Échecs répétés de fécondation in vitro : anomalies retrouvées sur le bilan diagnostique

Conclusion Le bilan diagnostique réalisé en cas d’échecs répétés de FIV retrouve des anomalies biologiques, caryotypiques et morphologiques, avec une prévalence proche de la littérature. D’autres études devront être réalisées afin d’évaluer l’impact réel de ces anomalies dans les échecs d’implantation et l’utilité d’une prise en charge thérapeutique. Objectives Investigate the proportion of abnormalities identified on the diagnostic assessment performed after at least two previous failed IVF attempts. Discuss the real benefit of this evaluation. Methods Retrospective descriptive study. Between January 2008 and January 2012, 205 couples with at least two consecutive failed IVF attempts had a diagnosis evaluation which consisted in couple's karyotypes; autoimmune and haemostasis biological check-up, pelvic ultrasound-Doppler and hysteroscopy for women. Results The main biological anomalies were autoimmune for 23.9% of women: antinuclear antibodies (5.7%), antithyroid peroxidase (11.5%) and antithyroglobulin (8.3%); thrombotic with antiphospholipid antibodies for 8.2% of women (1.4% lupus anticoagulant and 6.8% anticardiolipin antibodies), and heterozygous prothrombin gene mutation for 9.5%. Karyotypes were abnormal for 2.1% of women and 0% of men. Ultrasound-Doppler appeared to be abnormal in 44.7% of cases (pulsatility index of uterine artery≥3 and/or protodiastolic notch), and diagnostic hysteroscopy was abnormal in 14.6% of cases. In or...
Source: Gynecologie Obstetrique and Fertilite - Category: OBGYN Source Type: research