Publications by authors named "Paola Vigano'"
Adenomyosis is an important clinical condition with uncertain prevalence, and clinical focus on adenomyosis in patients undergoing assisted reproductive technology (ART) has increased during recent years. Recognizing the limited clinical knowledge on the impact of adenomyosis on ART outcomes, the First Lugano Adenomyosis Workshop was a symposium involving experts in the field of adenomyosis, covering basic research, imaging, surgery and infertility to highlight current advances and future research areas over a wide range of topics related to adenomyosis. Adenomyosis is characterized by altered oestrogen and progesterone signalling pathways.
View Article and Find Full Text PDFBackground: Over the past few decades, several studies have found that semen quality parameters have steadily declined over time. Many hypotheses have been made to explain this finding, among which a sedentary lifestyle has been investigated. To synthesize the current evidence, we performed a systematic review of published papers reporting on the relationship between sedentary habits and semen parameters.
View Article and Find Full Text PDFInfertility, affecting approximately 16% of the global population, has led to increased reliance on reproductive medicine. The impact of human papillomavirus (HPV) infection in one or both partners on outcomes of Assisted Reproduction Technologies (ART) remains unclear. This prospective cohort study aimed to evaluate prevalence and effects of HPV infection in subjects and couples candidates to ART.
View Article and Find Full Text PDFArticle Synopsis
- Some studies suggest that the number of eggs a woman has (ovarian reserve) doesn't really affect her chances of getting pregnant naturally, as long as she has regular periods.
- Researchers compared women who couldn't get pregnant for no clear reason with women whose partners had serious infertility issues.
- They found no major differences in their egg counts, showing that having a lower egg count might not really matter for getting pregnant naturally.
A century ago, Sampson identified three uterine anatomical structures that may determine the amount of retrograde menstruation and the likelihood of the development of endometriosis: the cervix, the intramural portion of the fallopian tubes, and the myometrium. Critical appraisal was undertaken of data published over the last 40 years on the potential effect of the characteristics of these three anatomical variables on the risk of endometriosis. There is some evidence to support the pathogenic role of the diameter of the cervical canal, stenosis of internal or external orifices, and stiffness of cervical tissue.
View Article and Find Full Text PDFBackground: In assisted reproductive technology (ART), the choice between intracytoplasmic sperm injection (ICSI) and conventional in vitro insemination (IVF) remains a pivotal decision for couples with female or unexplained infertility. The hypothesis that ICSI may not confer significant improvements in live birth rates in the absence of a male infertility factor was explored in this study.
Methods: This was a retrospective collection of data recorded by the Human Fertilisation and Embryology Authority (HFEA) in the UK from 2005 to 2018 and analysed through regression analysis models on both the entire dataset and a matched-pair subset.
Importance: Evidence suggests that aberrant uterine contractility in nonpregnant women with endometriosis and adenomyosis contributes to symptoms and potentially heralds their pathogenesis. However, uterine peristalsis remains understudied, inconsistently measured, and poorly understood.
Objective: To summarize evidence on uterine contractility across the menstrual cycle phases in women with endometriosis and adenomyosis.
Study Question: What are the quantitative, qualitative, and temporal patterns of retrograde mentruation?
Summary Answer: The extreme quantitative and qualitative heterogeneity of the available studies prevents the definitive conclusion that retrograde menstruation is a universal and consistent phenomenon during the reproductive period.
What Is Known Already: Retrograde menstruation has been defined as a universal, physiological phenomenon that occurs similarly in about 90% of menstruators during the reproductive period. However, uncertainties still exist in terms of the event frequency, total amount, and cellular composition of retrograde menstruation and the differences between individuals with versus those without endometriosis.
Multiple births from medically assisted reproduction: contribution of different types of procedures and trends over time.
Eur J Obstet Gynecol Reprod Biol
September 2024
Article Synopsis
- - The study evaluated how different medically assisted reproduction (MAR) strategies, like ovarian stimulation with insemination and various IVF techniques, affect the risk of multiple births over a 15-year period in Lombardy, Italy.
- - Out of 30,900 births after MAR, 15.6% were multiple births, but this rate decreased significantly from 22.0% in 2007 to 8.7% in 2022, particularly due to changes in IVF practices.
- - First line treatments had a stable multiple birth rate, while IVF-related multiple births saw a sharp decline, illustrating the impact of legislative changes on reproductive strategies in Italy.
Study Question: Is IVF indicated for couples with age-related infertility?
Summary Answer: IVF may be of doubtful utility for age-related infertility.
What Is Known Already: A diagnosis of unexplained infertility is drawn when the diagnostic work-up fails to identify any patent cause. Although typically managed uniformly, unexplained infertility is likely to comprise a wide range of conditions, including age-related infertility (at least in older women).
Background And Objective: No clear-cut markers for predicting positive sperm retrieval (+SR) at microdissection testicular sperm extraction (mTESE) have been identified thus far. Our aim was to conduct a systematic review and meta-analysis to evaluate the ability of follicle-stimulating hormone (FSH), inhibin B (InhB), and anti-Müllerian hormone (AMH) to predict +SR in men with nonobstructive azoospermia (NOA) undergoing mTESE.
Methods: We performed a search in the PubMed, EMBASE, Web of Science, and Scopus databases according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement.
Background: The rate of preterm birth of singletons conceived through in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) is increased, being as high as 15% to 16% across Europe and the United States. However, the underlying etiology, phenotype, and mechanisms initiating preterm birth (PTB) are poorly understood.
Objective: To quantify the PTB risk and examine supposed etiology in IVF/ICSI singleton pregnancies compared to naturally conceived.
Article Synopsis
- The study investigates whether the prevalence of endometriosis differs among patients with obstructive Müllerian anomalies (OMA), nonobstructive Müllerian anomalies (NOMA), and those without Müllerian anomalies.
- Results indicate that endometriosis is significantly more common in patients with OMA compared to those with NOMA, while the prevalence in NOMA patients is similar to those without Müllerian anomalies.
- The research reinforces existing theories on endometriosis, notably the retrograde menstruation theory related to OMA, while raising questions about the mechanisms in NOMA patients.
Study Question: Do extracellular vesicles (EVs) secreted by aneuploid human embryos possess a unique transcriptomic profile that elicits a relevant transcriptomic response in decidualized primary endometrial stromal cells (dESCs)?
Summary Answer: Aneuploid embryo-derived EVs contain transcripts of , , , and with differential abundance from euploid embryo-derived EVs and induce upregulation of transcript in dESCs.
What Is Known Already: We have previously reported that IVF embryos secrete EVs that can be internalized by ESCs, conceptualizing that successful implantation to the endometrium is facilitated by EVs. Whether these EVs may additionally serve as biomarkers of ploidy status is unknown.
Unlabelled: "SO FAR AWAY" * How Doctors Can Contribute to Making Endometriosis Hell on Earth [* by Knopfler M. In Dire Straits. Brothers in Arms.
View Article and Find Full Text PDFObjective: To evaluate whether laser-mediated assisted hatching (AH) performed on vitrified/warmed blastocysts before embryo transfer can improve live birth rate.
Design: The "pArtiaL zonA pelluciDa removal by assisteD hatchINg of blastocysts (ALADDIN)" is a 2-center comparative study with a parallel randomized controlled design.
Setting: University hospital.
A significant body of evidence has supported a negative impact of endometriosis on ovarian follicles; however, the origin and relevance of this ovarian impairment in endometriosis is still a matter of debate. The ovarian damage can be caused by endometriosis itself or by surgeries aiming to remove endometriotic lesions. In this review, we summarized the existing knowledge on the mechanisms by which endometriosis can impact the ovarian follicles, from molecular to clinical points of view.
View Article and Find Full Text PDFPurpose: To understand how often couples return to ART centres for a second child.
Methods: Retrospective monocentric cohort study including women who had a first live birth with IVF. The primary objective was to assess the rate of those returning for a second child within five years of the previous pregnancy.
Importance: Although multiple mechanisms have been proposed to explain the infertility related to endometriosis, there are no conclusive data on the association of endometriosis with endometrial receptivity. The oocyte donation model in assisted reproduction technology (ART) cycles can clarify this issue.
Objective: To explore the association of a history of endometriosis with ART outcomes in recipients of oocyte donation.