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Coccia ME, Rizzello F, Wakunga S, Badolato L, Evangelisti P, Bertocci F, Giachini C, Criscuoli L, Micelli E, Picone R. Correction to: 'Two countries-two labs': the transnational gamete donation (TGD) programme to support egg donation. J Assist Reprod Genet 2024; 41:521. [PMID: 38167786 PMCID: PMC10894773 DOI: 10.1007/s10815-023-03006-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Affiliation(s)
- Maria Elisabetta Coccia
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Francesca Rizzello
- Assisted Reproductive Technology Centre, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
| | | | - Laura Badolato
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Paolo Evangelisti
- Assisted Reproductive Technology Centre, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Francesco Bertocci
- Assisted Reproductive Technology Centre, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | | | - Luciana Criscuoli
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Elisabetta Micelli
- Assisted Reproductive Technology Centre, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Rita Picone
- Assisted Reproductive Technology Centre, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
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Cirillo M, Argento FR, Becatti M, Fiorillo C, Coccia ME, Fatini C. Mediterranean Diet and Oxidative Stress: A Relationship with Pain Perception in Endometriosis. Int J Mol Sci 2023; 24:14601. [PMID: 37834048 PMCID: PMC10572576 DOI: 10.3390/ijms241914601] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 08/21/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Endometriosis is a chronic and inflammatory disease associated with pelvic pain. Dietary changes may be therapeutic for chronic inflammatory processes, reducing visceral input. The aim was to evaluate the role of dietary changes according to the Mediterranean Diet (MD) on pain perception in endometriosis and their relationship with oxidative stress. METHODS in this prospective study, we included 35 endometriosis women. At baseline (T0) and after 3 (T1) and 6 (T2) months from the start of the diet, we investigated pain intensity with VAS (Visual Analogue Scale, from 0 to 10), vitamin profile, and oxidative stress. RESULTS we found a significant increase in the diet score (p < 0.001). At T1, patients reduced pain in terms of dyspareunia (p = 0.04), non-menstrual pelvic pain (p = 0.06), dysuria (p = 0.04), and dyschezia (p < 0.001). Dyspareunia (p = 0.002) and dyschezia (p < 0.001) were further significantly reduced also at T2. We observed a significant positive correlation between lipid peroxidation and VAS non-menstrual pelvic pain and dysuria and a significant negative correlation between Oxygen radical absorbance capacity and VAS non-menstrual pain and dyschezia. CONCLUSIONS our findings show a clear tendency toward a relationship between pain relief in endometriosis and MD. This appears promising to treat endometriosis-related symptoms and could be considered a new effective strategy for chronic pain management in the long term.
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Affiliation(s)
- Michela Cirillo
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy;
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, 50134 Florence, Italy;
| | - Flavia Rita Argento
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, 50134 Florence, Italy; (F.R.A.); (M.B.); (C.F.)
| | - Matteo Becatti
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, 50134 Florence, Italy; (F.R.A.); (M.B.); (C.F.)
| | - Claudia Fiorillo
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, 50134 Florence, Italy; (F.R.A.); (M.B.); (C.F.)
| | - Maria Elisabetta Coccia
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, 50134 Florence, Italy;
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, 50134 Florence, Italy; (F.R.A.); (M.B.); (C.F.)
| | - Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy;
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, 50134 Florence, Italy;
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Cirillo M, Basile V, Mazzoli L, Coccia ME, Fatini C. Impact of COVID-19 Pandemic on Women's Health and Obstetric Outcomes after Assisted Reproduction: A Survey from an Italian Fertility Center. J Pers Med 2023; 13:jpm13030563. [PMID: 36983744 PMCID: PMC10059757 DOI: 10.3390/jpm13030563] [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: 02/24/2023] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND the restrictive measures that were adopted during three waves of the COVID-19 pandemic had an impact on both the emotional state and lifestyle of the general population. We evaluated the impact of COVID-19 pandemic on lifestyles and emotional states of women planning assisted reproductive technology (ART), and whether these changes affected ART outcomes. METHODS quantitative research, using a web-based survey, was performed on 289 Caucasian women. RESULTS In preconception, we observed higher percentage of women with positive obstetric outcomes who reduced body weight (52.4% vs. 27.2%, p = 0.09). Over 60% of women with positive outcomes practiced physical activity vs. 47% of women with negative outcomes (p = 0.03), as well as having better quality of sleep (45% vs. 35%), and a more solid relationships with their partners (65.1% vs. 51.7%, p = 0.03). Women who increased their intake of whole grains, fruits, vegetables, and legumes (p < 0.05), according to the Mediterranean diet, showed positive outcomes. We observed that participants who experienced "very much" or "extreme" anxiety, sadness, and fear (p < 0.05) during pandemic were clearly more numerous in the group with negative pregnancy outcomes. CONCLUSIONS healthy lifestyle together with a positive emotional state in preconception can positively influence the obstetric outcomes after ART.
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Affiliation(s)
- Michela Cirillo
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
| | - Valentina Basile
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
| | - Letizia Mazzoli
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
| | - Maria Elisabetta Coccia
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, 50134 Florence, Italy
| | - Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
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Becatti M, Cito G, Argento FR, Fini E, Bettiol A, Borghi S, Mannucci A, Fucci R, Giachini C, Picone R, Emmi G, Taddei N, Coccia ME, Fiorillo C. Blood Leukocyte ROS Production Reflects Seminal Fluid Oxidative Stress and Spermatozoa Dysfunction in Idiopathic Infertile Men. Antioxidants (Basel) 2023; 12:antiox12020479. [PMID: 36830037 PMCID: PMC9952358 DOI: 10.3390/antiox12020479] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 02/16/2023] Open
Abstract
A large proportion of infertile men do not receive a clear diagnosis, being considered as idiopathic or unexplained cases due to infertility diagnosis based on standard semen parameters. Particularly in unexplained cases, the search for new indicators seems mandatory to provide specific information. In the etiopathogenesis of male infertility oxidative stress displays important roles by negatively affecting sperm quality and function. In this study, performed in a population of 34 idiopathic infertile men and in 52 age-matched controls, redox parameters were assessed in blood, leukocytes, spermatozoa, and seminal fluid and related to semen parameters. The main findings indicate that blood oxidative stress markers reflect seminal oxidative stress. Interestingly, blood leukocyte ROS production was significantly correlated to sperm ROS production and to semen parameters. Overall, these results suggest the potential employ of blood redox markers as a relevant and adjunctive tool for sperm quality evaluation aimed to preconception care.
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Affiliation(s)
- Matteo Becatti
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, 50134 Firenze, Italy
- Correspondence: ; Tel.: +39-055-2751261
| | - Gianmartin Cito
- Department of Experimental and Clinical Medicine, University of Firenze, 50134 Firenze, Italy
| | - Flavia Rita Argento
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, 50134 Firenze, Italy
| | - Eleonora Fini
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, 50134 Firenze, Italy
| | - Alessandra Bettiol
- Department of Experimental and Clinical Medicine, University of Firenze, 50134 Firenze, Italy
| | - Serena Borghi
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, 50134 Firenze, Italy
| | - Amanda Mannucci
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, 50134 Firenze, Italy
| | - Rossella Fucci
- Assisted Reproductive Technology Centre, Careggi University Hospital, 50134 Firenze, Italy
| | - Claudia Giachini
- Assisted Reproductive Technology Centre, Careggi University Hospital, 50134 Firenze, Italy
| | - Rita Picone
- Assisted Reproductive Technology Centre, Careggi University Hospital, 50134 Firenze, Italy
| | - Giacomo Emmi
- Department of Experimental and Clinical Medicine, University of Firenze, 50134 Firenze, Italy
| | - Niccolò Taddei
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, 50134 Firenze, Italy
| | | | - Claudia Fiorillo
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, 50134 Firenze, Italy
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Cirillo M, Argento FR, Attanasio M, Becatti M, Ladisa I, Fiorillo C, Coccia ME, Fatini C. Atherosclerosis and Endometriosis: The Role of Diet and Oxidative Stress in a Gender-Specific Disorder. Biomedicines 2023; 11:biomedicines11020450. [PMID: 36830986 PMCID: PMC9953736 DOI: 10.3390/biomedicines11020450] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 02/09/2023] Open
Abstract
Background: Accelerated atherosclerosis in patients with endometriosis has been hypothesised, and lifestyle improvement might control cardiovascular risk. We explored cardiometabolic markers and oxidative stress and evaluated the effects of the Mediterranean Diet (MD) in modulating these markers. Methods: In this prospective study, we included 35 women with endometriosis. At baseline (T0) and after 3 (T1) and 6 (T2) months from the start of the diet, we investigated cardiometabolic parameters, lifestyle and oxidative stress. Results: After a 3-month intervention with MD, we observed a significant reduction in total cholesterol (p = 0.01) and LDL-c (p = 0.003). We observed at T1 an increase in B12 and E vitamins, folate and zinc. After 6 months, zinc (p = 0.04) and folate (p = 0.08) increased in comparison to T0. A reduction in homocysteine from T0 to T1 (p = 0.01) was found. After 3 months, an increase in Rapid Assessment of Physical Activity tool 1 (RAPA) (p < 0.001) and RAPA 2 was observed (p = 0.009). We observed high levels of oxidative stress markers at baseline. After 6 months of MD, a significant improvement in lymphocyte Reactive Oxygen Species (ROS) (p < 0.001) and total antioxidant capacity was observed (p = 0.02). Conclusions: The improvement of lifestyle, and in particular the Mediterranean dietary intervention, allowed the improvement of the metabolic and oxidative profile and overall health-related quality of life.
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Affiliation(s)
- Michela Cirillo
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
| | - Flavia Rita Argento
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, 50134 Florence, Italy
| | - Monica Attanasio
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Matteo Becatti
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, 50134 Florence, Italy
| | - Irene Ladisa
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
| | - Claudia Fiorillo
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, 50134 Florence, Italy
| | - Maria Elisabetta Coccia
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, 50134 Florence, Italy
| | - Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
- Correspondence:
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Timmerman S, Valentin L, Ceusters J, Testa AC, Landolfo C, Sladkevicius P, Van Holsbeke C, Domali E, Fruscio R, Epstein E, Franchi D, Kudla MJ, Chiappa V, Alcazar JL, Leone FPG, Buonomo F, Coccia ME, Guerriero S, Deo N, Jokubkiene L, Kaijser J, Scambia G, Andreotti R, Timmerman D, Bourne T, Van Calster B, Froyman W. External Validation of the Ovarian-Adnexal Reporting and Data System (O-RADS) Lexicon and the International Ovarian Tumor Analysis 2-Step Strategy to Stratify Ovarian Tumors Into O-RADS Risk Groups. JAMA Oncol 2023; 9:225-233. [PMID: 36520422 PMCID: PMC9856950 DOI: 10.1001/jamaoncol.2022.5969] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Importance Correct diagnosis of ovarian cancer results in better prognosis. Adnexal lesions can be stratified into the Ovarian-Adnexal Reporting and Data System (O-RADS) risk of malignancy categories with either the O-RADS lexicon, proposed by the American College of Radiology, or the International Ovarian Tumor Analysis (IOTA) 2-step strategy. Objective To investigate the diagnostic performance of the O-RADS lexicon and the IOTA 2-step strategy. Design, Setting, and Participants Retrospective external diagnostic validation study based on interim data of IOTA5, a prospective international multicenter cohort study, in 36 oncology referral centers or other types of centers. A total of 8519 consecutive adult patients presenting with an adnexal mass between January 1, 2012, and March 1, 2015, and treated either with surgery or conservatively were included in this diagnostic study. Twenty-five patients were excluded for withdrawal of consent, 2777 were excluded from 19 centers that did not meet predefined data quality criteria, and 812 were excluded because they were already in follow-up at recruitment. The analysis included 4905 patients with a newly detected adnexal mass in 17 centers that met predefined data quality criteria. Data were analyzed from January 31 to March 1, 2022. Exposures Stratification into O-RADS categories (malignancy risk <1%, 1% to <10%, 10% to <50%, and ≥50%). For the IOTA 2-step strategy, the stratification is based on the individual risk of malignancy calculated with the IOTA 2-step strategy. Main Outcomes and Measures Observed prevalence of malignancy in each O-RADS risk category, as well as sensitivity and specificity. The reference standard was the status of the tumor at inclusion, determined by histology or clinical and ultrasonographic follow-up for 1 year. Multiple imputation was used for uncertain outcomes owing to inconclusive follow-up information. Results Median age of the 4905 patients was 48 years (IQR, 36-62 years). Data on race and ethnicity were not collected. A total of 3441 tumors (70%) were benign, 978 (20%) were malignant, and 486 (10%) had uncertain classification. Using the O-RADS lexicon resulted in 1.1% (24 of 2196) observed prevalence of malignancy in O-RADS 2, 4% (34 of 857) in O-RADS 3, 27% (246 of 904) in O-RADS 4, and 78% (732 of 939) in O-RADS 5; the corresponding results for the IOTA 2-step strategy were 0.9% (18 of 1984), 4% (58 of 1304), 30% (206 of 690), and 82% (756 of 927). At the 10% risk threshold (O-RADS 4-5), the O-RADS lexicon had 92% sensitivity (95% CI, 87%-96%) and 80% specificity (95% CI, 74%-85%), and the IOTA 2-step strategy had 91% sensitivity (95% CI, 84%-95%) and 85% specificity (95% CI, 80%-88%). Conclusions and Relevance The findings of this external diagnostic validation study suggest that both the O-RADS lexicon and the IOTA 2-step strategy can be used to stratify patients into risk groups. However, the observed malignancy rate in O-RADS 2 was not clearly below 1%.
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Affiliation(s)
- Stefan Timmerman
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Department of Obstetrics and Gynecology, University Hospital Leuven, Leuven, Belgium
| | - Lil Valentin
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Jolien Ceusters
- Laboratory of Tumor Immunology and Immunotherapy, Department of Oncology, Leuven Cancer Institute, KU Leuven, Leuven, Belgium
| | - Antonia C Testa
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCSS, Rome, Italy
| | - Chiara Landolfo
- Queen Charlotte's and Chelsea Hospital, Imperial College, London, United Kingdom
| | - Povilas Sladkevicius
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | | | - Ekaterini Domali
- First Department of Obstetrics and Gynecology, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Robert Fruscio
- Clinic of Obstetrics and Gynecology, University of Milan-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Elisabeth Epstein
- Department of Clinical Science and Education, Karolinska Institutet and Department of Obstetrics and Gynecology, Södersjukhuset, Stockholm, Sweden
| | - Dorella Franchi
- Preventive Gynecology Unit, Division of Gynecology, European Institute of Oncology IRCCS, Milan, Italy
| | - Marek J Kudla
- Department of Perinatology and Oncological Gynecology, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland
| | - Valentina Chiappa
- Department of Gynecologic Oncology, National Cancer Institute of Milan, Milan, Italy
| | - Juan L Alcazar
- Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, School of Medicine, Pamplona, Spain
| | - Francesco P G Leone
- Department of Obstetrics and Gynecology, Biomedical and Clinical Sciences Institute L. Sacco, University of Milan, Milan, Italy
| | - Francesca Buonomo
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo," Trieste, Italy
| | - Maria Elisabetta Coccia
- Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Florence, Italy
| | - Stefano Guerriero
- Department of Obstetrics and Gynecology, University of Cagliari, Policlinico Universitario Duilio Casula, Monserrato, Cagliari, Italy
| | - Nandita Deo
- Department of Obstetrics and Gynaecology, Whipps Cross Hospital, London, United Kingdom
| | - Ligita Jokubkiene
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Jeroen Kaijser
- Department of Obstetrics and Gynecology, Ikazia Hospital, Rotterdam, the Netherlands
| | - Giovanni Scambia
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCSS, Rome, Italy
| | - Rochelle Andreotti
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Dirk Timmerman
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Department of Obstetrics and Gynecology, University Hospital Leuven, Leuven, Belgium
| | - Tom Bourne
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Queen Charlotte's and Chelsea Hospital, Imperial College, London, United Kingdom
| | - Ben Van Calster
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, the Netherlands
| | - Wouter Froyman
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Department of Obstetrics and Gynecology, University Hospital Leuven, Leuven, Belgium
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Scaravelli G, Pisaturo V, Levi Setti PE, Ubaldi FM, Livi C, Borini A, Greco E, Villani MT, Coccia ME, Revelli A, Ricci G, Fusi F, Costa M, Migliorati E, De Luca R, Vigiliano V, Bolli S, Reschini M. Monozygotic twin rate among ART centers: a multicenter analysis of data from 18 Italian units. J Assist Reprod Genet 2022; 39:2349-2354. [PMID: 36053372 PMCID: PMC9596663 DOI: 10.1007/s10815-022-02603-z] [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: 05/02/2022] [Accepted: 08/19/2022] [Indexed: 10/14/2022] Open
Abstract
PURPOSE The risk of monozygotic twins (MZTs) is increased in couples undergoing assisted reproductive technology (ART) treatments. Several systematic reviews have investigated the possible determinants linked to ART, but results obtained have not been conclusive. The study aims to investigate whether the incidence of MZT differed among ART centers. METHODS This is a multicenter retrospective cohort study using the Italian ART National Registry database and involving the centers reporting data from individual ART cycles from 2015 to 2019. To investigate the incidence of MZT, only single embryo transfer cycles were considered. Women who had sex-discordant deliveries were excluded. MZT rate was calculated as the number of multiple pregnancies (more than one gestational sac at first ultrasound) out of the total number of clinical pregnancies. A binomial distribution model was used to determine the 95% CI of the frequency of MZT. RESULTS Eighteen centers were included, and they provided data on 10,433 pregnancies. The total number of MZT was 162, corresponding to an incidence of 1.5% (95% CI: 1.3-1.8%). The rate of MZT among centers varied between 0% (95% CI: 0.0-25.9%) and 3.2% (95% CI: 1.3-8.1%). All the 95% CIs included 1.5%, rejecting the hypothesis that the MZT rate may significantly differ among centers. CONCLUSIONS The rate of MZT did not significantly vary among ART centers. Local factors are unlikely to explain the increased rate of MZT in ART pregnancies.
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Affiliation(s)
- Giulia Scaravelli
- ART Italian National Register, National Center for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - Valerio Pisaturo
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via M. Fanti 6, 20122, Milan, Italy.
| | - Paolo Emanuele Levi Setti
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, IRCCS Humanitas Research Hospital, Rozzano (Milan), Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Claudia Livi
- Demetra GeneraLife Assisted Procreation Center, Florence, Italy
| | | | - Ermanno Greco
- Villa Mafalda, Rome, Italy
- UniCamillus, International Medical University, Rome, Italy
| | - Maria Teresa Villani
- Department of Obstetrics and Gynaecology, Fertility Centre, Arcispedale Santa Maria Nuova, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Alberto Revelli
- Gynecology and Obstetrics 1U/2U, Physiopathology of Reproduction and IVF Unit, Sant'Anna Hospital, University of Torino, Turin, Italy
| | - Giuseppe Ricci
- Department of Obstetrics and Gynecology, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Francesco Fusi
- Department of Maternal Fetal and Pediatric Medicine, ASST, Papa Giovanni XXIII, Bergamo, Italy
| | - Mauro Costa
- Department of Reproductive Medicine, Ospedale Evangelico Internazionale, Genoa, Italy
| | - Emanuela Migliorati
- Surgery for Gynecology and Obstetrics, Genera Umbria S.R.L, Umbertide, Perugia, Italy
| | - Roberto De Luca
- ART Italian National Register, National Center for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - Vincenzo Vigiliano
- ART Italian National Register, National Center for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - Simone Bolli
- ART Italian National Register, National Center for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - Marco Reschini
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via M. Fanti 6, 20122, Milan, Italy
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8
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Huri M, Noferi V, Renda I, Piazzini F, Benemei S, Coccia ME. The COVID-19 Pandemic Impact on the Outcome of Medically Assisted Reproduction Pregnancies. Front Reprod Health 2022; 4:860425. [PMID: 36303677 PMCID: PMC9580677 DOI: 10.3389/frph.2022.860425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/17/2022] [Indexed: 01/23/2023] Open
Abstract
Background The impact of the Coronavirus Disease-2019 (COVID-19) pandemic on pregnancy is not well-understood. During the outbreak, the initial approach suggested by the major societies was to postpone all non-urgent assisted reproductive technology (ART) treatments. Nevertheless, the Italian Society of Fertility and Sterility and Reproductive Medicine considered ethically correct to proceed with ART treatments, as the infertility rate is increasing over time, with a consistent decline in the live birth rate. The objective of our study was to assess the impact of the COVID-19 pandemic on the outcomes of ART pregnancies, in terms of early pregnancy loss, overall success rate, and live birth rate. Methods We conducted a single-center retro-prospective cohort study. Patients who underwent ART treatments from 1 March 2020 to 28 February 2021 (pandemic ART cohort, pART; n = 749) and from 1 March 2019 to 29 February 2020 (control cohort, CTR; n = 844) were enrolled. The study had a duration of 24 months. Patients underwent baseline severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) nasopharyngeal swab; quantitative serum beta human chorionic gonadotropin (β-hCG) to assess pregnancy; pelvic transvaginal ultrasound; and follow-up until delivery. The study took place at the ART Center of the University Hospital in Florence, Italy. Results There were not statistically significant differences on implantation rate (pART 0.348 ± 0.034 vs. CTR 0.365 ± 0.033, CI = 95%, p = 0.49), clinical pregnancy rate (pART 0.847 ± 0.044 vs. CTR 0.864 ± 0.038, CI = 95%, p = 0.56), and ectopic pregnancy rate (pART 0.008 ± 0.011 vs. CTR 0.01 ± 0.011, CI = 95%, p = 0.79). Neither first trimester miscarriage rate was different between the groups (pART 0.224 ± 0.056 vs. CTR 0.213 ± 0.05, CI = 95%, p = 0.77) nor second trimester miscarriage rate (pART 0.018 ± 0.018 vs. CTR 0.019 ± 0.017, CI = 95%, p = 0.95). Live birth rate remained unchanged during the pandemic (pART 0.22 ± 0.03 vs. CTR 0.239 ± 0.029, CI = 95%, p = 0.37) and stable even when compared to our center rate between 2015 and 2019 (pART 0.222 ± 0.03 vs. general rate 0.224 ± 0.014, CI = 95%, p = 0.83). Conclusion The COVID-19 pandemic did not cause a statistically significant change in the live birth rate and in the pregnancy loss rate. ART during the COVID-19 pandemic can be considered fair and safe, ethically and medically appropriate. Patients and physicians should be reassured that ART pregnancy outcomes do not seem to be jeopardized by the pandemic state.
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Affiliation(s)
- Mor Huri
- Assisted Reproductive Technology Center, Careggi Hospital, University of Florence, Florence, Italy
- *Correspondence: Mor Huri
| | - Virginia Noferi
- Assisted Reproductive Technology Center, Careggi Hospital, University of Florence, Florence, Italy
| | - Irene Renda
- Assisted Reproductive Technology Center, Careggi Hospital, University of Florence, Florence, Italy
| | - Francesca Piazzini
- Assisted Reproductive Technology Center, Careggi Hospital, University of Florence, Florence, Italy
| | - Silvia Benemei
- Clinical Trial Unit for Phase 1 Trials, Headache Centre, Careggi University Hospital, Florence, Italy
| | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Center, Careggi Hospital, University of Florence, Florence, Italy
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9
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Cito G, Pizzarelli C, Zurkirch V, Basile V, Ruggiero M, Coccia ME, Inaudi P, Rossi P. Parenthood in Infertile Couples Attending Assisted Reproductive Technologies (ARTs) Centers: What Has Changed During the COVID-19 Pandemic? J Reprod Infertil 2022; 23:120-127. [PMID: 36043127 PMCID: PMC9363909 DOI: 10.18502/jri.v23i2.8997] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 07/27/2021] [Indexed: 11/24/2022] Open
Abstract
Background: The COVID-19 pandemic has been shown to impact the lifestyle of couples of reproductive age and, in particular, their desire for parenthood. The purpose of this study was to carry out an evaluation on the potential changes of desire for parenthood among infertile couples waiting for assisted reproduction during the pandemic.
Methods: In this multicenter cross-sectional study, the quality of sexual life in Italian infertile couples was assessed and their well-being was evaluated before the pandemic and during the quarantine. All couples were asked to fill out a questionnaire, in which their desire for parenthood, sexual life, and well-being were investigated.
Results: Out of 1650 cases, 300 patients were finally enrolled. COVID-19 negatively impacted the well-being of individuals, leading to significantly reduced scores of happiness, feeling energetic, and interest in life (p<0.05). Although most couples had prolonged infertility, a small number of cases (4.0%) achieved a spontaneous natural pregnancy during the lockdown, probably due to more intimacy and longer time spent together. However, major concerns about the consequential effects of the virus on pregnancy and the risk of contagion in the hospital led a small number of infertile couples (5.0%) to decide to postpone their parenting project.
Conclusion: The COVID-19 pandemic may have created a further negative impact on couples, reducing their desire for parenthood. This attitude could result in a decrease in births in the near future.
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Affiliation(s)
- Gianmartin Cito
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
- Corresponding Author: Gianmartin Cito, Department of Urology, Careggi Hospital, University of Florence, Florence, Italy, E-mail:
| | | | - Vanessa Zurkirch
- Regional Referral Centre for Relational Criticalities–Tuscany Region, Careggi Hospital, University of Florence, Florence, Italy
| | - Valentina Basile
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Maria Ruggiero
- Assisted Reproductive Technology Centre, San Rossore Private Hospital, Pisa, Italy
| | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Pieraldo Inaudi
- Obstetrics and Gynecology Unit, Centro Chirurgico Fiorentino e Centro Salute Riproduttiva, Firenze, Italy
| | - Paolo Rossi
- Andrology Unit, Saint Claire Hospital, University of Pisa, Pisa, Italy
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10
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Reschini M, Pagliardini L, Boeri L, Piazzini F, Bandini V, Fornelli G, Dolci C, Cermisoni GC, Viganò P, Somigliana E, Coccia ME, Papaleo E. COVID-19 Vaccination Does Not Affect Reproductive Health Parameters in Men. Front Public Health 2022; 10:839967. [PMID: 35186854 PMCID: PMC8847439 DOI: 10.3389/fpubh.2022.839967] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/10/2022] [Indexed: 12/14/2022] Open
Abstract
With the implementation of COVID-19 vaccine up-take, doubts regarding the impact of immunization on future fertility have begun to emerge. We have examined vaccine safety on male reproductive health. We set up a multicentre (three infertility centers), retrospective study in order to assess semen parameters and fertilization rate of one hundred-six men in a pairwise comparison between the first and second assisted reproduction technology (ART) attempt, performed respectively before and after COVID-19 vaccination. Median time (range) between the first vaccine dose and the second ART cycle was 75 days (39-112). Semen parameters did not change before and after the exposure. Fertilization rate was also similar before and after vaccination. Twenty-five patients (24%) were oligozoospermic before the vaccination while 26 (25%) after the exposure (P = 0.87). Severe asthenozoospermia were present in 11 patients before as well as after the exposure. No difference was observed even after considering different types of vaccines (mRNA or viral vector). COVID-19 vaccination did not affect sperm quality and fertilization capacity of men undergoing ART treatments and should be considered safe for men's reproductive health.
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Affiliation(s)
- Marco Reschini
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luca Pagliardini
- Reproductive Sciences Laboratory, Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Centro Scienze Natalità, Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luca Boeri
- Urology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Francesca Piazzini
- Assisted Reproductive Unit-Careggi Hospital-University of Florence, Florence, Italy
| | - Veronica Bandini
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianfranco Fornelli
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carolina Dolci
- Centro Scienze Natalità, Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Greta Chiara Cermisoni
- Centro Scienze Natalità, Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Viganò
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Edgardo Somigliana
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | | | - Enrico Papaleo
- Centro Scienze Natalità, Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
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11
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Mannucci A, Argento FR, Fini E, Coccia ME, Taddei N, Becatti M, Fiorillo C. The Impact of Oxidative Stress in Male Infertility. Front Mol Biosci 2022; 8:799294. [PMID: 35071326 PMCID: PMC8766739 DOI: 10.3389/fmolb.2021.799294] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [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: 10/21/2021] [Accepted: 12/16/2021] [Indexed: 12/15/2022] Open
Abstract
At present infertility is affecting about 15% of couples and male factor is responsible for almost 50% of infertility cases. Oxidative stress, due to enhanced Reactive Oxygen Species (ROS) production and/or decreased antioxidants, has been repeatedly suggested as a new emerging causative factor of this condition. However, the central roles exerted by ROS in sperm physiology cannot be neglected. On these bases, the present review is focused on illustrating both the role of ROS in male infertility and their main sources of production. Oxidative stress assessment, the clinical use of redox biomarkers and the treatment of oxidative stress-related male infertility are also discussed.
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Affiliation(s)
- Amanda Mannucci
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Flavia Rita Argento
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Eleonora Fini
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Niccolò Taddei
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Matteo Becatti
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Claudia Fiorillo
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
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12
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Pugi D, Dèttore D, Marazziti D, Ferretti F, Coluccia A, Coccia ME, Pozza A. Fertility-Related Quality of Life in Men Undergoing Medically Assisted Reproduction During the Pandemic: Perfectionism and Thought Control Beliefs Moderate the Effects of the Type of Treatment. Clin Neuropsychiatry 2021; 18:312-323. [PMID: 35096078 PMCID: PMC8785427 DOI: 10.36131/cnfioritieditore20210605] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE After a diagnosis of infertility, an increasing number of couples turns to the Medically Assisted Reproduction (MAR) to achieve a pregnancy. A diagnosis of infertility has a negative impact on the individual's well-being and it can increase the risk of anxious-depressive symptoms, stress, and low self-esteem. Data associated with infertility-related Quality of Life (QoL) are lacking in men. Little is known about men's experience of infertility and its treatments during the pandemic. Among the variables potentially associated with infertility-related QoL, the role of obsessive beliefs is neglected, although preliminary studies considered perfectionistic traits. METHOD One hundred and fifty-one participants were included. Eighty men (mean age: 40.83 years) were attending a MAR pathway. Of these, 50 men (67.5%) were undergoing homologous MAR and 30 men (37.5%) were undergoing heterologous MAR. A control group consisting of 71 subjects (mean age: 36.69 years), paired by age, marital status, and number of children, was drawn from the general population. The Obsessive Beliefs Questionnaire-46, the Depression Anxiety Stress Scales-20, and the Fertility Quality of Life Questionnaire were administered. RESULTS High levels of anxiety, depression and stress were moderately associated with lower infertility-related Quality of Life. For men undergoing homologous MAR, perfectionism beliefs represented a vulnerability factor for a lower fertility-related QoL, while for men undergoing heterologous MAR, high thought control beliefs represented a risk factor for a lower fertility-related QoL. CONCLUSIONS A focus on the obsessive beliefs should be included in the psychological treatment of infertile men, specifically perfectionism in homologous MAR and control of thoughts in heterologous MAR. Therefore, psychological assessment and support interventions should be personalized according to the MAR pathway and be focused on men's cognitive features in order to improve their QoL during the MAR pathway.
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Affiliation(s)
- Daniele Pugi
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy, UNICamillus University of Health Medical Sciences, Roma, Italy
| | - Fabio Ferretti
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Anna Coluccia
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Maria Elisabetta Coccia
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy,Corresponding author Andrea Pozza, PhD Department of Medical Sciences, Surgery, and Neurosciences, University of Siena, viale Bracci 16‐53100 Siena, Italy Phone: + 39 0577586409 Fax. +39 0577233222
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13
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Cirillo M, Boddi M, Coccia ME, Attanasio M, Fatini C. Ectopic Fat Depots and Cardiometabolic Burden: A Possible Dangerous Liaison in Women Planning Assisted Reproduction. J Family Reprod Health 2021; 15:118-124. [PMID: 34721601 PMCID: PMC8520667 DOI: 10.18502/jfrh.v15i2.6453] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: We evaluated cardiometabolic burden in women planning assisted reproduction in order to identify subgroups at higher risk of pregnancy complications and cardiovascular disease. Materials and methods: In this cross-sectional study we investigated 60 infertile women with BMI≥25 kg/m2 referred to the Center for Assisted Reproduction. All women underwent metabolic, anthropometric parameters and ultrasound evaluation of ectopic fat depots. Results: All women had waist ≥80 cm. We found that 93.3% of women had pathological subcutaneous, 58.3% visceral and 80% para-perirenal fat; all women had fatty liver. Visceral fat and severity of steatosis were significantly related to the presence of metabolic syndrome (OR =5.7; p=0.03).A significant negative correlation between low HDL-c and para-perirenal fat (p<0.0001), a significant positive correlation with fasting plasma glucose and para-perirenal fat (p=0.001) were found. We observed a significant positive correlation between visceral fat and hs-CRP (p=0.002), HOMA-IR (p=0.04) and triglycerides (p=0.002), a significant negative correlation with HDL-c (p=0.05). Conclusion: This study by highlighting a clinically "dangerous liaison" between ectopic fat depots and metabolic/inflammatory markers, might permit to identify women with a worse metabolic phenotype and encourage lifestyle changes for improving their general and reproductive health together.
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Affiliation(s)
- Michela Cirillo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
| | - Maria Boddi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy.,Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Monica Attanasio
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
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14
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Cirillo M, Attanasio M, Paniccia R, Rizzello F, Coccia ME, Fatini C. Impact of cardiovascular burden on coagulation pathway in apparently healthy women planning oocyte donation. Clin Hemorheol Microcirc 2021; 79:531-539. [PMID: 34420940 DOI: 10.3233/ch-211108] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hormonal fertility treatments are associated with increased coagulation factors inducing procoagulant milieu and possibly thrombotic risk. OBJECTIVE To assess coagulation by ROTEM and coagulation tests in apparently healthy infertile women before oocyte donation procedure. METHODS We enrolled 51 women (Assisted Reproductive Technology Centre, Florence). ROTEM and coagulation parameters were assessed before the start of infertility treatment. RESULTS We divided women in 3 groups according to the number of cardiovascular risk factors: Group A (n = 10), Group B (n = 16), and Group C (n = 25). By considering ROTEM Extem test, a significantly increased of MCF, TPI, and G were observed in groups B (p = 0.005, p = 0.03, and p = 0.007) and C (p = 0.01, p = 0.05, and p = 0.005) in comparison to group A. As regards ROTEM Intem test, the TPI and G values were significantly higher in groups B and C in comparison to group A (p < 0.01). MCF by Fibtem test significantly increased in groups B and C than in group A (p = 0.004 and p = 0.002, respectively). FVIII, vWF:Ag and D-dimer values significantly increase according to the presence of≥2 risk factors. CONCLUSIONS Data from coagulative assessment permit to sensitively identify women with potentially procoagulable state, which represents a risk factor of thromboembolic event during hormone treatment.
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Affiliation(s)
- Michela Cirillo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, Florence, Italy
| | - Monica Attanasio
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Centre for Bleeding Disorders and Coagulation, Department of Oncology, Careggi University Hospital, Florence, Italy
| | - Rita Paniccia
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Centre for Bleeding Disorders and Coagulation, Department of Oncology, Careggi University Hospital, Florence, Italy
| | - Francesca Rizzello
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, Florence, Italy
| | - Maria Elisabetta Coccia
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, Florence, Italy.,Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, Florence, Italy
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15
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Zaca’ C, Scaravelli G, Setti PL, Livi C, Ubaldi FM, Villani MT, Greco E, Coccia ME, Revelli A, Ricci G, Fusi F, Vigiliano V, Luca RD, Bolli S, Borini1 A. O-156 Fertilization rate as a novel indicator for cumulative live birth rate: multicenter retrospective cohort study of 9,394 complete IVF cycles. Hum Reprod 2021. [DOI: 10.1093/humrep/deab127.024] [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: 11/12/2022] Open
Abstract
Abstract
Study question
Does fertilization rate (FR) affect cumulative success rates in assisted reproduction cycles?
Summary answer
These data indicate a positive association between FR with CLBR suggesting the predictive clinical relevance of this parameter and its adoption as Key Performance Indicator(KPI).
What is known already
Numerous studies have aimed at characterizing outcome predictors. Maternal age is historically and correctly recognized as the single most important factor impacting on the clinical outcome of ART. More recently ovarian response has also gained interest in this respect. However, the quest for novel, more comprehensive predictive factors is not over; new relevant evidence is starting to emerge. FR is a noteworthy parameter because expressing a fundamental aspect of both oocyte and sperm developmental competence. In fact it has been adopted as a key performance indicator of the IVF laboratory, to assess laboratory, operator, and gamete competence.
Study design, size, duration
Reported data concern a retrospective cohort study carried out between 2015 to 2017 involving 7,968 couples undergoing 9,394 complete ICSI cycles, i.e. whose all embryos were transferred or disposed.All women aged between 18-42 years were included.We excluded from analysis: surgical sperm retrieval cases, cycles resulting in neither fresh or frozen–thawed embryo transfers,cycles in which live birth were not achieved, but with remaining cryopreserved embryos,cycles of PGT, cycle with fertilization failure and standard IVF cycles.
Participants/materials, setting, methods
The cohort was groupped according to fertilization rate intervals based on recommendations of the Vienna Consensus (<65% - Group 1; 65%-80% - Group 2; >80% - Group 3). Harnessing the large size of the original dataset, further cycle stratifications were carried out based on female age (<34, 35-38, 39-42 years) and number of oocytes retrieved (5-7, 8-10, >10 oocytes).
Main results and the role of chance
No significant difference in female age was observed between fertilization rate groups (p = 0.640). CLBR was progressively higher in relation fertilization rate in Groups 1, 2 and 3 (20.1%, 34.7%, 41.3%, P < 0.001, respectively). Number of recovered oocytes, embryo number per cycle, cumulative pregnancy rate followed the same trend (p < 0.001). The decrease in CLBR with increasing female age was significantly correlated with fertilization rate and CLBR in all three female age groups (P < 0.001). Finally, to further control for possible patient-specific confounding factors, maternal age, number of retrieved oocytes, percent of inseminated oocytes and fertilization rate were evaluated in a multivariate logistic regression analysis. From this assessment, fertilization rate emerged as a factor independently associated with cumulative live birth rate, to a degree equivalent or higher compared with the number or retrieved oocytes.
Limitations, reasons for caution
The study design is retrospective and requires further refinement to control for factors that may impact clinical outcome.
Wider implications of the findings
These data indicate a positive association of FR with CLBR, thereby suggesting that fertilization, in addition to representing an assay for gamete quality and laboratory performance,has an independent clinical significance.Irrespective of the number of retrieved oocytes and female age, we observed that, rates of FR are positively associated with CLBR.
Trial registration number
None
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Affiliation(s)
- C Zaca’
- 9.Baby - Family and Fertility Center, IVF laboratory unit, Bologna, Italy
| | - G Scaravelli
- National Health Institute, ART Italian National Register- National Centre for Diseases Prevention and Health Promotion, Roma, Italy
| | - P.E. Levi Setti
- Humanitas Fertility Center. Humanitas Clinical and Research Center- - IRCCS, Department of Gynecology- Division of Gynecology and Reproductive Medicine, Rozzano, Italy
| | - C Livi
- Demetra, Assisted Reproductive Center, Firenze, Italy
| | - F M Ubaldi
- GENERA, Centre for Reproductive Medicine, Roma, Italy
| | - M T Villani
- IRCCS, Department of Obstetrics and Gynecology-, Reggio Emilia, Italy
| | - E Greco
- European Hospital, Center for Reproductive Medicine, Roma, Italy
| | - M E Coccia
- Careggi Hospital - University of Florence, Assisted Reproductive Center, Firenze, Italy
| | - A Revelli
- Sant’Anna Hospital, Gynecology and Obstetrics U- Physiopathology of Reproduction and IVF Unit, Torino, Italy
| | - G Ricci
- IRCCS Burlo Garofolo, Institute for Maternal and Child Health, Trieste, Italy
| | - F Fusi
- ASST - Papa Giovanni XXIII, Department of Maternal Fetal and Pediatric Medicine, Bergamo, Italy
| | - V Vigiliano
- National Health Institute, ART Italian National Register- National Centre for Diseases Prevention and Health Promotion, Roma, Italy
| | - R. De Luca
- National Health Institute, ART Italian National Register- National Centre for Diseases Prevention and Health Promotion, Roma, Italy
| | - S Bolli
- National Health Institute, ART Italian National Register- National Centre for Diseases Prevention and Health Promotion, Rome, Italy
| | - A Borini1
- Humanitas Fertility Center. Humanitas Clinical and Research Center- - IRCCS, Department of Gynecology- Division of Gynecology and Reproductive Medicine, Rozzano, Italy
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16
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Cirillo M, Coccia ME, Attanasio M, Fatini C. Homocysteine, vitamin B status and MTHFR polymorphisms in Italian infertile women. Eur J Obstet Gynecol Reprod Biol 2021; 263:72-78. [PMID: 34167037 DOI: 10.1016/j.ejogrb.2021.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 09/10/2020] [Revised: 05/25/2021] [Accepted: 06/07/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the vitamin B status related to the homocysteine pathway and the prevalence of polymorphisms of the MTHFR gene in infertile women programming homologous or heterologous ART. STUDY DESIGN We investigated 393 consecutive Caucasian women, referred to the Internal Medicine Clinic at the Center for Assisted Reproductive Technology, in order to be framed for their vascular risk before starting homologous or heterologous (oocyte donation) procedures. Total homocysteine, Vitamin B12, folate and vitamin B6 were measured. The women were divided into quartiles of serum concentration of folate, vitamin B12 and vitamin B6. The C677T and A1298C polymorphisms of the MTHFR gene were genotyped by an electronic microchip technology. RESULTS Sixty-one women (15.5%) had hyperhomocysteinemia, 22.9% had reduced levels of vitamin B12, 4.1% had reduced levels of serum folate and 0.1% had a deficiency of vitamin B6. Women in the highest quartile of vitamin B12 and folates had lower homocysteine levels than women in the first and second quartiles (p < 0.0001). The homozygosity for MTHFR C677T polymorphism was detected in 33.3% (131), and heterozygosity for MTHFR C677T polymorphism in 45.3% (178) of women. We observed a significant association between hyperhomocysteinemia and 677T allele, but not 1298C, of the MTHFR polymorphisms (p = 0.04). CONCLUSIONS We found inadequate vitamin B status related to the homocysteine pathway in women planning Assisted Reproductive Technology. Moreover, interesting association was found regarding hyperhomocysteinemia in women carrying T allele of the C677T MTHFR polymorphism. A specific supplementation with 5-MTHF and adequate vitamin B12 concentrations before Assisted Reproductive Technology warrant serious consideration, in particular in women carrying T allele of the C677T MTHFR polymorphism.
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Affiliation(s)
- Michela Cirillo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy.
| | - Maria Elisabetta Coccia
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy; Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy.
| | - Monica Attanasio
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
| | - Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy.
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17
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Scaravelli G, Zacà C, Levi Setti PE, Livi C, Ubaldi FM, Villani MT, Greco E, Coccia ME, Revelli A, Ricci G, Fusi F, Vigiliano V, De Luca R, Bolli S, Borini A. Fertilization rate as a novel indicator for cumulative live birth rate: a multicenter retrospective cohort study of 9,394 complete in vitro fertilization cycles. Fertil Steril 2021; 116:766-773. [PMID: 33972085 DOI: 10.1016/j.fertnstert.2021.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 02/04/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To appraise the fertilization rate as a predictive factor for cumulative live birth rate (CLBR). DESIGN Multicenter retrospective cohort study. SETTING Ten in vitro fertilization clinics, whose data were collected and processed by the assisted reproductive technology (ART) Italian National Registry. PATIENT(S) 7,968 couples undergoing 9,394 complete intracytoplasmic sperm injection cycles. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The primary outcome measure was the CLBR in association with the fertilization rate intervals (<65%-group 1; 65%-80%-group 2; and >80%-group 3). Further data stratification was performed on the basis of maternal age (<34, 35-38, and 39-42 years) and number of retrieved oocytes (5-7, 8-10, and > 10 oocytes). RESULT(S) The CLBR was progressively higher in relation to the fertilization rate in groups 1, 2, and 3 (20.1%, 34.7%, and 41.3%, respectively). The number of recovered oocytes, embryo number per cycle, and cumulative pregnancy rate followed the same trend. The decrease in CLBR with increasing maternal age was significantly correlated with the fertilization rate and CLBR in all 3 maternal age groups. Multivariate logistic regression analysis showed fertilization rate as a factor independently associated with CLBR. CONCLUSION(S) The present data indicated a positive association between the fertilization rate and the CLBR, suggesting the predictive clinical relevance of this parameter and its adoption as a key performance indicator.
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Affiliation(s)
- Giulia Scaravelli
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - Carlotta Zacà
- 9.Baby, Family and Fertility Center, Tecnobios Procreazione, Bologna, Italy
| | - Paolo Emanuele Levi Setti
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Humanitas Fertility Center. Humanitas Clinical and Research Center (IRCCS), Rozzano (Milan), Italy
| | - Claudia Livi
- Demetra Assisted Reproductive Center, Florence, Italy
| | | | - Maria Teresa Villani
- Department of Obstetrics and Gynecology, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, Emilia, Italy
| | - Ermanno Greco
- Center for Reproductive Medicine, European Hospital, Rome, Italy
| | | | - Alberto Revelli
- Gynecology and Obstetrics 1U, Physiopathology of Reproduction and IVF Unit, Sant'Anna Hospital, University of Torino, Italy
| | - Giuseppe Ricci
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Francesco Fusi
- Department of Maternal Fetal and Pediatric Medicine, ASST, Papa Giovanni XXIII, Bergamo, Italy
| | - Vincenzo Vigiliano
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - Roberto De Luca
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - Simone Bolli
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - Andrea Borini
- 9.Baby, Family and Fertility Center, Tecnobios Procreazione, Bologna, Italy.
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18
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Abstract
The relationship between endometriosis and subclinical atherosclerosis represents an emerging topic in women's health, as women with endometriosis are at higher risk of cardiovascular disease later in life. We investigated metabolic parameters and indirect endothelial markers related to atherosclerosis, in women suffering from stage III/IV of endometriosis compared with women without endometriosis. The study population comprised 643 women: 92 women (14.3%) with stage III/IV of endometriosis and 551 (85.7%) without endometriosis. By analyzing biohumoral parameters we observed a significant increased total cholesterol (p = 0.01), LDL-C (p = 0.01), triglycerides (p = 0.05) and homocysteinaemia (p = 0.04), lower vitamin B6 and folate (p = 0.07 and p = 0.03, respectively) values, and higher high-sensitive C reactive protein (p = 0.05) concentrations in stage III/IV in comparison to those observed in women without endometriosis. After adjustment for traditional cardiovascular risk factors, the poorer lipid profile (total cholesterol, LDL-C), as well as Lipoprotein (a), remained significantly associated with severity of endometriosis (p = 0.01 and p = 0.03, respectively). Our findings highlight the role of endometriosis as a gender-specific cardiovascular risk factor. The clinical relevance of our study lies in identifying women with stage III/IV of endometriosis at higher risk of atherosclerotic disease, who could benefit from an early cardiovascular screening to control future cardiovascular risk.
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Affiliation(s)
- Michela Cirillo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Division of Obstetrics and Gynaecology, Centre for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy
| | - Maria Elisabetta Coccia
- Division of Obstetrics and Gynaecology, Centre for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy.,Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Felice Petraglia
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy.,dCISMEG: Centre for Research and Innovation in Health and Gender Medicine, Careggi University Hospital, Florence, Italy
| | - Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Division of Obstetrics and Gynaecology, Centre for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy.,CISMEG: Centre for Research and Innovation in Health and Gender Medicine, Careggi University Hospital, Florence, Italy
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19
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Palagiano A, Cozzolino M, Ubaldi FM, Palagiano C, Coccia ME. Effects of Hydrosalpinx on Endometrial Implantation Failures: Evaluating Salpingectomy in Women Undergoing in vitro fertilization. Rev Bras Ginecol Obstet 2021; 43:304-310. [PMID: 33601465 PMCID: PMC10183881 DOI: 10.1055/s-0040-1722155] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Hydrosalpinx is a disease characterized by the obstruction of the salpinx, with progressive accumulation in the shape of a fluid-filled sac at the distal part of the tuba uterina, and closed to the ovary. Women with hydrosalpinges have lower implantation and pregnancy rates due to a combination of mechanical and chemical factors thought to disrupt the endometrial environment. Evidence suggests that the presence of hydrosalpinx reduces the rate of pregnancy with assisted reproductive technology. The main aim of the present is review to make an overview of the possible effects of hydrosalpinx on in vitro fertilization (IVF). We conducted a literature search on the PubMed, Ovid MEDLINE, and Google Scholar data bases regarding hydrosalpinx and IVF outcomes. Hydrosalpinx probably has a direct toxic effect on sperm motility and on the embryos. In addition, the increasing liquid inside the salpinges could alter the mechanisms of endometrial receptivity. The window of endometrial receptivity is essential in the implantation of blastocysts, and it triggers multiple reactions arising from the endometrium as well as the blastocysts. Hydrosalpinx could influence the expression of homeobox A10 (HOXA10) gene, which plays an essential role in directing embryonic development and implantation. Salpingectomy restores the endometrial expression of HOXA10; therefore, it may be one mechanism by which tubal removal could result in improved implantation rates in IVF. In addition, salpingectomy does not affect the ovarian response, nor reduces the antral follicle count. Further studies are needed to establish the therapeutic value of fluid aspiration under ultrasonographic guidance, during or after oocyte retrieval, in terms of pregnancy rate and ongoing pregnancy.
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Affiliation(s)
- Antonio Palagiano
- Department of General and Specialized Surgery for Women and Children, Università degli Studi della Campania Luigi Vanvitelli, Napoli, Italy
| | - Mauro Cozzolino
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, United States.,Universidad Rey Juan Carlos, Madrid, Spain.,IVIRMA, IVI Foundation, Valencia, Spain
| | | | | | - Maria Elisabetta Coccia
- Department of Biomedical, Experimental and Clinical Sciences, Division of Obstetrics and Gynecology, Università degli Studi di Firenze, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy
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20
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Cozzolino M, Troiano G, Coccia ME. Spontaneous pregnancy versus assisted reproductive technologies: implications on maternal mental health. Women Health 2021; 61:303-312. [PMID: 33593227 DOI: 10.1080/03630242.2021.1881025] [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] [Indexed: 10/22/2022]
Abstract
Postpartum depression (PPD) is a major depressive disorder that affects women during the perinatal period. Our study aimed to evaluate the onset of psychological effects in spontaneous pregnancies in contrast with pregnancies resulting from in vitro fertilization (IVF). We carried out a prospective cohort study using the Edinburgh Postnatal Depression Scale to evaluate postpartum depression. Patients were divided into 3 different groups based on their conception method: group A included spontaneous pregnancies, group B included pregnancies after homologous IVF, and group C pregnancies after heterologous IVF. The study included 245 patients. In the first year postpartum the incidence of psychological disorders was different exclusively at discharge from hospital (24.8% A vs. 38.7 B vs. 19% C) [P < .05] and one year after childbirth (13.3% A vs. 3.4% B vs. 4.8% C) [P < .05]. The multifactorial analysis showed a significant positive association between psychological distress and advanced maternal age, low parental education, nulliparity, preterm delivery and low fetal weight at birth, multiple pregnancies and multiple births, low pain threshold, and high rate of requesting analgesia intrapartum [P < .05]. Our results suggest a high correlation between PPD and pregnancies resulting from homologous IVF at the time of discharge, whereas there is a higher chance that spontaneous pregnancies develop postpartum depression one year after delivery.
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Affiliation(s)
- Mauro Cozzolino
- IVIRMA, IVI Foundation, Avenida Fernando Abril Martorell, Valencia, Spain.,Department of Obstetrics, Gynaecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA.,Universidad Rey Juan Carlos, Madrid, Spain
| | | | - Maria Elisabetta Coccia
- Department of Biomedical, Experimental and Clinical Sciences - Division of Obstetrics and Gynecology, University of Florence, Florence, Italy
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21
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Cirillo M, Rizzello F, Badolato L, De Angelis D, Evangelisti P, Coccia ME, Fatini C. The effects of COVID-19 lockdown on lifestyle and emotional state in women undergoing assisted reproductive technology: Results of an Italian survey. J Gynecol Obstet Hum Reprod 2021; 50:102079. [PMID: 33545410 PMCID: PMC8060062 DOI: 10.1016/j.jogoh.2021.102079] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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] [Received: 10/26/2020] [Revised: 12/09/2020] [Accepted: 01/25/2021] [Indexed: 11/15/2022]
Abstract
PURPOSE On March 8, 2020, the Italian Government implemented extraordinary measures to limit viral transmission of COV-19/SARS-CoV-2. We evaluated the impact of COVID-19 lockdown on lifestyle and emotional state in women planning infertility treatments. BASIC PROCEDURES We performed a quantitative research study using a web-based survey, in 140 women referred to Assisted Reproductive Technologies Center. MAIN FINDINGS We observed changes in body weight during lockdown in 80 % of women, and a significant increase in BMI in comparison to that observed before (p=.001). We observed a high percentage of non-adherence to the Mediterranean pattern during lockdown due to higher frequency of consumption of sweet/pastries, cheese and meat, rather than fruit, vegetables and legumes. Before lockdown 36.4 % women were snack consumers while during lockdown 55 % (p=.002). By considering individuals' attitude to snack consumption, we observed an increase related to boredom (p=<.0001) and anxiety (p=.05) during lockdown. Increased levels of anxiety and sadness were observed in about 30 %, and of boredom in 25 %. The percentage of women worried about their planning infertility treatment was more than 50 %. PRINCIPAL CONCLUSIONS Quarantine-related restrictions strongly influenced lifestyle psychological behavior leading to an increased burden of cardiovascular disease.
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Affiliation(s)
- Michela Cirillo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
| | - Francesca Rizzello
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
| | - Laura Badolato
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
| | - Denise De Angelis
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
| | - Paolo Evangelisti
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
| | - Maria Elisabetta Coccia
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy; Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy.
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Cito G, Gemma L, Giachini C, Micelli E, Cocci A, Fucci R, Picone R, Sforza S, Nesi G, Santi R, Minervini A, Masieri L, Carini M, Coccia ME, Natali A. Sperm retrieval by conventional testicular sperm extraction for assisted reproduction in patients with Zinner syndrome. Clin Exp Reprod Med 2021; 48:85-90. [PMID: 33486943 PMCID: PMC7943355 DOI: 10.5653/cerm.2020.03769] [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] [Received: 04/19/2020] [Accepted: 09/08/2020] [Indexed: 11/18/2022] Open
Abstract
We present data from three Caucasian men with Zinner syndrome who attended our center for the treatment of primary couple’s infertility. Each patient was scheduled for conventional testicular sperm extraction (cTESE) and cryopreservation. Sperm analysis confirmed absolute azoospermia. Patient 1 had right and left testis volumes of 24 mL and 23 mL, respectively; left seminal vesicle (SV) agenesis, severe right SV hypotrophy with right renal agenesis. Follicle-stimulating hormone (FSH) was 3.2 IU/L. Patient 2 exhibited right and left testis volumes of 18 mL and 16 mL, respectively; a left SV cyst of 32 × 28 mm, ipsilateral kidney absence, and right SV agenesis. FSH was 2.8 IU/L. Patient 3 showed a testicular volume of 10 mL bilaterally, a 65 × 46 mm left SV cyst, right SV enlargement, and left kidney agenesis. FSH was 32.0 IU/L. Sperm retrieval was successful in all patients. Nevertheless, cTESE should be performed on the day of oocyte retrieval.
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Affiliation(s)
| | - Luca Gemma
- Department of Urology, Careggi Hospital, Florence, Italy
| | - Claudia Giachini
- Assisted Reproductive Technology Centre, Careggi Hospital, Florence, Italy
| | - Elisabetta Micelli
- Assisted Reproductive Technology Centre, Careggi Hospital, Florence, Italy
| | - Andrea Cocci
- Department of Urology, Careggi Hospital, Florence, Italy
| | - Rossella Fucci
- Assisted Reproductive Technology Centre, Careggi Hospital, Florence, Italy
| | - Rita Picone
- Assisted Reproductive Technology Centre, Careggi Hospital, Florence, Italy
| | - Simone Sforza
- Department of Urology, Careggi Hospital, Florence, Italy
| | - Gabriella Nesi
- Pathology Section, Department of Health Sciences, University of Florence, Florence, Italy
| | - Raffaella Santi
- Pathology Section, Department of Health Sciences, University of Florence, Florence, Italy
| | | | | | - Marco Carini
- Department of Urology, Careggi Hospital, Florence, Italy
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23
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Cito G, Micelli E, Cocci A, Polloni G, Russo GI, Coccia ME, Simoncini T, Carini M, Minervini A, Natali A. The Impact of the COVID-19 Quarantine on Sexual Life in Italy. Urology 2021; 147:37-42. [PMID: 32888982 PMCID: PMC7462585 DOI: 10.1016/j.urology.2020.06.101] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [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: 05/21/2020] [Revised: 06/17/2020] [Accepted: 06/25/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The aim of the study is to evaluate how individual and couple's sexuality had changed during the COVID-19 pandemic-related quarantine. METHODS A quantitative correlational research study was conducted, using a web-based survey. RESULTS About 1576 participants were involved: 1018 women (64.6%) and 558 men (35.4%). A significant decline in the mean well-being scores during the quarantine, compared to before, was reported. A positive correlation between the well-being scores and the number of sexual intercourse (SI) before and during the quarantine was found. The mean number of SI decreased significantly during the quarantine. The main reasons were: poor privacy (43.2%) and lack of psychological stimuli (40.9%). About 1124 respondents (71.3%) did not report sexual desire (SD) reduction. A positive association between SD and SI during the quarantine was found. About 61.2% did not report autoerotism reduction. In those who reported decreased masturbation activity, the main causes were poor privacy (46.4%) and lack of desire (34.7%). We found that men presented lower SD during the quarantine, than women (P < 0.01). CONCLUSION Potentially, the more time available might lead couples to reconnect at an intimate level and to improve their sexuality. However, the majority of quarantined participants experienced reduced number of SI per week, with poor household privacy and lack of psychological stimuli as cited causes, even as a majority did not report reduced autoeroticism.
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Affiliation(s)
- Gianmartin Cito
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
| | - Elisabetta Micelli
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy; Department of Experimental and Clinical Medicine, Division of Obstetrics and Gynecology, University of Pisa, Pisa, Italy
| | - Andrea Cocci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Gaia Polloni
- Clinical Psychology and Clinical Sexology, Cognitive Therapy Centre, Como, Italy
| | | | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Tommaso Simoncini
- Department of Experimental and Clinical Medicine, Division of Obstetrics and Gynecology, University of Pisa, Pisa, Italy
| | - Marco Carini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Minervini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Alessandro Natali
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
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Micelli E, Fatini C, Ralli E, Cirillo M, Romanelli C, Badolato L, Basile V, Picone R, Orlandi G, Giachini C, Evangelisti P, Fucci R, Cito G, Rizzello F, Coccia ME. Cardiometabolic and Thrombotic Risk Profile in Women Undergoing Oocyte Donation for Assisted Reproduction. J Womens Health (Larchmt) 2020; 30:758-764. [PMID: 33337929 DOI: 10.1089/jwh.2020.8383] [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] [Indexed: 11/12/2022] Open
Abstract
Background: The last two decades have seen a growing number of pregnancies in women who needed the donation of oocytes. With oocyte donation pregnancies, studies on obstetric outcomes among these women revealed an increased incidence of pre-eclampsia and pregnancy-induced hypertension. Furthermore, several studies have found a higher incidence of low birth weight, preterm birth, and delivery by cesarean section in oocyte donation rather than in women subjected to assisted reproduction techniques (ART) with autologous oocytes. Numerous studies have also shown a deep connection between cardiovascular and thrombotic risk factors and adverse pregnancy outcomes. In this setting, to strictly assess the preconceptional risk for women who undergo egg donation to achieve pregnancy, the aim of our study is to draw a detailed assessment of the vascular risk profile of patients with gamete donation ART indications through the evaluation of comorbidities and cardiometabolic and thrombophilic markers Materials and Methods: Patients undergoing ART with oocyte or sperm donation or double donation of gametes underwent a careful clinical assessment through a detailed personal and family anamnesis and they were evaluated for cardiometabolic and thrombophilic profile. Clinical and demographic characteristics, comorbidities, and biohumoral parameters were collected. The study was approved by the Regional Ethical Committee(Em 2018-017 CINECA 10189). Results: We evaluated 525 women. Around 73.1% were >40 years and 35% of them were older than 45 years. There was a high prevalence of dyslipidemias (58.1%), smoking habit (24.6%), a body mass index >25 in 28.6% of patients, a high abdominal circumference in 58.1% of cases, a prevalence of acquired thrombophilia in about 7% and hereditary of 19.2%. Around 39.2% of patients had total cholesterol >200 mg/dL, 19.5% had high-density lipoprotein <48 mg/dL and 43.6% had low-density lipoprotein >115 mg/dL, and 6.9% had triglyceride values >150 mg/dL. Conclusions: A careful assessment of the preconceptional status of patients undergoing ART programs with oocyte donation can be highly recommended.
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Affiliation(s)
- Elisabetta Micelli
- Division of Obstetrics and Gynecology, Center for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy
| | - Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Eleonora Ralli
- Division of Obstetrics and Gynecology, Center for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy
| | - Michela Cirillo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Chiara Romanelli
- Division of Obstetrics and Gynecology, Center for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy
| | - Laura Badolato
- Division of Obstetrics and Gynecology, Center for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy
| | - Valentina Basile
- Division of Obstetrics and Gynecology, Center for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy
| | - Rita Picone
- Division of Obstetrics and Gynecology, Center for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy
| | - Giulia Orlandi
- Division of Obstetrics and Gynecology, Center for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy
| | - Claudia Giachini
- Division of Obstetrics and Gynecology, Center for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy
| | - Paolo Evangelisti
- Division of Obstetrics and Gynecology, Center for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy
| | - Rossella Fucci
- Division of Obstetrics and Gynecology, Center for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy
| | - Gianmartin Cito
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Francesca Rizzello
- Division of Obstetrics and Gynecology, Center for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy
| | - Maria Elisabetta Coccia
- Division of Obstetrics and Gynecology, Center for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy
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25
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Coccia ME, Rizzello F, Wakunga S, Badolato L, Evangelisti P, Bertocci F, Giachini C, Criscuoli L, Micelli E, Picone R. 'Two countries-two labs': the transnational gamete donation (TGD) programme to support egg donation. J Assist Reprod Genet 2020; 37:3039-3049. [PMID: 33047185 PMCID: PMC7714895 DOI: 10.1007/s10815-020-01961-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 09/30/2020] [Indexed: 11/01/2022] Open
Abstract
PURPOSE To evaluate the effectiveness, efficiency, and safety of a transnational gamete donation (TGD) programme based on the shipping of vitrified donor oocytes. METHODS A retro-prospective observational study was conducted in the Assisted Reproductive Technology Center of the University Hospital of Florence, Italy. The study population included 622 consecutive donor oocyte cycles. A mean number of 6 vitrified oocytes per couple were shipped from two Spanish biobanks. In the receiving centre, gametes were warmed and inseminated and the subsequent embryo transfer (ET) was performed. The main outcome measurement was LBR. Secondary outcomes included oocyte survival rate, ICSI damage rate, normal fertilization, cleavage, and implantation rate (IR) in both 'fresh' and cryotransfer cycles. RESULTS A total number of 3536 mature oocytes were warmed with 81.4% surviving oocytes. 2PN oocytes were 1941 with an ICSI normal fertilization rate of 70.4% and a cleavage rate of 93.4%; 857 day-3 embryos were transferred in 498 women, 63 blastocysts in 44. Couples with at least one vitrified embryo were 181 (32.3%). IR was 25.1% and 33.1% for day-3 ET and blastocyst stage respectively. Crude pregnancy rate and LBR after the first ET were 35.5% and 27% correspondingly with a conservative cumulative LBR of 34% and an optimal LBR of 51.4%. CONCLUSION Imported vitrified donor oocytes retain their competence and are capable of resulting in ongoing pregnancies and healthy babies in a proportion comparable to other existing systems as egg donation with vitrification/warming in the same laboratory and transnational fresh oocyte donation.
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Affiliation(s)
- Maria Elisabetta Coccia
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Francesca Rizzello
- Assisted Reproductive Technology Centre, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
| | | | - Laura Badolato
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Paolo Evangelisti
- Assisted Reproductive Technology Centre, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Francesco Bertocci
- Assisted Reproductive Technology Centre, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | | | - Luciana Criscuoli
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Elisabetta Micelli
- Assisted Reproductive Technology Centre, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Rita Picone
- Assisted Reproductive Technology Centre, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
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Capezzuoli T, Vannuccini S, Fantappiè G, Orlandi G, Rizzello F, Coccia ME, Petraglia F. Ultrasound findings in infertile women with endometriosis: evidence of concomitant uterine disorders. Gynecol Endocrinol 2020; 36:808-812. [PMID: 32133885 DOI: 10.1080/09513590.2020.1736027] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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] [Indexed: 12/29/2022] Open
Abstract
Endometriosis is a gynecological disease characterized by pain and infertility. The diagnosis is very often made during the infertility work-up, together with other reproductive diseases and uterine disorders. A retrospective cohort study was conducted on infertile women with clinical or ultrasound suspect of endometriosis, undergoing an ultrasound (US) evaluation by a team of expert sonographers (n = 419), with the aim to evaluate the prevalence of concomitant uterine disorders. The US coexistence of endometriosis with uterine fibroids and/or adenomyosis was investigated according to three age intervals (<35years; 35 ≥ years <45; ≥45 years) and to endometriosis phenotypes: ovarian endometriosis (OMA), deep infiltrating endometriosis (DIE), or both. The US diagnosis of fibroids was made in 3.1% of cases, adenomyosis was found in 21.2%, and the co-existence of both uterine disorders with endometriosis was reported in 14.6% of patients. When analyzed according to age, patients aged >35 years were more likely to be affected by uterine fibroids (p = .003), adenomyosis (p = .030) and both adenomyosis and fibroids (p < .0001). No statistically significant association was found between endometriosis phenotypes and myometrial pathologies. Uterine disorders coexistence should be considered in the assessment of women with endometriosis, in order to better define a treatment strategy for infertility, especially in women older than 35 years.
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Affiliation(s)
- Tommaso Capezzuoli
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Silvia Vannuccini
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Giulia Fantappiè
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Giulia Orlandi
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Francesca Rizzello
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Felice Petraglia
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
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Abstract
Objective: The preconception period is largely neglected, whereas it represents an opportunity to identify and modify clinical and behavioral risks, particularly in infertile women characterized by an unfavorable vascular burden. The present study was performed to strengthen previous findings and to increase the awareness of clinicians who should envision a broader preconception approach in infertile women, beyond their reproductive health. Materials and methods: In this cross-sectional study, we investigated 1003 Caucasian women, referred to the Internal Medicine Clinic at the Assisted Reproductive Technologies Center, Florence. Results: A high prevalence of dyslipidemia (57.4%), overweight/obesity (29.1%) and, smoking habit (26.6%) were found. We provided evidence of unhealthy lifestyle habits, represented by a closer adherence to the Mediterranean diet in the 9.5% only and by a sedentary behavior in 73%. A significant correlation between the Mediterranean Diet score and both anthropometric and metabolic parameters was found. We also observed a lower score adherence with both metabolic syndrome and diabetes (for both p=0.02), but not with hypertension. Conclusion: Before infertility treatment, the correction and the management of modifiable and non-modifiable cardiovascular risk factors are mandatory and represent the main goal for a safe pregnancy, and lifetime women's health.
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Affiliation(s)
- Michela Cirillo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
| | - Maria Elisabetta Coccia
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
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Micelli E, Cito G, Cocci A, Polloni G, Russo GI, Minervini A, Carini M, Natali A, Coccia ME. Desire for parenthood at the time of COVID-19 pandemic: an insight into the Italian situation. J Psychosom Obstet Gynaecol 2020; 41:183-190. [PMID: 32379999 DOI: 10.1080/0167482x.2020.1759545] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Purpose: To evaluate the impact of the COVID-19 pandemic lifestyle change on couples of reproductive age and on their desire for parenthood.Materials and methods: A quantitative correlational research study, based on a web survey, was conducted among Italian men and women in heterosexual stable relationships, aged between 18 and 46 years. The self-administered Italian version questionnaire was created using Google Forms and posted on chats and social networks.The mood of participants before and during the quarantine was assessed using a scale from 1 to 10 (1 = no wellbeing; 10 = total wellbeing). Couples' quality of life and their reproductive desire were evaluated.Results: 1482 respondents were included: 944 women (63.7%) and 538 men (36.3%). A significant trend toward reduced mean wellbeing scores during the quarantine, compared to before, was found (p < .01). From 18.1% participants who were planning to have a child before the pandemic, 37.3% abandoned the intention, related to worries of future economic difficulties (58%) and consequences on pregnancy (58%). Of 81.9% who did not intend to conceive, 11.5% revealed a desire for parenthood during quarantine than before (p < .01), related to will for change (50%) and need for positivity (40%). 4.3% of these actually tried to get pregnant. Stratifying by age, a trend toward older ages was found in the desire for parenthood before and during the COVID-19 pandemic (p < .05).Conclusions: COVID-19 pandemic is impacting on the desire for parenthood. It is unknown whether these findings will result in a substantial modification of birth rate in the near future.
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Affiliation(s)
- Elisabetta Micelli
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Gianmartin Cito
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Cocci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Gaia Polloni
- Clinical Psychology and Clinical Sexology, Cognitive Therapy Centre, Como, Italy
| | | | - Andrea Minervini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Carini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Alessandro Natali
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
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29
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Van Calster B, Valentin L, Froyman W, Landolfo C, Ceusters J, Testa AC, Wynants L, Sladkevicius P, Van Holsbeke C, Domali E, Fruscio R, Epstein E, Franchi D, Kudla MJ, Chiappa V, Alcazar JL, Leone FPG, Buonomo F, Coccia ME, Guerriero S, Deo N, Jokubkiene L, Savelli L, Fischerová D, Czekierdowski A, Kaijser J, Coosemans A, Scambia G, Vergote I, Bourne T, Timmerman D. Validation of models to diagnose ovarian cancer in patients managed surgically or conservatively: multicentre cohort study. BMJ 2020; 370:m2614. [PMID: 32732303 PMCID: PMC7391073 DOI: 10.1136/bmj.m2614] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To evaluate the performance of diagnostic prediction models for ovarian malignancy in all patients with an ovarian mass managed surgically or conservatively. DESIGN Multicentre cohort study. SETTING 36 oncology referral centres (tertiary centres with a specific gynaecological oncology unit) or other types of centre. PARTICIPANTS Consecutive adult patients presenting with an adnexal mass between January 2012 and March 2015 and managed by surgery or follow-up. MAIN OUTCOME MEASURES Overall and centre specific discrimination, calibration, and clinical utility of six prediction models for ovarian malignancy (risk of malignancy index (RMI), logistic regression model 2 (LR2), simple rules, simple rules risk model (SRRisk), assessment of different neoplasias in the adnexa (ADNEX) with or without CA125). ADNEX allows the risk of malignancy to be subdivided into risks of a borderline, stage I primary, stage II-IV primary, or secondary metastatic malignancy. The outcome was based on histology if patients underwent surgery, or on results of clinical and ultrasound follow-up at 12 (±2) months. Multiple imputation was used when outcome based on follow-up was uncertain. RESULTS The primary analysis included 17 centres that met strict quality criteria for surgical and follow-up data (5717 of all 8519 patients). 812 patients (14%) had a mass that was already in follow-up at study recruitment, therefore 4905 patients were included in the statistical analysis. The outcome was benign in 3441 (70%) patients and malignant in 978 (20%). Uncertain outcomes (486, 10%) were most often explained by limited follow-up information. The overall area under the receiver operating characteristic curve was highest for ADNEX with CA125 (0.94, 95% confidence interval 0.92 to 0.96), ADNEX without CA125 (0.94, 0.91 to 0.95) and SRRisk (0.94, 0.91 to 0.95), and lowest for RMI (0.89, 0.85 to 0.92). Calibration varied among centres for all models, however the ADNEX models and SRRisk were the best calibrated. Calibration of the estimated risks for the tumour subtypes was good for ADNEX irrespective of whether or not CA125 was included as a predictor. Overall clinical utility (net benefit) was highest for the ADNEX models and SRRisk, and lowest for RMI. For patients who received at least one follow-up scan (n=1958), overall area under the receiver operating characteristic curve ranged from 0.76 (95% confidence interval 0.66 to 0.84) for RMI to 0.89 (0.81 to 0.94) for ADNEX with CA125. CONCLUSIONS Our study found the ADNEX models and SRRisk are the best models to distinguish between benign and malignant masses in all patients presenting with an adnexal mass, including those managed conservatively. TRIAL REGISTRATION ClinicalTrials.gov NCT01698632.
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Affiliation(s)
- Ben Van Calster
- Department of Development and Regeneration, KU Leuven, Herestraat 49 Box 805, 3000 Leuven, Belgium
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, Netherlands
- EPI-Centre, KU Leuven, Leuven, Belgium
| | - Lil Valentin
- Department of Obstetrics and Gynaecology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Wouter Froyman
- Department of Development and Regeneration, KU Leuven, Herestraat 49 Box 805, 3000 Leuven, Belgium
- Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
| | - Chiara Landolfo
- Department of Development and Regeneration, KU Leuven, Herestraat 49 Box 805, 3000 Leuven, Belgium
- Queen Charlotte's and Chelsea Hospital, Imperial College, London, UK
| | - Jolien Ceusters
- Laboratory of Tumour Immunology and Immunotherapy, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Antonia C Testa
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- Department of Life Science and Public Health, Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - Laure Wynants
- Department of Development and Regeneration, KU Leuven, Herestraat 49 Box 805, 3000 Leuven, Belgium
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Povilas Sladkevicius
- Department of Obstetrics and Gynaecology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | | | - Ekaterini Domali
- First Department of Obstetrics and Gynaecology, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Robert Fruscio
- Clinic of Obstetrics and Gynaecology, University of Milan-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Elisabeth Epstein
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Obstetrics and Gynaecology, Södersjukhuset, Stockholm, Sweden
| | - Dorella Franchi
- Preventive Gynaecology Unit, Division of Gynaecology, European Institute of Oncology IRCCS, Milan, Italy
| | - Marek J Kudla
- Department of Perinatology and Oncological Gynaecology, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Valentina Chiappa
- Department of Gynaecologic Oncology, National Cancer Institute of Milan, Milan, Italy
| | - Juan L Alcazar
- Department of Obstetrics and Gynaecology, Clinica Universidad de Navarra, School of Medicine, Pamplona, Spain
| | - Francesco P G Leone
- Department of Obstetrics and Gynaecology, Biomedical and Clinical Sciences Institute L. Sacco, University of Milan, Milan, Italy
| | - Francesca Buonomo
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Maria Elisabetta Coccia
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Stefano Guerriero
- Department of Obstetrics and Gynaecology, University of Cagliari, Policlinico Universitario Duilio Casula, Monserrato, Cagliari, Italy
| | - Nandita Deo
- Department of Obstetrics and Gynaecology, Whipps Cross Hospital, London, UK
| | - Ligita Jokubkiene
- Department of Obstetrics and Gynaecology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Luca Savelli
- Department of Obstetrics and Gynaecology, University of Bologna, Bologna, Italy
| | - Daniela Fischerová
- Gynaecological Oncology Centre, Department of Obstetrics and Gynaecology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Artur Czekierdowski
- First Department of Gynaecological Oncology and Gynaecology, Medical University of Lublin, Lublin, Poland
| | - Jeroen Kaijser
- Department of Obstetrics and Gynaecology, Ikazia Hospital, Rotterdam, Netherlands
| | - An Coosemans
- Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Tumour Immunology and Immunotherapy, Department of Oncology, KU Leuven, Leuven, Belgium
- Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Giovanni Scambia
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- Department of Life Science and Public Health, Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - Ignace Vergote
- Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Tumour Immunology and Immunotherapy, Department of Oncology, KU Leuven, Leuven, Belgium
- Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Tom Bourne
- Department of Development and Regeneration, KU Leuven, Herestraat 49 Box 805, 3000 Leuven, Belgium
- Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
- Queen Charlotte's and Chelsea Hospital, Imperial College, London, UK
| | - Dirk Timmerman
- Department of Development and Regeneration, KU Leuven, Herestraat 49 Box 805, 3000 Leuven, Belgium dirk.timmerman@uzleuven
- Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
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Asiabi P, Ambroise J, Giachini C, Coccia ME, Bearzatto B, Chiti MC, Dolmans MM, Amorim CA. Assessing and validating housekeeping genes in normal, cancerous, and polycystic human ovaries. J Assist Reprod Genet 2020; 37:2545-2553. [PMID: 32729067 DOI: 10.1007/s10815-020-01901-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 03/31/2020] [Accepted: 07/23/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Housekeeping genes (HKGs), reference or endogenous control genes, are vital to normalize mRNA levels between different samples. Since using inappropriate HKGs can lead to unreliable results, selecting the proper ones is critical for gene expression studies. To this end, normal human ovaries, as well as those from patients diagnosed with ovarian endometrioid adenocarcinoma (OEA), ovarian mucinous adenocarcinoma (OMA), ovarian serous papillary carcinoma (OSPC), and polycystic ovary syndrome (PCOS), were used to identify the most suitable housekeeping genes. METHODS RNA was isolated from 5 normal human ovaries (52-79 years of age), 9 cancerous ovaries (3 OEA, 3 OMA, 3 OSPC; 49-75 years of age), and 4 PCOS ovaries (18-35 years of age) in women undergoing hysterectomy. cDNA was synthesized using a whole transcriptome kit, and quantitative real-time PCR was performed using TaqMan array 96-well plates containing 32 human endogenous controls in triplicate. RESULTS Among 32 HKGs studied, RPS17, RPL37A, PPIA, 18srRNA, B2M, RPLP0, RPLP30, HPRT1, POP4, CDKN1B, and ELF1 were selected as the best reference genes. CONCLUSIONS This study confirms recent investigations demonstrating that conventional HKGs, such as GAPDH and beta-actin, are not suitable reference genes for specific pathological conditions, emphasizing the importance of determining the best HKGs on a case-by-case basis and according to tissue type. Our results have identified reliable HKGs for studies of normal human ovaries and those affected by OEA, OMA, OSPC, or PCOS, as well as combined studies of control subjects vs. each cancer or PCOS group.
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Affiliation(s)
- P Asiabi
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Avenue Mounier 52, bte B1.52.02, 1200, Brussels, Belgium
| | - J Ambroise
- Centre de Technologies Moléculaires Appliquées, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, 1200, Brussels, Belgium
| | - C Giachini
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, 50134, Florence, Italy
| | - M E Coccia
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, 50134, Florence, Italy
| | - B Bearzatto
- Centre de Technologies Moléculaires Appliquées, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, 1200, Brussels, Belgium
| | - M C Chiti
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Avenue Mounier 52, bte B1.52.02, 1200, Brussels, Belgium
| | - M M Dolmans
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Avenue Mounier 52, bte B1.52.02, 1200, Brussels, Belgium
- Gynecology Department, Cliniques Universitaires Saint-Luc, 1200, Brussels, Belgium
| | - C A Amorim
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Avenue Mounier 52, bte B1.52.02, 1200, Brussels, Belgium.
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Cito G, Picone R, Fucci R, Del Popolo G, Cocci A, Gemma L, Lombardi G, Minervini A, Carini M, Natali A, Coccia ME. Reproductive Outcomes in Infertile Men With Spinal Cord Injury (SCI): A Retrospective Case-Control Analysis. Urology 2020; 141:82-88. [DOI: 10.1016/j.urology.2020.03.043] [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] [Received: 11/25/2019] [Revised: 02/17/2020] [Accepted: 03/29/2020] [Indexed: 10/24/2022]
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32
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Cito G, Coccia ME, Picone R, Fucci R, Micelli E, Cocci A, Di Mauro M, Rizzello F, Giachini C, Minervini A, Carini M, Natali A. Can cytomegalovirus infection affect male reproductive function? Results of a retrospective single-centre analysis. Andrologia 2020; 52:e13699. [PMID: 32510732 DOI: 10.1111/and.13699] [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: 02/10/2020] [Revised: 04/06/2020] [Accepted: 05/16/2020] [Indexed: 11/28/2022] Open
Abstract
Our objective was to investigate whether the chronic cytomegalovirus (CMV) infection can affect semen parameters in men with couple infertility and to assess the impact of male CMV infection on the reproductive outcomes of CMV-seronegative women suffering from tubal factor. Group 1 included CMV IgG-seropositive men, Group 2 CMV IgG-seronegative patients. Seminal parameters, two-pronuclear (2PN) fertilization rate (FR), 1-2-3PN FR, cleavage rate (CR), miscarriage rate (MR), pregnancy rate (PR) and live birth rate (LBR) were collected. Two hundred and twenty-two men were included: 115 (51.8%) in Group 1 and 107 (48.2%) in Group 2. There was reported a low trend towards higher sperm concentration/ml, total sperm count and viability in CMV IgG-seronegative males, compared to CMV IgG-seropositive (p > .05). Semen volume, pH, motility and normal sperm morphology were similar among groups. Considering the subgroup of men, partners of CMV IgG-seronegative females, 65 couples (29.2%) were selected. Median 2PN FR was 67%, total FR 83%, CR 100%, PR/cycle 26.2%, MR 10.8%, LBR/cycle 15.4%. No significant differences were found regarding the reproductive outcomes between CMV IgG-seropositive men and those seronegative. CMV did not seem to play a key role in male reproductive function, as well as in influencing sperm fertility potential in the assisted reproductive outcomes.
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Affiliation(s)
- Gianmartin Cito
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Rita Picone
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Rossella Fucci
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Elisabetta Micelli
- Department of Gynecology and Obstetrics, St. Claire Hospital, University of Pisa, Pisa, Italy
| | - Andrea Cocci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Marina Di Mauro
- Department of Urology, Vittorio Emanuele Hospital, University of Catania, Catania, Italy
| | - Francesca Rizzello
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Claudia Giachini
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Minervini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Carini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Alessandro Natali
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
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33
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Cito G, Coccia ME, Salvianti F, Fucci R, Picone R, Giachini C, Cocci A, Falcone P, Micelli E, Verrienti P, Minervini A, Carini M, Pinzani P, Natali A. Blood plasma miR-20a-5p expression as a potential non-invasive diagnostic biomarker of male infertility: A pilot study. Andrology 2020; 8:1256-1264. [PMID: 32406197 DOI: 10.1111/andr.12816] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 03/22/2020] [Revised: 04/29/2020] [Accepted: 05/06/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Recently, alterations in miRNAs expression profile in semen have been linked to damaged spermatogenesis, suggesting miRNAs could be used as potential infertility biomarkers. In previous animal studies, miR-20a-5p was found to be down-expressed in low motile spermatozoa, implying its potential target of genes associated with cell apoptosis. OBJECTIVE To investigate miR-20a-5p expression in blood plasma of patients suffering from non-obstructive azoospermia (NOA), compared to normozoospermic controls. MATERIALS AND METHODS Between January 2018 and December 2019, from 52 infertile couples eligible for the study, 24 couples were finally enrolled in this monocentric observational prospective pilot study. Patients were included into two groups: Group 1 comprised men with NOA (n = 14) and Group 2 fertile men partners of women with female tubal factor infertility (n = 10). All NOA patients underwent testicular sperm extraction. The expression of circulating miR-20a-5p in plasma samples was assessed by RT-qPCR. A relative quantification strategy was adopted using the 2-ΔCq method to calculate the target miR-20a-5p expression with respect to miR-16-5p as endogenous control. RESULTS Median blood plasma miR-20a-5p was significantly higher in patients affected by NOA (0.16 2-ΔCt , range: 0.05-0.79 2-ΔCt ) than in fertile controls (0.06 2-ΔCt , range: 0.04-0.10 2-ΔCt ), P < .001. MiR-20a-5p was positively correlated with follicle-stimulating hormone (FSH) (rrho = -0.490, P = .015) and luteinizing hormone (LH) (rrho = -0.462, P = .023), and negatively correlated with serum total testosterone (TT) (rrho = -0.534, P = .007) and right and left testicular size (rrho = -0.473, P = .020 and rrho = -0.471, P = .020, respectively). Successful sperm retrieval (SR) rate was 50.0%. Median value of miR-20a-5p did not differ significantly among patients with successful SR and those with negative SR. Testicular histological examination showed: hypospermatogenesis in 6/14 (42.8%), maturation arrest in 4/14 (28.6%), sertoli cell-only syndrome in 4/14 (28.6%). No significant differences in miR-20a-5p were found between histopathological patterns (P > .05). CONCLUSIONS MiR-20a-5p could represent a novel non-invasive diagnostic biomarker of male infertility.
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Affiliation(s)
- Gianmartin Cito
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Francesca Salvianti
- Clinical Biochemistry and Clinical Molecular Biology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Rossella Fucci
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Rita Picone
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Claudia Giachini
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Cocci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Patrizia Falcone
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Elisabetta Micelli
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Pierangelo Verrienti
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Minervini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Carini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Pamela Pinzani
- Clinical Biochemistry and Clinical Molecular Biology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Alessandro Natali
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
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Rizzello F, Coccia ME, Fatini C, Badolato L, Fantappiè G, Merrino V, Petraglia F. Comorbidities, risk factors and maternal/perinatal outcomes in oocyte donation pregnancies. Reprod Biomed Online 2020; 41:309-315. [PMID: 32576492 DOI: 10.1016/j.rbmo.2020.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/09/2019] [Revised: 04/05/2020] [Accepted: 04/23/2020] [Indexed: 12/11/2022]
Abstract
RESEARCH QUESTION To evaluate pre-existing comorbidities, obstetric risk factors and adverse obstetric and neonatal outcomes in pregnancies conceived by oocyte donation, compared with naturally conceived pregnancies or by conventional IVF/intracytoplasmic sperm injection (IVF/ICSI). DESIGN This retrospective single-centre contemporary cohort study reviewed data from singleton deliveries at the University Hospital of Careggi, Florence, from 2009 to 2017. Maternal and perinatal outcomes were analysed. RESULTS The study included 25,851 pregnancies and newborns: 276 (1.1%) children were conceived after oocyte donation, 925 (3.6%) after IVF/ICSI and 24,650 (95.4%) after natural conception. Women in the oocyte donation group were significantly older compared with IVF/ICSI and natural conception groups (P < 0.0001) and had a higher prevalence of chronic hypertension compared with the natural conception group (P = 0.0090). They were administered anticoagulant medications more frequently during pregnancy. The incidence of gestational hypertension was significantly higher than in natural conception (aOR 3.6) and IVF/ICSI pregnancies (aOR 2.7). The incidence of Caesarean section in oocyte donation pregnancies was higher than in natural conception and IVF/ICSI groups (aOR 3.4 and 2.3, respectively). An 11-fold increased risk of post-partum haemorrhage (PPH) was found in oocyte donation versus natural conception and an almost four-fold increased risk was found in oocyte donation versus IVF/ICSI; prematurity and low birthweight were more frequent after oocyte donation versus natural conception (aOR 2.4 and 1.8, respectively). CONCLUSIONS Patients undergoing oocyte donation represent a group with increased comorbidities and risk factors for adverse obstetric outcomes. Oocyte donation seems to be independently associated with gestational hypertension and PPH. Pregnancies after oocyte donation warrant clinical surveillance with proper screening and, possibly, preventive strategies.
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Affiliation(s)
- Francesca Rizzello
- Assisted Reproductive Technology Centre, Careggi University Hospital Florence, Italy.
| | - Maria Elisabetta Coccia
- Department of Biomedical, Experimental and Clinical Sciences 'Mario Serio', University of Florence Florence, Italy
| | - Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence Florence, Italy
| | - Laura Badolato
- Department of Biomedical, Experimental and Clinical Sciences 'Mario Serio', University of Florence Florence, Italy
| | - Giulia Fantappiè
- Department of Biomedical, Experimental and Clinical Sciences 'Mario Serio', University of Florence Florence, Italy
| | - Valeria Merrino
- Department of Biomedical, Experimental and Clinical Sciences 'Mario Serio', University of Florence Florence, Italy
| | - Felice Petraglia
- Department of Biomedical, Experimental and Clinical Sciences 'Mario Serio', University of Florence Florence, Italy
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Cito G, Micelli E, Cocci A, Polloni G, Coccia ME, Carini M, Minervini A, Natali A. Paternal Behaviors in the Era of COVID-19. World J Mens Health 2020; 38:251-253. [PMID: 32378371 PMCID: PMC7308232 DOI: 10.5534/wjmh.200071] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 04/18/2020] [Accepted: 04/22/2020] [Indexed: 12/16/2022] Open
Affiliation(s)
- Gianmartin Cito
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
| | - Elisabetta Micelli
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Cocci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Gaia Polloni
- Clinical Psychology and Clinical Sexology, Cognitive Therapy Centre, Como, Italy
| | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Carini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Minervini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Alessandro Natali
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
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Santi D, De Vincentis S, Alfano P, Balercia G, Calogero AE, Cargnelutti F, Coccia ME, Condorelli RA, Dal Lago A, de Angelis C, Gallo M, Iannantuoni N, Lombardo F, Marino A, Mazzella M, Pallotti F, Paoli D, Pivonello R, Rago R, Rampini M, Salvio G, Simoni M. Use of follicle-stimulating hormone for the male partner of idiopathic infertile couples in Italy: Results from a multicentre, observational, clinical practice survey. Andrology 2020; 8:637-644. [PMID: 31872967 DOI: 10.1111/andr.12748] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 10/21/2019] [Revised: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND The management of male idiopathic infertility is heterogeneous. Although meta-analyses reported the effectiveness on pregnancy rate, the real clinical impact of follicle-stimulating hormone (FSH) was not evaluated so far. In Italy, FSH is approved by the National Medicines Agency (AIFA) for idiopathic infertile patients with FSH < 8 IU/L, independently of semen parameters. AIM Primary endpoint was to record the therapeutic approach to the male partner of infertile couples. Secondary aim was to assess changes of semen parameters during FSH treatment. METHODS A multicentre, prospective, observational, clinical practice survey was carried out, enrolling the male partner of infertile couples attending ten Italian participating centres. Inclusion criteria were as follows: couple infertility, age >18 years and FSH serum levels <8 IU/L. Thus, all men in which AIFA allowed the FSH prescription were enrolled. Primary endpoint was the number of infertile patients treated with FSH. Secondary outcomes were semen parameters. The treating physician decided whether to offer FSH therapy and whether to re-evaluate the male partner. RESULTS A total of 718 infertile couples were enrolled, and 241 patients were re-evaluated (median follow-up: 4.5 months). In 64.9% (466 patients), a treatment was prescribed. FSH was prescribed in 397 patients (85.2% of treated men). Sperm concentration (P = .002) and normal form percentage (P < .001) significantly improved during FSH administration. No correlation was found between these parameters and FSH duration (P = .545 and P = .627, respectively) or dosage (P = .455 and P = .533, respectively). Among patients treated with FSH, the incidence of oligozoospermia decreased from 73.0% to 56.0% (P < .001) and teratozoospermia from 43.6% to 27.7% (P < .001). DISCUSSION This first nation-wide survey reveals a FSH prescription rate of 55% in patients qualifying for treatment according to AIFA. Although the study was not designed to highlight FSH efficacy in male infertility, a slight increase in semen parameters was demonstrated in about half of the treated men without adverse events.
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Affiliation(s)
- Daniele Santi
- Unità di Endocrinologia, Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena, Italy.,Unità di Endocrinologia, Dipartimento di Specialità Mediche, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Sara De Vincentis
- Unità di Endocrinologia, Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena, Italy.,Unità di Endocrinologia, Dipartimento di Specialità Mediche, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Patrizia Alfano
- Centro per la Tutela della Salute della Donna e del Bambino S. Anna, Roma, Italy
| | - Giancarlo Balercia
- Endocrinologia, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy
| | - Aldo E Calogero
- Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Catania, Italy
| | - Francesco Cargnelutti
- Laboratorio di Seminologia - Banca del Seme "Loredana Gandini", Dipartimento di Medicina Sperimentale, "Sapienza" Università di Roma, Roma, Italy
| | - Maria Elisabetta Coccia
- Centro di Procreazione Medicalmente Assistita, Azienda Ospedaliero-Universitaria Careggi, Università di Firenze, Firenze, Italy
| | - Rosita A Condorelli
- Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Catania, Italy
| | - Alessandro Dal Lago
- Unità di Fisiopatologia della Riproduzione e Andrologia, Ospedale Sandro Pertini, Roma, Italy.,Università "Sapienza" di Roma, Sperimentale, Roma, Italy
| | - Cristina de Angelis
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Napoli, Italy
| | - Mariagrazia Gallo
- Unità di Fisiopatologia della Riproduzione e Andrologia, Ospedale Sandro Pertini, Roma, Italy.,Università "Sapienza" di Roma, Sperimentale, Roma, Italy
| | | | - Francesco Lombardo
- Laboratorio di Seminologia - Banca del Seme "Loredana Gandini", Dipartimento di Medicina Sperimentale, "Sapienza" Università di Roma, Roma, Italy
| | - Angelo Marino
- Medicina della Riproduzione, ANDROS Clinica Day Surgery, Palermo, Italy
| | - Marco Mazzella
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Napoli, Italy
| | - Francesco Pallotti
- Laboratorio di Seminologia - Banca del Seme "Loredana Gandini", Dipartimento di Medicina Sperimentale, "Sapienza" Università di Roma, Roma, Italy
| | - Donatella Paoli
- Laboratorio di Seminologia - Banca del Seme "Loredana Gandini", Dipartimento di Medicina Sperimentale, "Sapienza" Università di Roma, Roma, Italy
| | - Rosario Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Napoli, Italy
| | - Rocco Rago
- Unità di Fisiopatologia della Riproduzione e Andrologia, Ospedale Sandro Pertini, Roma, Italy.,Università "Sapienza" di Roma, Sperimentale, Roma, Italy
| | - Mariarita Rampini
- Centro per la Tutela della Salute della Donna e del Bambino S. Anna, Roma, Italy
| | - Gianmaria Salvio
- Endocrinologia, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy
| | - Manuela Simoni
- Unità di Endocrinologia, Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena, Italy.,Unità di Endocrinologia, Dipartimento di Specialità Mediche, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
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Cito G, Coccia ME, Fucci R, Picone R, Cocci A, Sessa M, Sessa F, Rizzello F, Micelli E, Trotta M, Badolato L, Campi R, Criscuoli L, Serni S, Carini M, Natali A. Hepatitis B Surface Antigen Seropositive Men in Serodiscordant Couples: Effects on the Assisted Reproductive Outcomes. World J Mens Health 2019; 39:99-106. [PMID: 32009315 PMCID: PMC7752521 DOI: 10.5534/wjmh.190121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 09/17/2019] [Revised: 10/23/2019] [Accepted: 11/15/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose To evaluate the influence of hepatitis B virus (HBV) infection in men of serodiscordant couples on the reproductive outcomes. Materials and Methods A total of 134 infertile couples were included in this retrospective single-center cohort study. Sixty-six couples had hepatitis B surface antigen (HBsAg)-seropositive men and seronegative partners, while 68 couples were controls with both seronegative men and women. Overall, 134 fresh in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatments were performed. As the main outcome measures, on the day of the fresh IVF/ICSI cycle, we assessed seminal parameters Before and after sperm preparation techniques. Two-pronuclear (2PN) fertilization, 1-2-3PN fertilization, cleavage, miscarriage, pregnancy and live birth rates were collected. Results No significant differences were found between groups in terms of oocytes retrieved, oocytes injected and embryos obtained (p=0.64, p=0.97, and p=0.40, respectively). The 2PN fertilization rate (FR) was comparable among groups (p=0.51). The 1-2-3PN FR was significantly lower in the HBsAg group than in the control group (66.6% vs. 69.7%, respectively). The clinical pregnancy per cycle, implantation, miscarriage and live birth rate were comparable between the HBsAg group and the control group. The median sperm concentration/ml and total sperm count, measured at baseline and after sperm preparation, was comparable between groups (p>0.05). There was a trend toward significant lower progressive motility (35.0% vs. 55.0%; p<0.05) in the HBsAg group at baseline and after sperm preparation (p<0.05). Conclusions HBV infected men have the same chance to became father, compared to seronegative patients.
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Affiliation(s)
- Gianmartin Cito
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
| | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Rossella Fucci
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Rita Picone
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Cocci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Maurizio Sessa
- Campania Pharmacovigilance and Pharmacoepidemiology Regional Centre, Department of Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Francesco Sessa
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Francesca Rizzello
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Elisabetta Micelli
- Department of Gynecology and Obstetrics, St. Claire Hospital, University of Pisa, Pisa, Italy
| | - Michele Trotta
- Department of Critical Care Medicine and Surgery, Infectious Disease Unit, Careggi Hospital, University of Florence, Florence, Italy
| | - Laura Badolato
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Riccardo Campi
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Luciana Criscuoli
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Sergio Serni
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Carini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Alessandro Natali
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
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Abstract
The pathophysiology of severe endometriosis in young women remains unknown. Menorrhagia, or heavy and prolonged menstrual bleeding, is the most common symptom experienced by women with von Willebrand disease (vWD) and represents a possible risk factor for developing endometriosis. A 17-year-old woman affected by vWD presented with severe dysmenorrhea and heavy menstrual bleeding. After being diagnosed with multiple ovarian endometriomas, the patient underwent repeated surgeries due to suspicious appearance of recurrent pelvic masses. vWD may be a risk factor for developing severe endometriosis, and patients with endometriosis should be screened for vWD and other bleeding disorders. Ovarian endometriomas in such patients might present a more severe progression and unique ultrasound findings, mimicking malignancies.
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Affiliation(s)
- Francesca Rizzello
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Eleonora Ralli
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Chiara Romanelli
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
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39
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Scaravelli G, Levi-Setti PE, Livi C, La Sala G, Ubaldi FM, Greco E, Coccia ME, Borini A, Revelli A, Ricci G, Vigiliano V, De Luca R, Bolli S, Rienzi L. Correction to: Contribution of cryopreservation to the cumulative live birth rate: a large multicentric cycle-based data analysis from the Italian National Registry. J Assist Reprod Genet 2019; 36:2297. [PMID: 31631238 DOI: 10.1007/s10815-019-01581-z] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The original article unfortunately contained a mistake. The names of the collaborators were captured as authors of the article.
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Affiliation(s)
- G Scaravelli
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy.
| | - P E Levi-Setti
- IRCCS, Division of Gynecology and Reproductive Medicine, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy
- Department of Obstetrics, Gynecology and Reproductive Science, School of Medicine, Yale University, New Haven, CT, USA
| | - C Livi
- ART Center DEMETRA, Florence, Italy
| | - G La Sala
- Department of Obstetrics and Gynecology, Arcispedale S. Maria Nuova, Reggio Emilia, Italy
- University of Modena and Reggio Emilia, Modena, Italy
| | - F M Ubaldi
- GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, Via de Notaris 2B, Rome, Italy
| | - E Greco
- Center for Reproductive Medicine, European Hospital, Via Portuense 700, 00149, Rome, Italy
| | - M E Coccia
- DAI-MI -AOU, Careggi-University of Florence, Florence, Italy
| | - A Borini
- 9.baby, Family and Fertility Center, Tecnobios Procreazione, Bologna, Italy
| | - A Revelli
- Gynecology and Obstetrics 1U, Physiopathology of Reproduction and IVF Unit, Sant'Anna Hospital, University of Torino, Torino, Italy
| | - G Ricci
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - V Vigiliano
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - R De Luca
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - S Bolli
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - L Rienzi
- GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, Via de Notaris 2B, Rome, Italy
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Pozza A, Dèttore D, Coccia ME. Depression and Anxiety in Pathways of Medically Assisted Reproduction: The Role of Infertility Stress Dimensions. Clin Pract Epidemiol Ment Health 2019; 15:101-109. [PMID: 31819758 PMCID: PMC6882134 DOI: 10.2174/1745017901915010101] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 07/24/2019] [Revised: 08/04/2019] [Accepted: 08/05/2019] [Indexed: 11/25/2022]
Abstract
Background: Depressive and anxious symptoms are common psychological reactions to infertility and Medically Assisted Reproduction (MAR). No study compared depressive and anxious symptoms and infertility stress dimensions across homologous and heterologous MAR, nor explored the specific role of the infertility stress dimensions in the two pathways. Homologous MAR may be associated with higher distress as the couple feel that the responsibility to reproduce and carry on the family line falls on them, and they feel inadequate if they are unable to bear children. Objective: We compared depressive/anxious symptoms and infertility stress dimensions between individuals undergoing homologous and heterologous MAR. We also explored the association between the infertility stress dimensions and depressive/anxious symptoms separately in two MAR pathways. Methods: Two-hundred twenty-six individuals participated [mean age = 39.71 years; 54.45% women]: 118 (52.2%) in homologous and 108 (47.8%) in heterologous MAR. The Fertility Problem Inventory, Beck Depression Inventory-II, and State and Trait Anxiety Inventory-Y form were administered. Results: Individuals in homologous MAR had higher depressive/state-trait anxious symptoms, general infertility stress, and infertility-related sexual concerns than those in heterologous MAR. In homologous MAR, social and sexual concerns were associated with depressive/trait anxious symptoms while gender had no effect. In heterologous MAR, male gender was associated with lower state anxious symptoms while infertility stress dimensions had no effect. Conclusion: Individuals in homologous MAR are a more distressed subgroup which requires a tailored supportive psychological intervention specifically on sexual and social concerns.
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Affiliation(s)
- Andrea Pozza
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
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41
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Scaravelli G, Levi-Setti PE, Livi C, La Sala G, Ubaldi FM, Greco E, Coccia ME, Borini A, Revelli A, Ricci G, Vigiliano V, De Luca R, Bolli S, Rienzi L. Contribution of cryopreservation to the cumulative live birth rate: a large multicentric cycle-based data analysis from the Italian National Registry. J Assist Reprod Genet 2019; 36:2287-2295. [PMID: 31463873 PMCID: PMC6885470 DOI: 10.1007/s10815-019-01566-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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] [Received: 04/10/2019] [Accepted: 08/13/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To estimate the contribution of cryopreservation to the cumulative live birth rate (CLBR) after law modification in Italy in the era of vitrification and freeze-all. METHODS The Italian National Registry performed a cycle-based data collection. Nine Italian IVF clinics were involved incorporating a total of 10,260 fresh cycles performed between January 2015 and April 2016 resulting in 9273 oocyte retrievals and 3266 subsequent warming cycles from the same oocyte retrievals performed up to December 2016. Mean female age was 37 ± 4.3 years. Primary outcome measure was CLBR per oocyte retrieval. Confounding factors were tested in multivariate regression analysis, and the relative impact of cryopreservation to the CLBR in different patient categories was calculated. RESULTS CLBR per oocyte retrieval was 32.6%, 26.5%, 18.7%, 13.0%, and 5.5% for women younger than 36, aged 36-39, 40-41, and older than 41 years, respectively. The total relative contribution of oocyte/embryo cryopreservation was 40.6% (95% CI 38.41-42.75). An association between maternal age, number of oocytes retrieved, fertilization rate, cryopreservation, and cumulative live birth was shown. When adjusted for confounders, a 2.3-fold increase was observed in the chance of live birth when cryopreservation was performed (OR 2.3; 95% CI 1.99-2.56). In high responder patients (> 15 oocytes retrieved) where freeze-all was applied in 67.6% of cycles to avoid the risk of hyper stimulation syndrome, the relative contribution of vitrification to the CLBR was 80.6%. CONCLUSIONS Cryopreservation is essential in IVF and should always be available to patients to optimize success rates. Multicentric, cycle-based data analyses are crucial to provide infertile couples, clinicians, and regulatory bodies with accurate information on IVF effectiveness including fresh and cryopreserved cycles.
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Affiliation(s)
- G Scaravelli
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy.
| | - P E Levi-Setti
- IRCCS, Division of Gynecology and Reproductive Medicine, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy.,Department of Obstetrics, Gynecology and Reproductive Science, School of Medicine, Yale University, New Haven, CT, USA
| | - C Livi
- ART Center DEMETRA, Florence, Italy
| | - G La Sala
- Department of Obstetrics and Gynecology, Arcispedale S. Maria Nuova, Reggio Emilia, Italy.,University of Modena and Reggio Emilia, Modena, Italy
| | - F M Ubaldi
- GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, Via de Notaris 2B, Rome, Italy
| | - E Greco
- Center for Reproductive Medicine, European Hospital, Via Portuense 700, 00149, Rome, Italy
| | - M E Coccia
- DAI-MI -AOU, Careggi-University of Florence, Florence, Italy
| | - A Borini
- 9.baby, Family and Fertility Center, Tecnobios Procreazione, Bologna, Italy
| | - A Revelli
- Gynecology and Obstetrics 1U, Physiopathology of Reproduction and IVF Unit, Sant'Anna Hospital, University of Torino, Torino, Italy
| | - G Ricci
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.,Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - V Vigiliano
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - R De Luca
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - S Bolli
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, Rome, Italy
| | - L Rienzi
- GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, Via de Notaris 2B, Rome, Italy
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42
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Cito G, Cocci A, Micelli E, Gabutti A, Russo GI, Coccia ME, Franco G, Serni S, Carini M, Natali A. Vitamin D and Male Fertility: An Updated Review. World J Mens Health 2019; 38:164-177. [PMID: 31190482 PMCID: PMC7076312 DOI: 10.5534/wjmh.190057] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 04/08/2019] [Revised: 04/14/2019] [Accepted: 04/22/2019] [Indexed: 12/14/2022] Open
Abstract
To date, the key role of vitamin D in male reproductive system has been suggested, since the expression of vitamin D receptors and metabolizing enzymes was demonstrated in the testis and spermatozoa. Nevertheless, a general consensus about the role of vitamin D in male fertility is still debated. The aim of this review is to provide an updated systematic revision of the current available literature, discussing the experimental and clinical evidence on the role of vitamin D in the regulation of testis hormone production, seminal parameters and male fertility. The consequences of vitamin D deficiency on serum levels of testicular hormones have been analysed by several observational and interventional studies, with controversial results. Equally, the experimental researches not were able to state a certain relationship between vitamin D status and testis hormone production. Possible bias, including age, body mass index, and baseline vitamin D status justified the differences among studies. As well as concerning the effect of vitamin D on semen parameters, most of the studies agreed in the possibility that vitamin D might have a positive effect on human male fertility potential, particularly through better sperm motility. Regarding pregnancy outcomes, normal level of vitamin D seems to be related to better pregnancies. However, all the previous studies displayed a wide heterogeneity in study design, population, methodology, and cut off values used for the evaluation of vitamin D status. Future studies are needed to better clarify the exact role of vitamin D on hormonal and seminal panel in both fertile and infertile men.
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Affiliation(s)
- Gianmartin Cito
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
| | - Andrea Cocci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Elisabetta Micelli
- Department of Gynecology and Obstetrics, St. Claire Hospital, University of Pisa, Pisa, Italy
| | - Alejandro Gabutti
- Department of Radiology, Salvador Zubirán National Institute of Health Sciences and Nutrition, Mexico City, Mexico
| | - Giorgio Ivan Russo
- Department of Urology, Vittorio Emanuele II, University of Catania, Catania, Italy
| | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Giorgio Franco
- Department of Urology, "La Sapienza" University of Rome, Rome, Italy
| | - Sergio Serni
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Carini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Alessandro Natali
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
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Cozzolino M, Coccia ME, Lazzeri G, Basile F, Troiano G. Variables Associated with Endometriosis-related Pain: A Pilot Study using a Visual Analogue Scale. Rev Bras Ginecol Obstet 2019; 41:170-175. [PMID: 30991431 PMCID: PMC10316809 DOI: 10.1055/s-0039-1679879] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE Endometriosis is a complex disease, and pain is an important component of the syndrome. One of the most used methods to assess pain is the visual analogue scale (VAS). The aim of the present research was to study the pain experienced by patients who referred to our unit for endometriosis, using the VAS to understand the variables that could influence it. METHODS We have conducted a prospective study from February 2012 to December 2016, enrolling 388 patients who referred to a university hospital, in Florence, Italy. We have included in the present study patients during their follow-up for endometriosis; we have also included patients who underwent surgery with a histological diagnosis of endometriosis. We have collected sociodemographic and clinical information regarding age, body mass index (BMI), smoking habit, number of pregnancies, and endometriosis staging. Finally, we have administered the VAS for several symptoms. RESULTS Dysmenorrhea was the symptom associated with the highest perception of pain (mean VAS score of 5.76). The logistic regression showed that the stage of endometriosis could influence the pain associated to constipation and to dysuria. The linear regression showed that age could influence the pain associated to constipation, to dyspareunia, and to dysmenorrhea. A positive correlation was found between dysmenorrhea and chronic pelvic pain (CPP), between dysmenorrhea and dyspareunia, and between constipation and dysuria. CONCLUSION Using a validated method, the VAS, we have studied the pain experienced by a group of patients with a history of endometriosis and observed that smoking habit and BMI did not influence the VAS scores, and that dysmenorrhea was associated with the highest perception of pain.
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Affiliation(s)
- Mauro Cozzolino
- Department of Biomedical, Experimental and Clinical Sciences - Division of Obstetrics and Gynecology, University of Florence, Careggi University Hospital, Florence, Italy.,Universidad Rey Juan Carlos, Madrid, Spain
| | - Maria Elisabetta Coccia
- Department of Biomedical, Experimental and Clinical Sciences - Division of Obstetrics and Gynecology, University of Florence, Careggi University Hospital, Florence, Italy
| | - Giacomo Lazzeri
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Francesca Basile
- Department of Human Pathology and Evolutionary Age, University of Messina, Messina, Italy
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Cito G, Coccia ME, Fucci R, Picone R, Cocci A, Russo GI, Rizzello F, Trotta M, Badolato L, Basile V, Criscuoli L, Serni S, Carini M, Natali A. Influence of male human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection on the reproductive outcomes in serodiscordant couples: a case-control study. Andrology 2019; 7:852-858. [PMID: 30993859 DOI: 10.1111/andr.12623] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 01/04/2019] [Revised: 03/06/2019] [Accepted: 03/07/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND Nowadays, serodiscordant couples (SDCs) with human immunodeficiency virus (HIV) or hepatitis C virus (HCV)-infected men have the chance to conceive safely, giving birth with a minimum risk of cross-infection. OBJECTIVE To assess the impact of male HIV and HCV infection on the assisted reproductive technologies (ART) outcomes in SDCs, with HIV or HCV seropositive men and negative partners. MATERIALS AND METHODS Of 153 couples: 24 in Group 1 (HIV-seropositive men), 60 in Group 2 (HCV-seropositive men) and 69 in Group 3 (controls). Sperm-washing procedure was performed using a three-step system. Fresh ICSI cycles were carried out in HIV SDCs, HCV SDCs and controls. Seminal parameters, fertilization rate (FR), cleavage rate (CR), pregnancy rate per cycle (PR/C), miscarriage rate, implantation rate (IR) and live birth rate were evaluated. RESULTS All the seropositive men have undetectable viral loads at the time of insemination, and both partners were free from co-morbid infections. The median number of embryos transferred was 2.0 (IQR 1.0-3.0), with no differences among groups. FR was significantly reduced in HIV and HCV SDCs compared to the controls (66%, 61% and 75%, respectively; p < 0.01). CR was similar between groups (p = 0.3). IR was 12.1%, 11.1% and 14.1%, respectively, in the three groups (p = 0.30). PR/C was 21.7%, 17.6% and 20.2% in HIV, HCV and controls, respectively. Live birth rate per cycle was 17.4%, 15.7% and 15.9%, respectively. There were no significant differences in clinical pregnancies per cycle, as well as miscarriages and live births (p = 0.30; 0.30; 0.60, respectively). CONCLUSIONS The sperm-washing technique with ICSI may generate a promising way to improve pregnancy outcomes and to reduce the risk of viral transmission in these couples. In this setting, we can correctly counsel HIV- and HCV-infected men of SDCs with regard to the likelihood of father their own biological child.
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Affiliation(s)
- G Cito
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - M E Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - R Fucci
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - R Picone
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - A Cocci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - G I Russo
- Department of Urology, Vittorio Emanuele Hospital, University of Catania, Catania, Italy
| | - F Rizzello
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - M Trotta
- Department of Critical Care Medicine and Surgery, Infectious Disease Unit, Careggi Hospital, University of Florence, Florence, Italy
| | - L Badolato
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - V Basile
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - L Criscuoli
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - S Serni
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - M Carini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - A Natali
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
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Cito G, Coccia ME, Bertocci F, Picone R, Cocci A, Fucci R, Basile V, Micelli E, Criscuoli L, Serni S, Carini M, Natali A. Successful pregnancy in double factor infertility: Sperm in vitro culture by modified testicular fine-needle aspiration. Urologia 2019; 86:141-144. [PMID: 30919754 DOI: 10.1177/0391560319840203] [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] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Infertility may depend up to 27% of couples on both partners. In patients with obstructive azoospermia, testicular fine-needle aspiration represents a good option to retrieve spermatozoa, in order to perform an assisted reproductive treatment. In vitro maturation of testicular spermatozoa could be the better choice of treatment in view of the increased motility, improving fertilization and pregnancy rates. CASE DESCRIPTION A 34-year-old azoospermic man and his 33-year-old partner referred for treatment of simultaneous male and female infertility factor. The woman presented a diminished ovarian reserve, with serum follicle stimulating hormone value of 27.15 IU/L. The man underwent trans-rectal and testicular ultrasounds that detected the congenital absence of proximal vas deferens on the right side and the absence of seminal vesicle and distal vas deferens on the left side. We proposed a chance to have their own biological child. The man underwent modified testicular fine-needle aspiration using a 18-gauge butterfly needle. Sperm retrieval was successful with 0.001 × 106 spermatozoa/mL and absence of motility. Testicular sperm suspension was cultured for 24 h to identify sperm viability, achieving 10% of sperm motility. Two metaphase II oocytes were retrieved and processed with intracytoplasmic sperm injection. Clinical pregnancy with live birth was obtained. CONCLUSION Performing modified testicular fine-needle aspiration increases successful sperm retrieval. Testicular sperm in vitro culture for 24 h proved to be a real and practical technique to increase sperm motility, in order to select mature and viable spermatozoa and improve successful intracytoplasmic sperm injection outcomes.
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Affiliation(s)
- Gianmartin Cito
- 1 Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- 2 Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Francesco Bertocci
- 2 Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Rita Picone
- 2 Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Cocci
- 1 Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Rossella Fucci
- 2 Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Valentina Basile
- 2 Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Elisabetta Micelli
- 3 Department of Gynecology and Obstetrics, St. Claire Hospital, University of Pisa, Pisa, Italy
| | - Luciana Criscuoli
- 2 Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Sergio Serni
- 1 Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Carini
- 1 Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Alessandro Natali
- 1 Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
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Cito G, Coccia ME, Picone R, Cocci A, Russo GI, Garaffa G, Fucci R, Bertocci F, Borrani E, Basile V, Micelli E, Criscuoli L, Serni S, Carini M, Natali A. Impact of advanced paternal age on the intracytoplasmic sperm injection (ICSI) outcomes in donor egg cycles. Transl Androl Urol 2019; 8:S22-S30. [PMID: 31143668 DOI: 10.21037/tau.2018.12.13] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background The purpose of this study is to assess the impact of paternal age on the oocyte-donation outcomes in intracytoplasmic sperm injection (ICSI) cycles. Methods Two hundred and seventy-eight infertile couples were retrospectively involved. Inclusion criteria were: infertility from almost 1 year, normal or sub-fertile seminal parameters, overall oocyte survival rate greater than 85%. Baseline characteristics included male age, recipient age, male body mass index (BMI), smoking, drinking status. Main outcome measures: fertilization rate (FR), cleavage rate (CR), pregnancy rate (PR). Results Patients were categorized in group 1 ≤45, group 2 >45 years. A total of 1,724 frozen oocytes were included. After warming, 1,642 oocytes survived. Median overall oocyte survival rate was 100% [interquartile range (IQR), 85-100%]. Median male age was 44±5.60 years (IQR, 31-70 years). Median recipients age was 42±3.62 years (IQR, 29-50 years). Group 1 included 166 men, group 2 112 men. Two hundred and seventy-eight fresh ICSI cycle were performed. "Two-pronuclear" (2PN) FR was 72.6%±0.20%, CR 93.0%±0.16%, PR 39.6%. Miscarriage rate was 25.5%. Live birth rate per cycles was 29.5%. Comparison between group 1, group 2 and ICSI outcomes confirmed an association with FR, resulting 80.0% (IQR, 67.0-83.0%) and 67.0% (IQR, 50.0-80.0%), respectively (P<0.01). There were no significant differences between the two groups with respect to seminal parameters. Conclusions It would be recommended more emphasis on the advancing male age when counselling older couples who undergo egg donation program.
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Affiliation(s)
- Gianmartin Cito
- Department of Urologye, Careggi Hospital, University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Rita Picone
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Cocci
- Department of Urologye, Careggi Hospital, University of Florence, Florence, Italy
| | - Giorgio Ivan Russo
- Department of Urology, Vittorio Emanuele II, University of Catania, Catania, Italy
| | - Giulio Garaffa
- Institute of Urology, University College London Hospitals, London, UK
| | - Rossella Fucci
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Francesco Bertocci
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Elena Borrani
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Valentina Basile
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Elisabetta Micelli
- Department of Obstetrics and Gynecology, Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Luciana Criscuoli
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Sergio Serni
- Department of Urologye, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Carini
- Department of Urologye, Careggi Hospital, University of Florence, Florence, Italy
| | - Alessandro Natali
- Department of Urologye, Careggi Hospital, University of Florence, Florence, Italy
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Cito G, Coccia ME, Picone R, Cocci A, Russo GI, Cai T, Bencini G, Fucci R, Micelli E, Criscuoli L, Bertocci F, Borrani E, Serni S, Carini M, Natali A. Male Inflammatory Parameters Are not Useful to Predict the Outcomes of Intracytoplasmic Sperm Injection: Results from a Cross-Sectional Study. World J Mens Health 2019; 37:347-354. [PMID: 30799563 PMCID: PMC6704309 DOI: 10.5534/wjmh.180110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 11/22/2018] [Revised: 12/19/2018] [Accepted: 01/09/2019] [Indexed: 12/21/2022] Open
Abstract
Purpose The relationship between male systemic inflammation and fertility seems intriguing, but no data about its impact on the assisted reproductive technology outcomes has been reported. Here, we aimed to evaluate the prognostic role of male systemic inflammatory parameters in intracytoplasmic sperm injection (ICSI) outcomes prediction, in couples undergoing an ovum donation program. Materials and Methods From January 2016 to December 2017, one hundred-ten couples were considered for this cross-sectional study. Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-eosinophil ratio (MER), platelet-to-lymphocyte ratio (PLR), seminal parameters, fertilization rate (FR), cleavage rate (CR), pregnancy rate (PR) were evaluated. Male patients were divided into Group A with FR ≤70%, Group B with FR >70%. Results Overall, FR was 74.5%, CR 90.9%, PR 41.8%. Group A included 43 patients, Group B 67 men. Group A showed a median NLR of 1.55, PLR of 106.09, MER of 2.33. Group B reported a median NLR of 1.64, PLR 109.0, MER 2.76. We found no statistically differences between two groups with respect to NLR, PLR, MER (p=0.90, p=0.70, p=0.96, respectively). The age-adjusted linear regression analysis demonstrated only a relationship between NLR and sperm motility count (r=−0.02; p<0.05). Using the univariate logistic regression analysis, we found no significant associations. Conclusions We did not find any relationship between ICSI outcomes and male inflammation parameters.
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Affiliation(s)
- Gianmartin Cito
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
| | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Rita Picone
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Cocci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Giorgio Ivan Russo
- Department of Urology, Vittorio Emanuele II, University of Catania, Catania, Italy
| | - Tommaso Cai
- Department of Urology, Santa Chiara Regional Hospital, Trento, Italy
| | - Giulia Bencini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Rossella Fucci
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Elisabetta Micelli
- Department of Obstetrics and Gynecology, Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Luciana Criscuoli
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Francesco Bertocci
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Elena Borrani
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Sergio Serni
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Carini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Alessandro Natali
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
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Cito G, Coccia ME, Sessa F, Cocci A, Verrienti P, Picone R, Fucci R, Criscuoli L, Serni S, Carini M, Natali A. Testicular Fine-Needle Aspiration for Sperm Retrieval in Azoospermia: A Small Step toward the Technical Standardization. World J Mens Health 2019; 37:55-67. [PMID: 30584991 PMCID: PMC6305866 DOI: 10.5534/wjmh.180077] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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] [Received: 08/31/2018] [Revised: 10/23/2018] [Accepted: 10/24/2018] [Indexed: 01/23/2023] Open
Abstract
PURPOSE The aim was to describe our preliminary experience performing testicular fine-needle aspiration (TEFNA) with a larger needle in infertile patients with obstructive azoospermia, and to provide a systematic literature review of the different testicular sperm aspiration techniques, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement recommendations. MATERIALS AND METHODS We prospectively collected data between March 2017 and June 2018. All men underwent bilateral TEFNA under analgo-sedation, using a larger disposable 18-gauge butterfly needle with 60 mL Luer-Lock syringe attached to it. RESULTS Thirty consecutive patients were enrolled. Median operative time was 16 minutes (interquartile range [IQR]: 12-30 minutes). No intraoperative complications occurred. Two/thirty patients (6.7%) reported postoperative adverse events: 1 patient had prolonged orchialgia, 1 patient presented scrotal hematoma. Successful sperm retrieval was found in 28/30 cases (93.3%). Median sperm concentration was 0.05 ×10⁶/mL (IQR: 0.001-0.1 ×10⁶/mL). Median total sperm motility was 10% (IQR: 0%-15%). In 20/30 men (66.7%) sperm retrieved was used for fresh intracytoplasmic sperm injection cycle, in 8/30 (26.7%) sperm cryopreservation was necessary, because on the day of sperm retrieval the female resulted not responder to ovarian stimulation. In this cases mean number of 3 (IQR: 1-4) bio system straws was cryopreserved. CONCLUSIONS TEFNA with 18-gauge needle proved to be a feasible, safe and effective treatment, even if future prospective studies will be addressed to clarify what type of azoospermia benefits from this procedure, and if a larger needle permits to improve Assisted Reproductive Technologies (ART) outcomes.
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Affiliation(s)
- Gianmartin Cito
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Center, Careggi Hospital, University of Florence, Florence, Italy
| | - Francesco Sessa
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Cocci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
| | - Pierangelo Verrienti
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Rita Picone
- Assisted Reproductive Technology Center, Careggi Hospital, University of Florence, Florence, Italy
| | - Rossella Fucci
- Assisted Reproductive Technology Center, Careggi Hospital, University of Florence, Florence, Italy
| | - Luciana Criscuoli
- Assisted Reproductive Technology Center, Careggi Hospital, University of Florence, Florence, Italy
| | - Sergio Serni
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Carini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Alessandro Natali
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
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Cito G, Coccia ME, Picone R, Nesi G, Cocci A, Dabizzi S, Garaffa G, Fucci R, Falcone P, Bertocci F, Santi R, Criscuoli L, Serni S, Carini M, Natali A. Novel method of histopathological analysis after testicular sperm extraction in patients with nonobstructive and obstructive azoospermia. Clin Exp Reprod Med 2018; 45:170-176. [PMID: 30538947 PMCID: PMC6277673 DOI: 10.5653/cerm.2018.45.4.170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 06/22/2018] [Revised: 07/12/2018] [Accepted: 08/07/2018] [Indexed: 11/06/2022] Open
Abstract
Objective To assess whether the “testicular pool” could be used for histological analysis and whether it gave more accurate information than the standard testicular biopsy. Methods Between January 2017 and March 2018, this single-center prospective study included 60 azoospermic men undergoing conventional bilateral testicular sperm extraction. Six samples were excised from each testicle and transferred to an embryologist. One additional biopsy was randomly taken from each testis for a histological analysis. After processing, the testicular pool was also sent for a histological analysis, which showed normal spermatogenesis (NS), hypospermatogenesis (HYPO), maturation arrest (MA), Sertoli cell-only syndrome (SCOS), and tubular atrophy (TA). Results Twenty of the 60 patients (33.3%) had obstructive azoospermia (OA), while the remaining 40 (66.6%) had nonobstructive azoospermia. Their mean age was 40.5 years. All patients with OA had previously undergone unsuccessful testicular fine-needle aspiration. Successful sperm retrieval (SSR) occurred in 93.3% of patients. Histological analysis of the testicular biopsy revealed NS in 12 patients (20%), HYPO and TA in 28 patients (46.6%), MA in eight patients (13.3%), and SCOS in 12 patients (20%). The testicular pool analysis showed NS in 12 patients (20%), HYPO and TA in 44 patients (73.3%), MA in four patients (6.6%), and SCOS in no patients. In four patients with MA (6.6% of the total sample) and 12 patients with SCOS (20% of the total sample) according to the standard testicular biopsy, the embryologist found SSR with cryopreservation. Overall, in 44 patients (73.3%), the testicular pool analysis confirmed the histological findings of the standard testicular biopsy. In the 16 cases (26.6%) with a discrepancy between the single-biopsy histological findings and SSR, the testicular pool analysis confirmed the embryological data on SSR. Conclusion The testicular pool proved to be easily analyzable, practical, manageable, and more accurate for predicting sperm retrieval than standard testicular biopsy.
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Affiliation(s)
- Gianmartin Cito
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Rita Picone
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Gabriella Nesi
- Department of Pathology, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Cocci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Sara Dabizzi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, Careggi Hospital, University of Florence, Florence, Italy
| | - Giulio Garaffa
- Institute of Urology, University College London Hospitals, London, UK
| | - Rossella Fucci
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Patrizia Falcone
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Francesco Bertocci
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Raffaella Santi
- Department of Pathology, Careggi Hospital, University of Florence, Florence, Italy
| | - Luciana Criscuoli
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Sergio Serni
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Carini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Alessandro Natali
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
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Fatini C, Cirillo M, Coccia ME. Assisted Reproductive Technology, Comorbidities, and Cardiovascular Risk: The Experience of an Italian Center. J Womens Health (Larchmt) 2018; 27:1285-1292. [DOI: 10.1089/jwh.2018.6981] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Division of Obstetrics and Gynecology, Center for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy
- Center for Research and Innovation in Health and Gender Medicine, CISMEG, Careggi University Hospital, Florence, Italy
| | - Michela Cirillo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Division of Obstetrics and Gynecology, Center for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy
| | - Maria Elisabetta Coccia
- Division of Obstetrics and Gynecology, Center for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
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