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Master Thesis

L'infection uro-génitale féminine par chlamydiae trachomatis avec ou sans atteinte tubaire induit-elle une diminution de la réserve ovarienne ?

Abstract : Objective : With the limit of the treatment in Procreation Medical Assisted, identified the patients who have a risk of "poor response ovarian" is an actual challenge. If some risk factors (RF) are known, urogenital chlamydia trachomatis (CT) infection and his impact ot ovarian level is poorly docymented. In a unicentric, retrospective study from 2008 to 2015, we tested the link between the serology IgG CT associated or not with a Tubal Lesion (TL) and the Diminished Ovarian Reserve (DOR). Methods : We have defined 4 groups of patients in function of serology IgG status for the CT and TL status : group 1 "control", group 2 "positive serology" isolated, group 3 "TL" isolated, group 4 "positive serology" associated to "TL". Our primary study endpoint was the DOR, extrapolated from BOLOGNA criteria, defined by : a RF of "poor ovarian response" and/or an anomly on ovarian reserve markers. Our secondary endpoints were : ovarian reserve markers, and therapeutic outcome. Results : We analysed 864 files, allocated using the 4 groups (respectively 279, 87, 280, 218). In univariate analysis, we found a significant difference for DOR rates (p=0 ,003). There wasn’t any significant difference for the secondary criterias (related to a lack of power). In multivariate analysis, 2 criterias have been significant : the age, and the combination of "positive serology IgG CT" and "TL" (respectively p=0,029 and p=0,050). L’Odd Ratio is 1,46 [1,17 ; 1,75]. The potency was 93%, the sensitivity of 18,8% and the specificity of 89%. Conclusion : If the age is a RF known, our study is the first wich demonstrate the combination of "positive serology IgG CT" and "TL" as a RF of DOR.
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https://dumas.ccsd.cnrs.fr/dumas-01306879
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Submitted on : Monday, April 25, 2016 - 5:08:03 PM
Last modification on : Monday, July 20, 2020 - 6:46:02 PM
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Pierre-Humbert Hayot. L'infection uro-génitale féminine par chlamydiae trachomatis avec ou sans atteinte tubaire induit-elle une diminution de la réserve ovarienne ?. Sciences du Vivant [q-bio]. 2016. ⟨dumas-01306879⟩

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