Sylvie Epelboin | Université Paris Diderot (original) (raw)

Papers by Sylvie Epelboin

Gynécologie Obstétrique Fertilité & Sénologie

OBJECTIVE To assess the impact of hepatitis B virus (HBV) infection in women on In Vitro Fertiliz... more OBJECTIVE To assess the impact of hepatitis B virus (HBV) infection in women on In Vitro Fertilization (IVF) outcomes. METHODS An observational monocentric case-control cohort study conducted between 2012 and 2019 compared the outcomes of the first cycle of IVF between 64 woman infected with HBV and 128 seronegative controls. Frozen embryos transfers made within 18 months of the puncture were included. The exclusion criteria were severe infections, viral co-infection in women, any viral infection in their spouse, or lack of fresh embryo transfer. The matching was performed according to age, primary infertility or secondary, conventional or intracytoplasmic injection IVF technique and date of attempt. The main analysis focused on cumulative live births rates (LBR). RESULTS The clinical and ovarian stimulation characteristics were comparable except for a longer period of infertility in the HBV group. The LBR in the HBV group, when compared to controls, was not different after transfer of fresh (14.06 vs 25.00% p = 0.08) or frozen embryos (4.17 vs 18.92% p = 0.08), but significantly decreased in cumulative analysis (15.63 vs 35.94% p = 0.003). HBV infection was negatively associated with LBR in multivariate analysis OR = 0.38 (95% CI 0.14-0.92) p <0.05. The implantation rate was lower in the HBV group versus controls, in fresh (14.89 vs 27.72% p = 0.02) and frozen (3.03 vs 21.65% p = 0.01) embryo transfers. CONCLUSION This study suggests a negative impact of HBV infection in women on the cumulative LBR after IVF.

L'Autre, le semblable, le différent..., 2014

Background: It is unknown whether prolonged artificial hormonal environment during early fetal de... more Background: It is unknown whether prolonged artificial hormonal environment during early fetal development affects the birthweight of singletons born after frozen-thawed embryo transfer (FET). Methods: A retrospective observational study included singleton births>22 weeks of gestation obtained after FET between 2013-2019 after endometrial preparation with ovulatory cycle (OC) or artificial cycle (AC). Our primary objective was to compare birthweight of singletons after FET between endometrial preparation by OC or AC. Secondary objectives included prolonged pregnancies, high birthweight, low birthweight, SGA and LGA rates. Multivariate analyses were performed considering potential confounding factors. Results: Among 198 singleton live births after FET, 112 were obtained with OC and 86 with AC. Prolonged pregnancies rate was higher in AC (25.6% vs. 7.1%, respectively, p=0.001). Mean birthweight was higher (+219g) in AC (3386g vs. 3167g, p=0.01; adjusted-p=0.052), as well as the rat...

Contraception Fertilite Sexualite, 1988

Human Reproduction, 2021

Is there an increased risk of preeclampsia after Frozen-thawed Embryo Transfer(FET) compared to I... more Is there an increased risk of preeclampsia after Frozen-thawed Embryo Transfer(FET) compared to In Vitro Fertilization-fresh transfer(IVF-fresh-ET) according to endometrial type of preparation for FET? The frequency of preeclampsia and hypertension were significantly higher in the group of artificial cycle (AC-FET) compared to ovulatory cycle (OC-FET) and fresh-ET (P < 0.0001). Risks of maternal morbidity are known to be reduced in pregnancies resulting from FET compared to fresh-ET except for the risk of preeclampsia, that was reported to be significantly higher in pregnancies resulting from FET compared to fresh-ET or spontaneous conception. Most recent studies demonstrate an equal live birth rate with either OC-FET or AC-FET preparation. Few studies compared the maternal vascular morbidities with the two hormonal environments that preside over the early stages of embryonic development: OC (major role of the corpus luteum) and AC (prolonged hormone replacement with high doses o...

L'approche anthropologique des manifestations d'infertilite, dans une population rurale (... more L'approche anthropologique des manifestations d'infertilite, dans une population rurale (Peuls Bandes) du Senegal Oriental objective une semiologie traditionnelle (representations de la fecondite, therapeutiques locales) qui n'est pas superposable a la semiologie de type scientifique. Toute une serie de malheurs biologiques (fausses couches a repetition, sterilite conjugale, perte d'enfants en bas âge) forment le concept d'infertilite. Les diagnostics etiologiques formules dans le systeme traditionnel aboutissent a une quete therapeutique diversifiee, visant a guerir l'individu, la famille nucleaire, mais aussi le groupe social

PLOS Medicine, 2021

Background To the best of our knowledge, no study has exhaustively evaluated the association betw... more Background To the best of our knowledge, no study has exhaustively evaluated the association between maternal morbidities and Coronavirus Disease 2019 (COVID-19) during the first wave of the pandemic in pregnant women. We investigated, in natural conceptions and assisted reproductive technique (ART) pregnancies, whether maternal morbidities were more frequent in pregnant women with COVID-19 diagnosis compared to pregnant women without COVID-19 diagnosis during the first wave of the COVID-19 pandemic. Methods and findings We conducted a retrospective analysis of prospectively collected data in a national cohort of all hospitalizations for births ≥22 weeks of gestation in France from January to June 2020 using the French national hospitalization database (PMSI). Pregnant women with COVID-19 were identified if they had been recorded in the database using the ICD-10 (International Classification of Disease) code for presence of a hospitalization for COVID-19. A total of 244,645 births w...

La Revue du praticien, 1997

Reproductive BioMedicine Online, 2021

RESEARCH QUESTION What is the prevalence of embryo abnormal early cleavage (ACL) identified by ti... more RESEARCH QUESTION What is the prevalence of embryo abnormal early cleavage (ACL) identified by time lapse and factors related to patients and treatment that explain ACL occurrence? DESIGN A single-centre, retrospective cohort study. Data were collected on all IVF cycles for which embryos were observed in the EmbryoScope® between December 2015 and August 2017. Only diploid zygotes cleaved on day 2 were included. The study included 318 cycles (250 couples and 1343 embryos). Embryo videos were retrospectively analysed for ACL. The prevalence of each type of ACL was recorded. The influence of clinical factors (whether they were intrinsic to patients or specific to IVF treatment) on ACL occurrence was analysed in multivariate multilevel mixed-effect logistic regression analysis. RESULTS A high prevalence of ACL was observed: 37.6% (505/1343) of embryos presented at least one ACL, 22.8% (306/1343) a trichotomous mitosis, 25.8% (347/1343) a rapid cleavage, 6.7% (90/1343) a cell fusion and two or more ACL (16.1%). Part of the variation (12-25%) in ACL occurrence could be explained by embryo origin. Trichotomous mitosis and two or more ACL phenotypes were less likely to occur in women with endometriosis or tubal pathology and tubal pathology alone, respectively. No factor related to IVF cycles was found to be statistically associated with ACL occurrence. CONCLUSIONS Our findings emphasize the importance of considering embryo origin when interpreting studies focusing on embryo characteristics and factors that could affect their quality. The present study is limited by a small sample size of known embryo implantations and monocentric criterion.

Clinical Epigenetics, 2020

Background Epidemiological studies suggest that singletons born from assisted reproductive techno... more Background Epidemiological studies suggest that singletons born from assisted reproductive technologies (ART) have a high risk of adverse perinatal outcomes, specifically for imprinting disorders. Because ART processes take place at times when epigenetic reprogramming/imprinting are occurring, there is concern that ART can affect genomic imprints. However, little is currently known about the risk of imprinting defects according to the type of ART or the type of underlying female infertility. From the French national health database, a cohort of 3,501,495 singletons born over a 5-year period (2013–2017) following fresh embryo or frozen embryo transfers (fresh-ET or FET from in vitro fertilization), intrauterine insemination, or natural conception was followed up to early childhood. Based on clinical features, several syndromes/diseases involving imprinted genes were monitored. The effects of ART conception and the underlying cause of female infertility were assessed. Results Compared...

Journal of Gynecology Obstetrics and Human Reproduction, 2020

In some studies, early pregnancy loss (EPL) rate is higher with artificial cycle (AC) endometrial... more In some studies, early pregnancy loss (EPL) rate is higher with artificial cycle (AC) endometrial preparation for frozen-thawed embryo (FET) transfer than with other protocols, even though pregnancy rates are similar. An inadequate luteal phase support could explain these findings. The aim of this study was to compare, among the patients who had a pregnancy after FET with AC endometrial preparation, serum progesterone (PG) levels between those who experienced an EPL or an ongoing pregnancy. Material and methods: A monocentric retrospective cohort study, conducted at a University affiliated fertility center, studied 130 FET cycles with AC endometrial preparation between June 2016 and July 2017. Serum PG rates were compared according to reproductive outcomes and to endometrial preparation protocol on day 10 or 12 after FET (PG0) according to the embryo stage, and every 48 h in case of pregnancy (i.e. PG1; PG2). Results: Among patients who had a pregnancy after FET with AC (n = 33), serum PG levels were higher in case of an ongoing pregnancy than EPL, only significantly at PG1 (PG0 12.4 ng/mL [7.5À14.6] vs 8.2 ng/mL [6.0À13.0], p = 0.320; PG1 15.0 ng/mL [14.0À15.9] vs 8.5 ng/mL [5.9À13.8], p = 0.048). Discussion: We found that serum PG level was lower in women experiencing early pregnancy loss after FET with AC endometrial preparation, potentially reflecting a lack of appropriate luteal phase support with PG. A cycle AC test, monitoring serum PG levels after its steady state, could detect this lack of PG, allowing physicians to adapt PG supplementation.

Gynécologie Obstétrique Fertilité & Sénologie , 2020

Resume Objectifs L’objectif de cette etude etait de quantifier les risques de morbidite maternell... more Resume Objectifs L’objectif de cette etude etait de quantifier les risques de morbidite maternelle et perinatale en fecondation in vitro (FIV) par rapport aux grossesses non issues de FIV sur une cohorte nationale francaise recente. Methode Les donnees etaient issues du systeme d’information des donnees d’hospitalisation incluant toutes les grossesses ayant conduit a un accouchement et les naissances de 2013 a 2016. Les risques d’accouchement premature, de morbidite maternelle (thrombose veineuse et arterielle, diabete gestationnel, troubles vasculaires, placenta praevia, hematome retroplacentaire), d’hypotrophie et de malformation congenitale ont ete compares entre les deux groupes en analyse univariee et multivariee apres ajustement sur les caracteristiques des femmes (l’âge, la primiparite, l’obesite, la dependance au tabac, les antecedents de diabete ou d’hypertension arterielle), les accouchements multiples et le sexe des enfants. Resultats Au total, 2 875 662 grossesses ayant conduit a un accouchement et 2 922 712 naissances ont ete analysees, dont 49 224 (1,7 %) issues de FIV avec transfert d’embryons frais. En analyse multivariee, tous les risques de morbidite etaient significativement plus eleves en FIV : les accouchements prematures (ORajuste = 1,28 ; IC95 % = 1,24–1,32), la morbidite maternelle (ORajuste = 1,24 ; IC95 % = 1,21–2,28) (principalement pour les thromboses veineuses dans les accouchements multiples, le placenta praevia et les hematomes retroplacentaires). Les risques d’hypotrophie (ORajuste = 1,13 ; IC95 % = 1,10–1,16) et de malformations congenitales (ORajuste = 1,11 ; IC95 % = 1,05–1,17) etaient faiblement augmentes. Conclusion Les resultats de cette premiere etude portant sur un large effectif de naissances recentes en France confirment qu’il existait une augmentation des risques de morbidite maternelle et perinatale en FIV. Ces risques etaient comparables a ceux publies dans la litterature internationale. Cette etude constitue le point de depart d’une surveillance de la morbidite maternelle et perinatale en FIV.

Médecine et Maladies Infectieuses, 2016

Pas de différence significative sur le plan RVS (Réponse Virologique Soutenue) dans cette populat... more Pas de différence significative sur le plan RVS (Réponse Virologique Soutenue) dans cette population : 56.1 vs 60.9 % (p = 0.27). Une surveillance plus étroite du taux d'hémoglobine est indispensable car le seuil de tolérance de l'anémie est beaucoup plus bas que chez le reste des patients (sans drépanocytose homozygote). Conclusion La prise en charge de l'hépatite chronique C en présence de drépanocytose homozygote doi-être optimale et pluridisciplinaire. La drépanocytose homozygote ne semble pas influencer de façon significative sur la RVS. Intérêt d'études pilotes pour connaître l'impact réel de cette pathologie dans la prise en charge l'hépatite chronique C. Aucun lien d'intérêt HEP-17 Résultats de la fécondation in vitro chez les femmes infectées par le VHB : étude monocentrique cas-témoins

EMC - Tratado de Medicina, 2019

El porcentaje de parejas infértiles es actualmente del orden del 15-25% en Francia. La consulta d... more El porcentaje de parejas infértiles es actualmente del orden del 15-25% en Francia. La consulta de infecundidad permite evaluar la fertilidad para mejorar la fecundabilidad y disminuir el plazo hasta la concepción. El médico general suele ser el primer interlocutor de las parejas infértiles. Por tanto, es primordial que las detecte y que oriente a las parejas elegibles para la reproducción asistida hacia el médico especialista de la reproducción después de haber realizado un estudio completo.

Therapies, 2019

OBJECTIVE Prenatal exposure of women to diethylstilbestrol (DES) has been associated with reprodu... more OBJECTIVE Prenatal exposure of women to diethylstilbestrol (DES) has been associated with reproductive tract anomalies, menstrual irregularity, infertility and pregnancy complications. In prenatally exposed men, adverse effects included genital anomalies and possible risk of infertility. In children of prenatally exposed women, i.e the third generation, an increased incidence of genital defects was observed in sons (hypospadias), but not in daughters. In daughters of prenatally exposed men, the incidence of genital anomalies was in the normal range. Experimental studies in mice evidenced an increased incidence of reproductive tract anomalies in the female descendants of females and males prenatally exposed to DES, indicative of transgenerational transmission of DES defects. The aim of this study is to assess genital tract defects, fertility and pregnancy outcome, in daughters of women and men prenatally exposed to DES. METHODS In a retrospective observational analysis, 759 daughters of prenatally exposed women and men reported their genital and reproductive characteristics that were compared with those of: 1) general population in France; 2) two cohorts of daughters of exposed women reported in previous publications; 3) women prenatally exposed to DES. RESULTS An increased incidence of uterine defects was observed, with both doubling of uterus and bicornuate and aplastic uterus which constitutes the Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS). No specific anomalies described in prenatally exposed women such as T-shape or hypoplastic uterus were reported. Infertility appeared to be in the normal range. Pregnancy outcomes of our 121 pregnancies of women born to DES exposed mothers and two other published cohorts presented inconsistent results for ectopic pregnancy, miscarriage and preterm delivery. Early and late miscarriages were higher than expected in general population in our cohort but not in the two others. CONCLUSION These results must be considered as preliminary, due to the small numbers of patients, limited follow-up duration after birth due to young age of the studied population, and observational methods. An important point is that the high risk of reproductive dysfunction of women prenatally exposed to DES was not observed in their daughters. There is a signal on the high incidence of uterine defects, especially aplastic uterus, and its possible link with DES exposure through epigenetic effects is discussed in our findings. Inconsistent findings regarding pregnancy outcomes in the third generation are worthy of further examination.

Fertility and Sterility, 2019

04). There was no significant difference in the risk of small for gestational age. CONCLUSIONS: I... more 04). There was no significant difference in the risk of small for gestational age. CONCLUSIONS: IVF-OD patients must be considered an independent risk factor for some adverse perinatal outcomes, mainly hypertensive disorders in pregnancy, preeclampsia and severe preeclampsia, but also preterm birth and low birth weight. Immunological aspects may be involved in this results and further research focusing in the etiopathogenesis of these pathologies are needed.

Journal of Gynecology Obstetrics and Human Reproduction, 2019

Therapies, 2018

Please cite this article as: Michel TournaireEmmanuel DevoucheSylvie EpelboinAnne CabauAnnabel Du... more Please cite this article as: Michel TournaireEmmanuel DevoucheSylvie EpelboinAnne CabauAnnabel DunbavandAnne Levadou Birth defects in children of men exposed in utero to diethylstilbestrol (DES)<!-Birth defects in children of men exposed in utero to DES-> (2018),

Fertility and Sterility, 2016

Objective: To compare the efficacy of assisted reproductive technology (ART) in women infected wi... more Objective: To compare the efficacy of assisted reproductive technology (ART) in women infected with human immunodeficiency virus type 1 (HIV-1) versus HIV-negative controls. Design: Retrospective case-control study. Setting: University hospital ART unit. Patient(s): Eighty-two women infected with HIV-1 and 82 women as seronegative controls. Intervention(s): Ovarian stimulation, oocytes retrieval, standard in vitro fertilization (IVF) or intracytoplasmic sperm injection, embryo transfer. Main Outcome Measure(s): Clinical pregnancies and live-birth rates. Result(s): After oocyte retrieval, all women infected with HIV-1 infected were matched 1:1 to HIV-negative controls according to the following criteria: date of ART attempt, age, parity, main cause of infertility, ART technique, and rank of attempt. Only the first IVF cycle during the study period was considered for each couple. We found no statistically significant differences between the two groups for ovarian stimulation data, fertilization rate, or average number of embryos transferred. The clinical pregnancy rate per transfer was statistically significantly lower for the cases compared with the controls (12% vs. 32%), as were the implantation rate (10% vs. 21%) and the live-birth rate (7% vs. 19%). Conclusion(s): In one of the largest studies to pair six factors that influence the results of ART, HIV infection in women was associated with poorer outcomes after ART. These results suggest that women with controlled HIV-1-infection should be counseled not to