{"id":17151,"date":"2023-07-25T09:10:53","date_gmt":"2023-07-25T08:10:53","guid":{"rendered":"https:\/\/now-fertility.com\/recommandations-de-bonnes-pratiques-de-leshre-sur-lechec-recurrent-de-limplantation-rif\/"},"modified":"2023-07-25T09:10:53","modified_gmt":"2023-07-25T08:10:53","slug":"recommandations-de-bonnes-pratiques-de-leshre-sur-lechec-recurrent-de-limplantation-rif","status":"publish","type":"post","link":"https:\/\/now-fertility.com\/fr\/recommandations-de-bonnes-pratiques-de-leshre-sur-lechec-recurrent-de-limplantation-rif\/","title":{"rendered":"Recommandations de bonnes pratiques de l\u2019ESHRE sur l\u2019\u00e9chec r\u00e9current de l\u2019implantation (RIF)"},"content":{"rendered":"

La Soci\u00e9t\u00e9 europ\u00e9enne de m\u00e9decine de la reproduction et d\u2019embryologie (ESHRE) a \u00e9tabli des recommandations de bonnes pratiques fournissant une d\u00e9finition de l\u2019\u00e9chec r\u00e9current de l\u2019implantation (RIF) ainsi que des recommandations sur la fa\u00e7on d\u2019enqu\u00eater sur les causes et d\u2019am\u00e9liorer les chances d\u2019une grossesse.<\/p>\n

D\u00e9finition de l\u2019\u00e9chec r\u00e9current de l\u2019implantation<\/h3>\n

Il y a un manque de coh\u00e9rence dans la d\u00e9finition clinique du RIF. Les facteurs cl\u00e9s qui doivent \u00eatre pris en compte lors de l\u2019\u00e9tablissement de la d\u00e9finition du FRR sont le nombre d\u2019embryons transf\u00e9r\u00e9s, si les embryons transf\u00e9r\u00e9s sont test\u00e9s g\u00e9n\u00e9tiquement et l\u2019\u00e2ge maternel. En g\u00e9n\u00e9ral, un patient consid\u00e9r\u00e9 comme ayant un RIF et devant faire l\u2019objet d\u2019une investigation comprend:<\/p>\n

    \n
  1. Transfert d\u2019embryons euplo\u00efdes (g\u00e9n\u00e9tiquement normaux) :
    \nTransfert de 2 embryons quel que soit l\u2019\u00e2ge de la femme.<\/li>\n
  2. Transfert d\u2019embryons d\u2019euplo\u00efdie inconnue :
    \nTransfert de 3 embryons chez des femmes de moins de 35 ans.
    \nTransfert de 4 embryons chez des femmes \u00e2g\u00e9es de 35 \u00e0 39 ans.
    \nTransfert de 6 embryons chez les femmes de plus de 40 ans.<\/li>\n<\/ol>\n

    Enqu\u00eates pour le FRR<\/h3>\n

    De multiples facteurs et causes du RIF ont \u00e9t\u00e9 sugg\u00e9r\u00e9s et \u00e9tudi\u00e9s. Cependant, il n\u2019y a pas suffisamment de preuves pour permettre d\u2019utiliser des lignes directrices claires pour l\u2019enqu\u00eate et la gestion du RIF. Les enqu\u00eates pour le RIF comprennent l\u2019enqu\u00eate sur les facteurs f\u00e9minins et masculins.<\/p>\n

      \n
    1. Recommand\u00e9<\/strong>
      \nun. Passez en revue les facteurs li\u00e9s au mode de vie (les deux partenaires).
      \nb. Une r\u00e9\u00e9valuation de l\u2019\u00e9paisseur de l\u2019endom\u00e8tre est recommand\u00e9e. Un examen du sch\u00e9ma th\u00e9rapeutique \u00e0 l\u2019\u0153stradiol est recommand\u00e9 s\u2019il est not\u00e9 que l\u2019endom\u00e8tre reste mince. Une hyst\u00e9roscopie pour exclure le syndrome d\u2019Asherman peut \u00eatre envisag\u00e9e.
      \nc. L\u2019\u00e9valuation de l\u2019APA (syndrome des antiphospholipides) et de l\u2019APS est recommand\u00e9e chez les femmes RIF pr\u00e9sentant des facteurs de risque suppl\u00e9mentaires de thrombophilie et peut \u00eatre envisag\u00e9e chez les femmes ne pr\u00e9sentant pas de tels facteurs de risque.<\/li>\n
    2. Peut \u00eatre consid\u00e9r\u00e9<\/strong>
      \nun. Caryotypage (les deux partenaires) pour confirmer l\u2019absence d\u2019anomalie chromosomique chez les parents. Si une anomalie chromosomique est d\u00e9tect\u00e9e, un conseil g\u00e9n\u00e9tique et, le cas \u00e9ch\u00e9ant, un test g\u00e9n\u00e9tique pr\u00e9implantatoire (PGT) sont recommand\u00e9s.
      \nb. \u00c9chographie 3D.
      \nc. Hyst\u00e9roscopie lorsqu\u2019il y a suspicion d\u2019anomalie ut\u00e9rine visualis\u00e9e \u00e0 l\u2019\u00e9chographie transvaginale.
      \nd. Test de la fonction endom\u00e9triale : Bien qu\u2019il n\u2019y ait pas suffisamment de donn\u00e9es pour recommander l\u2019utilisation syst\u00e9matique de tout test de r\u00e9ceptivit\u00e9 de l\u2019endom\u00e8tre disponible dans le commerce pour diagnostiquer la cause de l\u2019IRF, l\u2019\u00e9valuation d\u2019aspects sp\u00e9cifiques de la fonction endom\u00e9triale par des tests peut \u00eatre envisag\u00e9e.
      \ne. L\u2019\u00e9valuation de l\u2019endom\u00e9trite chronique (EC) peut \u00eatre envisag\u00e9e. Si l\u2019EC est diagnostiqu\u00e9e, un traitement antibiotique peut \u00eatre envisag\u00e9.
      \nf. \u00c9valuation de la fonction thyro\u00efdienne.
      \ng. \u00c9valuation des taux de progest\u00e9rone folliculaire tardive et mi-lut\u00e9ale.<\/li>\n
    3. Non recommand\u00e9<\/strong>
      \nun. Les donn\u00e9es sont insuffisantes pour recommander la mesure syst\u00e9matique des niveaux de vitamine D ou le traitement de la carence en vitamine D
      \nb. Profilage du microbiome ut\u00e9rin et vaginal
      \nc. Test des cellules NK p\u00e9riph\u00e9riques et ut\u00e9rines
      \nd. \u00c9valuation des lymphocytes T ut\u00e9rins
      \ne. \u00c9valuation des niveaux de cytokines dans le sang
      \nf. Compatibilit\u00e9 HLA-C
      \ng. Fragmentation de l\u2019ADN des spermatozo\u00efdes<\/li>\n<\/ol>\n

      Interventions pour le RIF<\/h3>\n
        \n
      1. Recommand\u00e9<\/strong>
        \nun. Examiner le traitement \u00e0 l\u2019\u0153stradiol si la muqueuse endom\u00e9triale reste mince
        \nb. Les soins aux patients et le counseling sont recommand\u00e9s puisque les femmes atteintes de RIF ont \u00e9t\u00e9 signal\u00e9es comme ayant des niveaux de stress significativement plus \u00e9lev\u00e9s par rapport aux t\u00e9moins sains et fertiles et admis avec des sentiments d\u2019isolement social et de sensibilit\u00e9 aux commentaires.
        \nc. Optimiser les facteurs li\u00e9s au mode de vie<\/li>\n
      2. Peut \u00eatre consid\u00e9r\u00e9<\/strong>
        \nun. Test g\u00e9n\u00e9tique pr\u00e9implantatoire pour les aneuplo\u00efdies (PGT-A)
        \nb. Transfert d\u2019embryons au stade blastocyste
        \nc. Antibiotiques si l\u2019endom\u00e9trite chronique est diagnostiqu\u00e9e<\/li>\n
      3. Non recommand\u00e9<\/strong>
        \nun. L\u00e9sion intentionnelle de l\u2019endom\u00e8tre
        \nb. Immunomodulation telle que l\u2019administration de facteur de stimulation des colonies de granulocytes (G-CSF) (intra-ut\u00e9rine ou sous-cutan\u00e9e), perfusion intralipidique intraveineuse, immunoglobuline intraveineuse (IgIV)
        \nc. Perfusion intra-ut\u00e9rine de cellules mononucl\u00e9\u00e9es du sang p\u00e9riph\u00e9rique autologue (PBMC)
        \nd. Perfusion intra-ut\u00e9rine de plasma riche en plaquettes (PRP)
        \n<\/span>e. Injection intra-ut\u00e9rine d\u2019hCG
        \nf. H\u00e9parine de bas poids mol\u00e9culaire (HBPM)
        \ng. Pr\u00e9traitement par agoniste de la GnRH et inhibiteur de l\u2019aromatase
        \nh. \u00c9closion assist\u00e9e<\/li>\n<\/ol>\n

        R\u00e9f\u00e9rence: Human Reproduction Open, 2023, 2023(3), hoad023<\/p>\n","protected":false},"excerpt":{"rendered":"

        La Soci\u00e9t\u00e9 europ\u00e9enne de m\u00e9decine de la reproduction et d\u2019embryologie (ESHRE) a \u00e9tabli des recommandations de bonnes pratiques fournissant une d\u00e9finition de l\u2019\u00e9chec r\u00e9current de l\u2019implantation (RIF) ainsi que des recommandations sur la fa\u00e7on d\u2019enqu\u00eater sur les causes et d\u2019am\u00e9liorer les chances d\u2019une grossesse. D\u00e9finition de l\u2019\u00e9chec r\u00e9current de l\u2019implantation Il y a un manque […]<\/p>\n","protected":false},"author":1,"featured_media":16993,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"default","adv-header-id-meta":"2959","stick-header-meta":"enabled","header-above-stick-meta":"on","header-main-stick-meta":"on","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[33],"tags":[],"class_list":["post-17151","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog-fr"],"yoast_head":"\nRecommandations de bonnes pratiques de l\u2019ESHRE sur l\u2019\u00e9chec r\u00e9current de l\u2019implantation (RIF) - NOW-fertility<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/now-fertility.com\/fr\/recommandations-de-bonnes-pratiques-de-leshre-sur-lechec-recurrent-de-limplantation-rif\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Recommandations de bonnes pratiques de l\u2019ESHRE sur l\u2019\u00e9chec r\u00e9current de l\u2019implantation (RIF) - NOW-fertility\" \/>\n<meta property=\"og:description\" content=\"La Soci\u00e9t\u00e9 europ\u00e9enne de m\u00e9decine de la reproduction et d\u2019embryologie (ESHRE) a \u00e9tabli des recommandations de bonnes pratiques fournissant une d\u00e9finition de l\u2019\u00e9chec r\u00e9current de l\u2019implantation (RIF) ainsi que des recommandations sur la fa\u00e7on d\u2019enqu\u00eater sur les causes et d\u2019am\u00e9liorer les chances d\u2019une grossesse. 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