OBJECTIVES:Congenital anomalies of the kidney and urinary tract (CAKUT) account for one-third of all congenital malformations detected by ultrasound. With the introduction of chromosomal microarrays, over 50 genes involved in CAKUT have been identified. The main objective of our study was to assess the contribution of chromosomal analysis performed for CAKUT within our fetal diagnosis and treatment center. MATERIAL AND METHODS:We included pregnancies with CAKUT confirmed by ultrasound from January 2013 to December 2020. Once the diagnosis of CAKUT was established, we collected data about proposal for a fetal sampling, type of fetal sampling and results of fetal sampling. When chromosomal aberration was detected, we recorded the type, size, mode of inheritance (de novo or inherited). RESULTS:We realized 53 amniocentesis (70.7%), 12 chronionic villus sampling (16%) and 10 fetal blood sampling (13.3%). Three fetal sampling were excluded and we finally studied 72 samples. Among all cases, four fetuses (5.5%) showed aneuploidies: one case of trisomy 18, one case of trisomy 20 and two cases of trisomy 21. Six fetuses (8.3%) showed copy number variations. After diagnosis and at the request of couple, 9 medical termination of pregnancy were performed. CONCLUSION:Chromosomal analysis carried out in the exploration of congenital renal anomalies make it possible to establish a diagnosis in certain cases, and on the other hand make it possible to modify the outcome of pregnancy or the management of future pregnancies. Faced with new emerging techniques and considering the diagnostic rate of congenital renal malformations, these analyses have their place.

Objectifs: Les anomalies congénitales des reins et des voies urinaires (CAKUT) représentent un tiers de toutes les malformations congénitales détectées à l’échographie. Avec l’introduction des puces à ADN, plus de 50 gènes impliqués dans les CAKUT ont été identifiés. L’objectif principal de notre étude était d’évaluer l’apport de l’analyse chromosomique réalisée pour CAKUT au sein de notre centre de diagnostic anténatal.Matériel et methods: Nous avons inclus les grossesses avec CAKUT confirmées par échographie de janvier 2013 à décembre 2020. Une fois le diagnostic de CAKUT établi, nous avons recueilli les données concernant la proposition du prélèvement fœtal, sa méthode et ses résultats. Lorsqu’une aberration chromosomique était détectée, nous avons enregistré son type, sa taille, son mode de transmission (hérité ou de novo).Résultats: Nous avons réalisé 75 prélèvements fœtaux dont 53 amniocentèses (70,7 %), 12 ponctions de villosités choriales (16 %) et 10 ponctions de sang fœtal (13,3 %). Trois prélèvements fœtaux ont été exclus. Finalement nous avons étudié 72 échantillons.Parmi tous les cas, quatre fœtus (5,5 %) présentaient des aneuploïdies : un cas de trisomie 18, un cas de trisomie 20 et deux cas de trisomie 21. Six fœtus (8,3 %) présentaient des variations du nombre de copies de segments d’ADN. Suite au diagnostic et à la demande du couple, 9 interruptions médicales de grossesse ont été pratiquées.Conclusion: L’analyse chromosomique réalisée pour l’exploration des anomalies rénales congénitales permet d’établir un diagnostic dans certains cas, de modifier l’issue de la grossesse et la prise en charge des grossesses futures. Face aux nouvelles techniques émergentes et compte tenu du taux de diagnostic des malformations rénales congénitales, ces analyses ont toute leur place dans l’exploration des anomalies rénales dépistées par échographie.

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.

•Evaluation of in vitro maturation of immature oocytes with cumulus cells co-culture.•Evaluation of nuclear and cytoplasmic maturation of in vitro matured oocytes.•No statistical difference between fertilization rates from standard in vitro procedure recovered oocytes and in vitro matured oocytes.•In vitro maturation with cumulus cells-oocyte coculture can produce good quality embryos for potential use in IVF.

OBJECTIVE:The main objective of this work was to establish the contraceptive profile of French female medical residents and to assess the impact of workload on their choice of contraception method as well as difficulties encountered. STUDY DESIGN:We conducted a descriptive, cross-sectional, prospective national study over six months, between May and October 2019, using an anonymous online survey sent to all female medical residents in France. We formed two study groups according to reported working hours: W+ and W-. Grouping was based on three criteria: weekly workload, weekly night duty, and weekend duty per month. RESULTS:Of the 17,120 active female residents, the response rate was 15.42%. Oral contraception was the most commonly used method. The contraceptive profile of female residents was similar to that of the general French population. The W+ group of residents experienced more frequent contraceptive difficulties that had no impact on their choice of contraception. Despite the difficulties of using contraception, the W+ group used effective corrective methods, allowing them to prevent unplanned pregnancies. Residents in the W+ group reported more irregular gynecological follow-up. CONCLUSION:Better gynecological monitoring during medical studies would optimize contraceptive choices made by female medical residents in France.

Alors que les cigarettes électroniques sont en plein essor en France depuis une dizaine d’années, les données sur leur prévalence, leurs modes d’utilisation et leur sécurité sont restées fragmentées et controversées. Les cigarettes électroniques ne semblent pas être un produit d’utilisation inoffensif, car bien qu’elles contiennent moins de substances nocives que les cigarettes traditionnelles, elles contiennent toujours des produits toxiques tels que des perturbateurs endocriniens qui semblent avoir un impact négatif sur l’homéostasie hormonale, la morphologie et le fonctionnement du système reproducteur animal. Présentées comme une alternative inoffensive aux cigarettes traditionnelles par les lobbies industriels, les cigarettes électroniques sont souvent proposées comme une aide au sevrage tabagique au même titre que les substituts nicotiniques. Cette stratégie est notamment proposée sans connaissance de ses effets sur la santé reproductive humaine. En effet, il existe actuellement peu de publications scientifiques étudiant l’impact de l’utilisation de la cigarette électronique, de la nicotine et des vapeurs qu’elle délivre sur la fertilité et le fonctionnement de l’appareil reproducteur humain féminin et masculin. Ainsi, la grande majorité des données, dont nous disposons à ce jour, provient d’études réalisées sur des populations animales et montrent que l’exposition à la cigarette électronique affecte la fertilité. Il n’existe, à notre connaissance, aucune publication scientifique sur les résultats en Assistance médicale à la procréation en cas d’utilisation de la cigarette électronique, motivant la réalisation de l’étude FIV-VAP actuellement en cours au sein du Service de médecine et biologie de la reproduction du CHU d’Amiens.

The impact of endocrine disruptors on early pregnancy and clinical outcomes in IVF Moncef Benkhalifa (1,2,3), Debbie Montjean (2), Hafida Corsi-Cauet (3), Henri Copin (1,3), Véronique Bach (3), Pierre Miron (2), Rosalie Cabry (1,3) (1) Reproductive Medicine and Reproductive Genetics, University Hospital & School of Medicine. Picardie University Jules Verne. Amiens France (2) ART Centers. Laval and Brossard. Fertilys International Inc. Laval. Québec. Canada (3) PERITOX Laboratory. Picardie University Jules Verne. Amiens. France Since more than 40 years, there are annual increasing of studies, meta-analysis reporting and discussing the potential associations between endocrine disrupting chemicals (EDCs) and human fertility potential declining. Today it’s accepted that a substantial number of environmental and exposition factors affect the fertility and fecundity capacity of couples during the peri and post conception period. It’s accepted that most of EDCs interfere with or mimic steroid hormone action; predominantly by affecting estrogen, androgen and thyroid hormones signaling pathways and disturbing specific molecular process on relation with single or multiple biological functions. Some of EDCs can interact with the male and female reproductive system and lead to endocrine disruption in the testis and ovary. they exert their effects mainly via binding transcription factor receptors, EDCs can alter endocrine function through a variety of mechanisms. At fertility age EDCs may alter the expression and/or activity of enzymes required for synthesis and/or catabolism of testicular and ovarian sex steroids and the expression of hormone receptors and/or their ability to bind their and endogenous ligands. For example, in male, the literature reported a negative correlation between disrupted spermatogenesis and lifestyle factors (environmental-professional expositions) such as alcohol consumption, cigarette smoking, drug use, and obesity caused by high-energy diet. In female infertility diseases, the negative impact of chemicals ED has been studied in animals. Many disorders have been described, such as low ovarian weight, impaired folliculogenesis, a high aneuploidy rate and the acceleration of follicular atresia. Indeed, women exposed to some endocrine-disrupting pesticides (such as atrazine, lindane) have an elevated risk of long menstrual cycles or anovulation but the most serious consequence is POF and endometriosis pathophysiology’s. In our IVF experience in Picardie region (France), we observed that various pesticides with an endocrine-disrupting action are associated with poor oocyte quality (maturation and competency), embryonic defects and poor IVF outcomes, and some pesticide compounds are linked to specific causes of female infertility, such as premature ovarian insufficiency, polycystic ovarian syndrome, and endometriosis. It was reported that EDCs can reduce embryo implantation chances and increase miscarriage, placenta and post-natal abnormalities. for endometrium receptivity and implantation failure EDCs can play by modifying keys elements of the immune response relevant to pregnancy, and disrupt immune tolerance required for robust placentation, optimal fetal development and be a as contributing risk factors in recurrent miscarriage, preeclampsia, preterm birth and related pathologic gestation Environmental insults, including endocrine disrupting chemicals during critical periods of fetal development, can alter DNA methylation patterns, leading to inappropriate developmental gene expression and disease risks. Similar to environmental factors, endocrine-disrupting chemicals can influence gene expression without modifying the DNA sequence. It is commonly accepted that the transgenerational inheritance of parentally acquired traits is conveyed by epigenetic alterations risks also known as “epimutations”. In Conclusion, the negative impact of exposure to various endocrine-disrupting is becoming now a worldwide public health. Indeed, the community should be informed about the fertility decline, low ongoing pregnancy rates, and elevated risk of miscarriage associated with exposure to high doses of pesticides for example. We must keep in mind that humans are exposed to EDCs mixtures composed of hundreds of chemicals every day and not a single chemical in isolation.

While electronic cigarettes have been on the rise in France for the past ten years, data on their prevalence, use patterns and safety have remained fragmented and controversial. Electronic cigarettes seem to not be a harmless product to use, because although they contain fewer harmful substances than traditional cigarettes, they still contain toxic products such as endocrine disruptors, which appear to have a negative impact on hormonal homeostasis, morphology and functioning of the animal reproductive system. Mostly presented as a harmless alternative to traditional cigarettes by industry lobbies, electronic cigarettes are often offered as an aid to smoking cessation in the same way as nicotinic substitutes. This strategy is especially proposed without knowledge of its effects on human reproductive health. Indeed, there are currently very few scientific publications, which study the impact of the use of electronic cigarettes, nicotine and the vapours it delivers on fertility and the functioning of the human female and male reproductive systems. Thus, the great majority of the data we have to date come from studies carried out in animal populations and show that electronic cigarettes exposure affect fertility. There is, to our knowledge, no scientific publication on the results in Assisted Reproductive Technology in case of use of electronic cigarettes, motivating the realization of the study IVF-VAP currently underway in the department of Medicine and Biology of Reproduction of the Amiens Picardie University Hospital. C 2023 Published by Elsevier Masson SAS.

Cat Eye Syndrome (CES) is a rare genetic disease caused by the presence of a small supernumerary marker chromosome derived from chromosome 22, which results in a partial tetrasomy of 22p-22q11.21. CES is classically defined by association of iris coloboma, anal atresia, and preauricular tags or pits, with high clinical and genetic heterogeneity. We conducted an international retrospective study of patients carrying genomic gain in the 22q11.21 chromosomal region upstream from LCR22-A identified using FISH, MLPA, and/or array-CGH. We report a cohort of 43 CES cases. We highlight that the clinical triad represents no more than 50% of cases. However, only 16% of CES patients presented with the three signs of the triad and 9% not present any of these three signs. We also highlight the importance of other impairments: cardiac anomalies are one of the major signs of CES (51% of cases), and high frequency of intellectual disability (47%). Ocular motility defects (45%), abdominal malformations (44%), ophthalmologic malformations (35%), and genitourinary tract defects (32%) are other frequent clinical features. We observed that sSMC is the most frequent chromosomal anomaly (91%) and we highlight the high prevalence of mosaic cases (40%) and the unexpectedly high prevalence of parental transmission of sSMC (23%). Most often, the transmitting parent has mild or absent features and carries the mosaic marker at a very low rate (<10%). These data allow us to better delineate the clinical phenotype associated with CES, which must be taken into account in the cytogenetic testing for this syndrome. These findings draw attention to the need for genetic counseling and the risk of recurrence.

Unexplained infertility is defined by the absence of identifiable causes of infertility. The results of randomized studies and meta-analysis regarding the treatment of unexplained infertility are discordant due to methodological problems. The aim of this study is to compare the clinical pregnancy rate per cycle (CPR/c) in IUI and IVF/ICSI in cases of unexplained infertility, according to the woman’s age group and to identify the factors which predict success. We performed a retrospective study in two ART centers, comparing overall clinical pregnancy, ongoing pregnancy and live birth rates in IVF/ICSI and IUI. We also compared pregnancy and birth rates according to different female age groups. 855 IVF/ICSI and 804 IUI cycles were compared. We found a significant difference (p < 0.001) in the pregnancy and live birth rates per cycle between IUI and IVF/ICSI, overall and in the different female age groups, except in women aged 40 and over. The greatest chances of pregnancy with IUI are found in women with secondary unexplained infertility, during the first two cycles and with a bi-follicular response to stimulation. In IVF/ICSI, pregnancy rates are higher in women with secondary unexplained infertility, in the first two cycles, in IVF and in women receiving a transfer of two embryos regardless of the embryonic stage. We recommend IVF/ICSI treatment rather than IUI for unexplained infertility (OR CPR/c 4.20 with 95% CI [3.72–4.68]). This is in accordance with NICE, which advises the use of IVF after 2 years.

Background. - Growth hormone (GH) is known to be involved in ovarian folliculogenesis and oocyte maturation. In patients with poor ovarian response without growth hormone deficiency (GHD), adjuvant GH treatment improves in-vitro fertilization (IVF) results. Improvement of oocyte quality in IVF by GH replacement was reported in only a few patients with GHD. We report on a new case with study of follicular fluid. Methods. - A 29-year-old patient with hypopituitarism was referred to our infertility center. She was undergoing hormonal replacement for hypogonadotropic hypogonadism and diabetes insipidus, and did not consider at first GH replacement. Four IVF procedures were performed between 2011 and 2014. Growth hormone replacement (somatotropin 1.1 mg/day) was initiated before the fourth IVF procedure and unmasked central hypothyroidism; levothyroxine (75 mg/day) was introduced. It took 10 months to reach the treatment objectives for insulin-like growth factor 1 (IGF1), free triiodothyronine (fT3) and free thyroxine (fT4). GH, IGF1 and thyroid hormones were measured in the blood and follicular fluid before and after GH and thyroid hormone replacement. Oocyte and embryo quality were also compared. Results. - The first 3 IVF procedures were performed without GH replacement. 62% to 100% of mature oocytes presented one or more morphologic abnormalities: diffuse cytoplasmic granularity, large perivitelline space with fragments, fragmentation of the first polar body, ovoid shape, or difficult denudation. Embryo quality was moderate to poor (grade B to D), and no pregnancy was obtained after embryo transfer. After GH replacement, hormones levels increased in follicular fluid: GH [7.68 vs. 1.39 mIU/L], IGF1 [109 vs. < 25 ng/mL], fT3 [3.7 vs. 2.5 pmol/L] and fT4 [1.45 vs. 0.84 ng/mL]. Concomitantly, there was dramatic improvement in oocyte quality (no abnormal morphologies) and embryo quality (grade A), allowing an embryo transfer with successful pregnancy.

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 (4.98 vs. 2.75 mIU/L, respectively; p <0.01) and IGF1 (72.1 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.

Les causes des anomalies de l'ADN spermatique sont mal identifiées, elles pourraient pourtant avoir un impact majeur sur les issues de parcours en AMP. Nous avons mené une étude prospective de janvier 2015 à juin 2020 incluant 277 patients ayant eu une analyse de l'ADN spermatique (fragmentation et index de dénaturation). L'objectif principal était d'identifier les paramètres influençant la qualité de cet ADN. 136 hommes sur 262 (52 %) avaient un index de dénaturation (SDI) > 20 %, considéré comme seuil pathologique, et 56 sur 273 (21 %) avaient une fragmentation (FRAG) > 20 %. La quantité de tabac consommé a un impact sur le SDI (6,4 paquets/années dans le groupe SDI anormal vs 4,46 dans le groupe normal, p = 0,045). La consommation de cannabis était plus importante dans le groupe SDI anormal (21 % vs 12 %, p = 0,045). Les hommes ayant un SDI ou une FRAG élevés avaient davantage d'anomalies du spermogramme (76 % vs 50 %, p < 0,001). Le taux de fécondation en fécondation in vitro (FIV) était réduit pour les patients au-delà du seul pathologique : 72,3 % en FIV si SDI normal contre 58,5 % si anormal (p = 0,025) et 68,4 % si FRAG normale contre 53,6 % si anormale (p = 0,049). Cette différence n'était pas retrouvée lors d'une FIV avec injection intra-cytoplasmique de spermatozoïde. Notre étude met en évidence l'impact négatif de l'observation d'un seuil pathologique des explorations de l'ADN spermatique sur les paramètres du spermogramme et les taux de fécondation en FIV. Des traitements antioxydants peuvent être proposés à ces patients, d'autres études sont nécessaires afin de confirmer leur efficacité.

L'objectif principal est d'étudier l'impact de l'exposition au chlorpyrifos (CPF), un insecticide organophosphoré, en périodes pré- et post-natales de rates de type « Wistar » sur le développement des organes génitaux des ratons. Les animaux ont été exposés au CPF durant les phases de gestation et de lactation puis jusqu'à l'âge adulte selon trois niveaux d'exposition : CPF1 (1 mg/kg), CPF5 (5 mg/kg) et un groupe contrôle CPF0. Les sacrifices étaient menés pour 1/3 à la naissance, pour 1/3 le jour du sevrage (j21) et pour le dernier tiers à j60 de vie, à part égale entre mâles et femelles. Nous avons obtenu 259 ratons (134 mâles et 125 femelles), 86 dans le groupe CPF1, 80 dans le groupe CPF5 et 93 dans le groupe contrôle (CPF0). On a retrouvé chez les mâles à j21 et j60 une différence significative avec une diminution du poids et de la taille des ratons ainsi que de la taille et du poids des testicules et des pénis à j0, j21 et j60. L'analyse histologique des testicules a montré l'existence d'une désorganisation modérée du tissu testiculaire chez les animaux du groupe CPF5 dès j0, et sévère à j21 et j60. Chez les animaux du groupe CPF1, des éléments de désorganisation modérés sont apparus à j21 et j60. Il a été observé chez les femelles sacrifiées une différence statiquement significative des poids et tailles des rates et du poids des ovaires à j21 et j60. L'analyse histologique des ovaires a permis de retrouver à j0 une absence de modification histologique entre les trois groupes. Ces altérations apparaissent à j21 et se confirment à j60 dans les groupes CPF 1 et 5, en comparaison au groupe contrôle. Ces travaux apportent la preuve d'un effet histopathologique dose–dépendant de l'exposition au chlorpyrifos des organes génitaux en période pré- et post-natale.

Objectives. - Increased nuchal translucency and cystic hygroma have a neonatal prognosis, when the karyotype is normal, which depends on the findings during the medical follow-up. Array comparative genomic hybridization (aCGH) has been systematically included in this follow-up by prenatal diagnosis teams. There are no guidelines and little information on the advantages of carrying out this test systematically. The aim of our study is to evaluate the contribution of the aCGH in the medical follow-up. Methods. - Fifty-one patients were included during 18 months and followed till the end of their pregnancy in prenatal diagnosis centers in Brest and Amiens. Inclusion criterion was a nuchal translucency above 3,5 mm on the first trimester ultrasound. A fetal DNA ChromoQuant and aCGH analysis on chorionic villi sampling, and an ultrasound at 18 weeks of gestation were performed during the follow-up. Results. - The aCGH was decisive in only 2 cases. The ultrasound at 18 weeks gestation seemed to be more sensible in the detection of an abnormality. When the aCGH relieved an abnormality, the ultrasound permitted already to detect the presence of a deformity. In 10 cases, the aCGH could not be interpreted on the chorionic villi sampling. In 9 cases, an amniocentesis was performed in order to obtain this result. Conclusion. - Given the results of this study, the aCGH was rarely determinant or decisive on the realization of a therapeutic abortion. These elements make us reflect on the necessity of maintaining this test before 14 weeks of gestation or propose it as a second-line test after the ultrasound shows signs at 18 weeks of gestation. (C) 2019 Published by Elsevier Masson SAS.

Déjà un papier, sur Parler… J’au rais mieux aimé un enregistrement sonore, un monologue proféré, un dialogue articulé, voire une performance orale, ou un chœur alterné, un chant, une ode, un opéra, paroles, musique, danse sur scène. Du parler, avec la voix orale de la bouche qui parle ! Mais un papier, un article !

None of the models developed in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) is sufficiently good predictors of pregnancy. The aim of this study was to determine whether ratios between prognostic factors could predict the clinical pregnancy rate in IVF/ICSI. We analyzed IVF/ICSI cycles (based on long GnRH agonist—FSH protocols) at two ART centers (the second to validate externally the data). The ratios studied were (i) the total FSH dose divided by the serum estradiol level on the hCG trigger day, (ii) the total FSH dose divided by the number of mature oocytes, (iii) the serum estradiol level on the trigger day divided by the number of mature oocytes, (iv) the serum estradiol level on the trigger day divided by the endometrial thickness on the trigger day, (v) the serum estradiol level on the trigger day divided by the number of mature oocytes and then by the number of grade 1 or 2 embryos obtained, and (vi) the serum estradiol level on the trigger day divided by the endometrial thickness on the trigger day and then by the number of grade 1 or 2 embryos obtained. The analysis covered 2421 IVF/ICSI cycles with an embryo transfer, leading to 753 clinical pregnancies (31.1% per transfer). Four ratios were significantly predictive in both centers; their discriminant power remained moderate (area under the receiver operating characteristic curve between 0.574 and 0.610). In contrast, the models’ calibration was excellent (coefficients: 0.943–0.978; p < 0.001). Our ratios were no better than existing models in IVF/ICSI programs. In fact, a strongly discriminant predictive model will be probably never be obtained, given the many factors that influence the occurrence of a pregnancy.