1,720,981 research outputs found
Exogenous luteinizing hormone supplementation in controlled ovarian stimulation: why, when and to whom?
No full textFollicle stimulating hormone (FSH) and luteinizing hormone (LH) play an important role in assisted reproductive technol- ogy during ovarian stimulation1. These hormones execute dif- ferent but complementary functions in the control of ovarian folliculogenesis and steroidogenesis but, while the role of FSH is well understood, the need for LH supplementation in controlled ovarian stimulation (COS) is still debated and con- troversial. Several confounding factors (e.g. different exogen- ous LH formulations, different stimulation protocols, different study populations, difficulty in identifying a threshold value below which an LH add-back could be beneficial) contribute to the continuing uncertainty reported in the literature con- cerning exogenous LH supplementation, despite the large number of trials that have been published
Regulation, data management, informed consent, and legal issues for ART
No full textThe number of assisted reproduction treatments undertaken worldwide has risen steadily since 1990. However when it comes to regulation, due to political, ethical, and social reasons related to assisted reproduction practice, each country has a different perspective. Several factors contribute to these differences, including financial issues (affordability, treatment costs), customary law, cultural and belief dimensions. In addition, individual and professional options may play different roles in different societies. The different restrictions across different countries, highlight a very complex reality, whose legislation represents a constant topic of debate and undergoes continuous evolution. In the daily practice, patient counseling and informed consent have both legal and ethical dimensions. The aim of this chapter is to provide an overview of assisted reproductive technology regulation, presenting its major legal issues and to underline the specific aspects of quality or data management and informed consent in assisted reproductive technology treatments. © 2023 Elsevier Inc. All rights reserved
Spontaneous pregnancy and unexplained infertility: a gift with many whys
No full textThe
dualism between the so‐called “Psychogenic hypothesis”
and the hypothesis of “Psychological consequences
of infertility” has been solved with the proposal of
an interactive and bidirectional relationship between
infertility and psychosocial diseases.[1] Infertility itself
can cause severe stress on both partners and start a
vicious cycle resulting in the decreasing likelihood of
pregnancy and even of treatment success. The infertility
treatment could be responsible for a major impairment
of the sex life because it frequently digs into the intimacy
of the coupl
Administration of micronized palmitoylethanolamide (PEA)-transpolydatin in the treatment of chronic pelvic pain in women affected by endometriosis. preliminary results [Utilizzo della Palmitoiletanolamide micronizzata (PEA)-transpolidatina nel trattamento del dolore pelvico cronico in donne affette da endometriosi. Risultati preliminari]
No full textAim. Aim of the study was to evaluate the effectiveness of micronized palmitoylethanolamide (PEA)-transpolydatin in the treatment of chronic pelvic pain in women affected by endometriosis. Methods. Twenty-four patients with suspected endometriosis affected by severe pelvic pain were enrolled. All patients received two tablets a day of PEA 400 mg and 40 mg polydatin for 90 days consecutively. A Visual Analogic Scale was used for the assessment of the severity of global pain, dysmenorrhea, dyspareunia, dysuria and dischezia. A second questionnaire was submitted to patients to assess the quality of life. The compilation of a diary lead us to evaluate the monthly assumption of any painkillers. Patients were evaluated at the begin of the treatment and then monthly until the end of the study (90 days). The statistical analysis was performed by using the ANOVA for the analysis of variance. Results. Statistically significant results were found in relation to pelvic pain, dysmenorrhea and dyspareunia compared to the initial evaluation of patients. Results related to dysuria and dischezia were not statistically significant (P>0.05). The decrease in pelvic pain leads to an improvement of the quality of life of patients. A decreased assumption of non-steroidal anti-inflammatory drugs (NSAIDs) was also observed. Conclusion. PEA could be considered an effective supplement to conventional analgesic therapies in the management of pelvic pain related to endometriosis
Environmental toxin exposure in polycystic ovary syndrome women and possible ovarian neoplastic repercussion
No full textPurpose: Over the last two decades, increasing attention has been paid to environmental toxins and their effects on the female reproductive system. Endocrine disrupting chemicals (EDCs) are exogenous substances or mixtures that can mimic the action of steroid hormones and interfere with their metabolism. Advanced glycation end products (AGEs) are proinflammatory molecules that can interact with cell surface receptors and mediate the triggering of proinflammatory pathways and oxidative stress. The purpose of this review is to explore the effects of environmental toxin exposure in the pathogenesis of both polycystic ovary syndrome (PCOS) and OC (ovarian cancer), considered separately, and also to evaluate possible neoplastic ovarian repercussion after exposure in patients diagnosed with PCOS.Materials and methods: We searched PubMed for articles published in the English language with the use of the following MeSH search terms: "polycystic ovary syndrome" and "ovarian cancer" combined with "endocrine disruptors". Titles and abstracts were examined and full articles that met the selection criteria were retrieved. A manual search of review articles and cross-references completed the search.Results: Extensive data from different studies collected in recent years concerning the effects of EDC/AGE exposure have confirmed their role in the pathophysiology of both PCOS and OC. They favor PCOS/OC development through different mechanisms that finally lead to hormonal and metabolic disruption and epigenetic modifications.Conclusions: Environmental toxin exposure in PCOS women could favor neoplastic transformation by exacerbating and potentiating some PCOS features. Further research, although difficult, is needed in order to prevent further diffusion of these substances in the environment, or at least to provide adequate information to the population considered at risk
Ovarian stimulation in patients in risk of OHSS
No full textOvarian hyperstimulation syndrome (OHSS) represents an exaggerated response to controlled ovarian stimulation (COS) that in some cases could be life-threatening. Assuming that complete prevention of OHSS is not possible, several strategies could be carried out to reduce the risk and early identification of risk factors represents the first step of a multi-stage process. Some well-established risk factors that could rise the risk of OHSS include young age, polycystic ovary syndrome, prior hyper-response/OHSS. In recent years research has focus on identifying biomarkers/hormonal markers that could represent potential predictors of OHSS (anti-Mullerian hormone and antral follicle count). The possible prevention strategies available for the clinician could be divided into primary and secondary. Primary prevention includes personalized stimulation protocols in order to suit patients' characteristics (individually tailored COS, use of GnRH antagonist stimulation protocols, in vitro maturation). Secondary prevention includes all strategies directed to counteract an excessive ovarian response (cycle cancellation, coasting, trigger ovulation by low doses of hCG or by alternative agents, cryopreservation of oocytes/embryos, adequate luteal phase support). So far, the combined use of a GnRH antagonist protocol with GnRH agonist triggering and oocyte and embryo freezing could not be recommended as a standard preventive measure, but it surely represents a promising one
A pilot study on oocyte retrieval simulator: a new tool for training?
No full textThis prospective study was aimed at assessing the usefulness of a box simulator in oocyte pick-up and at establishing whether it could be an appropriate training tool for egg retrieval. Forty-four clinicians, divided in two groups on the grounds of the previous experience (Novices and Experts), participated to two training sessions with a pick-up simulator. Data concerning the mean number of follicles correctly aspired (%OK med), the average time needed to correctly aspirate one follicle (t foll med) and the ratio between the two afore-mentioned parameters (%OK med/t foll med) were collected. At the end of the two sessions all participants completed a questionnaire aimed at assessing the performance of the simulator in terms of realism and acceptability for use. A significant improvement in efficiency (mean number of follicles correctly aspired, 82% versus 75%), speed (mean time needed to aspirate one follicle, 21 versus 28 s) and accuracy (mean percentage of follicles correctly aspirated in one minute, 2.53% versus 1.86%) was noted in the total sample. The performance accuracy was significantly increased in both groups (2.34% versus 1.83% for Novices and 2.50% versus 2.06%, for Experts). Speed was significantly improved in the Novices’ group. Simulator-based training has been shown to be effective and useful and it should be considered in training programs
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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