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• W2071400916 abstract "En raison du grand nombre de grossesses gémellaires observées après transfert embryonnaire, des complications maternelles et infantiles qu'elles entraînent et de leur coût pour les systèmes de santé, la mise en place de programmes de transfert sélectif d'un embryon unique (TSEU) est devenue une priorité. La France ne rattrapera son retard dans le développement du TSEU par rapport aux pays d'Europe du Nord que si les praticiens sont persuadés que le taux de succès ne souffrira pas trop de son application, ce qui est le cas dans plusieurs protocoles décrits dans la littérature. C'est également le cas dans notre programme réservé aux patientes âgées de moins de 37 ans bénéficiant d'une première FIV–ICSI chez qui, deux embryons de morphologie satisfaisante sont obtenus, l'un étant transféré, l'autre systématiquement congelé. Pour une meilleure efficacité, la sélection des embryons repose sur une double évaluation : observation d'un clivage précoce régulier 26 heures après insémination–injection et observation de la morphologie embryonnaire à j2 fondée sur la présence de quatre blastomères, l'absence d'irrégularités des blastomères et de fragments anucléés. Enfin, une politique de TSEU ne peut se concevoir sans un programme de congélation efficace. Un taux de grossesse après décongélation de 13 % a suffi pour obtenir un taux de grossesse cumulé après TSEU (n = 205), puis transfert d'embryons congelés (TEC) comparable au taux cumulé observé chez les patientes ayant bénéficié d'un transfert de deux embryons (n = 394) suivi d'un TEC (46,3 versus 46,7 %). Le taux d'accouchement gémellaire s'est élevé à 2,6 % après TSEU et à 26,6 % après transfert de deux embryons (p < 0,01). Multiple embryo transfer is associated with a high frequency of twin pregnancies with costly complications involving both mother and child. As a result high priority is currently being given to the development of single embryo transfer (SET) programs. France seems to be lagging behind Northern European countries in the development of SET and widespread use of SET will depend on convincing physicians that this policy will not have a negative impact on success rate, as has been the case for many protocols described in the literature as well as in our own experience. Our SET program includes patients less than 36 years of age undergoing their first FIV–ICSI. If two embryos showing satisfactory morphology are obtained, one is selected transferred and the other is systematically frozen. Selection for transfer is based on two criteria, i.e. observation of even early cleavage 26 hours after FIV–ICSI and evaluation of embryo morphology score on day 2. Embryo morphology score is based on the presence of four blastomeres and absence of blastomere irregularities and anucleated fragmentation. Last, a prerequisite for SET is an effective freezing program. A pregnancy rate of 13% per thawing was sufficient enough to obtain a cumulative pregnancy rate after SET (N = 205) and subsequent frozen embryo transfer (FET) similar to the cumulative pregnancy rate obtained after double embryo transfer (N = 394) and subsequent FET (46.3 vs 46.7%, NS). Twin delivery rate were respectively 2,6% after SET and 26,6% after double embryo transfer (P < 0.01)." @default.
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• W2071400916 date "2006-09-01" @default.
• W2071400916 modified "2023-09-27" @default.
• W2071400916 title "Comment améliorer nos résultats en AMP ? La France est-elle en retard ? Stratégie de transfert de l'embryon unique : la place du choix de l'embryon et de la congélation embryonnaire" @default.
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• W2071400916 doi "https://doi.org/10.1016/j.gyobfe.2006.07.004" @default.
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