In spite of all progress realized in the field of assisted reproduction the pregnancy rate by In vitro fertilization (IVF) in France, across indications, is only 23% after IVF cycle. Different causes may account for these failures and that, during all stages of pregnancy. Recent studies have investigated an essential step in fecundation : uterine receptivity. Some teams have shown that a lot of immunological factors would have very significant in this step, by them possible expression in this process. Other studies looked at genes modulation, essential to implantation, with endometrium manipulation, simple, such as endometrial biopsy (EB). The last findings published on this subject, but after 2 IVF failures, are most encouraging because the pregnancy rate for these teams after just endometrial local injury (EB after 2 IVF failures) is well above their usual pregnancy rate. Some teams have focused on immunoassay of endometrial biopsy, in order to profile uterine receptivity and suggest with results, suitable treatment for each patient (ongoing study). EB is quick, easy, make in a simple consultation and with a low cost, contrary to immunological study, which depend of ultra-specialized laboratories and therefore with an important cost.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
315
Endometrial biopsy (EB) between J17 and J22 of previous ovarian hyperstimulation cycle
CHU de SAINT-ETIENNE
Saint-Etienne, France
number of Early pregnancy
Early pregnancy is defined by beta human chorionic gonadotropin (HCG)\>100 mIU/ml defined by at least one rate of beta HCG\>100 on the 3 possible dosages after embryo transfer (if first dosage negative or \>100 : stop, if first dosage positive but \<100 : Second dosing, if \>100 or less than first result : stop, otherwise third dosing). Endometrial biopsy (diameter : 1mm ; length : 5mm) with use a pipelle, in the second part of the cycle between J17 and J22 during cycle before IVF
Time frame: Day 28
Number of middle pregnancy
Middle pregnancy is defined by an intra uterine gestation sac on echography of 5 or 6 weeks of amenorrheas.
Time frame: 5 weeks of amenorrheas.
Number of late pregnancy
Late pregnancy is defined by an intra uterine evolutionary pregnancy on echography of 12 weeks of amenorrheas.
Time frame: 12 weeks of amenorrheas.
number of Live birth
Time frame: delivery
number of patient with endometrial chronic infection
Presence of endometrial chronic infection is measured by histopathologic analysis of biopsy
Time frame: Day 22 of previous cycle of IVF
number of patient with pain
Pain is estimated by visual analogue scale note at the end of biopsy (day 22 of previous cycle of IVF)
Time frame: Day 22 of previous cycle of IVF
number of patient with endometrial acute infection
An endometrial acute infection is defined by pelvic spontaneous pain and/or leucorrhoea, abnormal metrorrhagia and/or fever appearing after biopsy.
Time frame: Day 24 of previous cycle of IVF
number of patient with uterine perforation
An uterine perforation is defined by intense pain at the time of the biopsy or in the days to come and/or leucorrhoea, abnormal metrorrhagia and/or fever.
Time frame: Day 22 of previous cycle of IVF
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