also not able to collect information on the duration of pretreatment and the duration of wash out period. WIDER IMPLICATIONS OF THE FINDINGS In clinical practice, to avoid poor ORR, GnRHa trigger alone should not be considered in patients with higher BMI and/or low ovarian reserve, balanced by the risk of ovarian hyperstimulation syndrome. In the case of a low 12-h post-triggering LH level, practicians must be aware of the risk of poor ORR, and hCG retriggering could be considered. STUDY FUNDING/COMPETING INTEREST(S) None. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- S Gambini
- Assistance Publique-Hôpitaux de Paris (APHP), Université Sorbonne Paris Nord, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean-Verdier, Bondy, France
| | - C Sonigo
- Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Saclay, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Antoine Béclère, Clamart, France
| | - G Robin
- CHU de Lille, Université de Lille, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jeanne de Flandre, Lille, France
| | - I Cedrin-Durnerin
- Assistance Publique-Hôpitaux de Paris (APHP), Université Sorbonne Paris Nord, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean-Verdier, Bondy, France
| | - C Vinolas
- Assistance Publique-Hôpitaux de Paris (APHP), Université Sorbonne Paris Nord, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean-Verdier, Bondy, France
| | - C Sifer
- Assistance Publique-Hôpitaux de Paris (APHP), Université Sorbonne Paris Nord, Unité de Biologie de la Reproduction, Hôpital Jean-Verdier, Bondy, France
| | - Y Boumerdassi
- Assistance Publique-Hôpitaux de Paris (APHP), Université Sorbonne Paris Nord, Unité de Biologie de la Reproduction, Hôpital Jean-Verdier, Bondy, France
| | - A Mayeur
- Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Saclay, Service de Biologie de la Reproduction, Hôpital Antoine Béclère, Clamart, France
| | - V Gallot
- Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Saclay, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Antoine Béclère, Clamart, France
| | - M Grynberg
- Assistance Publique-Hôpitaux de Paris (APHP), Université Sorbonne Paris Nord, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean-Verdier, Bondy, France
- Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Saclay, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Antoine Béclère, Clamart, France
| | - M Peigné
- Assistance Publique-Hôpitaux de Paris (APHP), Université Sorbonne Paris Nord, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean-Verdier, Bondy, France
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Sarandi S, Boumerdassi Y, O'Neill L, Puy V, Sifer C. [Interest of iDAScore (intelligent Data Analysis Score) for embryo selection in routine IVF laboratory practice: Results of a preliminary study]. Gynecol Obstet Fertil Senol 2023; 51:372-377. [PMID: 37271479 DOI: 10.1016/j.gofs.2023.05.001] [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: 10/06/2022] [Revised: 04/11/2023] [Accepted: 05/15/2023] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Embryo selection is a major challenge in ART, especially since the generalization of single embryo transfer, and its optimization could lead to the improvement of clinical results in IVF. Recently, several Artificial Intelligence (AI) models, based on deep-learning such as iDAScore, have been developed. These models, trained on time-lapse videos of embryos with known implantation data, can predict the probability of pregnancy for a given embryo, allowing automatization and standardization in embryo selection. MATERIAL AND METHODS In this study, we have compared the hierarchical categorization of 311 D5 blastocysts of iDAScore v1.0 and the embryologists of our unit. These 311 D5 blastocysts have been classified as top (70.1%), good (Q+: 10.6%) and poor (Q-: 19.3%) quality by embryologists according to Gardner classification. Median iDAScores were [9.9-8.4],]8.4-7.5] and]7.5-2.1] for top, good and poor-quality blastocysts respectively. RESULTS We observed a significantly concordant categorization between iDAScore and embryologists for top, good and poor-quality blastocysts (respectively, 89.5, 36.4 and 48.3%, P < 10-4). Moreover, the hierarchical categorization of the three best blastocysts between iDAScore and the embryologists was as follow: 1st rank: 71.9%; 2nd rank: 61.6%; 3rd rank: 56.8% (P=0.07). One hundred and fifty-one blastocysts with known implantation data were analyzed. The iDAScore of blastocysts that implanted was significantly higher than those that did not implant (implantation+: 9.10±0.57; implantation-: 8.70±0.95, P=0.003). CONCLUSION This preliminary study shows that iDAScore is able to perform a reproducible, reliable and immediate hierarchical classification of blastocysts. Moreover, this tool can identify the blastocysts with the highest implantation potential. If these results confirmed on a larger scale of embryos and patients, IA could revolutionize IVF laboratories by standardizing embryo hierarchical selection.
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Affiliation(s)
- S Sarandi
- Service d'histologie-embryologie-cytogénétique-CECOS, centre hospitalier universitaire Jean-Verdier, AP-HP, avenue du 14-Juillet, 93140 Bondy, France
| | - Y Boumerdassi
- Service d'histologie-embryologie-cytogénétique-CECOS, centre hospitalier universitaire Jean-Verdier, AP-HP, avenue du 14-Juillet, 93140 Bondy, France; Université Sorbonne Paris Nord, 93000 Bobigny, France
| | - L O'Neill
- Service d'histologie-embryologie-cytogénétique-CECOS, centre hospitalier universitaire Jean-Verdier, AP-HP, avenue du 14-Juillet, 93140 Bondy, France
| | - V Puy
- Service d'histologie-embryologie-cytogénétique-CECOS, centre hospitalier universitaire Jean-Verdier, AP-HP, avenue du 14-Juillet, 93140 Bondy, France; Université Sorbonne Paris Nord, 93000 Bobigny, France
| | - C Sifer
- Service d'histologie-embryologie-cytogénétique-CECOS, centre hospitalier universitaire Jean-Verdier, AP-HP, avenue du 14-Juillet, 93140 Bondy, France.
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Labrosse J, Sifer C, Cedrin I, Peigne M, Grynberg M. P-625 In vitro maturation of oocytes: a breakthrough for treating infertility in inactivating mutation of the luteinizing hormone/choriogonadotropin receptor. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.574] [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
How can pregnancy and live birth be achieved in patients with inactivating homozygous luteinizing hormone/choriogonadotropin receptor (LHCGR) mutation?
Summary answer
We report the first live birth after in vitro maturation (IVM) in a patient with a novel homozygous inactivating LHCGR mutation (exon 6, c.470 A>G).
What is known already
LH plays a fundamental role in female reproductive physiology and is responsible for steroidogenesis, oocyte maturation, ovulation and subsequent progesterone production by the corpus luteum. LH binds to the LHCGR located on the membrane of theca cells and mature granulosa cells. Inactivating mutations of the LHCGR lead to the impossibility to obtain final oocyte maturation both during natural cycles and after ovarian stimulation for in vitro fertilization purposes. Therefore, egg donation represents the only option for treating their infertility.
Study design, size, duration
A case report.
Participants/materials, setting, methods
A 35 year-old nulliparous patient referred to our university hospital for primary infertility.
Main results and the role of chance
The 35-year-old nulliparous patient presented with primary spaniomenorrhea but timely and spontaneous onset of secondary sexual characteristics. Serum LH levels were high (ranging from 15 to 30 IU/L) and to a lesser extent so were FSH levels. The ovarian reserve was normal for age, as assessed by serum AMH levels and ultrasound. There was no argument for polycystic ovarian syndrome, 21-hydroxylase deficiency, Cushing’s syndrome or hyperprolactinemia. Two previous attempts of controlled ovarian stimulation with gonadotropins and ovulation trigger with hCG and GnRH-agonist trigger had failed, resulting in low estradiol levels despite correct follicular growth on ultrasound and absence of ovulation after trigger. However, genetic analysis identified a novel homozygous inactivating LHCGR mutation (exon 6, c.470A>G) which had never been described previously. IVM was performed. A total of 7 oocytes were obtained after IVM, resulting in 4 Day 3 embryos. All embryos were frozen. Subsequently, 2 Day 3 embryos were replaced after endometrial preparation by hormone replacement therapy. The patient became pregnant and gave birth to a healthy baby. Two Day 3 embryos remain.
Limitations, reasons for caution
By definition, a case-report requires further studies to confirm our findings.
Wider implications of the findings
We describe a novel inactivating LHCGR mutation with subsequent live birth after IVM. As a growing number of gonadotropin receptor mutations are identified, this successfully achieved live birth places IVM as the only reliable option for these patients to conceive with their own eggs.
Trial registration number
Not applicable.
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Affiliation(s)
- J Labrosse
- Hopital Jean Verdier - Assistance Publique Hopitaux de Paris, Reproductive Medicine and Fertility Preservation , Bondy, France
| | - C Sifer
- Hopital Jean Verdier - Assistance Publique Hopitaux de Paris, Reproductive Biology , Bondy, France
| | - I Cedrin
- Hopital Jean Verdier - Assistance Publique Hopitaux de Paris, Reproductive Medicine and Fertility Preservation , Bondy, France
| | - M Peigne
- Hopital Jean Verdier - Assistance Publique Hopitaux de Paris, Reproductive Medicine and Fertility Preservation , Bondy, France
| | - M Grynberg
- Hopital Jean Verdier - Assistance Publique Hopitaux de Paris, Reproductive Medicine and Fertility Preservation , Bondy, France
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Sarandi S, Labrosse J, Hammami F, Arumugam V, Bennani Smires B, Puy V, Vinolas C, Cedrin-Durnerin I, Peigne M, Grynberg M, Sifer C. P-254 Is Intelligent Data Analysis-score (IDA-score) a useful tool in daily routine IVF laboratory practice to select embryos? Preliminary results of an external independent series. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.244] [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
Is IDA-score a useful tool to accurately classify embryos?
Summary answer
IDA-score is a reliable tool to categorize embryos into top/good/poor morphological quality. However, hierarchical classification of embryos between IDA-score and embryologists was significantly different.
What is known already
Since Preimplantation Genetic Test for aneuploidy is not authorized in France, morphological scoring by embryologists is the only way to select blastocysts for transfer at Day-5. However, morphological scoring cannot perfectly predict implantation likelihood. Promising recent artificial intelligence techniques might improve both hierarchical classification and clinical outcomes. For instance, IDA-score combined with Embryoscope (Vitrolife®) has been suggested as a way to objectively compare a given embryo to a large embryo dataset and generate a score that predicts the likelihood of implantation using a deep-learning approach. So far, no external independent analysis compares the accuracy of this score with human performance.
Study design, size, duration
This retrospective-monocentric-study was performed in our reproductive medicine unit from September to December 2021. A total of 167 embryos from 58 couples undergoing ICSI were monitored on a daily-basis and scored at Day-5 by IDA-score and morphological scoring by a panel of senior-embryologists blinded from results of IDA-score. In all, 52 single embryos selected by embryologists were transferred during fresh or frozen cycles. Clinical pregnancy rates were defined by presence of fetal heartbeat on ultrasound.
Participants/materials, setting, methods
Each embryo was monitored and scored at Day-5 by both morphological scoring and IDA-score. Only the best 3 embryos were ranked and compared. Morphological score was based on Gardner-and-Schoolcraft grading system and classified according to morphological score as top-quality (≥B4BB), good-quality (≥B3BB) and poor-quality (<B3BB;trophectoderm/inner-cell-mass:CC) embryos. IDA-scores were ranged from 1-10. We compared hierarchical classification by IDA-score and embryologists using appropriate statistical tests and IDA-scores of transferred blastocysts with successful implantation and those without.
Main results and the role of chance
The mean age of women was 33.96±0.66 years. Morphological scoring led to 68.8% (115/167) top quality embryos, 80.2% (134/167) good quality embryos and 19.8% (33/167) poor quality embryos. Mean IDA-scores of embryos were respectively 9.06 ± 0.48 for top-quality, 8.72 ± 0.62 for good-quality and 7.12 ± 1.34 for poor-quality blastocysts (global p <10-4). However, concerning hierarchical classification, there was a significant lack of global accuracy between IDA-scores and embryologists regarding the 3 best embryos of the cohort (68.3%; p <10-4). Similarly, there was a significant lack of accuracy to classify embryos belonging to the same quality group (67.8% (78/115) for top-quality; 64.9% (87/134) for good-quality; 81.8% (27/33) for poor-quality). We obtained a clinical pregnancy rate of 38.4% (20/52) per transfer. We failed to observe any statistically significant difference between embryos transferred that implanted (8.92 ± 0.79) and embryos that did not implant (8.69 ± 0.93; p = 0.37) according to IDA-scores. However, IDA-scores tended to be higher in case of clinical pregnancy. In order for the observed difference of 0.2 in IDA-scores to reach the level of significance, at least 674 embryos should be transferred.
Limitations, reasons for caution
These results should be interpreted with caution due to the retrospective design of the study and small effectives.
Wider implications of the findings
We present preliminary results of an external independent series to confirm the efficiency of IDA-score in daily routine practice. Since IDA-score is not consistent with human scoring concerning hierarchical classification, its performance has to be further assessed to clearly establish the input of artificial intelligence in IVF laboratory practice.
Trial registration number
not applicable
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Affiliation(s)
- S Sarandi
- Hopital Jean Verdier - Assistance Publique Hopitaux de Paris, Reproductive Biology , Bondy, France
| | - J Labrosse
- Hopital Jean Verdier - Assistance Publique Hopitaux de Paris, Reproductive Medicine and Fertility Preservation , Bondy, France
| | - F Hammami
- Hopital Jean Verdier - Assistance Publique Hopitaux de Paris, Reproductive Biology , Bondy, France
| | - V Arumugam
- Hopital Jean Verdier - Assistance Publique Hopitaux de Paris, Reproductive Biology , Bondy, France
| | - B Bennani Smires
- Hopital Jean Verdier - Assistance Publique Hopitaux de Paris, Reproductive Biology , Bondy, France
| | - V Puy
- Hopital Jean Verdier - Assistance Publique Hopitaux de Paris, Reproductive Biology , Bondy, France
| | - C Vinolas
- Hopital Jean Verdier - Assistance Publique Hopitaux de Paris, Reproductive Medicine and Fertility Preservation , Bondy, France
| | - I Cedrin-Durnerin
- Hopital Jean Verdier - Assistance Publique Hopitaux de Paris, Reproductive Medicine and Fertility Preservation , Bondy, France
| | - M Peigne
- Hopital Jean Verdier - Assistance Publique Hopitaux de Paris, Reproductive Medicine and Fertility Preservation , Bondy, France
| | - M Grynberg
- Hopital Jean Verdier - Assistance Publique Hopitaux de Paris, Reproductive Medicine and Fertility Preservation , Bondy, France
| | - C Sifer
- Hopital Jean Verdier - Assistance Publique Hopitaux de Paris, Reproductive Biology , Bondy, France
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Boumerdassi Y, Sadoun M, Bouyer J, Bennani Smires B, Sarandi S, Vinolas C, Cedrin-Durnerin I, Labrosse J, Eustache F, Peigné M, Grynberg M, Sifer C. P-276 Embryo development of fresh versus vitrified metaphase II oocytes in low prognosis patients: a retrospective sibling-oocyte monocentric study. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.265] [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
Do fresh and vitrified/warmed oocytes have the same developmental potential in low prognosis patients defined by POSEIDON criteria?
Summary answer
Embryos derived from vitrified/warmed oocytes show lower competence for embryo development when compared to those obtained from fresh oocytes in low prognosis patients.
What is known already
The strategy of oocyte accumulation has been proposed for the management of low-prognosis patients with the aim to increase the number of oocytes available for fertilization and further the number of embryos.
The effect of oocyte vitrification/warming on the embryo developmental potential has mainly been studied in oocyte donation programs. Investigations on sibling-oocyte failed to show difference in the morphological embryo development, but the evaluation stopped after 2-3 days of embryo culture. In addition, morphokinetic evaluation revealed delayed development of embryos derived from vitrified oocytes, from the first cleavage to the time of blastulation.
Study design, size, duration
Single-center sibling-oocyte retrospective monocentric study including low-prognosis patients, defined by POSEIDON criteria, who had undergone an accumulation of oocyte strategy for managing their infertility, between November 2013 and January 2021. Only patients presenting fresh and vitrified/warmed oocytes at the time of insemination were analyzed for the sibling-oocyte comparison. Main study outcomes were fertilization, cleavage, blastulation rates, day-2 and day-5 embryo quality, and the rate of embryos available for transfer/cryopreservation.
Participants/materials, setting, methods
Forty-five patients were included, with a mean age of 34.8 ± 3.4 years. Oocyte vitrification/warming was performed using the Cryotop method. Top-quality and good-quality embryos were defined at day-2 respectively as 4 and 3-5 adequate-sized blastomeres, without multinucleation and containing <20% of cytoplasmic fragmentation, and at day-5 according to Gardner and Schoolcraft’s classification, top ≥B4 (AB/BA/AA) and good ≥ B3BB. Statistical analyses used mixed effects logistic regression to take into account the sibling-oocyte design.
Main results and the role of chance
A total of 656 oocytes were inseminated, 225 fresh and 431 vitrified/warmed oocytes. The oocyte survival rate after warming was 82%, 95%CI [76-87%]. There was no difference between fresh and vitrified/warmed oocytes groups regarding the degeneration rate following ICSI (5.0% vs 4.8% respectively, p = 0.95), the fertilization rate (74.6% vs 71.4% respectively, p = 0.42) or the cleavage rate on day-2 (98.3% vs 95.4% respectively, p = 0.15). However, the embryo development was significantly different from day 2, with higher day 2 top-quality and good-quality embryos rates in the fresh oocytes group when compared to the vitrified/warmed oocytes group (top-quality: 38.3% vs 24.8% respectively, p = 0.01; good-quality 58.0% vs 45.2% respectively, p = 0.02). The same results were observed on blastocysts when extended culture was decided, with a higher blastulation rate in the fresh oocyte group (56.7% vs 31.7% respectively, p < 0.001) and higher top-quality and good-quality day 5 blastocyst rate (top-quality: 23.4% vs 5.6% respectively, p = 0.01; good-quality 23.9% vs 7.9%, p = 0.01).The rate of embryos available for transfer/cryostorage was similar in both groups (40,7 % vs 38,8 %, p = 0,71). The cumulative live-birth rate was 33,3% (4/45 from vitrified oocytes group, 5/45 from fresh oocytes group, 6/45 from mixed oocytes group).
Limitations, reasons for caution
The retrospective nature of the study, on a limited number of limited number of patients represents an inherent limitation. Embryo assessment was subjective, the evaluator knowing the oocyte’s source group. The impact of the morphological alterations observed in embryos derived from vitrified/warmed oocytes need to be confirmed with clinical outcomes.
Wider implications of the findings
The majority of studies comparing fresh and vitrified/warmed oocytes were performed in egg-donation programs. This study focuses on low-prognosis patients, who reflect perhaps more the patients who consult in ART centers. Further prospective studies are needed to confirm our findings.
Trial registration number
Not applicable
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Affiliation(s)
- Y Boumerdassi
- Hôpital Jean -Verdier, Cytogenetic and Reproductive Biology , Bondy, France
| | - M Sadoun
- Hôpital Jean -Verdier, Department of Reproductive Medicine and Fertility Preservation , Bondy, France
| | - J Bouyer
- Centre de recherche en épidémiologie et santé des populations CESP , Inserm U1018, Paris, France
| | - B Bennani Smires
- Hôpital Jean -Verdier, Cytogenetic and Reproductive Biology , Bondy, France
| | - S Sarandi
- Hôpital Jean -Verdier, Cytogenetic and Reproductive Biology , Bondy, France
| | - C Vinolas
- Hôpital Jean -Verdier, Department of Reproductive Medicine and Fertility Preservation , Bondy, France
| | - I Cedrin-Durnerin
- Hôpital Jean -Verdier, Department of Reproductive Medicine and Fertility Preservation , Bondy, France
| | - J Labrosse
- Hôpital Jean -Verdier, Department of Reproductive Medicine and Fertility Preservation , Bondy, France
| | - F Eustache
- Hôpital Jean -Verdier, Department of Reproductive Medicine and Fertility Preservation , Bondy, France
| | - M Peigné
- Hôpital Jean -Verdier, Department of Reproductive Medicine and Fertility Preservation , Bondy, France
| | - M Grynberg
- Hôpital Jean -Verdier, Department of Reproductive Medicine and Fertility Preservation , Bondy, France
| | - C Sifer
- Hôpital Jean -Verdier, Cytogenetic and Reproductive Biology , Bondy, France
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Grynberg M, Amsellem N, Mayeur A, Laup L, Pistilli B, Delaloge S, Sifer C, Sonigo C. O-195 Disease-free survival is not impacted by fertility preservation techniques for breast cancer women. Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.109] [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 fertility preservation (FP) strategies using ovarian stimulation or not, impact long-term disease-free survival of breast cancer (BC) patients?
Summary answer
The disease-free survival of BC patients is not impacted by FP techniques whatever the timing of chemotherapy (neoadjuvant /adjuvant) and the use of ovarian stimulation.
What is known already
Fertility is often impaired in young women treated for BC. Therefore, FP has become a major issue in this population. Cryopreservation of oocytes or embryos after controlled ovarian hyperstimulation (COH) represents the most established method in this clinical situation. However, the hormonal consequences of COH protocols still raise safety concerns, often leading oncologists to contraindicate the use of this FP technique. Although alternative FP options without exogenous hormone administration may be considered, they remain suboptimal for treating the putative future infertility.
Study design, size, duration
Retrospective bicentric cohort study including including 740 BC women, 18-43 years of age, referred for FP between 2013 and 2019.
Participants/materials, setting, methods
Overall, 328 underwent at least one ovarian stimulation cycle (STIM group) and 412 had a technique without hormonal administration (No STIM group). Log Rank test was used to compare both groups and Cox proportional-hazard model was applied for multivariable analyses.
Main results and the role of chance
Women of the No STIM group were significantly younger and present with more severe disease. Follow-up data for recurrences were available for 80.9% of the cohort and the median time to follow-up was 4.2 [2.9-5.8] vs. 5.6 [4.1-6.7] years between STIM and No STIM group (p < 0.0001). According to log-rank test, the risk of recurrence did not differ between the two groups (p = 0.09) even after adjustment on age, SBR grade, triple negative status or type of planned chemotherapy.
Limitations, reasons for caution
The retrospective nature of the study represents the main limitation. The median follow-up of 4.2 to 5.6 years, might be considered short to assess the long-term safety of FP techniques. The heterogeneity between oncological centers regarding the use of COH and specific protocols may lalso be a reason for caution.
Wider implications of the findings
Our findings provide reassuring safety data on the use COH for FP in BC patients, whatever the timing of chemotherapy. However, further investigations with a longer follow-up are needed to definitely consider COH safe in particular in neoadjuvant situations. In addition, the benefit of letrozole supplementation during COH requires confirmation.
Trial registration number
Not applicable
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Affiliation(s)
- M Grynberg
- Hôpital Antoine Béclère, Reproductive Medicine & Fertility Preservation , Clamart, France
| | - N Amsellem
- Antoine Béclère UNiversity Hospital, Reproductive Medicine & Fertility Preservation , Clamart, France
| | - A Mayeur
- Antoine Béclère University Hospital, Histology-Embryology-Cytogenetic Laboratory , Clamart, France
| | - L Laup
- Jean Verdier University Hospital, Reproductive Medicine & Fertility Preservation , Bondy, France
| | - B Pistilli
- Gustave Roussy Institute, Department of Medical Oncology , Villejuif, France
| | - S Delaloge
- Gustave Roussy Hospital, Department of Medical Oncology , Villejuif, France
| | - C Sifer
- Jean Verdier University Hospital, Reproductive Biology and Cytogenetic , Bondy, France
| | - C Sonigo
- Antoine Béclère Hospital, Reproductive Medicine & Fertility Preservation , Clamart, France
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Sellami I, Grynberg M, Benoit A, Sifer C, Mayeur A, Sonigo C. O-180 Oocyte vitrification for fertility preservation does not delay the initiation of neoadjuvant chemotherapy for breast cancer. Hum Reprod 2021. [DOI: 10.1093/humrep/deab127.081] [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
Does oocyte vitrification for fertility preservation (FP) delay the initiation of neoadjuvant chemotherapy for breast cancer?
Summary answer
The indication of neoadjuvant chemotherapy for breast cancer should not be considered as an impediment to urgent oocyte vitrification for FP.
What is known already
FP is considered as one of the most important issues to address for young breast cancer patients. Cryopreservation of oocytes or embryos may be considered after controlled ovarian hyperstimulation (COH) or in vitro maturation (IVM). Pregnancies have been reported after reutilization of oocytes frozen following both procedures. Although oocyte competence is better after COH, this strategy requires on average 13 days to be achieved. In addition, the safety of ovarian stimulation before tumor removal is currently not formally established. In case of neoadjuvant chemotherapy, the risk-benefit balance of COH is not well known.
Study design, size, duration
Retrospective cohort study including all breast cancer patients eligible for oocyte vitrification following COH or IVM before initiation of neoadjuvant chemotherapy between January 2016 and December 2020.
Participants/materials, setting, methods
Inclusion criteria were: female patients with confirmed non metastatic breast cancer, 18 to 40 years of age, with indication of neoadjuvant chemotherapy, who have had oocyte retrieval for FP after COH or IVM +/- cryopreservation of ovarian tissue. Various time-points related to cancer diagnosis, FP or chemotherapy were obtained from medical record review.
Main results and the role of chance
A total of 198 patients with confirmed breast cancer who had oocyte retrieval following COH (n = 57) or IVM +/- cryopreservation of ovarian tissue (n = 141) for FP prior to neoadjuvant chemotherapy were included. Although women in IVM group were significantly younger as compared to patients who underwent COH (31.7 ± 4.2 vs. 33.3 ± 4.0 years, p = 0.019), ovarian reserve parameters, BMI and cancer stage did not differ between the two groups. Overall, the average time from cancer diagnosis to chemotherapy start was similar between patients having undergone COH or IVM before oocyte vitrification (37.3 ± 13.8 vs. 36.9 ±13.5 days in COH and IVM groups respectively, p=0.857).
Limitations, reasons for caution
The time from referral to FP consultation may have influenced the type of FP. In addition, the retrospective nature of the present analysis may constitute a limitation. Moreover, the efficiency and security of the different FP strategies used has not been analysed.
Wider implications of the findings
Oocyte vitrification following COH or IVM was not associated with delayed breast cancer treatment in the neoadjuvant setting, so long as there was a prompt FP referral. Young patients undergoing neoadjuvant chemotherapy should be informed of these findings to avoid unnecessary anxiety due to concern for delays.
Trial registration number
Not applicable
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Affiliation(s)
- I Sellami
- Antoine Beclere Hospital, Reproductive Medicine and fertility preservation, Clamart, France
| | - M Grynberg
- Antoine Beclere Hospital, Reproductive Medicine and fertility preservation, Clamart, France
| | - A Benoit
- Antoine Beclere Hospital, Reproductive Medicine and fertility preservation, Clamart, France
| | - C Sifer
- Jean Verdier Hospital, Reproductive Medicine and fertility preservation, Bondy, France
| | - A Mayeur
- Antoine Beclere Hospital, Reproductive Medicine and fertility preservation, Clamart, France
| | - C Sonigo
- Antoine Beclere Hospital, Reproductive Medicine and fertility preservation, Clamart, France
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Cedri. . Durnerin I, Peigné M, Labrosse J, Guerout M, Vinolas C, Sadoun M, Laup L, Bennan. Smires B, Sarandi S, Sifer C, Grynberg M. P–595 Systematic dydrogesterone supplementation of artificial endometrial preparation cycles for frozen-thawed embryo transfer during Covid–19 pandemic: a good way to limit monitoring visits and optimize outcomes. Hum Reprod 2021. [PMCID: PMC8385879 DOI: 10.1093/humrep/deab130.594] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Study question Does systematic dydrogesterone supplementation in artificial cycles (AC) for frozen-thawed embryo transfer (FET) during Covid–19 pandemic modify outcomes compared to prior individualized supplementation adjusted on serum progesterone (P) levels ? Summary answer Systematic dydrogesterone supplementation in AC for FET is associated with similar outcomes compared to prior individualized supplementation in patients with low P levels. What is known already In AC for FET using vaginal P for endometrial preparation, low serum P levels following P administration have been associated with decreased pregnancy and live birth rates. This deleterious effect can be overcome by addition of other routes of P administration. We obtained effective results by adding dydrogesterone to vaginal P and postponing FET by one day in patients with low P levels. However, in order to limit patient monitoring visits and to schedule better FET activity during Covid–19 pandemic, we implemented a systematic dydrogesterone supplementation without luteal P measurement in artificial FET cycles. Study design, size, duration This retrospective study aimed to analyse outcomes of 394 FET after 2 different protocols of artificial endometrial preparation. From September 2019 to Covid–19 lockdown on 15th March 2020, patients had serum P level measured on D1 of vaginal P administration. When P levels were < 11 ng/ml, dydrogesterone supplementation was administered and FET was postponed by one day. From May to December 2020, no P measurement was performed and dydrogesterone supplementation was systematically used. Participants/materials, setting, methods In our university hospital, endometrial preparation was performed using sequential administration of vaginal estradiol until endometrial thickness reached >7 mm, followed by transdermal estradiol combined with 800 mg/day vaginal micronized P started in the evening (D0). Oral dydrogesterone supplementation (30 mg/day) was started concomitantly to vaginal P in all patients during Covid–19 pandemic and only after D1 P measurement followed by one day FET postponement in patients with P levels <11 ng/ml before the lockdown. Main results and the role of chance During the Covid–19 pandemic, 198 FET were performed on D2, D3 or D5 of P administration with dydrogesterone supplementation depending on embryo stage at cryopreservation. Concerning the 196 FET before lockdown, 124 (63%) were performed after dydrogesterone addition from D1 onwards and postponement by one day in patients with serum P levels <11 ng/ml at D1 while 72 were performed in phase following introduction of vaginal P without dydrogesterone supplementation in patients with P > 11 ng/ml. Characteristics of patients in the 2 time periods were similar for age (34.5 + 5 vs 34.1 + 4.8 years), endometrial thickness prior to P introduction (9.9 + 2.1 vs 9.9 + 2.2 mm), number of transferred embryos (1.3 + 0.5 vs 1.4 + 0.5) , embryo transfer stage (D2/D3/blastocyst: 8/16/76% vs 3/18/79%). No significant difference was observed between both time periods [nor between “dydrogesterone addition and postponement by 1 day” and “in phase” FET before lockdown] in terms of positive pregnancy test (39.4% vs 39.3% [44% vs 30.5%]), heartbeat activity at 8 weeks (29.3% vs 28% [29% vs 26.4%]) and ongoing pregnancy rates at 12 weeks (30.7% but truncated at end of October 2020 vs 25.5% [26.6% vs 23.6%]). Limitations, reasons for caution Full results of the Covid–19 period will be further provided concerning ongoing pregnancy rates as well as comparison of live birth rates and obstetrical and neonatal outcomes. Wider implications of the findings: These results suggest that systematic dydrogesterone supplementation is as effective as individualized supplementation according to serum P levels following administration of vaginal P. This strategy enabled us to schedule easier FET and limit patient visits for monitoring while maintaining optimal results for FET in AC during the Covid–19 pandemic. Trial registration number Not applicable
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Affiliation(s)
- I Cedri. . Durnerin
- Hôpital Jean Verdier, Reproductive medicine and fertility preservation, Bondy, France
| | - M Peigné
- Hôpital Jean Verdier, Reproductive medicine and fertility preservation, Bondy, France
| | - J Labrosse
- Hôpital Jean Verdier, Reproductive medicine and fertility preservation, Bondy, France
| | - M Guerout
- Hôpital Jean Verdier, Reproductive medicine and fertility preservation, Bondy, France
| | - C Vinolas
- Hôpital Jean Verdier, Reproductive medicine and fertility preservation, 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
| | - B Bennan. Smires
- Hôpital Jean Verdier, Biology of reproduction and CECOS, Bondy, France
| | - S Sarandi
- Hôpital Jean Verdier, Biology of reproduction and CECOS, Bondy, France
| | - C Sifer
- Hôpital Jean Verdier, Biology of reproduction and CECOS, Bondy, France
| | - M Grynberg
- Hôpital Jean Verdier, Reproductive medicine and fertility preservation, Bondy, France
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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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Grynberg M, Labrosse J, Bennani Smires B, Sifer C, Peigne M, Sonigo C. Could hormonal and follicular rearrangements explain timely menopause in unilaterally oophorectomized women? Hum Reprod 2021; 36:1941-1947. [PMID: 34037751 DOI: 10.1093/humrep/deab132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/29/2020] [Revised: 04/26/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Does unilateral oophorectomy modify the relationship between serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC)? SUMMARY ANSWER No altered 'per-ovary' and 'per-follicle' AMH production and antral follicle distribution was evident in unilaterally oophorectomized women compared to matched controls. WHAT IS KNOWN ALREADY The age of menopause onset is relatively unchanged in patients having undergone unilateral oophorectomy. Mechanisms that occur to preserve and maintain ovarian function in this context remain to be elucidated. STUDY DESIGN, SIZE, DURATION Forty-one infertile women, with no polycystic ovary syndrome (PCOS) and no endometriosis, aged 19-42 years old, having undergone unilateral oophorectomy (One Ovary group; average time since surgery: 23.8 ± 2.2 months) were retrospectively age-matched (±1 year) with 205 infertile women having two intact ovaries and similar clinical features (Control group). PARTICIPANTS/MATERIALS, SETTING, METHODS Serum AMH levels, 3-4 mm AFC, 5-12 mm AFC, and total AFC (3-12 mm) were assessed on cycle Day 3 in both groups. Hormonal and ultrasonographic measurements obtained from patients in the Control group (i.e. having two ovaries) were divided by two to be compared with measurements obtained from patients of the One Ovary group (i.e. having one single remaining ovary). To estimate per-follicle AMH production, we calculated the ratio between serum AMH levels over 3-4 mm AFC, 5-12 mm AFC, and total AFC (3-12 mm), and the strength of the correlation between serum AMH levels and total AFC. The main outcome measure was to assess Day 3 AMH/Day 3 AFC ratio and hormonal-follicular correlation. MAIN RESULTS AND THE ROLE OF CHANCE As expected, before correction, mean serum AMH levels (1.46 ± 0.2 vs 2.77 ± 0.1 ng/ml, P < 0.001) and total AFC (7.3 ± 0.6 vs 15.1 ± 0.4 follicles, P < 0.0001) were lower in the One Ovary group compared to the Control group, respectively. Yet, after correction, per-ovary AMH levels (1.46 ± 0.2 vs 1.39 ± 0.1 ng/ml) and total AFC (7.3 ± 0.6 vs 7.5 ± 0.2 follicles) values were comparable between the two groups. Consistently, per-follicle AMH levels (3-4 mm, 5-12 mm, and total) were not significantly different between the two groups (0.39 ± 0.05 vs 0.37 ± 0.02 ng/ml/follicle; 0.69 ± 0.12 vs 0.59 ± 0.05 ng/ml/follicle, and 0.23 ± 0.03 vs 0.19 ± 0.01 ng/ml/follicle; respectively). In addition, the prevalence of 3-4 mm follicles was comparable between the two groups (66.7% for One Ovary group vs 58.8% for Control group, respectively). Finally, the correlation between serum AMH levels and total AFC was similar for patients in the One Ovary group (r = 0.70; P < 0.0001) compared to those in the Control group (r = 0.68; P < 0.0001). LIMITATIONS/REASONS FOR CAUTION The retrospective character of the analysis might lead to potential bias. WIDER IMPLICATIONS OF THE FINDINGS The present investigation did not provide evidence of altered 'per-ovary' and 'per-follicle' AMH production and antral follicle distribution in unilaterally oophorectomized women compared to matched controls. Further studies are warranted to support the hypothesis that follicle-sparing mechanisms are clearly at stake in remaining ovaries after unilateral oophorectomy to explain their long-lasting function and timely menopausal onset. STUDY FUNDING/COMPETING INTEREST(S) The authors have no funding or competing interests to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- M Grynberg
- AP-HP, Department of Reproductive Medicine & Fertility Preservation, Hôpital Antoine Béclère, Clamart, France.,AP-HP, Department of Reproductive Medicine & Fertility Preservation, Hôpital Jean Verdier, Bondy, France.,University Paris-Sud, Clamart, France
| | - J Labrosse
- AP-HP, Department of Reproductive Medicine & Fertility Preservation, Hôpital Jean Verdier, Bondy, France
| | - B Bennani Smires
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Bondy, France
| | - C Sifer
- Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Bondy, France
| | - M Peigne
- AP-HP, Department of Reproductive Medicine & Fertility Preservation, Hôpital Jean Verdier, Bondy, France
| | - C Sonigo
- AP-HP, Department of Reproductive Medicine & Fertility Preservation, Hôpital Antoine Béclère, Clamart, France.,University Paris-Sud, Clamart, France
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Boumerdassi Y, Huet S, Millin M, Sarandi S, Bennani Smires B, Sifer C. [Impact of the type of incubator (non-humidified versus humidified) on embryo culture media osmolality]. ACTA ACUST UNITED AC 2020; 49:522-528. [PMID: 33316438 DOI: 10.1016/j.gofs.2020.12.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Benchtop incubators with small individual chambers have been developed in order to improve the stability of embryo culture conditions reducing the environmental stress during the embryo development. These new dry incubators were designed without any air humidification system in order to prevent bacterial proliferation and to enable the use of time-lapse system. However, an elevated evaporation of the culture media could occur in these conditions. The main objective of the study is to analyse the impact of the used incubator type on the embryo culture media osmolality. MATERIALS AND METHODS Microdrops of 50μL of culture media were placed in 60mm diameter culture dishes, and quickly covered with either 7 or 8mL of mineral oil in an IVF workstation with laminar airflow. Two series of culture dishes have been randomly placed either in a humidified incubator or in a dry benchtop incubator. The microdrops of each culture dishes were sampled at D0, D1, D2, D3, and D5 respectively to measure the osmolality in triplicate using a cryoscopic osmometer. The mean values of osmolality in each incubator have been compared respectively on D0, D1, D2, D3 and D5 with appropriate statistical tests, and considered statistically significant when P<0.05. RESULTS The osmolality of the microdrops placed in the dry benchtop incubator differed significantly after the third day of culture, regardless of the level of mineral oil in the culture dishes. Indeed, using Petri dishes covered respectively with 7 or 8mL of mineral oil, osmolality values of samples from the dry incubator were significantly higher than those from the humidified one, at D3 and D5 (D3/7mL: 273±2.1 vs. 268±1.0mOsm/kg; P=0.02; D3/8mL: 282±8.0 vs. 270±0.7mOsm/kg; P=0.04) and D5 (D5/7mL: 283±1.5 vs. 270±3.6mOsm/kg; P=0.004; D5/8mL: 287±5.6 vs. 268±2.3mOsm/kg; P=0.005). Furthermore, the analysis on paired samples showed that the osmolality in the dry benchtop incubator at D5 using 7mL of oil (283±1.5mOsm/kg; P=0.003) and at D3 (273±2.1mOsm/kg; P=0.016) and D5 (287±5.6mOsm/kg; P=0.009) using 8mL of oil was significantly higher than that measured at D0 (265±1.9mOsm/kg). CONCLUSION A significant increase of the embryo culture media osmolality was observed in the dry benchtop incubator with ambient hygrometry in our standard conditions. Adding 1mL of oil was not sufficient to reduce the evaporation of the media. Although maintained at a physiological level, the impact of the osmolality changes on the in vitro embryo development has to be further determined.
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Affiliation(s)
- Y Boumerdassi
- Service d'histologie-embryologie-cytogénétique-CECOS, centre hospitalier universitaire Jean-Verdier, AP-HP, avenue du 14-Juillet, 93140 Bondy, France
| | - S Huet
- Service d'histologie-embryologie-cytogénétique-CECOS, centre hospitalier universitaire Jean-Verdier, AP-HP, avenue du 14-Juillet, 93140 Bondy, France
| | - M Millin
- Service d'histologie-embryologie-cytogénétique-CECOS, centre hospitalier universitaire Jean-Verdier, AP-HP, avenue du 14-Juillet, 93140 Bondy, France
| | - S Sarandi
- Service d'histologie-embryologie-cytogénétique-CECOS, centre hospitalier universitaire Jean-Verdier, AP-HP, avenue du 14-Juillet, 93140 Bondy, France
| | - B Bennani Smires
- Service d'histologie-embryologie-cytogénétique-CECOS, centre hospitalier universitaire Jean-Verdier, AP-HP, avenue du 14-Juillet, 93140 Bondy, France; Université Paris XIII, 93000 Bobigny, France
| | - C Sifer
- Service d'histologie-embryologie-cytogénétique-CECOS, centre hospitalier universitaire Jean-Verdier, AP-HP, avenue du 14-Juillet, 93140 Bondy, France; Université Paris XIII, 93000 Bobigny, France.
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Herbemont C, El Kouhen I, Brax A, Vinolas C, Dagher-Hayeck B, Comtet M, Calvo J, Sarandi S, Grynberg M, Cédrin-Durnerin I, Sifer C. [Dual trigger with gonadotropin-releasing hormone agonist and hCG to improve oocyte maturation rate]. ACTA ACUST UNITED AC 2019; 47:568-573. [PMID: 31271894 DOI: 10.1016/j.gofs.2019.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 03/11/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study investigates dual trigger with GnRHa and hCG as a potential treatment in patients with a history of ≥25 % immature oocytes retrieved in IVF/ICSI cycles. METHODS This is a retrospective case-control study performed between October 2008 and December 2017. Forty-seven patients who experienced high oocyte immaturity rate (≥25 %) during their first IVF/ICSI cycle (analyzed as control group) and received a dual trigger for their subsequent cycle, were involved. During dual trigger cycles, patients received antagonist protocol and ovulation triggering using triptorelin 0.2mg and hCG. Primary endpoint was maturation rate (MR). Secondary endpoints were fertilization, D2 top quality embryo (TQE) rates, clinical pregnancy rate per fresh embryo transfer and cumulative clinical pregnancy rate per couple. RESULTS A significant increase in MR was achieved in case of dual trigger (71.0 %) when compared to control group (47.8 %; P<0.0001). Moreover, cumulative clinical pregnancy rate yielded 46.8 % in dual trigger group, which was statistically higher than 27.6 % obtained in control group (P=0.05). However, fertilization, D2 TQE rates and clinical pregnancy rates/transfer were statistically similar when compared between the two groups. CONCLUSION Dual trigger seems efficient for managing patients with high oocyte immaturity rate.
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Affiliation(s)
- C Herbemont
- Service d'histologie-embryologie-cytogénétique-CECOS, CHU de Jean-Verdier, AP-HP, avenue du 14-Juillet, 93143 Bondy, France
| | - I El Kouhen
- Service d'histologie-embryologie-cytogénétique-CECOS, CHU de Jean-Verdier, AP-HP, avenue du 14-Juillet, 93143 Bondy, France
| | - A Brax
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Jean-Verdier, AP-HP, avenue du 14-Juillet, 93143 Bondy, France
| | - C Vinolas
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Jean-Verdier, AP-HP, avenue du 14-Juillet, 93143 Bondy, France
| | - B Dagher-Hayeck
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Jean-Verdier, AP-HP, avenue du 14-Juillet, 93143 Bondy, France
| | - M Comtet
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Jean-Verdier, AP-HP, avenue du 14-Juillet, 93143 Bondy, France; Université Paris XIII, 93000 Bobigny, France
| | - J Calvo
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Jean-Verdier, AP-HP, avenue du 14-Juillet, 93143 Bondy, France
| | - S Sarandi
- Service d'histologie-embryologie-cytogénétique-CECOS, CHU de Jean-Verdier, AP-HP, avenue du 14-Juillet, 93143 Bondy, France
| | - M Grynberg
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Jean-Verdier, AP-HP, avenue du 14-Juillet, 93143 Bondy, France; Inserm, U1133, université Paris-Diderot, 75013 Paris, France
| | - I Cédrin-Durnerin
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Jean-Verdier, AP-HP, avenue du 14-Juillet, 93143 Bondy, France
| | - C Sifer
- Service d'histologie-embryologie-cytogénétique-CECOS, CHU de Jean-Verdier, AP-HP, avenue du 14-Juillet, 93143 Bondy, France; Université Paris XIII, 93000 Bobigny, France.
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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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Herbemont C, Maurin P, Cedrin-Durnerin I, Grynberg M, Sifer C. What stage of in vitro embryo development is affected by oxygen tension? a randomized clinical trial (RCT). Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.1013] [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: 11/29/2022]
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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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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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Herbemont C, Sermondade N, Cedrin I, 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? Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.590] [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: 10/21/2022]
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Sifer C. [Culture to blastocyst-stage: Is it valid to observe cleaved embryos? Yes]. Gynecol Obstet Fertil 2016; 44:441-443. [PMID: 27451062 DOI: 10.1016/j.gyobfe.2016.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 05/29/2016] [Indexed: 06/06/2023]
Affiliation(s)
- C Sifer
- Service d'histologie-embryologie-cytogénétique, CECOS, CHU Jean-Verdier, AP-HP, avenue du 14-Juillet, 93143 Bondy, France.
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Sonigo C, Simon C, Boubaya M, Benoit A, Sifer C, Sermondade N, Grynberg M. What threshold values of antral follicle count and serum AMH levels should be considered for oocyte cryopreservation after in vitro maturation? Hum Reprod 2016; 31:1493-500. [PMID: 27165625 DOI: 10.1093/humrep/dew102] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [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: 10/30/2015] [Accepted: 04/12/2016] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION What threshold values of ultrasonographic antral follicle count (AFC) and serum anti-Müllerian hormone (AMH) levels should be considered for ensuring the cryopreservation of sufficient number of in vitro matured (IVM) oocytes, in cancer patients seeking fertility preservation (FP)? SUMMARY ANSWER AFC and serum AMH values >20 follicles and 3.7 ng/ml, respectively, are required for obtaining at least 10 IVM oocytes for cryopreservation. WHAT IS KNOWN ALREADY IVM of cumulus oocyte complexes (COCs) followed by oocyte cryopreservation has emerged recently as an option for urgent FP. Recent data have reported that, in healthy patients, 8-20 cryopreserved oocytes after ovarian stimulation would maximize the chance of obtaining a live birth. Although both AFC and AMH have been reported as predictive factors of IVM success in infertile patients with polycystic ovary syndrome (PCOS), there is a dramatic lack of data regarding the values of these parameters in oncological patients as candidates for FP. STUDY DESIGN, SIZE, DURATION From January 2009 to April 2015, we prospectively studied 340 cancer patients, aged 18-41 years, as candidates for oocyte cryopreservation following IVM. PARTICIPANTS/MATERIALS, SETTING, METHODS All patients had AFC and AMH measurements, 48-72 h before oocyte retrieval, regardless of the phase of the cycle. COCs were recovered under ultrasound guidance 36 h after hCG priming. Logistic regression allowed the determination of threshold values of AFC and AMH, for obtaining at least 8, 10 or 15 matures oocytes frozen after the IVM procedure. Similar analyses were performed for a final number of mature oocytes ≤2. MAIN RESULTS AND THE ROLE OF CHANCE Among the 340 cancer patients included, 300 were diagnosed with breast cancers, 14 had hematological malignancies and 26 underwent the procedure for others indications. Overall, the mean age of the population was 31.8 ± 4.5 years. Mean AFC and serum AMH levels were 21.7 ± 13.3 follicles and 4.4 ± 3.8 ng/ml, respectively. IVM was performed in equal proportions during the follicular or luteal phase of the cycle (49 and 51%, respectively). Statistical analysis showed that AFC and AMH values above 28 follicles and 3.9 ng/ml, 20 follicles and 3.7 ng/ml and 19 follicles and 3.5 ng/ml are required, respectively, for obtaining at least 15, 10 or 8 frozen IVM oocytes with a sensitivity ranging from 0.82 to 0.90. On the contrary, ≤2 IVM oocytes were cryopreserved when AFC and AMH were <19 follicles and 3.0 ng/ml, respectively. LIMITATIONS, REASONS FOR CAUTION Although the potential of cryopreserved IVM oocytes from cancer patients remains unknown, data obtained from infertile PCOS women have shown a dramatically reduced competence of these oocytes when compared with that of oocytes recovered after ovarian stimulation. As a consequence, the optimal number of IVM oocytes frozen in candidates for FP is currently unpredictable. WIDER IMPLICATIONS OF THE FINDINGS Cryopreservation of oocytes after IVM should be considered in the FP strategy when ovarian stimulation is unfeasible, in particular when markers of the follicular ovarian status are at a relatively high range. Further investigation is needed to objectively assess the real potential of these IVM oocytes after cryopreservation. Therefore, even when a good COCs yield is expected, we should systematically encourage IVM in combination with ovarian tissue cryopreservation. STUDY FUNDING/COMPETING INTERESTS No external funding was obtained for the present study. The authors have no conflict of interest to declare. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- C Sonigo
- AP-HP, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean Verdier, Avenue du 14 Juillet, Bondy 93143, France INSERM, U1185, Université Paris-Sud, Le Kremlin-Bicêtre 94270, France Université Paris XIII, Bobigny 93000, France
| | - C Simon
- AP-HP, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean Verdier, Avenue du 14 Juillet, Bondy 93143, France
| | - M Boubaya
- Unité de Recherche Clinique, Hôpital Avicenne, Bobigny 93009, France
| | - A Benoit
- AP-HP, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean Verdier, Avenue du 14 Juillet, Bondy 93143, France
| | - C Sifer
- AP-HP, Service de Cytogénétique et Biologie de la Reproduction, Hôpital Jean Verdier, Avenue du 14 Juillet, Bondy 93143, France
| | - N Sermondade
- AP-HP, Service de Cytogénétique et Biologie de la Reproduction, Hôpital Jean Verdier, Avenue du 14 Juillet, Bondy 93143, France
| | - M Grynberg
- AP-HP, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean Verdier, Avenue du 14 Juillet, Bondy 93143, France Université Paris XIII, Bobigny 93000, France INSERM, U1133, Université Paris-Diderot, Paris 75013, France
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Boujenah J, Benzacken B, Pipiras E, Sifer C, Herbemont C, Cornelis F, Bricou A, Poncelet C. Fetal-maternal chimerism in peritoneal tissue implants after tubal ectopic pregnancy. ACTA ACUST UNITED AC 2016; 44:309-10. [PMID: 27105930 DOI: 10.1016/j.gyobfe.2016.03.012] [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: 02/03/2016] [Indexed: 11/27/2022]
Affiliation(s)
- J Boujenah
- University Hospital Jean-Verdier, Department of Obstetrics, Gynecology and Reproductive Medecine, avenue du 14-Juillet, 93340 Bondy, France.
| | - B Benzacken
- University Hospital Jean-Verdier, Department of Cytogenetic, Embryology and Histology, avenue du 14-Juillet, 93340 Bondy, France
| | - E Pipiras
- University Hospital Jean-Verdier, Department of Cytogenetic, Embryology and Histology, avenue du 14-Juillet, 93340 Bondy, France
| | - C Sifer
- University Hospital Jean-Verdier, Department of Cytogenetic, Embryology and Histology, avenue du 14-Juillet, 93340 Bondy, France
| | - C Herbemont
- University Hospital Jean-Verdier, Department of Cytogenetic, Embryology and Histology, avenue du 14-Juillet, 93340 Bondy, France
| | - F Cornelis
- University Hospital Jean-Verdier, Department of Cytogenetic, Embryology and Histology, avenue du 14-Juillet, 93340 Bondy, France
| | - A Bricou
- University Hospital Jean-Verdier, Department of Obstetrics, Gynecology and Reproductive Medecine, avenue du 14-Juillet, 93340 Bondy, France
| | - C Poncelet
- University Hospital Jean-Verdier, Department of Obstetrics, Gynecology and Reproductive Medecine, avenue du 14-Juillet, 93340 Bondy, France
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Bénard J, Calvo J, Comtet M, Benoit A, Sifer C, Grynberg M. [Fertility preservation in women of the childbearing age: Indications and strategies]. ACTA ACUST UNITED AC 2016; 45:424-44. [PMID: 27021926 DOI: 10.1016/j.jgyn.2016.02.005] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 02/15/2016] [Accepted: 02/24/2016] [Indexed: 12/21/2022]
Abstract
Advances on cryopreservation techniques now allow considering oocyte, embryo or ovarian tissue freezing for female fertility preservation. Originally developed for patients suffering from cancer, fertility preservation has rapidly invaded others medical fields, and represents now the standard of care for all young patient diagnosed with a disease that could impair fertility or having to receive possibly gonadotoxic treatment. As a result, autoimmune diseases, some genetic pathologies or iterative pelvic surgeries, at risk of premature ovarian failure, have become common indications of fertility preservation. In addition, the social egg freezing aiming at preventing the age-related fertility decline is still debated in France, although authorized in numerous countries. This review will discuss the different strategies of fertility preservation in young girls and women of reproductive age, regarding different medical or non-medical indications.
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Affiliation(s)
- J Bénard
- Service de médecine de la reproduction, hôpital Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; Université Paris XIII, 93000 Bobigny, France
| | - J Calvo
- Service de médecine de la reproduction, hôpital Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France
| | - M Comtet
- Service de médecine de la reproduction, hôpital Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France
| | - A Benoit
- Service de médecine de la reproduction, 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
| | - M Grynberg
- Service de médecine de la reproduction, 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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Sarandi S, Herbemont C, Sermondade N, Benoit A, Sonigo C, Poncelet C, Benard J, Gronier H, Boujenah J, Grynberg M, Sifer C. [A prospective study to compare the efficiency of oocyte vitrification using closed or open devices]. ACTA ACUST UNITED AC 2016; 44:280-4. [PMID: 26968255 DOI: 10.1016/j.gyobfe.2016.02.003] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 01/28/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Oocyte vitrification using an open device is thought to be a source of microbiological and chemical contaminations that can be avoided using a closed device. The principal purpose of this study was to compare the two vitrification protocols: closed and open system. The secondary aim was to study the effects of the storage in the vapor phase of nitrogen (VPN) on oocytes vitrified using an open system and to compare it to those of a storage in liquid nitrogen (LN). METHODS Forty-four patients have been included in our study between November 2014 and May 2015. Two hundred and fourteen oocytes have been vitrified at germinal vesicle (GV), metaphase I (0PB) and metaphase II (1PB) stages. We vitrified 96 oocytes (59 GV/37 0PB) using a closed vitrification device and 118 oocytes (57 GV/31 0PB/30 1PB) using an open device. The vitrified oocytes were then stored either in LN or in VPN. The main outcome measures were the survival rate after warming (SR), meiosis resumption rate (MRR) and maturation rate (MR). RESULTS The global post-thaw SR was significantly higher for oocytes vitrified using an open system (93.2%) compared to those vitrified using a closed one (64.5%; P<0.001). On the contrary, there was no significant difference in terms of global MRR and MR (82.1% vs. 87.5% and 60.7% vs. 61.2% using closed and open system respectively). The SR, MRR and the MR were not significantly different when vitrified oocytes were stored in VPN or LN (91.6, 83.8, 64.5% vs. 93.9, 89.8, 59.1% respectively). CONCLUSION Taking into account the limits of our protocol, the open vitrification system remains the more efficient system. The use of sterile liquid nitrogen for oocyte vitrification and the subsequent storage in vapor phase of nitrogen could minimize the hypothetical risks of biological and chemical contaminations.
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Affiliation(s)
- S Sarandi
- Service d'histologie-embryologie-cytogénétique-biologie de la reproduction-CECOS, centre hospitalier universitaire Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France
| | - C Herbemont
- Service d'histologie-embryologie-cytogénétique-biologie de la reproduction-CECOS, centre hospitalier universitaire Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; UFR SMBH, université Paris 13, Sorbonne Paris cité, 93000 Bobigny, France
| | - N Sermondade
- Service d'histologie-embryologie-cytogénétique-biologie de la reproduction-CECOS, centre hospitalier universitaire Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France
| | - A Benoit
- Service de médecine de la reproduction, centre hospitalier universitaire Jean-Verdier, 93140 Bondy, France
| | - C Sonigo
- Service de médecine de la reproduction, centre hospitalier universitaire Jean-Verdier, 93140 Bondy, France
| | - C Poncelet
- UFR SMBH, université Paris 13, Sorbonne Paris cité, 93000 Bobigny, France; Service de médecine de la reproduction, centre hospitalier universitaire Jean-Verdier, 93140 Bondy, France
| | - J Benard
- UFR SMBH, université Paris 13, Sorbonne Paris cité, 93000 Bobigny, France; Service de médecine de la reproduction, centre hospitalier universitaire Jean-Verdier, 93140 Bondy, France
| | - H Gronier
- Service de médecine de la reproduction, centre hospitalier universitaire Jean-Verdier, 93140 Bondy, France
| | - J Boujenah
- UFR SMBH, université Paris 13, Sorbonne Paris cité, 93000 Bobigny, France; Service de médecine de la reproduction, centre hospitalier universitaire Jean-Verdier, 93140 Bondy, France
| | - M Grynberg
- UFR SMBH, université Paris 13, Sorbonne Paris cité, 93000 Bobigny, France; Service de médecine de la reproduction, centre hospitalier universitaire Jean-Verdier, 93140 Bondy, France
| | - C Sifer
- Service d'histologie-embryologie-cytogénétique-biologie de la reproduction-CECOS, centre hospitalier universitaire Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; UFR SMBH, université Paris 13, Sorbonne Paris cité, 93000 Bobigny, France.
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Durand M, Sermondade N, Herbemont C, Benard J, Gronier H, Boujenah J, Cédrin-Durnerin I, Poncelet C, Grynberg M, Sifer C. [Embryo development in two single-step media: Analysis of 2059 sibling oocytes]. ACTA ACUST UNITED AC 2016; 44:163-7. [PMID: 26908149 DOI: 10.1016/j.gyobfe.2016.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 11/30/2015] [Accepted: 01/14/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to compare embryo development cultured in two single-step media commercially available: Fert/Sage One Step® (Origio) and Continuous Single Culture® (CSC) (Irvine Scientific). METHODS A prospective auto-controlled study of sibling oocytes from women undergoing conventional in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) was performed in our center from February to June 2015. After fertilization, for every patient, half of oocytes were cultured in the single-step Fert/Sage One Step® (serie SAGE) and the other half in the single-step CSC®(serie CSC). Fertilization and embryo morphology rates were assessed by day 1 to day 5-6 if needed. Embryo presenting<20% of fragmentation and 4 cells at day 2, 8 cells at day 3 were qualified as "top quality". Embryo with<20% of fragmentation and 3-5 cells at day 2, 6-10 cells at day 3 were qualified as "good quality". Blastocyst B3, B4, B5 with A or B inner cell mass and A or B trophectoderm were qualified as "good quality". Transferred or frozen embryos were qualified as useful embryos. RESULTS Sixty-two attempts of IVF and 133 of ICSI were analyzed, corresponding to 2059 inseminated or micro-injected oocytes. Fertilization rate were not different between the 2 series, respectively SAGE vs CSC (IVF: 73.4% vs 68.3% [P=0.49]; ICSI: 58.9% vs 63.8% [P=0.12]). No difference was found for embryo morphology, respectively SAGE vs CSC, at day 2 (top quality embryo at day 2 IVF: 34.4% vs 33% [P=0.98]; ICSI: 42.4% vs 44.9% [P=0.37]; and good quality embryo at day 2 IVF: 44% vs 50.2% [P=0.07]; ICSI: 64% vs 71% [P=0.35]); no difference at day 3 (top quality embryo at day 3 IVF: 19.4% vs 21.3% [P=0.61]; ICSI: 28.7% vs 27.4% [P=0.54]; and good quality embryo at day 3 IVF: 40.4% vs 50.2% [P=0.91]; ICSI: 51% vs 47.6% [P=0.47]). Blastocyst development rate were not different, respectively SAGE vs CSC (IVF: 39.9% vs 41.5% [P=0.63] with 42.9% vs 42.2% of good quality blastocyst [P=0.70]; ICSI: 41.1% vs 37.8% [P=0.18] with 32.9% vs 40.8% of good quality blastocyst [P=0.13]). No difference was found in the useful embryo rate in the 2 series SAGE vs CSC (IVF: 52.8% vs 55.2% [P=0.83]; ICSI: 62.4% vs 61.7% [P=0.70]). CONCLUSION Embryo development and rate of useful embryos, transferred or frozen, were not different according to the embryo culture in single-step media Fert/Sage One Step® vs single-step Continuous Single Culture®.
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Affiliation(s)
- M Durand
- Service d'histologie-embryologie-cytogénétique-CECOS, centre hospitalo-universitaire Jean-Verdier, Assistance publique-Hôpitaux de Paris, avenue du 14-Juillet, 93140 Bondy, France.
| | - N Sermondade
- Service d'histologie-embryologie-cytogénétique-CECOS, centre hospitalo-universitaire Jean-Verdier, Assistance publique-Hôpitaux de Paris, avenue du 14-Juillet, 93140 Bondy, France
| | - C Herbemont
- Service d'histologie-embryologie-cytogénétique-CECOS, centre hospitalo-universitaire Jean-Verdier, Assistance publique-Hôpitaux de Paris, avenue du 14-Juillet, 93140 Bondy, France
| | - J Benard
- Service de médecine de la reproduction, centre hospitalo-universitaire Jean-Verdier, Assistance publique-Hôpitaux de Paris, 93140 Bondy, France
| | - H Gronier
- Service de médecine de la reproduction, centre hospitalo-universitaire Jean-Verdier, Assistance publique-Hôpitaux de Paris, 93140 Bondy, France
| | - J Boujenah
- Service de médecine de la reproduction, centre hospitalo-universitaire Jean-Verdier, Assistance publique-Hôpitaux de Paris, 93140 Bondy, France
| | - I Cédrin-Durnerin
- Service de médecine de la reproduction, centre hospitalo-universitaire Jean-Verdier, Assistance publique-Hôpitaux de Paris, 93140 Bondy, France
| | - C Poncelet
- Service de médecine de la reproduction, centre hospitalo-universitaire Jean-Verdier, Assistance publique-Hôpitaux de Paris, 93140 Bondy, France
| | - M Grynberg
- Service de médecine de la reproduction, centre hospitalo-universitaire Jean-Verdier, Assistance publique-Hôpitaux de Paris, 93140 Bondy, France
| | - C Sifer
- Service d'histologie-embryologie-cytogénétique-CECOS, centre hospitalo-universitaire Jean-Verdier, Assistance publique-Hôpitaux de Paris, avenue du 14-Juillet, 93140 Bondy, France
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Grynberg M, Poulain M, le Parco S, Sifer C, Fanchin R, Frydman N. Similar in vitro maturation rates of oocytes retrieved during the follicular or luteal phase offer flexible options for urgent fertility preservation in breast cancer patients. Hum Reprod 2016; 31:623-9. [PMID: 26759139 DOI: 10.1093/humrep/dev325] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [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: 01/31/2015] [Accepted: 11/30/2015] [Indexed: 12/23/2022] Open
Abstract
STUDY QUESTION Are in vitro maturation (IVM) rates of cumulus-oocyte complexes (COCs), retrieved from breast cancer patients seeking urgent fertility preservation (FP) before neoadjuvant chemotherapy, different between those recovered in the follicular or in the luteal phase of the cycle? SUMMARY ANSWER The present investigation reveals no major difference in the number of COCs recovered or their IVM rates whatever the phase of the cycle at which egg retrieval is performed, suggesting that IVM is a promising tool for breast cancer patients seeking urgent oocyte cryopreservation. WHAT IS KNOWN ALREADY FP now represents a standard of care for young cancer patients having to undergo gonadotoxic treatment. Mature oocyte cryopreservation after IVM of COCs has been proposed for urgent FP, especially in women, who have no time to undergo ovarian stimulation, or when it is contraindicated. STUDY DESIGN, SIZE, DURATION From January 2011 to December 2014, we prospectively studied 248 breast cancer patients awaiting neoadjuvant chemotherapy, aged 18-40 years, candidates for oocyte vitrification following IVM, either at the follicular or the luteal phase of the cycle. PARTICIPANTS/MATERIALS, SETTING, METHODS Serum anti-Müllerian hormone and progesterone levels and antral follicle count (AFC) were measured prior to oocyte retrieval. Patients were sorted into two groups according to the phase of the cycle during which eggs were harvested (Follicular phase group, n = 127 and Luteal phase group, n = 121). Number of COCs recovered, maturation rates after 48 h of culture and total number of oocytes cryopreserved were assessed. Moreover, the oocyte retrieval rate (ORR) was calculated by the number of COCs recovered ×100/AFC. MAIN RESULTS AND THE ROLE OF CHANCE In the Follicular and the Luteal phase groups, women were comparable in terms of age, BMI and markers of follicular ovarian status. There was no significant difference in the number of COCs recovered (mean ± SEM), 9.3 ± 0.7 versus 11.1 ± 0.8, and ORR (median (range)) 43.1 (1-100) versus 47.8 (7.7-100)%. Moreover, maturation rates after 48 h of culture (median (range)) were comparable in the follicular and luteal phase groups, 66.7 (20-100) versus 64.5 (0-100)%. Finally, the total number of oocytes cryopreserved (mean ± SEM) was similar in both groups (6.2 ± 0.4 versus 6.8 ± 0.5). LIMITATIONS, REASONS FOR CAUTION Despite the intact meiotic competence of immature oocytes recovered during the follicular or the luteal phase, there is a dramatic lack of data regarding the outcome of IVM oocytes cryopreserved in cancer patients. WIDER IMPLICATIONS OF THE FINDINGS IVM of oocytes may be an interesting method of FP in urgent situations. Improving the culture conditions will be needed to increase the maturation rates and the overall potential of in vitro matured oocytes. STUDY FUNDING/COMPETING INTERESTS None. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- M Grynberg
- Department of Reproductive Medicine, AP-HP, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France University Paris XIII, 93000 Bobigny, France Unit Inserm U1133, Université Paris-Diderot, 75013 Paris, France
| | - M Poulain
- Unit of Reproductive Biology, AP-HP, Hôpital Antoine Béclère, Clamart F-92141, France Univ Paris-Sud, Clamart F-92140, France
| | - S le Parco
- Department of Obstetric-Gynecology and Reproductive Medicine, Hôpital Antoine Béclère, Clamart F-92140, France
| | - C Sifer
- Department of Cytogenetic and Reproductive Biology, AP-HP, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - R Fanchin
- Unit Inserm U1133, Université Paris-Diderot, 75013 Paris, France Univ Paris-Sud, Clamart F-92140, France Department of Obstetric-Gynecology and Reproductive Medicine, Hôpital Antoine Béclère, Clamart F-92140, France
| | - N Frydman
- Unit of Reproductive Biology, AP-HP, Hôpital Antoine Béclère, Clamart F-92141, France Univ Paris-Sud, Clamart F-92140, France
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Boujenah J, Montforte M, Hugues J, Sifer C, Poncelet C. Y a-t-il une place pour la cœlioscopie dans le parcours en assistance médicale à la procréation ? ACTA ACUST UNITED AC 2015; 43:604-11. [DOI: 10.1016/j.gyobfe.2015.07.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 07/16/2015] [Indexed: 10/23/2022]
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Dupont C, Hafhouf E, Sermondade N, Sellam O, Herbemont C, Boujenah J, Faure C, Levy R, Poncelet C, Hugues J, Cedrin-Durnerin I, Sonigo C, Grynberg M, Sifer C. Delivery rates after elective single cryopreserved embryo transfer related to embryo survival. Eur J Obstet Gynecol Reprod Biol 2015; 188:6-11. [DOI: 10.1016/j.ejogrb.2015.02.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 12/31/2014] [Accepted: 02/19/2015] [Indexed: 10/23/2022]
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Herbemont C, Sifer C. How to select the spermatozoon for intracytoplasmic sperm injection in 2015? Minerva Ginecol 2015; 67:185-193. [PMID: 25581325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The selection of the individual spermatozoon in intracytoplasmic sperm injection (ICSI) is routinely performed by the observation of its motility and morphology. However, in case of severe oligoasthenozoospermia or non-obstructive azoospermia requiring the use of testicular sperm, other methods are necessary to help the embryologist making this choice. According to some authors, sperm processing before ICSI seems to limit the DNA fragmentation index, and in this way improves ICSI outcomes. Moreover, intracytoplasmic morphologically selected sperm injection is potentially a good option in some specific indications such as severe teratozoospermia, or repeated ICSI failures. Other methods based on sperm structure, as sperm head birefringence observation, or based on its function, like the hyaluronic acid or zona pellucida binding capacity, could be of interest, but still need to be evaluated. Finally, in case of akinetozoospermia, the use of functional tests, such as pentoxifylline test, HOS-test, or to a lesser extent laser touch, makes the selection of viable spermatozoa easier. Nevertheless, studies on larger series have to be conducted to evaluate and precise the interest of each of these methods and their indications, before considering an application on larger scale.
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Affiliation(s)
- C Herbemont
- Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique-Hôpitaux de Paris, Bondy, France -
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Sifer C. [Controversy in ART: should we cryopreserve oocytes or embryos? Do prefer embryos]. ACTA ACUST UNITED AC 2014; 42:880-1. [PMID: 25458809 DOI: 10.1016/j.gyobfe.2014.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Indexed: 10/24/2022]
Affiliation(s)
- C Sifer
- Service d'histologie-embryologie-cytogénétique, hôpital Jean-Verdier, 93140 Bondy, France; Pôle femme et enfant, centre hospitalier universitaire Jean-Verdier, AP-HP, avenue du 14-Juillet, 93143 Bondy, France.
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Abstract
This work aims to show, from data available in the literature and our own experience, how embryos' vitrification change and/or improve the management of infertile couples. In all, 652 cycles of frozen-thawed embryo transfers (FET) following vitrification were prospectively included and compared with 1126 FETs from slow freezing (SF) method. Primary end points were the (i) survival rate (SR) (% of embryos with>50% post-thaw intact blastomeres) and (ii) intact survival rate (ISR) (% of embryos with 100% post-thaw intact blastomeres). Secondary end point was the clinical pregnancy rate (CPR) defined as the presence of an intra uterine gestational sac with positive foetal heart beat. In all, 1097 and 2408 embryos have been thawed following vitrification and SF, respectively. We observed a highly significant increase of SR and ISR respectively when thawing concerned vitrified embryos rather than those from SF method (97.0% vs. 72.7%, P<10(-4); 91.5% vs. 49.8%, P<10(-4)). Furthermore, CPR were of 26.5% (73/652) and of 18.1% (204/1126) following FETs performed after vitrification or SF and thawing (P=0.0002), respectively. At the blastocyst stage, ISR was significantly improved following vitrification compared to SF (94.5% vs. 21.4%, P<10(-4)). In the study period, vitrification (i) reduced the mean number of fresh transferred embryos (1.5 vs. 1.6; P=0.08) and (ii) increased the rate of FETs at the blastocyst stage when compared with the control period (18.1% vs 2.5%., P<10(-4)). Embryo vitrification preserves all embryos from an ART cycle because of its excellent results regarding ISR at all stages of embryo development. This procedure allows a significant increase of pregnancy rates after thawing. In addition, there is a trend for increasing ART cycles performed using extended culture embryo and vitrification. The expected improvement of the cumulative birth rate at the blastocyst stage following vitrification remains to be demonstrated in a prospective randomized study.
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Affiliation(s)
- C Sifer
- Service d'histologie-embryologie-cytogénétique-CECOS, centre hospitalier universitaire Jean-Verdier, Assistance Publique-Hôpitaux de Paris, 93140 Bondy, France.
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Sifer C, Sellam O, Sermondade N, Sonigo C, Hugues JN, Benoit A, Poncelet C, Grynberg M. Prospective study comparing survival and meiotic resumption rates of immature oocytes from in vitro maturation and stimulated cycles in cancer patients. Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.565] [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: 11/16/2022]
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Boujenah J, Bricou A, Moreaux G, Grynberg M, Sifer C, Hugues JN, Poncelet C. [Unilateral borderline ovarian tumor and unilateral adenexectomy?]. ACTA ACUST UNITED AC 2014; 42:635-9. [PMID: 25164163 DOI: 10.1016/j.gyobfe.2014.07.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 06/30/2014] [Accepted: 07/17/2014] [Indexed: 12/17/2022]
Abstract
To perform an adnexectomy in case of unilateral borderline tumor must consider the risk of recurrence, the preservation of fertility, and to integrate a global comprehensive management of a couple. Adnexectomy can be considering as a legitimate option when the woman desire a pregnancy. The risk of recurrence is low and the global survey high. Identification of woman with a high risk of recurrence is necessary. Adnexectomy can be considering as a legitimate option to preserve fertility in case of unilateral tumor. However, ovarian reserve data are missing after the surgery. Adnexectomy can be considering for the management of infertile woman with unilateral borderline tumor. IVF can be performed in the absence of any poor prognosis factor. Management with ovarian cryopreservation and In vitro Maturation remain unclear.
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Affiliation(s)
- J Boujenah
- Pôle femme et enfant, groupe hospitalier universitaire Paris Seine Saint-Denis, site Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; UFR SMBH Leonard-de-Vinci, université Paris-13, 93000 Bobigny, France.
| | - A Bricou
- Pôle femme et enfant, groupe hospitalier universitaire Paris Seine Saint-Denis, site Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; UFR SMBH Leonard-de-Vinci, université Paris-13, 93000 Bobigny, France
| | - G Moreaux
- Pôle femme et enfant, groupe hospitalier universitaire Paris Seine Saint-Denis, site Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; UFR SMBH Leonard-de-Vinci, université Paris-13, 93000 Bobigny, France
| | - M Grynberg
- Pôle femme et enfant, groupe hospitalier universitaire Paris Seine Saint-Denis, site Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; UFR SMBH Leonard-de-Vinci, université Paris-13, 93000 Bobigny, France
| | - C Sifer
- Pôle femme et enfant, groupe hospitalier universitaire Paris Seine Saint-Denis, site Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; UFR SMBH Leonard-de-Vinci, université Paris-13, 93000 Bobigny, France
| | - J N Hugues
- Pôle femme et enfant, groupe hospitalier universitaire Paris Seine Saint-Denis, site Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; UFR SMBH Leonard-de-Vinci, université Paris-13, 93000 Bobigny, France
| | - C Poncelet
- Pôle femme et enfant, groupe hospitalier universitaire Paris Seine Saint-Denis, site Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; UFR SMBH Leonard-de-Vinci, université Paris-13, 93000 Bobigny, France
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Durand M, Sifer C. [Complete fertilization failure following conventional IVF or ICSI: is it predictable? How to manage?]. Gynecol Obstet Fertil 2013; 41:727-734. [PMID: 24239479 DOI: 10.1016/j.gyobfe.2013.10.003] [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: 07/24/2013] [Indexed: 06/02/2023]
Abstract
The occurrence of complete fertilization failure following conventional in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) is a rare event. Each of six physiological stages of the fertilisation can be failing. The cause of a fertilisation failure is either the spermatozoa, or the oocyte. The aim of this study was to determine if this event is predictable, and to define the later strategy. On all sperm tests available, it seems that only, tests of zona pellucida binding and acrosomique reaction are relatively predictive of a complete fertilization failure after IVF. No test allows at the moment to predict an oocyte contribution to unsuccessful fertilization. The strategy retained after a complete fertilization failure following the first attempt of IVF is to propose an ICSI; either to do an IVF if this event arises in the rank n+1, or when the number of inseminated oocytes was low. Concerning the ICSI, the low number of micro-injected oocyte is often in question; so the strategy retained following a first fertilization failure after ICSI is to perform a new ICSI attempt after optimization of the ovarian stimulation. When the cause is spermatic, it is indicated trying a modified ICSI with the use of pentoxifiline, or an intracytoplasmic morphologically selected sperm injection (IMSI), sometimes with assisted oocyte activation. In last solution, we can propose the ovum donation.
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Affiliation(s)
- M Durand
- Service d'histologie-embryologie-cytogénétique-CECOS, CHU Jean-Verdier, AP-HP, avenue du 14-Juillet, 93140 Bondy, France
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Massart P, Durand LM, Sifer C, Piver P, Hugues JN. Immature oocyte syndrome: ovulation triggering with combined hCG /GnRH agonist or increased doses of hCG? Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.1262] [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: 10/26/2022]
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Courbiere B, Decanter C, Bringer-Deutsch S, Rives N, Mirallié S, Pech JC, De Ziegler D, Carré-Pigeon F, May-Panloup P, Sifer C, Amice V, Schweitzer T, Porcu-Buisson G, Poirot C. Emergency IVF for embryo freezing to preserve female fertility: a French multicentre cohort study. Hum Reprod 2013; 28:2381-8. [PMID: 23832792 DOI: 10.1093/humrep/det268] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
STUDY QUESTION What are the outcomes of French emergency IVF procedures involving embryo freezing for fertility preservation before gonadotoxic treatment? SUMMARY ANSWER Pregnancy rates after emergency IVF, cryopreservation of embryos, storage, thawing and embryo transfer (embryo transfer), in the specific context of the preservation of female fertility, seem to be similar to those reported for infertile couples undergoing ART. STUDY DESIGN, SIZE, DURATION A French retrospective multicentre cohort study initiated by the GRECOT network-the French Study Group for Ovarian and Testicular Cryopreservation. We sent an e-mail survey to the 97 French centres performing the assisted reproduction technique in 2011, asking whether the centre performed emergency IVF and requesting information about the patients' characteristics, indications, IVF cycles and laboratory and follow-up data. The response rate was 53.6% (52/97). PARTICIPANTS/MATERIALS, SETTING, METHODS Fourteen French centres reported that they performed emergency IVF (56 cycles in total) before gonadotoxic treatment, between 1999 and July 2011, in 52 patients. MAIN RESULTS AND THE ROLE OF CHANCE The patients had a mean age of 28.9 ± 4.3 years, and a median length of relationship of 3 years (1 month-15 years). Emergency IVF was indicated for haematological cancer (42%), brain tumour (23%), sarcoma (3.8%), mesothelioma (n = 1) and bowel cancer (n = 1). Gynaecological problems accounted for 17% of indications. In 7.7% of cases, emergency IVF was performed for autoimmune diseases. Among the 52 patients concerned, 28% (n = 14) had undergone previous courses of chemotherapy before beginning controlled ovarian stimulation (COS). The initiation of gonadotoxic treatment had to be delayed in 34% of the patients (n = 19). In total, 56 cycles were initiated. The mean duration of stimulation was 11.2 ± 2.5 days, with a mean peak estradiol concentration on the day on which ovulation was triggered of 1640 ± 1028 pg/ml. Three cycles were cancelled due to ovarian hyperstimulation syndrome (n = 1), poor response (n = 1) and treatment error (n = 1). A mean of 8.2 ± 4.8 oocytes were retrieved, with 6.1 ± 4.2 mature oocytes and 4.4 ± 3.3 pronuclear-stage embryos per cycle. The mean number of embryos frozen per cycle was 4.2 ± 3.1. During follow-up, three patients died from the consequences of their disease. For the 49 surviving patients, 22.5% of the couples concerned (n = 11) requested embryo replacement. A total of 33 embryos were thawed with a post-thawing survival rate of 76%. Embryo replacement was finally performed for 10 couples with a total of 25 embryos transferred, leading to one biochemical pregnancy, one miscarriage and three live births. Clinical pregnancy rate and live birth per couple who wanted a pregnancy after cancer were, respectively, 36% (95% CI = 10.9-69.2%) and 27% (95% CI = 6.0-61%). LIMITATIONS, REASONS FOR CAUTION The overall response rate for clinics was 53.6%. Therefore, it is not only that patients may not have been included, but also that those that were included were biased towards the University sector with a response rate of 83% (25/30) for a small number of patients. WIDER IMPLICATIONS OF THE FINDINGS According to literature, malignant disease is a risk factor for a poor response to COS. However, patients having emergency IVF before gonadotoxic treatment have a reasonable chance of pregnancy after embryo replacement. Embryo freezing is a valuable approach that should be included among the strategies used to preserve fertility. STUDY FUNDING/COMPETING INTEREST(S) No external funding was sought for this study. None of the authors has any conflict of interest to declare.
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Affiliation(s)
- B Courbiere
- Department of Gynaecology, Obstetrics, and Reproduction, AP-HM La Conception, 13 005 Marseille, France
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Tjon-Kon-Fat RI, Bensdorp AJ, Maas J, Oosterhuis GJE, Hoek A, Hompes PGA, Broekmans FJ, Verhoeve HR, de Bruin JP, Repping S, Cohlen BJ, Groen H, Mol BWJ, van der Veen F, Wely M, Peeraer K, Debrock S, De Loecker P, Laenen A, Welkenhuyzen M, Spiessens C, De Neubourg D, D'Hooghe TM, Puri S, Mohan B, Herbemont C, Adda E, Hugues JN, Sermondade N, Dupont C, Cedrin-Durnerin I, Poncelet C, Levy R, Sifer C, Bellver J, Pellicer A, Garcia-Velasco JA, Ballesteros A, Remohi J, Meseguer M. Session 45: Clinical female infertility. Hum Reprod 2013. [DOI: 10.1093/humrep/det178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sermondade N, Dupont C, Massart P, Cédrin-Durnerin I, Lévy R, Sifer C. [Impact of polycystic ovary syndrome on oocyte and embryo quality]. ACTA ACUST UNITED AC 2012; 41:27-30. [PMID: 23286960 DOI: 10.1016/j.gyobfe.2012.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 10/12/2012] [Indexed: 10/27/2022]
Abstract
This review analyzes the literature concerning oocyte and embryo quality, in case of in vitro fertilization (IVF) for women with polycystic ovary syndrome (PCOS). Alterations in oocyte quality, and consequently in embryo quality, may be due to endocrine and intra-ovarian paracrine changes. However, most of publications find similar biological and clinical results after IVF, with or without microinjection, for women with PCOS compared to those obtained in control populations. Subgroups of more pejorative outcome probably exist within PCOS population. Finally, obesity, which is frequent in PCOS, is clearly deleterious, and multidisciplinary care, including lifestyle modifications, is then needed.
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Affiliation(s)
- N Sermondade
- Service d'histologie-embryologie-cytogénétique-CECOS, hôpital Jean-Verdier, AP-HP, avenue du 14-Juillet, Bondy, France.
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Hakima N, Sermondade N, Sifer C. Causes spermatiques et échecs de fécondance : quelles explorations autres que le spermogramme ? ACTA ACUST UNITED AC 2012; 40:543-8. [DOI: 10.1016/j.gyobfe.2012.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Accepted: 05/24/2012] [Indexed: 10/28/2022]
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Affiliation(s)
- C Sifer
- Service d'histologie-embryologie-cytogénétique, centre hospitalier universitaire Jean-Verdier, Assistance publique-Hôpitaux de Paris, avenue du 14-Juillet, Bondy, France.
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Bonneau C, Chanelles O, Sifer C, Poncelet C. Use of laparoscopy in unexplained infertility. Eur J Obstet Gynecol Reprod Biol 2012; 163:57-61. [PMID: 22512828 DOI: 10.1016/j.ejogrb.2012.03.036] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Revised: 11/21/2011] [Accepted: 03/22/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The use of laparoscopy in unexplained infertility work-up is still a subject of debate, although laparoscopy remains the gold standard for diagnosis and treatment of several pelvic pathologies. The objective of this study was to assess the rates and types of pelvic pathologies observed during diagnostic laparoscopy, and the pregnancy rate in couples with unexplained infertility following laparoscopy. STUDY DESIGN Prospective study, from November 2003 to October 2009, including 114 infertile, spontaneously ovulating women with normal clinical examination, ovarian reserve assessment, pelvic ultrasound scan and patent tubes on hysterosalpingography. Semen analyses were normal according to the World Health Organization criteria. After three cycles of ovulation induction with or without intra-uterine insemination and no pregnancy, women were referred for diagnostic laparoscopy. RESULTS Laparoscopy revealed pelvic pathology in 95 patients. Endometriosis, pelvic adhesions and tubal disease were observed and treated in 72, 46 and 24 patients, respectively. Following laparoscopy, bilateral and unilateral tubal patencies were observed in 107 and five patients, respectively. Pregnancy was observed in 77 out of 102 patients who tried to conceive after surgery, 35 of whom conceived using their own tubes. CONCLUSION Diagnostic laparoscopy should be strongly considered in unexplained infertility work-up, and tubal efficiency should not be underestimated.
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Affiliation(s)
- C Bonneau
- Department of Obstetrics and Gynaecology, Pôle Femme-et-Enfant, CHU Jean Verdier, APHP, Bondy, France
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Benammar A, Sermondade N, Faure C, Dupont C, Cedrin-Durnerin I, Sifer C, Hercberg S, Levy R. Nutrition et fausses couches spontanées : une revue de la littérature. ACTA ACUST UNITED AC 2012; 40:162-9. [DOI: 10.1016/j.gyobfe.2012.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 09/07/2011] [Indexed: 12/14/2022]
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Li F, Ozkaya E, Akula K, De Sutter P, Oktay K, Rives N, Milazzo JP, Perdrix A, Bironneau A, Travers A, Mace B, Liard A, Bachy B, Elbaz V, Vannier JP, Delle Piane L, Dolfin E, Salvagno F, Molinari E, Gennarelli G, Marchino GL, Revelli A, Durmaz A, Komurcu N, Sanchez-Serrano M, Dolmans MM, Greve T, Pellicer A, Donnez J, Yding Andersen C, Vlismas A, Sabatini L, Edwards C, Mohamed M, Caragia A, Pepas L, Al-Shawaf T, Sanhueza P, Carrasco I, Rios M, Donoso P, Salinas R, Enriquez R, Saez V, Gonzalez P, Aydin Y, Cepni I, Ocal P, Aydin B, Aydogan B, Salahov R, Idil M, Akman L, Akdogan A, Sahin G, Terek C, Ozsaran A, Dikmen Y, Goker ENT, Tavmergen E, Grynberg M, Poulain M, Sebag Peyrelevade S, Treves R, Frydman N, Fanchin R, Borras A, Manau D, Espinosa N, Calafell JM, Moreno V, Civico S, Fabregues F, Balasch J, Kim MK, Lee DR, Cha SK, Lee WS, Kim YS, Won HJ, Han JE, Yoon TK, Torgal M, Bravo I, Metello JL, Sanches F, Sa e Melo P, Silber S, Ernst E, Andersen C, Naasan M, Oluyede G, Kirkham C, Ciprike V, Mocanu E, Martinez-Madrid B, Encinas T, Tinetti P, Jimenez L, Gilabert JA, Picazo RA, Wiweko B, Maidarti M, Bastings L, Liebenthron J, Westphal JR, Beerendonk CCM, Gerritse R, Braat DDM, Montag M, Peek R, Bernstein S, Wiesemann C, Karimi M, Omani Samani R, Labied S, Delforge YVES, Munaut C, Blacher S, Colige A, Delcombel R, Henry L, Fransolet M, Perrier d'Hauterive S, Nisolle M, Foidart JM, Sakai H, Sakamoto E, Kuchiki M, Doshida M, Toya M, Kyono K, Kyoya T, Ishikawa T, Nakamura Y, Shibuya Y, Tomiyama T, Kyono K, Sakamoto E, Sakai H, Kuchiki M, Sato K, Nakajo Y, Kyono K, Hashemifesharaki M, Falcone P, Lofiego V, Pisoni M, Ricci S, Pilla F, Mereu L, Mencaglia L, Westphal JR, Gerritse R, Beerendonk CCM, Bastings L, Braat DDM, Peek R, Schmidt KT, Nyboe Andersen A, Yding Andersen C, Noyes N, Melzer K, Fino ME, Druckenmiller S, Smith M, Knopman JM, Devesa M, Coroleu B, Tur R, Gonzalez C, Rodriguez I, Veiga A, Barri PN, Courbiere B, Decanter C, Bringer-Deutsch S, Rives N, Mirallie S, Pech JC, De Ziegler D, Carre-Pigeon F, May-Panloup P, Sifer C, Amice V, Schweitzer T, Porcu-Buisson G, Gook D, Archer J, Edgar DH, Maldonado I, Varghese A, Lopez P, Cervantes E, Gongora A, Sharma R, Granja J, Marquez MT, Agarwal A. MALE AND FEMALE FERTILITY PRESERVATION. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.82] [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: 11/14/2022] Open
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Hu JCY, Seo BK, Neri QV, Rozenwaks Z, Palermo GD, Fields T, Neri QV, Monahan D, Rosenwaks Z, Palermo GD, Szkodziak P, Plewka K, Wozniak S, Czuczwar P, Mroczkowski A, Lorenzo Leon C, Hernandez J, Chinea Mendez E, Concepcion Lorenzo C, Sanabria Perez V, Puopolo M, Palumbo A, Toth B, Franz C, Montag M, Boing A, Strowitzki T, Nieuwland R, Griesinger G, Schultze-Mosgau A, Cordes T, Depenbusch M, Diedrich K, Vloeberghs V, Verheyen G, Camus M, Van de Velde H, Goossens A, Tournaye H, Coppola G, Di Caprio G, Wilding M, Ferraro P, Esposito G, Di Matteo L, Dale R, Coppola G, Dale B, Daoud S, Auger J, Wolf JP, Dulioust E, Lafuente R, Lopez G, Brassesco M, Hamad M, Montenarh M, Hammadeh M, Robles F, Magli MC, Crippa A, Pescatori E, Ferraretti AP, Gianaroli L, Zahiri M, Movahedin M, Mowla SJ, Noruzinia M, Crippa A, Ferraretti AP, Magli MC, Crivello AM, Robles F, Gianaroli L, Sermondade N, Dupont C, Hafhouf E, Cedrin-Durnerin I, Poncelet C, Benzacken B, Levy R, Sifer C, Ferfouri F, Boitrelle F, Clement P, Molina Gomes D, Bailly M, Selva J, Vialard F, Yaprak E, Basar M, Guzel E, Arda O, Irez T, Norambuena P, Krenkova P, Tuettelmann F, Kliesch S, Paulasova P, Stambergova A, Macek M, Macek M, Rivera R, Garrido-Gomez T, Galletero S, Meseguer M, Dominguez F, Garrido N, Mallidis C, Sanchez V, Weigeng L, Redmann K, Wistuba J, Gross P, Wuebbelling F, Fallnich C, Burger M, Kliesch S, Schlatt S, San Celestino Carchenilla M, Pacheco Castro A, Simon Sanjurjo P, Molinero Ballesteros A, Rubio Garcia S, Garcia Velasco JA, Macanovic B, Otasevic V, Korac A, Vucetic M, Garalejic E, Ivanovic Burmazovic I, Filipovic MR, Buzadzic B, Stancic A, Jankovic A, Velickovic K, Golic I, Markelic M, Korac B, Gosalvez J, Ruiz-Jorro M, Garcia-Ochoa C, Sachez-Martin P, Martinez-Moya M, Caballero P, Hasegawa N, Fukunaga N, Nagai R, Kitasaka H, Yoshimura T, Tamura F, Kato M, Nakayama K, Oono H, Kojima E, Yasue K, Watanabe H, Asano E, Hashiba Y, Asada Y, Das M, Al-Hathal N, San-Gabriel M, Phillips S, Kadoch IJ, Bissonnette F, Holzer H, Zini A, Zebitay AG, Irez T, Ocal P, Sahmay S, Karahuseyinoglu S, Usta T, Repping S, Silber S, Van Wely M, Datta A, Nayini K, Eapen A, Barlow S, Lockwood G, Tavares R, Baptista M, Publicover SJ, Ramalho-Santos J, Vaamonde D, Rodriguez I, Diaz A, Darr C, Chow V, Ma S, Smith R, Jeria F, Rivera J, Gabler F, Nicolai H, Cunha M, Viana P, Goncalves A, Silva J, Oliveira C, Teixeira da Silva J, Ferraz L, Madureira C, Doria S, Sousa M, Barros A, Herrero MB, Delbes G, Troueng E, Holzer H, Chan PTK, Vingris L, Setti AS, Braga DPAF, Figueira RCS, Iaconelli A, Borges E, Sargin Oruc A, Gulerman C, Zeyrek T, Yilmaz N, Tuzcuoglu D, Cicek N, Scarselli F, Terribile M, Franco G, Zavaglia D, Dente D, Zazzaro V, Riccio T, Minasi MG, Greco E, Cejudo-Roman A, Ravina CG, Candenas L, Gallardo-Castro M, Martin-Lozano D, Fernandez-Sanchez M, Pinto FM, Balasuriya A, Serhal P, Doshi A, Harper J, Romany L, Garrido N, Fernandez JL, Pellicer A, Meseguer M, Ribas-Maynou J, Garcia-Peiro A, Fernandez-Encinas A, Prada E, Jorda I, Cortes P, Llagostera M, Navarro J, Benet J, Kesici H, Cayli S, Erdemir F, Karaca Z, Aslan H, Karaca Z, Cayli S, Ocakli S, Kesici H, Erdemir F, Aslan H, Tas U, Ozdemir AA, Aktas RG, Tok OE, Ocakli S, Cayli S, Karaca Z, Erdemir F, Aslan H, Li S, Lu C, Hwu Y, Lee RK, Landaburu I, Gonzalvo MC, Clavero A, Ramirez JP, Pedrinaci S, Serrano M, Montero L, Carrillo S, Weiss J, Ortiz AP, Castilla JA, Sahin O, Bakircioglu E, Serdarogullari M, Bayram A, Yayla S, Ulug U, Tosun SB, Bahceci M, Aktas RG, Ozdemir AA, Tok OE, Yoon SY, Shin DH, Shin TE, Park EA, Won HJ, Kim YS, Lee WS, Yoon TK, Lee DR, Hattori H, Nakajo Y, Kyoya T, Kuchiki M, Kanto S, Kyono K, Park M, Park MR, Lim EJ, Lee WS, Yoon TK, Lee DR, Choi Y, Mitra A, Bhattacharya J, Kundu A, Mukhopadhaya D, Pal M, Enciso M, Alfarawati S, Wells D, Fernandez-Encinas A, Garcia-Peiro A, Ribas-Maynou J, Abad C, Amengual MJ, Navarro J, Benet J, Esmaeili V, Safiri M, Shahverdi AH, Alizadeh AR, Ebrahimi B, Brucculeri AM, Ruvolo G, Giovannelli L, Schillaci R, Cittadini E, Scaravelli G, Perino A, Cortes Gallego S, Gabriel Segovia A, Nunez Calonge R, Guijarro Ponce A, Ortega Lopez L, Caballero Peregrin P, Heindryckx B, Kashir J, Jones C, Mounce G, Ramadan WM, Lemmon B, De Sutter P, Parrington J, Turner K, Child T, McVeigh E, Coward K, Bakircioglu E, Ulug U, Tosun S, Serdarogullari M, Bayram A, Ciray N, Bahceci M, Saeidi S, Shapouri F, Hoseinifar H, Sabbaghian M, Pacey A, Aflatoonian R, Bosco L, Ruvolo G, Carrillo L, Pane A, Manno M, Roccheri MC, Cittadini E, Selles E, Garcia-Herrero S, Martinez JA, Munoz M, Meseguer M, Garrido N, Durmaz A, Dikmen N, Gunduz C, Tavmergen Goker E, Tavmergen E, Gozuacik D, Vatansever HS, Kara B, Calimlioglu N, Yasar P, Tavmergen E, Tavmergen Goker E, Semerci B, Baka M, Ozbilgin K, Karabulut A, Tekin A, Sabah B, Cottin V, Kottelat D, Fellmann M, Halm S, Rosenthaler E, Kisida T, Kojima F, Sakamoto T, Makutina VA, Balezin SL, Rosly OF, Slishkina TV, Hatzi E, Lazaros L, Xita N, Makrydimas G, Sofikitis N, Kaponis A, Stefos T, Zikopoulos K, Georgiou I, Zikopoulos K, Lazaros L, Xita N, Makrydimas G, Sofikitis N, Kaponis A, Stefos T, Hatzi E, Georgiou I, Georgiou I, Lazaros L, Xita N, Makrydimas G, Sofikitis N, Kaponis A, Stefos T, Hatzi E, Zikopoulos K, Hibi H, Ohori T, Sumitomo M, Asada Y, Anarte C, Calvo I, Domingo A, Presilla N, Aleman M, Bou R, Guardiola F, Agirregoikoa JA, De Pablo JL, Barrenetxea G, Zhylkova I, Feskov O, Feskova I, Zozulina O, Somova O, Nabi A, Khalili MA, Roudbari F, Parmegiani L, Cognigni GE, Bernardi S, Taraborrelli S, Troilo E, Ciampaglia W, Pocognoli P, Infante FE, Tabarelli de fatis C, Arnone A, Maccarini AM, Filicori M, Silva L, Oliveira JBA, Petersen CG, Mauri AL, Massaro FC, Cavagna M, Baruffi RLR, Franco JG, Fujii Y, Endou Y, Mtoyama H, Shokri S, Aitken RJ. ANDROLOGY. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.73] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sifer C, Sermondade N, Dupont C, Poncelet C, Cédrin-Durnerin I, Hugues JN, Benzacken B, Levy R. [Outcome of embryo vitrification compared to slow freezing process at early cleavage stages. Report of the first French birth]. ACTA ACUST UNITED AC 2011; 40:158-61. [PMID: 22154672 DOI: 10.1016/j.gyobfe.2011.10.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 10/13/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Since the end of 2010, France by "l'Agence de Biomédecine" has validated the embryo vitrification procedure as an improvement of the slow freezing method. We presented here data concerning biological and clinical outcomes from a prospective observational study where early cleavage stage good quality embryos were vitrified and warmed. We compared these results to those of a retrospective series where embryos were thawed after a slow freezing procedure (SF). We report also the first French live birth following embryo vitrification. PATIENTS AND METHODS In all, 58 cycles of frozen-thawed embryo transfers (FET) following vitrification were prospectively included and compared with 189 FET from SF method. Primary end points were the (i) survival rate (SR) (% of embryos with ≥50% post-thaw intact blastomeres), (ii) intact survival rate (ISR) (% of embryos with 100% post-thaw intact blastomeres) and (iii) survival blastomeres index (SBI) (% of post thaw intact blastomeres per survival embryo). Secondary end point was the clinical pregnancy rate (CPR) defined as the presence of an intra-uterine gestational sac with positive foetal heart beat. We report here the first French live birth following embryo vitrification. RESULTS In all, 87 and 412 embryos have been thawed following vitrification and SF, respectively. We observed a highly significant increase of SR, ISR et SBI respectively when thawing concerned vitrified embryos rather than those from SF method (98.3±13.1% vs. 77.3±32.0%, P<10(-4); 88.2±28.3% vs. 47.7±41.4%, P<10(-4); 97.7±6.1% vs. 87.3±14.4%, P<10(-4)). Furthermore, CPR were of 32.7% (19/58) and of 18.5% (35/189) following FET performed after vitrification or SF and thawing (P=0.03), respectively. The live birth of two healthy girls occurred following a caesarean section after 38 weeks of amenorrhea the 8th of August 2011. DISCUSSION AND CONCLUSION We experienced in our study that the post-thaw survival of vitrified embryos was significantly better than those of embryos resulting from SF. Then, a better CPR per thawed embryo cycle was observed following vitrification.
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Affiliation(s)
- C Sifer
- Service d'histologie-embryologie-cytogénétique, pôle femme-et-enfant, CHU Jean-Verdier, Assistance Publique-Hôpitaux de Paris, avenue du 14-juillet, Bondy, France.
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Poncelet C, Bonneau C, Sifer C, Chanelles O. Interest of laparoscopy for “Unexplained Infertility”. Fertil Steril 2011. [DOI: 10.1016/j.fertnstert.2011.07.581] [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: 10/17/2022]
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Sermondade N, Hafhouf E, Dupont C, Bechoua S, Palacios C, Eustache F, Poncelet C, Benzacken B, Lévy R, Sifer C. Successful childbirth after intracytoplasmic morphologically selected sperm injection without assisted oocyte activation in a patient with globozoospermia. Hum Reprod 2011; 26:2944-9. [PMID: 21857011 DOI: 10.1093/humrep/der258] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We here report a successful pregnancy and healthy childbirth obtained in a case of total globozoospermia after intracytoplasmic morphologically selected sperm injection (IMSI) without assisted oocyte activation (AOA). Two semen analyses showed 100% globozoospermia on classic spermocytogram. Motile sperm organelle morphology examination (MSOME) analysis at ×10,000 magnification confirmed the round-headed aspect for 100% of sperm cells, but 1% of the spermatozoa seemed to present a small bud of acrosome. This particular aspect was confirmed by transmission electron microscopy and anti-CD46 staining analysis. Results from sperm DNA fragmentation and fluorescence in situ hybridization analyses were normal. The karyotype was 46XY, and no mutations or deletions in SPATA16 and DPY19L2 genes were detected. Considering these results, a single IMSI cycle was performed, and spermatozoa were selected for the absence of vacuoles and the presence of a small bud of acrosome. A comparable fertilization rate with or without calcium-ionophore AOA was observed. Two fresh top-quality embryos obtained without AOA were transferred at Day 2 after IMSI, leading to pregnancy and birth of a healthy baby boy. This successful outcome suggests that MSOME may be useful in cases of globozoospermia in order to carefully evaluate sperm morphology and to maximize the benefit of ICSI/IMSI.
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Affiliation(s)
- N Sermondade
- Service d'Histologie-Embryologie-Cytogénétique-CECOS, Hôpital Jean Verdier (AP-HP), Avenue du 14 Juillet, 93143 Bondy, France.
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Sermondade N, Sifer C. Observation des spermatozoïdes au fort grossissement (MSOME) : y a-t-il un consensus ? ACTA ACUST UNITED AC 2011; 39:309-14. [DOI: 10.1016/j.gyobfe.2011.03.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Accepted: 03/07/2011] [Indexed: 11/26/2022]
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Bern O, Strassburger D, Komarovsky D, Kasterstein E, Komsky A, Maslansky B, Raziel A, Ben-Ami I, Friedler S, Gidoni Y, Ron-El R, Barblett H, Shah T, Pinkus C, Mehmet D, Rebollar-Lazaro I, Dupont C, Sermondade N, Hafhouf E, Levy R, Cedrin-Durnerin I, Hugues JN, Poncelet C, Sifer C, Remohi Gimenez J, Cobo Cabal A, de los Santos MJ, Bellver J, Mifsud A, Romero JLL, Chamayou S, Bonaventura G, Alecci C, Tibullo D, Guglielmino A, Barcellona ML, Murakami M, Egashira A, Araki Y, Kuramoto T. SELECTED ORAL COMMUNICATION SESSION, SESSION 31: EMBRYOLOGY - CRYOPRESERVATION, Tuesday 5 July 2011 10:00 - 11:30. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.31] [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: 11/12/2022] Open
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Lucas H, Lammers J, Pfeffer J, Aknin I, Carré-Pigeon F, Jafou N, Paulus JM, Sifer C. FIV conventionnelle versus ICSI sur une même cohorte ovocytaire : analyse de l’expérience française pour les BLEFCO. ACTA ACUST UNITED AC 2010; 38:515-20. [DOI: 10.1016/j.gyobfe.2010.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Accepted: 07/05/2010] [Indexed: 10/19/2022]
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