Florence Scheffler

Objectif : Les objectifs de ce travail étaient : - de déterminer les concentrations des hormones de l'axe thyréotrope, somatotrope et de la vitamine D dans le liquide folliculaire (LF), ainsi que la présence d'anticorps antithyroïdiens (ACAT) ; - et d'analyser les associations de ces données avec les différents paramètres de fécondation in vitro (FIV).Matériel et méthodes : Une étude prospective a été menée dans le service de Médecine et Biologie de la Reproduction du CHU-Amiens Picardie. Les couples inclus étaient ceux bénéficiant d'une 1ère ou 2ème tentative de FIV. Les femmes incluses étaient euthyroïdiennes et de moins de 36 ans, les hommes devaient être âgés de moins de 45 ans avec une numération spermatique supérieure à 5x106/ml. Le dosage de la thyroid stimulating hormone (TSH), la triiodothyronine libre (T3L), thyroxine libre (T4L), l'hormone de croissance (GH), l'insulin-like growth factor 1 (IGF1), la 25 hydroxyvitamine D (25(OH)D) et des anticorps anti-thyroperoxydase (TPO) et anti-thyroglobuline (TG) a été réalisé dans les LF et le sérum le jour de la ponction ovocytaire. 3 analyses ont été réalisées à la recherche : - D'une corrélation entre les taux folliculaires et sériques, - D'une association ente les taux folliculaires et la qualité d'une cohorte ovocytaire, - D'une association ente les taux folliculaires et les issues de tentatives de FIV.Résultats : Une corrélation positive a été observée entre les taux sériques et folliculaires pour les hormones TSH, T3L, T4L, IGF1, 25(OH)D et les ACAT, mais pas pour la GH. Lors de l'analyse d'une cohorte d'ovocytes, une moindre proportion d'anomalies morphologiques ovocytaires est associée à des concentrations folliculaires plus élevées en GH et IGF1. L'obtention d'une grossesse en FIV est associée à une plus haute concentration folliculaire en 25(OH)D. Conclusion : Les concentrations en GH, IGF1 et 25(OH)D folliculaires sont associées aux résultats de tentatives de FIV +/- ICSI dans notre population. Il serait utile de confirmer nos résultats dans une plus large cohorte

Purpose Transgender men (TGM) are individuals who identify as males but were assigned female sex at birth. Gender-affirming testosterone therapy (GATT) is used to induce virilization, and its effects on fertility are discussed. To provide TGM with complete fertility counseling, we synthesized data concerning the impact of GATT on ovarian reserve and oocyte quality. Methods We conducted a narrative review of published data on the ovarian and oocyte features induced by GATT in TGM. Results Data on ovarian morphology and histology showed a normal proportion of primordial, primary, pre-antral, and antral follicles, and a significantly higher number of atretic and cystic follicles. Additionally, ovaries exhibited diffuse ovarian stromal hyperplasia and a thicker ovarian cortex, tunica albuginea, and basal membrane. No impact on ovarian reserve was observed. Oocyte quality following ovarian stimulation did not appear to be impaired and led to the birth of healthy offspring. Conclusion These findings may reassure transgender patients and their care providers that satisfactory reproductive outcomes are possible, even if GATT has already been initiated. However, further investigation is needed to assess the reversibility and functional impact of these changes on ovarian folliculogenesis, ART success rates, pregnancy, and child health.

Objective(s): Premature ovarian insufficiency (POI), affecting 1% of women, is characterized by the loss of ovarian activity with amenorrhea or oligomenorrhea and increased gonadotropins occurring before the age of 40 years. Iatrogenic, autoimmune, and genetic causes are known to be involved in POI, but nearly 70% of all forms remain unexplained. Recent and new genetic analyses promote the identification of new candidate genes. The aim of this study was to evaluate the contribution of array-CGH and next-generation sequencing (NGS) in the diagnosis of POI. Study design: Twenty-eight idiopathic POI patients with primary or secondary amenorrhea underwent genetic screening by array-CGH and NGS using a custom capture design of 163 genes known or suspected to be involved in ovarian function. The clinical, biological, and ultrasound characteristics of the patients were also recorded. Results: Four of the twenty-eight patients had primary amenorrhea (14.3%), and twenty-four (85.7%) had secondary amenorrhea, with an average age at diagnosis of 27.7. Eleven patients (39.3%) had a family history of POI. Our study identified a genetic anomaly in 16 of 28 patients (57.1%): one patient carried a causal copy number variation (CNV), eight patients carried a causal single nucleotide variation (SNV)/indel variation (28.6%), and seven other patients carried variants of uncertain significance. Conclusions: Our study was the first to combine genetic analyses by using both array-CGH and NGS in the same patients. It confirmed the usefulness of both analyses in the identification of pathogenic variations responsible for idiopathic POI. Early genetic diagnosis plays a major role in the management of complications and the screening of relatives.

Introduction: Oocyte quality contributes to the development of an optimal embryo and thus a successful pregnancy. The objective of this study was to analyse the association between oocyte cohort quality and the follicular levels of growth hormone (GH), insulin-like growth factor 1 (IGF1), 25-hydroxy vitamin D (25OHD), thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4) and antithyroid antibodies, as a function of intracytoplasmic sperm injection (ICSI) outcomes.Material and methods: We conducted a prospective comparative pilot study from January 2013 to December 2017. 59 ICSI cycles constituted an abnormal oocyte cohort (n=34 cycles, in which more than 50% of oocytes presented at least one morphological abnormality) and a normal oocyte cohort (n=25 cycles, in which 50% or less of the oocytes presented at least one morphological abnormality). GH, IGF1, 25OHD, TSH, fT3, fT4 and antithyroid antibodies were measured in follicular fluid.Results: The fertilisation rate was lower in the abnormal oocyte cohort (65.5%vs.80%, respectively, p=0.012). Oocytes’ proportion with at least one abnormality was 79.4% in the abnormal oocyte cohort and 29.0% in the normal oocyte cohort. The mean number of morphological abnormalities per oocyte was significantly higher in the abnormal oocyte cohort. The follicular levels of GH (4.98vs.2.75 mIU/L, respectively; p vs.54.2 ng/mL, respectively; p=0.05) were higher in the normal oocyte cohort. There was no association with follicular levels of TSH, fT3, fT4, antithyroid antibodies, or 25OHD.Conclusion: Oocyte cohort quality appears to be associated with follicular levels of GH and IGF1.