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Master Thesis

Étude de l’impact du transfert d’embryon congelé (versus transfert d’embryon frais) sur le poids de naissance et le taux de fausses couches

Abstract : Introduction: Various scientific publications have shown a difference in birth weight between children born from fresh embryo transfer (ET) and those born from frozen embryo transfer (FET). However, other studies have shown a not significant difference in weight between children born from ET and from FET. The main objective of this study is to compare the birth weight of children born from in-vitro fertilization (IVF) with FET to those born from IVF with ET. One of the secondary objectives is to investigate whether the transfer of frozen embryos has an impact on the course of pregnancy. Materials and Methods: This is a retrospective, single-centre comparative study within the 1305 IMR/Alphabio centre. Cases studied spread out from January 2014 to December 2018. Singletons born at term with a single pregnancy following transfer of a fresh or frozen embryo with IVF or intracytoplasmic sperm injection (ICSI) have been included in this study. Their parents are under 35 years of age, non-obese, non-smokers, mothers are primiparas without polycystic ovary syndrome, severe endometriosis nor obstetrical pathology. Gamete donation has been excluded. We used the Student's tests for quantitative variables and the Chi 2 test for qualitative variables. Results: 391 files were included in the study. A weight difference of 41.4 g between children born with FET and those born with ET has been noted. Following a Student's test, this weight difference in favor of children born with FET was not significant (p = 0.48). This study shows 44% of miscarriage in a FET versus 29% in a ET. After statistical calculations, this result is not significant. However, considering the rate of miscarriage during a FET and the results found in the literature, we have studied the impact of the FET according to the day of embryo’s transfer. We found 33% of miscarriage at the blastocyst stage versus 69% for a transfer at day 2(p = 0.0035). In addition, the "Hormone Replacement Therapy" protocol (HRT Protocol) results in significantly more miscarriages than the "Spontaneous Cycle" protocol (SC Protocol) and the "Follicle Stimulating Hormone" Protocol (FSH Protocol), regardless of the day of transfer. 47% of FCS for the HRT Protocol, 10% of FCS for the FSH Protocol and 20% of FCS for the SC Protocol. Conclusion: This study shows a 41.4 g difference in birth weight between children born with FET and those born with ET, but this difference is not significant. We can think that this absence of significant difference in weight may be due to the very selective inclusion criteria, deliberately excluding parental characteristics that may influence the child's birth weight. We have shown a link between transfer to the day 3 stage and the blastocyst stage; and a decrease in the rate of miscarriage. In addition, we have shown that the HRT Protocol causes significantly more miscarriage than the SC Protocol and the FSH Protocol.
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Submitted on : Thursday, November 12, 2020 - 3:35:37 PM
Last modification on : Tuesday, October 19, 2021 - 10:35:22 PM
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Mélissa Girard. Étude de l’impact du transfert d’embryon congelé (versus transfert d’embryon frais) sur le poids de naissance et le taux de fausses couches. Gynécologie et obstétrique. 2020. ⟨dumas-03001890⟩



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