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Palomba S, Viganò P, Chamayou S, Donarelli Z, Costantini MP, Marci R, Piomboni P, Fino E, Montano L, Guglielmino A, Somigliana E. Diagnosis and management of infertility: NICE-adapted guidelines from the Italian Society of Human Reproduction. Reprod Biol Endocrinol 2024; 22:9. [PMID: 38183116 PMCID: PMC10768082 DOI: 10.1186/s12958-023-01179-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/23/2023] [Indexed: 01/07/2024] Open
Abstract
In Italy the fertility rate is very low, and an increasing number of patients are infertile and require treatments. The Italian Law concerning the safety of patient care, and the professional liability of health professionals, indicates that health professionals must comply with the recommendations set out in the guidelines developed by public and private bodies and institutions, as well as scientific societies and technical-scientific associations of the health professions, except for specific cases. Unfortunately, no guideline for the diagnosis and the management of infertility is currently available in Italy. In 2019, the Italian Society of Human Reproduction pointed out the need to produce Italian guidelines and subsequently approved the establishment of a multidisciplinary and multiprofessional working group (MMWG) to develop such a guideline. The MMWG was representative of 5 scientific societies, one national federation of professional orders, 3 citizens' and patients' associations, 5 professions (including lawyer, biologist, doctor, midwife, and psychologist), and 3 medical specialties (including medical genetics, obstetrics and gynecology, and urology). The MMWG chose to adapt a high-quality guideline to the Italian context instead of developing one from scratch. Using the Italian version of the Appraisal of Guidelines for Research and Evaluation II scoring system, the National Institute of Clinical Excellence guidelines were selected and adapted to the Italian context. The document was improved upon by incorporating comments and suggestions where needed. This study presents the process of adaptation and discusses the pros and cons of the often-neglected choice of adapting rather than developing new guidelines.
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Affiliation(s)
- Stefano Palomba
- Department of Medical-Surgical Science and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.
- Unit of Gynecology, Sant'Andrea Hospital, Via di Grottarossa, 1039, Rome, Italy.
| | - Paola Viganò
- Infertility Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Sandrine Chamayou
- HERA Center, Unit of Reproductive Medicine (U.M.R.), Sant'Agata Li Battiati, Catania, Italy
| | - Zaira Donarelli
- Psychological Counselling Service, University of Palermo, Palermo, and Clinical Psychology Unit, ANDROS Day Surgery Clinic, Palermo, Italy
| | | | - Roberto Marci
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Paola Piomboni
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- Unit of Medically Assisted Reproduction, Siena University Hospital, Siena, Italy
| | - Egidio Fino
- Italian Society of Human Reproduction, SIRU, Rome, Italy
| | - Luigi Montano
- Unit and Service of Lifestyle Medicine in Uro-Andrology, Local Health Authority of Salerno, Salerno, Italy
| | - Antonino Guglielmino
- HERA Center, Unit of Reproductive Medicine (U.M.R.), Sant'Agata Li Battiati, Catania, Italy
| | - Edgardo Somigliana
- Infertility Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Heath, University of Milan, Milan, Italy
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Alteri A, Bosco L, Chamayou S, Casciani V, Cervi M, Cecchele A, Cho YS, Costantini MP, Dal Canto MB, De Stefani S, Fraioli A, Furlan V, Giacone F, Guarneri C, Guglielmino A, Iaccarino M, Miceli A, Minasi MG, Montano L, Notari T, Paffoni A, Palini S, Reschini M, Ruvolo G, Viganó P, Volpes A. The paradox of the Italian clinical embryologist in the national public health system: hints towards harmonization of a postgraduate educational curriculum. HUM FERTIL 2023; 26:1380-1384. [PMID: 35255778 DOI: 10.1080/14647273.2022.2045040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/04/2021] [Indexed: 11/04/2022]
Abstract
Clinical embryologists are highly trained laboratory professionals with multiple roles, including laboratory, clinical, biobanking and quality system management. In most European countries, clinical embryologists are trained to work in Medically Assisted Reproduction (MAR) centres without a specifically dedicated educational path. The criteria required for employment vary according to the educational structure and the public or private nature of the centre. We have herein described the educational profile required by Italian clinical embryologists to work in MAR centres of the National Health System (NHS). Public centres currently represent 36% of all the Italian MAR clinics. According to the Italian law, a future clinical embryologist must achieve a 3-4 year unpaid post-graduate specialization in a different field, choosing from Genetics, Microbiology, Clinical Pathology or Nutrition. Accesses to the above-mentioned post-graduate courses are themselves very limited. Clinical embryologists are basically trained by senior colleagues. This situation makes inevitably difficult to recruit laboratory staff in NHS centres. Moreover, it represents an emblematic example of the need for an equal training curriculum, possibly ensuring a comparable education quality, mobility of trainees and dissemination of skills for clinical embryologists all over Europe.
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Affiliation(s)
| | - Liana Bosco
- Società Italiana di Riproduzione Umana, Roma, Italy
| | | | | | - Marta Cervi
- Società Italiana di Riproduzione Umana, Roma, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Paola Viganó
- Società Italiana di Riproduzione Umana, Roma, Italy
| | - Aldo Volpes
- Società Italiana di Riproduzione Umana, Roma, Italy
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Palomba S, Carone D, Vitagliano A, Costanzi F, Fracassi A, Russo T, Del Negro S, Biello A, Di Filippo A, Mangiacasale A, Monaco A, Ranieri A, Ermini B, Barba BF, Castello C, Di Guardo F, Pastorella F, Bernasconi E, Tricarico EM, Filippi F, Polsinelli F, Monte GL, Sosa Fernandez LM, Galletta M, Giardina P, Totaro P, Laganara R, Liguori R, Buccheri M, Montanino Oliva M, Piscopo R, Iuliano A, Innantuoni N, Romanello I, Sinatra F, Liprino A, Thiella R, Tiezzi A, Bartolotti T, Tomasi A, Finocchiaro V, Thiella M, Fuggetta G, Messineo S, Isabella F, Tripodi M, Iaccarino S, La Sala GB, Papaleo E, Caserta D, Marci R, Somigliana E, Guglielmino A. Fertility specialists' views, behavior, and attitudes towards the use of endometrial scratching in Italy. BMC Womens Health 2023; 23:397. [PMID: 37516869 PMCID: PMC10386779 DOI: 10.1186/s12905-023-02564-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 07/22/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Endometrial scratching (ES) or injury is intentional damage to the endometrium performed to improve reproductive outcomes for infertile women desiring pregnancy. Moreover, recent systematic reviews with meta-analyses and randomized controlled trials demonstrated that ES is not effective, data on the safety are limited, and it should not be recommended in clinical practice. The aim of the current study was to assess the view and behavior towards ES among fertility specialists throughout infertility centers in Italy, and the relationship between these views and the attitudes towards the use of ES as an add-on in their commercial setting. METHODS Online survey among infertility centers, affiliated to Italian Society of Human Reproduction (SIRU), was performed using a detailed questionnaire including 45 questions with the possibility to give "closed" multi-choice answers for 41 items and "open" answers for 4 items. Online data from the websites of the infertility centers resulting in affiliation with the specialists were also recorded and analyzed. The quality of information about ES given on infertility centers websites was assessed using a scoring matrix including 10 specific questions (scored from 0 to 2 points), and the possible scores ranged from 0 to 13 points ('excellent' if the score was 9 points or more, 'moderate' if the score was between 5 and 8, and 'poor' if it was 4 points or less). RESULTS The response rate was of 60.6% (43 questionnaires / 71 infertility SIRU-affiliated centers). All included questionnaires were completed in their entirety. Most physicians (~ 70%) reported to offer ES to less than 10% of their patients. The procedure is mainly performed in the secretory phase (69.2%) using pipelle (61.5%), and usually in medical ambulatory (56.4%) before IVF cycles to improve implantation (71.8%) without drugs administration (e.g., pain drugs, antibiotics, anti-hemorrhagics, or others) before (76.8%) or after (64.1%) the procedure. Only a little proportion of infertility centers included in the analysis proposes formally the ES as an add-on procedure (9.3%), even if, when proposed, the full description of the indications, efficacy, safety, and costs is never addressed. However, the overall information quality of the websites was generally "poor" ranging from 3 to 8 and having a low total score (4.7 ± 1.6; mean ± standard deviation). CONCLUSIONS In Italy, ES is a procedure still performed among fertility specialists for improving the implantation rate in IVF patients. Moreover, they have a poor attitude in proposing ES as an add-on in the commercial setting.
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Affiliation(s)
- Stefano Palomba
- Sant'Andrea Hospital, University "Sapienza" of Rome, Rome, Italy.
| | | | | | - Flavia Costanzi
- Sant'Andrea Hospital, University "Sapienza" of Rome, Rome, Italy
| | | | - Tiziana Russo
- Grande Ospedale Metropolitano, Reggio Calabria, Italy
- Gatjc Fertility Center, Gioia Tauro, Reggio Calabria, Italy
| | - Serena Del Negro
- Gatjc Fertility Center, Gioia Tauro, Reggio Calabria, Italy
- Presidio Ospedaliero Di Soverato "Basso Ionio", Soverato, Catanzaro, Italy
| | | | | | | | | | | | - Beatrice Ermini
- Centro Italiano Di Procreazione Assistita - CIPA, Rome, Italy
| | | | - Claudio Castello
- Centro FIVET Città Di Torino, Casa Della Salute Valdese, Turin, Italy
| | - Federica Di Guardo
- Azienda Ospedaliero Universitaria Policlinico "G. Rodolico - San Marco", Catania, Italy
| | | | | | | | - Francesca Filippi
- Fondazione IRCCS Ca' Grande - Ospedale Maggiore - University of Milan, Milan, Italy
| | | | - Giuseppe Lo Monte
- Centro Di Medicina Della Riproduzione E Crioconservazione Dei Gameti, Ospedale Di Brunico, Bolzano, Italy
| | | | - Marco Galletta
- Centro Di Procreazione Medicalmente Assistita, Azienda Ospedaliera "Papardo", Messina, Italy
| | | | - Pasquale Totaro
- Centro Di Procreazione Medicalmente Assistita, Ospedale Santa Maria, Bari, Italy
| | | | | | | | | | | | - Assunta Iuliano
- UOC Di Ostetricia E Ginecologia, Azienda Ospedaliera "San Carlo", Potenza, Italy
| | | | - Irene Romanello
- SSD Di Procreazione Medicalmente Assistita, Azienza Sanitaria Friuli Occidentale, Sacile, Pordenone, Italy
| | | | | | | | | | | | | | | | | | - Giuseppa Fuggetta
- SSD Di Procreazione Medicalmente Assistita, Azienza Sanitaria Friuli Occidentale, Sacile, Pordenone, Italy
| | | | | | | | | | | | | | | | | | - Edgardo Somigliana
- Fondazione IRCCS Ca' Grande - Ospedale Maggiore - University of Milan, Milan, Italy
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Chamayou S, Lombardi R, Ragolia C, Alecci C, Storaci G, Romano S, Guglielmino A. Comparison of clinical outcomes between conventional in vitro fertilization and intracytoplasmic sperm injection on sibling oocytes. Reprod Biomed Online 2022. [DOI: 10.1016/j.rbmo.2022.08.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2022]
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Salcuni S, Mancinelli E, Muneratti A, Grillo A, Alessi C, Guglielmino A, Finos L. Couples undergoing Assisted Reproductive Techniques: An Actor-Partner Interdependence Model of dyadic adjustment, attachment, and body-image avoidance. Health Psychol Open 2021; 8:20551029211039923. [PMID: 34671483 PMCID: PMC8521762 DOI: 10.1177/20551029211039923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The aim is to assess the commonalities and interdependence referred to body-image avoidance among 118 couples newly introduced to first-level assisted reproductive techniques. Results showed non-clinical functioning levels, and partners showed a correlated, yet low, dyadic adjustment. The couple-effect was modeled through an Actor Partner Interdependence Model. For both partners, dyadic adjustment’s actor-effect associates with body-image avoidance. Moreover, psychological symptoms’ actor-effect associate to body-image avoidance, resulting significantly more influential than the partner-effect. Only for males, alexithymia’s actor-effect was significant. To conclude, partners’ functioning is quite specular yet not interdependent, as they do not show a couple-as-a-unit modality of functioning. Clinical implications are discussed.
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Affiliation(s)
- Silvia Salcuni
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Elisa Mancinelli
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Anna Muneratti
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | | | - Chiara Alessi
- Dipartimento Strutturale Aziendale Salute della Donna e del Bambino, Unità Operativa Complessa (UOC) Ostetricia e Ginecologia, Padova Hospital, Padova, Italy
| | | | - Livio Finos
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
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Mancinelli E, Salcuni S, Muratti A, Grillo A, Alessi C, Guglielmino A, Finos L. P–487 Couples undergoing first level assisted reproductive techniques: An Actor-Partner interdependence model of dyadic adjustment, psychological symptoms, alexithymia and romantic attachment on body-image avoidance. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
The study aims to assess the commonalities and interdependence of couples undergoing first-level Assisted Reproductive Techniques (ART) as regards body-image avoidance referred to body-image dissatisfaction.
Summary answer
Partners’ functioning seem specular yet not interdependent, as not showing a couple-as-a-unit modality of functioning. Body-image avoidance is only influenced by intra-personal variables. What is known already: Stressful bodily emotions and body perception related to infertility and ART are critical aspects for people desiring having children. Infertility undermines women’s self-esteem and body-image, damaging their self-identity as women, while in males infertility associates with body dissatisfaction referring to perceived reduced physical fitness and personal failure, thus undermining their body virility. For infertile women, body-image dissatisfaction associates with reduced marital adjustment, and vice-versa; yet no study has considered how males body-image dissatisfaction associates with marital satisfaction. Nonetheless, couples should be considered as a unit, considering that infertile couples’ adjustment is influenced by their own, and their partners’, perceived stress.
Study design, size, duration
The study follows a cross-sectional design and is part of an ongoing transversal and longitudinal project, started in 2012, investigating the well-being of couples undergoing ART. For the present study only a minority of the existing data were considered, thus only including couples at the first level of ART with the intent of investigating couples’ commonalities and interdependence before treatments pervasiveness increases.
Participants/materials, setting, methods
Minimum N = 79 couples needed to be considered according to Power analysis results. N = 118 couples aged 24 to 46 years (women Mage=34.92, SD = 3.98; men Mage=37.45, SD = 5.25) were included, and declaring trying to get pregnant from 1 to 8 years (M = 3.18; SD = 1.99) and to never had children, although 22.9% of women had at least an abortion. Participants completed the Body-Image Avoidance Questionnaire, Toronto Alexithymia Scale–20, Dyadic Adjustment Scale, Symptom Checklist–90-Revised and Experiences in Close Relationships Scale-Revised.
Main results and the role of chance
The sample presents non-clinical levels of functioning referring to their psychological symptoms, alexithymia and body-image avoidance. Multivariate rank tests show that females report significantly higher levels of body-image avoidance (stat=–5.73; adj.p=.001), psychological symptoms (stat=–4.58; adj.p=.001) and romantic anxious attachment (stat=–3.33; adj.p=.005). These differences were confirmed also after applying multiplicity control. Moreover, bi-variate Pearson’s r correlations show an association among partners’ dyadic adjustment (r=.293; p<.001), albeit their overall level of dyadic adjustment is low. Significant correlations among partners also emerged as regards psychological symptoms (r=.258; p<.001) and alexithymia (r=.16; p=.05). The couple-effect, thus considering the couple as the unit of analysis, was modeled through an Actor-Partner Interdependence Model. For both partners, dyadic adjustment’s actor-effect associates with body-image avoidance (women: β = 0.133, p=.026; man: β = 0.133, p=.026). Furthermore, for both men and women, psychological symptoms’ actor-effect associate to body-image avoidance (women: β = 0.467, p<.00; men: β = 0.499, p=.001). Comparing the level of influence of actor and partner effects among partners, the psychological symptoms’ actor effect results significantly more influential than the partner-effect (women: Δ = 0.378, p=.015; men: Δ = 0.587, p=.001). Only for males, alexithymia’s actor effect is significant (β = 0.499; p=.001).
Limitations, reasons for caution
Results should be considered in light of some limitations. Specifically, the cross-sectional study design, lack of a control group with no infertility issues, the use of self-report measures, homogeneity among couples and the sample small sample size (although sample size was appropriate to retain a power of at least .8).
Wider implications of the findings: Results support the differentiation of gender-specific psychosocial interventions along the ART path, preventing and mitigating the negative impact of infertility and ART on body-image dissatisfaction and avoidance and on the couples’ well-being.
Trial registration number
Not applicable
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Affiliation(s)
- E Mancinelli
- University of Padova, Department of Developmental Psyhcology and Socialization, Padova, Italy
| | - S Salcuni
- University of Padova, Department of Developmental Psyhcology and Socialization, Padova, Italy
| | - A Muratti
- University of Padova, Department of Developmental Psyhcology and Socialization, Padova, Italy
| | - A Grillo
- Reproductive Medicine Unit, Reproductive Medicine Unit, Catania, Italy
| | - C Alessi
- Padova Hospital, Complex Operative Unit C.O.U.- Obstetrics and Gynecology- Women’s and Children’s Health Corporate Structural Department, Padova, Italy
| | - A Guglielmino
- Reproductive Medicine Unit, Reproductive Medicine Unit, Catania, Italy
| | - L Finos
- University of Padova, Department of Developmental Psyhcology and Socialization, Padova, Italy
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Chamayou S, Ragolia C, Alecci C, Storaci G, Romano S, Sapienza R, Maglia E, Liprino A, Cardea C, Fichera M, Guglielmino A. More blastocysts are produced from fewer oocytes in ICSI compared to IVF - results from a sibling oocytes study and definition of a new key performance indicator. Reprod Biol Endocrinol 2021; 19:116. [PMID: 34311751 PMCID: PMC8311920 DOI: 10.1186/s12958-021-00804-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 07/16/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Which fertilization method, between ICSI and IVF in split insemination treatments, has the highest clinical efficiency in producing clinically usable blastocyst? METHODS 211 infertile couples underwent split insemination treatments for a non-severe male factor. 1300 metaphase II (MII) oocytes were inseminated by conventional IVF and 1302 MII oocytes were micro-injected with the same partner's semen. Embryo development until blastocyst stage on day V and clinical outcomes were valuated trough conventional key performance indicators (KPI), and new KPIs such as blastocyst rate per used MII oocytes and the number of MII oocytes to produce one clinically usable blastocyst from ICSI and IVF procedures. RESULTS The results were globally analyzed and according to ovarian stimulation protocol, infertility indication, and female age. The conventional KPI were online with the expected values from consensus references. From global results, 2.3 MII oocyte was needed to produce one clinically usable blastocyst after ICSI compared to 2.9 MII oocytes in IVF. On the same way, more blastocysts for clinical use were produced from fewer MII oocytes in ICSI compared to IVF in all sub-groups. CONCLUSIONS In split insemination treatments, the yield of clinically usable blastocysts was always superior in ICSI compared to IVF. The new KPI "number of needed oocytes to produce one clinically usable embryo" tests the clinical efficiency of the IVF laboratory.
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Affiliation(s)
- Sandrine Chamayou
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy.
| | - Carmen Ragolia
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Carmelita Alecci
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Giorgia Storaci
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Simona Romano
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Roberta Sapienza
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Elena Maglia
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Annalisa Liprino
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Clementina Cardea
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
| | - Michele Fichera
- Unit of Gynecology and Obstetrics-Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione - Centro HERA, via barriera del bosco, n. 51/53, Sant'Agata Li Battiati, Catania, Italy
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Montano L, Donato F, Bianco PM, Lettieri G, Guglielmino A, Motta O, Bonapace IM, Piscopo M. Semen quality as a potential susceptibility indicator to SARS-CoV-2 insults in polluted areas. Environ Sci Pollut Res Int 2021; 28:37031-37040. [PMID: 34053043 PMCID: PMC8164491 DOI: 10.1007/s11356-021-14579-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/21/2021] [Indexed: 05/11/2023]
Abstract
The epidemic of the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has impacted worldwide with its infectious spread and mortality rate. Thousands of articles have been published to tackle this crisis and many of these have indicated that high air pollution levels may be a contributing factor to high outbreak rates of COVID-19. Atmospheric pollutants, indeed, producing oxidative stress, inflammation, immuno-unbalance, and systemic coagulation, may be a possible significant co-factor of further damage, rendering the body prone to infections by a variety of pathogens, including viruses. Spermatozoa are extremely responsive to prooxidative effects produced by environmental pollutants and may serve as a powerful alert that signals the extent that environmental pressure, in a specific area, is doing damage to humans. In order to improve our current knowledge on this topic, this review article summarizes the relevant current observations emphasizing the weight that environmental pollution has on the sensitivity of a given population to several diseases and how semen quality, may be a potential indicator of sensitivity for virus insults (including SARS-CoV-2) in high polluted areas, and help to predict the risk for harmful effects of the SARS-CoV-2 epidemic. In addition, this review focused on the potential routes of virus transmission that may represent a population health risk and also identified the areas of critical importance that require urgent research to assess and manage the COVID-19 outbreak.
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Affiliation(s)
- Luigi Montano
- Andrology Unit, EcoFoodFertility Project, Coordination Unit, Local Health Authority (ASL) Salerno, Oliveto Citra, Via M. Clemente, 84020 Oliveto Citra, SA Italy
| | - Francesco Donato
- Department of Medical and Surgical Specialties Radiological Sciences and Public Health, Unit of Hygiene, Epidemiology, and Public Health, University of Brescia, Brescia, Italy
| | - Pietro Massimiliano Bianco
- ISPRA, Italian Institute for Environmental Protection and Research, Via Vitaliano Brancati 60, 00144 Rome, Italy
| | - Gennaro Lettieri
- Department of Biology, University of Naples Federico II, Via Cinthia 21, 80126 Napoli, Italy
| | | | - Oriana Motta
- Department of Medicine, Surgery and Dentistry, University of Salerno, Fisciano, Italy
| | - Ian Marc Bonapace
- Department of Biotechnology and Life Sciences, University of Insubria (VA), Varese, Italy
| | - Marina Piscopo
- Department of Biology, University of Naples Federico II, Via Cinthia 21, 80126 Napoli, Italy
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Montano L, Donato F, Bianco PM, Lettieri G, Guglielmino A, Motta O, Bonapace IM, Piscopo M. Air Pollution and COVID-19: A Possible Dangerous Synergy for Male Fertility. Int J Environ Res Public Health 2021; 18:ijerph18136846. [PMID: 34202243 PMCID: PMC8297116 DOI: 10.3390/ijerph18136846] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 12/11/2022]
Abstract
Several studies indicate that semen quality has strongly declined in the last decades worldwide. Air pollution represents a significant co-factor with the COVID-19 impact and has negative effects on the male reproductive system, through pro-oxidant, inflammatory and immune-dysregulating mechanisms. It has recently been reported that chronic exposure to PM2.5 causes overexpression of the alveolar ACE2 receptor, the entry route of SARS-CoV-2 into the organism shared by the lungs and testis where expression is highest in the body. In the testis, the ACE2/Ang-(1-7)/MasR pathway plays an important role in the regulation of spermatogenesis and an indirect mechanism of testicular damage could be due to the blockade of the ACE2 receptor by SARS-CoV-2. This prevents the conversion of specific angiotensins, and their excess causes inflammation with the overproduction of cytokines. PM2.5-induced overexpression of the alveolar ACE2 receptor, in turn, could increase local viral load in patients exposed to pollutants, producing ACE2 receptor depletion and compromising host defenses. By presenting an overall view of epidemiological data and molecular mechanisms, this manuscript aims to interpret the possible synergistic effects of both air pollution and COVID-19 on male reproductive function, warning that the spread of SARS-CoV-2 in the fertile years may represent a significant threat to global reproductive health. All of this should be of great concern, especially for men of the age of maximum reproductive capacity, and an important topic of debate for policy makers. Altered environmental conditions, together with the direct and indirect short- and long-term effects of viral infection could cause a worsening of semen quality with important consequences for male fertility, especially in those areas with higher environmental impact.
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Affiliation(s)
- Luigi Montano
- Andrology Unit and Service of Lifestyle Medicine in UroAndrology, Local Health Authority (ASL) Salerno, Coordination Unit of the Network for Environmental and Reproductive Health (EcoFoodFertility Project), “Oliveto Citra Hospital”, 84020 Oliveto Citra, Italy
- PhD Program in Evolutionary Biology and Ecology, Department of Biology, University of Rome Tor Vergata, 00133 Rome, Italy
- Correspondence: (L.M.); (I.M.B.); (M.P.); Tel.: +39-0331-339452 (I.M.B.); +39-0816-79081 (M.P.)
| | - Francesco Donato
- Unit of Hygiene, Epidemiology, and Public Health, Department of Medical and Surgical Specialties Radiological Sciences and Public Health, University of Brescia, 21100 Brescia, Italy;
| | - Pietro Massimiliano Bianco
- ISPRA, Italian Institute for Environmental Protection and Research, Via Vitaliano Brancati 60, 00144 Roma, Italy;
| | - Gennaro Lettieri
- Department of Biology, University of Naples Federico II, 80126 Napoli, Italy;
| | | | - Oriana Motta
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy;
| | - Ian Marc Bonapace
- Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy
- Correspondence: (L.M.); (I.M.B.); (M.P.); Tel.: +39-0331-339452 (I.M.B.); +39-0816-79081 (M.P.)
| | - Marina Piscopo
- Department of Biology, University of Naples Federico II, 80126 Napoli, Italy;
- Correspondence: (L.M.); (I.M.B.); (M.P.); Tel.: +39-0331-339452 (I.M.B.); +39-0816-79081 (M.P.)
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Chamayou S, Sicali M, Lombardo D, Maglia E, Liprino A, Cardea C, Fichera M, Venti E, Guglielmino A. The true panel of cystic fibrosis mutations in the Sicilian population. BMC Med Genet 2020; 21:89. [PMID: 32357917 PMCID: PMC7195759 DOI: 10.1186/s12881-020-0958-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/21/2020] [Indexed: 11/24/2022]
Abstract
Background The aim was to establish the true risk of having an affected child with Cystic Fibrosis (CF) in the Sicilian infertile population. Methods A longitudinal CFTR screening of 1279 Sicilian infertile patients for all CFTR mutations sequencing the entire gene by Next Generation Sequencing (NGS) was performed from patient’s blood. Results One patient out of 16 was a carrier of a CFTR mutation. Twenty-four mutations were found. Theoretically one couple out of 256 was at risk of CF transmission. Conclusions The risk of CF transmission is unexpectedly high in Sicily and with a high heterogeneity. Sequencing an entire and long gene such as CFTR makes accessible the true panel of mutations in a specific population and helps better to understand the true risk of having an affected child.
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Affiliation(s)
- Sandrine Chamayou
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy.
| | - Maria Sicali
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Debora Lombardo
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Elena Maglia
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Annalisa Liprino
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Clementina Cardea
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Michele Fichera
- Unit of Gynecology and Obstetric - Department of general surgery and medical surgical specialties, University of Catania, Catania, Italy
| | - Ermanno Venti
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
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Chamayou S, Sicali M, Lombardo D, Alecci C, Ragolia C, Maglia E, Liprino A, Cardea C, Storaci G, Romano S, Guglielmino A. Universal strategy for preimplantation genetic testing for cystic fibrosis based on next-generation sequencing. J Assist Reprod Genet 2019:10.1007/s10815-019-01636-1. [PMID: 31848897 DOI: 10.1007/s10815-019-01636-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 11/12/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE We developed and applied a universal strategy for preimplantation genetic testing for all cystic fibrosis gene mutations (PGT-CF) based on next-generation sequencing (NGS). METHODS A molecular protocol was designed to diagnose all CF mutations at preimplantation stage. The detection of CF mutations was performed by direct gene sequencing and linkage strategy testing 38 specific SNPs located upstream and inside the gene for PGT-CF. Seventeen couples at risk of CF transmission decided to undergo PGT-CF. Trophectoderm cell biopsies were performed on days 5-6 blastocysts. PGT for aneuploidy (PGT-A) was performed from the same samples. Tested embryos were transferred on further natural cycles. RESULTS PGT was performed on 109 embryos. Fifteen CF mutations were tested. PGT-CF and PGT-A were conclusive for, respectively, 92.7% and 95.3% of the samples. A mean of 24.1 SNPs was informative per couple. After single embryo transfer on natural cycle, 81.3% of the transferred tested embryos implanted. CONCLUSIONS The present protocol based on the entire CFTR gene sequencing together with informative SNPs outside and inside the gene can be applied to diagnose all CF mutations at preimplantation stage.
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Affiliation(s)
- Sandrine Chamayou
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy.
| | - Maria Sicali
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Debora Lombardo
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Carmelita Alecci
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Carmen Ragolia
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Elena Maglia
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Annalisa Liprino
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Clementina Cardea
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Giorgia Storaci
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Simona Romano
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
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Chamayou S, Sicali M, Lombardo D, Alecci C, Ragolia C, Maglia E, Liprino A, Cardea C, Storaci G, Romano S, Guglielmino A. Universal strategy for preimplantation genetic testing for cystic fibrosis based on next generation sequencing. J Assist Reprod Genet 2019; 37:213-222. [PMID: 31828483 PMCID: PMC7000499 DOI: 10.1007/s10815-019-01635-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 11/12/2019] [Indexed: 12/11/2022] Open
Abstract
Purpose We developed and applied a universal strategy for preimplantation genetic testing for all cystic fibrosis gene mutations (PGT-CF) based on next-generation sequencing (NGS). Methods A molecular protocol was designed to diagnose all CF mutations at preimplantation stage. The detection of CF mutations was performed by direct gene sequencing and linkage strategy testing 38 specific SNPs located upstream and inside the gene for PGT-CF. Seventeen couples at risk of CF transmission decided to undergo PGT-CF. Trophectoderm cell biopsies were performed on day 5–6 blastocysts. PGT for aneuploidy (PGT-A) was performed from the same samples. Tested embryos were transferred on further natural cycles. Results PGT was performed on 109 embryos. Fifteen CF mutations were tested. PGT-CF and PGT-A were conclusive for respectively 92.7% and 95.3% of the samples. A mean of 24.1 SNPs was informative per couple. After a single embryo transfer on natural cycle, 81.3% of the transferred tested embryos were implanted. Conclusions The present protocol based on the entire CFTR gene together with informative SNPs outside and inside the gene can be applied to diagnose all CF mutations at preimplantation stage. Electronic supplementary material The online version of this article (10.1007/s10815-019-01635-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sandrine Chamayou
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy.
| | - Maria Sicali
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Debora Lombardo
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Carmelita Alecci
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Carmen Ragolia
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Elena Maglia
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Annalisa Liprino
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Clementina Cardea
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Giorgia Storaci
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Simona Romano
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
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Chamayou S, Sicali M, Lombardo D, Alecci C, Guglielmino A. The decision on the embryo to transfer after Preimplantation Genetic Diagnosis for X-autosome reciprocal translocation in male carrier. Mol Cytogenet 2018; 11:63. [PMID: 30619509 PMCID: PMC6310935 DOI: 10.1186/s13039-018-0409-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 11/26/2018] [Indexed: 01/02/2023] Open
Abstract
Background The aim of Preimplantation Genetic Diagnosis (PGD) on embryos produced in vitro is to identify the embryos without genetic or chromosomal defect from those embryos that will develop the genetic disease or are chromosomally abnormal. In case of PGD for structural chromosome indication (PGR-SR), the normal/balanced embryos are transferred in the maternal uterus. This protocol is valid and widely applied for autosomal chromosome translocation. But which embryo should be transferred after preimplantation genetic diagnosis (PGD-SR) for X-3 reciprocal translocation in male patient? Case presentation The female patient was 26 years old with normal 46,XX karyotype. The male patient had a karyotype with balanced translocation 46,Y,t(X;3)(p11.2;p14)mat, inherited from the mother. The female patient underwent two cycles of ovarian stimulation. In the first cycle, the metaphase II oocytes were vitrified, while in the second cycle they were used as fresh. ICSI was performed on vitrified/warmed and fresh oocytes. Embryos were biopsied at blastocyst stage. Chromosomal analysis was performed by Next Generation Sequencing. Eleven blastocysts were biopsied from 23 vitrified/warmed and fresh metaphase II oocytes. Two embryos were diagnosed 46,XY; two embryos were diagnosed 46,XX; four embryos were diagnosed with unbalanced translocations and three embryos were diagnosed aneuploid. We knew that the two embryos diagnosed as 46,XX inherited the balanced translocation from the father and the two embryos diagnosed as 46,XY had a normal karyotype. It was explain to the couple that the phenotype of balanced translocated female embryos cannot be predicted because of the random inactivation of X chromosome and that could also occur on the der(X). The couple asked to have a 46,XY embryo transferred. Clinical pregnancy was obtained and non invasive prenatal test confirmed PGD-SR result. Conclusions Proposing PGD-SR for gonosome-autosome reciprocal translocation implies the risk to exclude balanced translocated female embryos with a normal phenotype for transfer because the early and late normal development at post-natal stage cannot be predicted based on the only chromosomal analysis.
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Affiliation(s)
- Sandrine Chamayou
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n 51/53 95030 Sant Agata Li Battiati, Catania, Italy
| | - Maria Sicali
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n 51/53 95030 Sant Agata Li Battiati, Catania, Italy
| | - Debora Lombardo
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n 51/53 95030 Sant Agata Li Battiati, Catania, Italy
| | - Carmelita Alecci
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n 51/53 95030 Sant Agata Li Battiati, Catania, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n 51/53 95030 Sant Agata Li Battiati, Catania, Italy
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Bosco L, Notari T, Ruvolo G, Roccheri MC, Martino C, Chiappetta R, Carone D, Lo Bosco G, Carrillo L, Raimondo S, Guglielmino A, Montano L. Sperm DNA fragmentation: An early and reliable marker of air pollution. Environ Toxicol Pharmacol 2018; 58:243-249. [PMID: 29448163 DOI: 10.1016/j.etap.2018.02.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 01/31/2018] [Accepted: 02/03/2018] [Indexed: 05/25/2023]
Abstract
Environmental factors could have a key role in the continuous and remarkable decline of sperm quality observed in the last decades. This study compared the seminal parameters and sperm DFI in men living in areas with different levels of air pollution. Results demonstrate that both steel plants workers and patients living in a high polluted area show a mean percentage of sperm DNA fragmentation above 30%, highlighting a clear sperm damage. In this work, two different techniques were used to measure sperm DNA damage in patients' groups, finding in both cases a high sperm DFI in patients living in polluted areas. We candidate sperm DNA fragmentation as a valuable early marker of the presence and harmful effects of pollution. We suggest that sperm DNA evaluation could be both an indicator of individual health and reproductive capacity, and a suitable datum to connect the surrounding environment with its effects.
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Affiliation(s)
- Liana Bosco
- Department of Biological, Chemistry and Pharmaceutical Sciences and Technologies, University of Palermo, Viale delle Scienze Ed.16, Palermo, Italy
| | - Tiziana Notari
- GEA - Gynecology Embryology Andrology - Reproductive Medicine Unit of Check Up Polydagnostic Center, Via A. De Luca 5, Salerno, Italy
| | | | - Maria C Roccheri
- Department of Biological, Chemistry and Pharmaceutical Sciences and Technologies, University of Palermo, Viale delle Scienze Ed.16, Palermo, Italy
| | - Chiara Martino
- Department of Biological, Chemistry and Pharmaceutical Sciences and Technologies, University of Palermo, Viale delle Scienze Ed.16, Palermo, Italy
| | - Rosanna Chiappetta
- Reproduction Center and Andrology, Via Scoglio del Tonno, Taranto, Italy
| | - Domenico Carone
- Reproduction Center and Andrology, Via Scoglio del Tonno, Taranto, Italy
| | - Giosuè Lo Bosco
- Department of Mathematics and Computer Science, University of Palermo, Via Archirafi, Palermo, Italy; Euro-Mediterranean Institute of Science and Technology, Via Michele Miraglia, Palermo
| | - Laura Carrillo
- Reproductive Biology Center, Via Villareale, Palermo, Italy
| | - Salvatore Raimondo
- Seminology Unit Gentile Research Centre, Via Vittorio Veneto 108, Gragnano NA Italy
| | | | - Luigi Montano
- Andrology Unit of the "S. Francesco d' Assisi " Hospital, Local Health Authority (ASL) Salerno, EcoFoodFertility Project Coordination Unit, Via M. Clemente, Oliveto Citra, SA Italy.
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Chamayou S, Sicali M, Alecci C, Ragolia C, Liprino A, Nibali D, Storaci G, Cardea A, Guglielmino A. The accumulation of vitrified oocytes is a strategy to increase the number of euploid available blastocysts for transfer after preimplantation genetic testing. J Assist Reprod Genet 2017; 34:479-486. [PMID: 28070710 PMCID: PMC5401691 DOI: 10.1007/s10815-016-0868-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 12/23/2016] [Indexed: 10/26/2022] Open
Abstract
PURPOSE In a preimplantation genetic diagnosis for aneuploidy (PGD-A) program, the more embryos available for biopsy, consequently increases the chances of obtaining euploid embryos to transfer. The aim was to increase the number of viable euploid blastocysts in patients undergoing PGD-A using fresh oocytes together with previously accumulated vitrified oocytes. METHODS Sixty-nine patients with normal ovarian reserve underwent PGD-A for repeated implantation failure or recurrent pregnancy loss indication. After several cycles of ovarian stimulation, 591 accumulated vitrified oocytes and 463 fresh oocytes were micro-injected with the same partner's semen sample. PGD-A was completed on 134 blastocysts from vitrified/warmed oocytes and 130 blastocysts from fresh oocytes. RESULTS A mean of 9.6% euploid blastocyst per micro-injected vitrified/warmed oocytes and 11.4% euploid blastocyst per micro-injected fresh oocyte were obtained (p > 0.05). The euploidy and aneuploidy rates were comparable in blastocysts obtained from micro-injected vitrified/warmed oocytes and fresh oocytes (42.5 versus 40.8% and 57.5 versus 59.2%, p > 0.05). Implantation rates of euploid blastocysts were comparable between the two sources of oocytes (56.0% from vitrified/warmed oocytes versus 60.9% from fresh oocytes, p > 0.05). CONCLUSIONS Oocyte vitrification and warming do not generate aneuploidy in blastocysts. The number of viable euploid embryos for transfer can be increased by using accumulated vitrified oocytes together with fresh oocytes in ICSI. TRIAL REGISTRATION NCT02820415 ClinicalTrials.gov.
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Affiliation(s)
- Sandrine Chamayou
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy.
| | - Maria Sicali
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Carmelita Alecci
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Carmen Ragolia
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Annalisa Liprino
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Daniela Nibali
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Giorgia Storaci
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Antonietta Cardea
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione-Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
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Bonaventura G, Chamayou S, Liprino A, Guglielmino A, Fichera M, Caruso M, Barcellona ML. Different Tissue-Derived Stem Cells: A Comparison of Neural Differentiation Capability. PLoS One 2015; 10:e0140790. [PMID: 26517263 PMCID: PMC4627815 DOI: 10.1371/journal.pone.0140790] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 09/30/2015] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Stem cells are capable of self-renewal and differentiation into a wide range of cell types with multiple clinical and therapeutic applications. Stem cells are providing hope for many diseases that currently lack effective therapeutic methods, including strokes, Huntington's disease, Alzheimer's and Parkinson's disease. However, the paucity of suitable cell types for cell replacement therapy in patients suffering from neurological disorders has hampered the development of this promising therapeutic approach. AIM The innovative aspect of this study has been to evaluate the neural differentiation capability of different tissue-derived stem cells coming from different tissue sources such as bone marrow, umbilical cord blood, human endometrium and amniotic fluid, cultured under the same supplemented media neuro-transcription factor conditions, testing the expression of neural markers such as GFAP, Nestin and Neurofilaments using the immunofluorescence staining assay and some typical clusters of differentiation such as CD34, CD90, CD105 and CD133 by using the cytofluorimetric test assay. RESULTS Amniotic fluid derived stem cells showed a more primitive phenotype compared to the differentiating potential demonstrated by the other stem cell sources, representing a realistic possibility in the field of regenerative cell therapy suitable for neurodegenerative diseases.
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Affiliation(s)
- Gabriele Bonaventura
- Department of Pharmaceutical Science, Biochemistry Section, University of Catania, Catania, Italy
- Institute of Neurological Sciences, Italian National Research Council, Catania, Italy
| | - Sandrine Chamayou
- Unità di Medicina della Riproduzione, Fondazione Hera, Sant’Agata Li Battiati (CT), Italy
| | - Annalisa Liprino
- Department of Obstetrics and Gynecology and Radiological Sciences (OGiRA), University of Catania, Catania, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione, Fondazione Hera, Sant’Agata Li Battiati (CT), Italy
| | - Michele Fichera
- Department of Obstetrics and Gynecology and Radiological Sciences (OGiRA), University of Catania, Catania, Italy
| | - Massimo Caruso
- Department of Clinic and Molecular Biomedicine, University of Catania, Catania, Italy
| | - Maria Luisa Barcellona
- Department of Pharmaceutical Science, Biochemistry Section, University of Catania, Catania, Italy
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Chamayou S, Romano S, Alecci C, Storaci G, Ragolia C, Palagiano A, Guglielmino A. Oocyte vitrification modifies nucleolar remodeling and zygote kinetics-a sibling study. J Assist Reprod Genet 2015; 32:581-6. [PMID: 25701142 PMCID: PMC4380896 DOI: 10.1007/s10815-015-0446-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 01/29/2015] [Indexed: 01/13/2023] Open
Abstract
Purpose Oocyte vitrification does not affect embryo quality after oocyte warming, making this method effective in the preservation of female fertility. Morphokinetic parameters can be used to predict the competence of an embryo produced from fresh oocytes. Our aim was to study the effect of oocyte vitrification on zygote-embryo kinetics (pl). Methods The embryo-kinetics of fresh and sibling vitrified/warmed oocytes were compared to determine the consequences of oocyte preservation on the timing of embryo development. A 44-hours time-lapse analysis, from the time of ICSI (t0), of 179 fertilized fresh oocytes was compared to 168 fertilized sibling vitrified/warmed oocytes. Results Oocyte vitrification accelerated pronuclear disappearance, one-cell stage timing and modified nucleoli activity by increasing their number and decreasing their diameter at the zygote stage. In contrast, embryo kinetics during cleavage were similar to those observed for fresh sibling oocytes based on the parameters examined in this study. Conclusions At the zygote stage, oocyte vitrification induces changes in pronuclei stability, probably due to pronuclei envelop instability as well as modifications in nucleoli functionality. Therefore, the predictive morphokinetic parameters on embryo competence found from fresh oocytes must be revised when applied on embryos from vitrified/warmed oocytes.
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Affiliation(s)
- S Chamayou
- Unità Di Medicina della Riproduzione - Istituto HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy,
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Chamayou S, Alecci C, Storaci G, Ragolia CC, Guglielmino A. Oocyte vitrification modifies nucleoli activity, a time-lapse monitoring analysis. Reprod Biomed Online 2014. [DOI: 10.1016/s1472-6483(14)50005-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chamayou S, Storaci G, Alecci C, Ragolia C, Guglielmino A. PP-16 EMBRYO DEVELOPMENT: EXACT KINETIC AND TRACEABILITY OF CELLULAR ABNORMALITIES MONITORED BY TIME-LAPSE CULTURE. Reprod Biomed Online 2012. [DOI: 10.1016/s1472-6483(12)60148-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Chamayou S, Bonaventura G, Alecci C, Tibullo D, Di Raimondo F, Guglielmino A, Barcellona ML. Consequences of metaphase II oocyte cryopreservation on mRNA content. Cryobiology 2011; 62:130-4. [PMID: 21272569 DOI: 10.1016/j.cryobiol.2011.01.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Revised: 12/17/2010] [Accepted: 01/19/2011] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We studied the consequences of freezing/thawing processes on mRNA contents in MII oocytes after slow-freezing/rapid thawing (SF/RT) and vitrification/warming (V/W) protocols, and compared the results to fresh MII oocytes. We quantified the nuclear transcript mRNA responsible for the translation of proteins belonging either to trans-regulatory protein family or to functional structural proteins such as proteins involved in DNA structural organization (NAP1L1, TOP1, H1F0H1), chromosomal structure maintenance (SMC, SCC3, RAD21, SMC1A, SMC1B, STAG3, REC8), mitochondrial energetic pathways (ATP5GJ, SDHC), cell cycle regulation and processes (CLTA, MAPK6, CKS2) and staminal cell potency-development competence stage (DPPA3, OCT4, FOXJ2). MATERIAL AND METHODS Surplus MII oocytes were donated from patients in IVF cycles and divided in three groups of 15 oocytes. Group 1 was comprised of non-cryopreserved oocytes and Groups 2 and 3 underwent SF/RT and V/W procedures, respectively. RESULTS There was an overall decrease of mRNA extracted from cryopreserved oocytes compared to control group. Only 39.4% of mRNA content were preserved after SF/RT while 63.3% of mRNA content were maintained after V/W. CONCLUSIONS Oocyte cryopreservation is associated with molecular injury associated with the decrease of stored mRNA. However the V/W protocol is more conservative than SF/RT resulting in a level of mRNA sufficient to maintain biologic functions in the subsequent fertilized oocyte.
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Affiliation(s)
- S Chamayou
- Unità di Medicina della Riproduzione--Fondazione Hera, Via Barriera del Bosco n. 51/53, Sant'Agata Li Battiali (CT), Italy.
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Bern O, Strassburger D, Komarovsky D, Kasterstein E, Komsky A, Maslansky B, Raziel A, Ben-Ami I, Friedler S, Gidoni Y, Ron-El R, Barblett H, Shah T, Pinkus C, Mehmet D, Rebollar-Lazaro I, Dupont C, Sermondade N, Hafhouf E, Levy R, Cedrin-Durnerin I, Hugues JN, Poncelet C, Sifer C, Remohi Gimenez J, Cobo Cabal A, de los Santos MJ, Bellver J, Mifsud A, Romero JLL, Chamayou S, Bonaventura G, Alecci C, Tibullo D, Guglielmino A, Barcellona ML, Murakami M, Egashira A, Araki Y, Kuramoto T. SELECTED ORAL COMMUNICATION SESSION, SESSION 31: EMBRYOLOGY - CRYOPRESERVATION, Tuesday 5 July 2011 10:00 - 11:30. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tamburino L, Guglielmino A, Venti E, Chamayou S. Molecular analysis of mutations and polymorphisms in the CFTR gene in male infertility. Reprod Biomed Online 2008; 17:27-35. [DOI: 10.1016/s1472-6483(10)60289-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Guglielmino A, Sorbello M, Murabito P, Naimo J, Palumbo A, Lo Giudice E, Giuffrida S, Fazzio S, Parisi G, Mangiameli S. A case of lumbar sciatica in a patient with spondylolysis and spondylolysthesis and underlying misdiagnosed brucellar discitis. Minerva Anestesiol 2007; 73:307-12. [PMID: 17529921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
We report the case of a patient affected by vertebral pain refractory to conventional analgesic therapy with a diagnosis of spondylolysthesis and also the affects of a misdiagnosed brucellar spondylodiscitis. The absence of a positive response to conventional analgesics, a suggestive medical history (epidemiologic data still show a high incidence of Brucella infections for the Province of Catania), radiological findings and microbiological tests led to the correct diagnosis of algic syndrome in a patient affected by brucellar spondylodiscitis with the concomitant presence of retroperitoneal muscular abscess, and a previously diagnosed spondylolysthesis. All symptoms improved after correct antibrucellar antibiotic therapy and surgical drainage of the retroperitoneal abscess. Vertebral pain is a relatively frequent symptom observed in Pain Medicine Services; in a zone in which Brucella infections may be considered endemic, neurobrucellosis must be considered highly probable in the differential diagnosis of several clinical pictures, including vertebral pain that could result from vertebral localization of Brucella infection. The role of the Pain Medicine Specialist is not only to treat the symptoms, but also to research and confirm the etiopathogenetic mechanisms before starting a correct treatment.
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Affiliation(s)
- A Guglielmino
- Anesthesia and Intensive Care Unit, Polyclinic University Hospital, Catania, Italy
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Chamayou S, Ragolia C, Alecci C, Storaci G, Maglia E, Russo E, Guglielmino A. Meiotic spindle presence and oocyte morphology do not predict clinical ICSI outcomes: a study of 967 transferred embryos. Reprod Biomed Online 2007; 13:661-7. [PMID: 17169176 DOI: 10.1016/s1472-6483(10)60656-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
With a view to correlating oocyte morphology and meiotic spindle presence to clinical intracytoplasmic sperm injection (ICSI) outcomes, 967 oocytes that led to 967 transferred embryos in 404 embryo transfers were studied. No relationship was found between oocyte morphology (ooplasm texture, perivitelline space largeness, perivitelline space granulation absence/presence and the first polar body shape) or meiotic spindle presence or absence and clinical pregnancy per transfer and implantation rates after ICSI. It was concluded that oocyte morphology and meiotic spindle presence or absence can only predict fertilization, cleavage rates and embryo quality, as previously described in the literature, but do not help in daily ICSI practice in the choice of the metaphase II oocyte that will lead to the embryo that starts clinical pregnancy.
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Affiliation(s)
- S Chamayou
- Unità di Medicina della Riproduzione - FOUDATION HERA, Viale Marco Polo 39/A, 95126 Catania, Italy.
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Guglielmino A, Sorbello M, Barbagallo G, Murabito P, Naimo J, Zingale SF, Lo Giudice E, Palumbo A, Castiglione A, Patti F, Pero G, Mangiameli S. Osteoporotic vertebral compression fracture pain (back pain): our experience with balloon kyphoplasty. Minerva Anestesiol 2007; 73:77-100. [PMID: 17356508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
AIM The aim of this study is to evaluate the safety and effectiveness of antalgic and functional results after interdisciplinary approach and treatment of vertebral compression fractures (VCF) with percutaneous balloon kyphoplasty (KP) by the pain medicine specialist. METHODS Between April and December 2004, after informed consent, 13 patients have been treated for a total amount of 15 KP. For L5 - T11 level spinal anesthesia was performed, above T11 local infiltration was used. The following parameters were recorded: intraoperative course, postoperative course, pain before and after treatment, vertebral height restoring and quality of life measuring on visual analogical scale (VAS) and quality of life questionnaire of the European Foundation for Osteoporosis (QUALEFFO) scale. RESULTS No complications or adverse events were recorded. VAS values for pain were 6.2+/-2.1 preKP vs 3.3+/-1.7 and 4.5+/-1.1 respectively postKP and at follow-up, with statistically significant differences. Vertebral heights were 53.5+/-16%, 71.2+/-21% and 68.1+/-13.5%, preKP, postKP and at follow-up respectively, with statistically significant differences, similarly to quality of life related parameters and QUALEFFO score. CONCLUSION Back pain due to vertebral compression fractures is a quite frequent diagnosis for the pain medicine specialist; KP is a new technique showing an association of a low incidence of complications with a success rate, both on pain control and on vertebral height restoring. In our study, KP proved to be a safe technique with a high success rate, both for pain relief and for vertebral height restoring, with immediate results and important consequences on the patient's quality of life, physical and mental status, with a low incidence of complications due also to the choice of performing this procedure in locoregional anesthesia.
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Affiliation(s)
- A Guglielmino
- Anesthesia and Intensive Care Unit, University Polyclinic, Catania, Italy
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Guglielmino A, Sorbello M, Fazzio S, Zingale SF, Bucolo GE, Pittalà G, Castiglione A, Patti F, Mangiameli S. Continuous intrathecal baclofen administration by a fully implantable electronic pump for severe spasticity treatment: our experience. Minerva Anestesiol 2006; 72:807-20. [PMID: 17006418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
AIM With this 8-month study, we wanted to evaluate the efficacy of continuous intrathecal baclofen infusion delivery by a programmable pump for severe spasticity according to patient selection criteria, implantation technique and related parameters, and outcome after the initial follow-up period. METHODS Intrathecal baclofen infusion was initiated in 30 patients within 24 h after a test dose of the agent resulted positive in spinal anaesthesia. During the procedure and the follow-up period, the following parameters were measured: incidence of anaesthesiological or surgical complications and adverse events, postdural puncture headache, prolonged motor block, difficulty in wound healing, infection, necessity to remove the pump; clinical response as measured on the Ashworth and spasms scales, quality of sleep, autonomy, quality of life and pain before and after intrathecal baclofen therapy. RESULTS Perioperative vital parameters (mean duration of the operation, 86+/-13 min) were stable; no motor block or postdural puncture headache, early or late infection developed. The 1 case of delayed wound healing resolved with treatment; a dislocated catheter was repositioned in 1 other case. The differences in changes between pre- and posttreatment were statistically significant, with best results obtained on rigidity and pain. The mean length of hospital stay was 8+/-2 days. Baclofen tolerance was observed in 1 case, but resolved after baclofen holiday with morphine. One case of pump malfunctioning was resolved with replacement of the device; no new neurological deficits occurred thereafter. CONCLUSIONS The good clinical response to treatment of spasticity and rigidity, improved quality of life, pain reduction and patient satisfaction with short length of admission demonstrate the efficacy of intrathecal baclofen therapy. Safe and efficacious, this mode of treatment appears to be the gold standard for treating severe spasticity.
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Affiliation(s)
- A Guglielmino
- Anesthesia and Intensive Care Unit, Polyclinic University Hospital of Catania, Catania, Italy
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Chamayou S, Alecci C, Ragolia C, Storaci G, Maglia E, Russo E, Guglielmino A. Comparison of in-vitro outcomes from cryopreserved oocytes and sibling fresh oocytes. Reprod Biomed Online 2006; 12:730-6. [PMID: 16792849 DOI: 10.1016/s1472-6483(10)61085-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In Italy, the restrictive IVF law generalizes the indication for oocyte freezing for surplus oocytes in 78.5% of in-vitro assisted reproductive cycles. With a view to understanding better what the prospects for intracytoplasmic sperm injection (ICSI) on frozen-thawed oocytes might be, the consequences of freeze-thaw procedures on fertilization, cleavage rates and embryo quality obtained from frozen-thawed oocytes were studied and compared with the results obtained from sibling fresh oocytes. Eleven IVF and 29 ICSI on 76 and 169 fresh oocytes were performed and the corresponding 40 ICSI on 221 sibling frozen-thawed oocytes. There was no difference in terms of fertilization rate between fresh and sibling frozen-thawed oocytes. The cleavage rate (98.0 and 94.4% with fresh oocytes in IVF and ICSI; 77.3% with frozen-thawed oocytes in ICSI; P < 0.001) and embryo quality (grade I embryos over total embryos: 36.7 and 22.2% with fresh oocytes in IVF and ICSI; 12.1% with frozen-thawed oocytes in ICSI; respectively P < 0.001 and P < 0.05) were statistically lower after oocyte cryopreservation. The significant decrease in meiotic spindle retrieval rate before freezing (62.4%) and after thawing procedures (43.4%; P < 0.001) suggests that cryoconservation induces irreversible damage to microtubule repolymerization. The consequences of oocyte cryopreservation procedures on embryo development are reviewed.
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Affiliation(s)
- S Chamayou
- Unità di Medicina della Riproduzione - Fondazione HERA, Viale Marco Polo 39/A, 95126 Catania, Italy.
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Tamburino L, Guglielmino A, Venti E, Chamayou S. 14 Screening for CFTR gene mutations and analysis of the TG12-T5 haplotype in infertile patients. J Cyst Fibros 2006. [DOI: 10.1016/s1569-1993(06)80015-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Pappalardo A, Patti F, Reggio A, Guglielmino A, Mangiameli S. [Spasticity in multiple sclerosis]. Clin Ter 2004; 155:135-8. [PMID: 15354762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Already in 1860, the great neurologist Charcot described the symptom spasticity in patients affected by "sclerose en plaque". Spasticity is one of the most common symptoms of multiple sclerosis MS). The consequences of spasticity are very disadvantages because it hinders the functional mobility and overburden disability. Moreover, in the later stages of MS spasticity may be complicated by seating problems, pressure sores, fibrous contractures and poor perineal hygiene. In this article, the therapeutical management of MS spasticity, in all its components (pharmacological, rehabilitative, surgical) is reviewed.
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Affiliation(s)
- A Pappalardo
- Centro Sclerosi Multipla, Università di Catania, Italia.
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Chamayou S, Alecci C, Ragolia C, Giambona A, Siciliano S, Maggio A, Fichera M, Guglielmino A. Successful application of preimplantation genetic diagnosis for beta-thalassaemia and sickle cell anaemia in Italy. Hum Reprod 2002; 17:1158-65. [PMID: 11980733 DOI: 10.1093/humrep/17.5.1158] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In Italy, the autosomal recessive diseases beta-thalassaemia and sickle cell anaemia are so widespread that in some regions they can be defined as 'social diseases'. In this study, nine clinical applications of preimplantation genetic diagnosis (PGD) were performed for beta-thalassaemia and sickle cell anaemia on seven Sicilian couples and carriers of beta-globin gene mutations. METHODS AND RESULTS The studied mutations were: Cd39, HbS, IVS1 nt1, IVS1 nt6 and IVS1 nt110. ICSI was performed with partner's sperm on 131 out of 147 retrieved oocytes, and this resulted in 72 zygotes; 32 embryos were successfully biopsied on day 3. The biopsied blastomeres were lysed and the beta-globin alleles amplified by nested PCR. The mutation diagnosis was performed by restriction enzyme digestion and reverse dot-blot. The amplification efficacy was 97.2%. The genotype study of non-transferred and surplus embryos showed that the allele drop-out rate was 8.6%. Seventeen embryos were transferred in utero on day 4. All couples received an embryo transfer; of the four pregnancies obtained, three resulted in live births and one miscarried at 11 weeks. Prenatal diagnosis at the 11th week and miscarriage material analysis confirmed the PGD results. CONCLUSIONS These studies represent the first successful application of PGD for beta-thalassaemia and sickle cell anaemia in Italy.
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Affiliation(s)
- S Chamayou
- Unità di Medicina della Riproduzione, Associazione HERA, Catania, Italy.
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Chamayou S, Guglielmino A, Giambona A, Siciliano S, Di Stefano G, Scibilia G, Humeau C, Maggio A, Di Leo S. Attitude of potential users in Sicily towards preimplantation genetic diagnosis for beta-thalassaemia and aneuploidies. Hum Reprod 1998; 13:1936-44. [PMID: 9740453 DOI: 10.1093/humrep/13.7.1936] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study aims to report the willingness of different populations of high-risk couples to undergo preimplantation genetic diagnosis (PGD) for beta-thalassaemia as an alternative to prenatal genetic diagnosis (PND), and the willingness of infertile couples to undergo PGD for aneuploidies. An information sheet and questionnaire presenting PGD and PND procedures were distributed to four population types: 54 high-risk couples for beta-thalassaemia coming for their first PND (population A); 51 similar couples coming for their second or further PND without previous experience of therapeutic abortion (population B-na); 50 similar couples coming for their second or further PND with previous experience of therapeutic abortion for beta-thalassaemia-affected fetus (population B-ab); and 74 infertile couples undergoing routine in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) (population C). Favourable first impressions towards PGD compared with PND were observed in all four populations in the following proportions: 79.6% population A; 76.5% population B-na; 92.0% population B-ab; and 96.0% population C. Willingness to undergo PGD for beta-thalassaemia was as follows: 44.4% population A; 47.1% population B-na; and 72.0% population B-ab. We conclude that previous experience of PND for beta-thalassaemia is a crucial point in the willingness to accept the PGD procedure, and that couples belonging to population B-ab are the most suitable to undergo PGD for beta-thalassaemia. Some 96.0% of infertile couples in population C were ready to undergo PGD for aneuploidies.
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Affiliation(s)
- S Chamayou
- Université Montpellier I, Laboratoire de Biologie de la Reproduction, Hôpital Arnaud de Villeneuve, France
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Abstract
The treatment of male factor infertility is a rapidly developing field. The introduction of microsurgical fertilization techniques allows assisted conception units to treat couples who previously would not have benefited from in-vitro fertilization techniques. However, these techniques are only used for the minority of subfertile men in andrological practice. Many subfertile men are still treated pharmacologically or by sperm selection methods to enhance sperm fertilizing ability. Numerous pharmacological compounds have been described that enhance sperm motility and thus, potentially, sperm fertilizing capacity. This paper attempts to review these compounds and assess their role in treatment of the subfertile male.
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Affiliation(s)
- F Lanzafame
- Department of Obstetrics and Gynaecology, Guy's Hospital, London, UK
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