title: [Repeated in vitro fertilization failure: Abnormalities identified in the diagnostic assessment].
abstract: OBJECTIVE
  Investigate the proportion of abnormalities identified on the diagnostic assessment performed after at least two previous failed IVF attempts. Discuss the real benefit of this evaluation.
  
  
  METHODS
  Retrospective descriptive study. Between January 2008 and January 2012, 205 couples with at least two consecutive failed IVF attempts had a diagnosis evaluation which consisted in couple's karyotypes; autoimmune and haemostasis biological check-up, pelvic ultrasound-Doppler and hysteroscopy for women.
  
  
  RESULTS
  The main biological anomalies were autoimmune for 23.9% of women: antinuclear antibodies (5.7%), antithyroid peroxidase (11.5%) and antithyroglobulin (8.3%); thrombotic with antiphospholipid antibodies for 8.2% of women (1.4% lupus anticoagulant and 6.8% anticardiolipin antibodies), and heterozygous prothrombin gene mutation for 9.5%. Karyotypes were abnormal for 2.1% of women and 0% of men. Ultrasound-Doppler appeared to be abnormal in 44.7% of cases (pulsatility index of uterine artery≥3 and/or protodiastolic notch), and diagnostic hysteroscopy was abnormal in 14.6% of cases. In order to target the real implantation failure, we compared the groups "<8 embryos transferred" versus "≥8 embryos transferred" and "pregnancy after the third or fourth IVF cycle" versus "no pregnancy", but no statistically significant difference was found.
  
  
  CONCLUSIONS
  The diagnostic assessment carried out for recurrent IVF failure can detect biological, karyotypic and morphological abnormalities, in the same proportion that in previous studies. Further studies will have to be conducted to evaluate the real impact of these abnormalities in the recurrent implantation failure and the effectiveness of therapeutic care.
authors.affiliation: Service d'assistance médicale à la procréation, centre Aliénor d'Aquitaine, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Lambert
authors.affiliation: Service d'assistance médicale à la procréation, centre Aliénor d'Aquitaine, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Hocké
authors.affiliation: Laboratoire de biologie de la reproduction, centre Aliénor d'Aquitaine, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Jimenez
authors.affiliation: Service d'assistance médicale à la procréation, centre Aliénor d'Aquitaine, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Frantz
authors.affiliation: Laboratoire de biologie de la reproduction, centre Aliénor d'Aquitaine, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Papaxanthos
authors.affiliation: Service d'assistance médicale à la procréation, centre Aliénor d'Aquitaine, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France. Electronic address: helenecreux@gmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Creux
mesh_terms: D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood; D017152:Antibodies, Antiphospholipid / Q000097:blood; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000150:complications; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007246:Infertility / Q000209:etiology* / Q000235:genetics; D007453:Iodide Peroxidase / Q000276:immunology; D059785:Karyotype; D008297:Male; D009154:Mutation; D011247:Pregnancy; D011516:Prothrombin / Q000235:genetics; D012189:Retrospective Studies; D017211:Treatment Failure
chemical_list: D000974:Antibodies, Antinuclear; D017152:Antibodies, Antiphospholipid; D001323:Autoantibodies; C006606:anti-thyroglobulin; D011516:Prothrombin; D007453:Iodide Peroxidase
keywords: FIV; IVF failure; Implantation; Infertility IVF; Infertilité; Recurrent implantation failure; Réceptivité utérine; Uterine receptivity; Échecs de FIV; Échecs répétés d’implantation