153 results on '"Somigliana, Edgardo"'
Search Results
2. The modest impact of assisted reproductive technology on the second birth: insights from a population-based study in Lombardy, Northern Italy
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Esposito, Giovanna, Viganò, Paola, Filippi, Francesca, Franchi, Matteo, Corrao, Giovanni, Parazzini, Fabio, and Somigliana, Edgardo
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- 2023
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3. Fertility counseling in women with hereditary cancer syndromes
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Somigliana, Edgardo, Costantini, Maria Paola, Filippi, Francesca, Terenziani, Monica, Riccaboni, Alessandra, Nicotra, Valeria, Rago, Rocco, Paffoni, Alessio, Mencaglia, Luca, Magnolfi, Stefania, Zuccarello, Daniela, Rienzi, Laura, Spinella, Francesca, Capalbo, Antonio, Scaravelli, Giulia, and Testa, Salvo
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- 2022
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4. Wastage of gonadotropins during IVF cycles: Real life data from two Italian infertility centers
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Somigliana, Edgardo, Bertoli, Massimo, Caputo, Alessandra, Reschini, Marco, Bardiani, Ivana, Bruno, Giacomo M., Di Matteo, Sergio, and Colombo, Giorgio L.
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- 2021
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5. Sperm cryopreservation in adolescents with cancer
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Reschini, Marco, Somigliana, Edgardo, Meazza, Cristina, Podda, Marta, Guarneri, Cristina, Giacchetta, Daniela, Massimino, Maura, Restelli, Liliana, Filippi, Francesca, and Terenziani, Monica
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- 2021
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6. Fertility preservation in women with cervical cancer
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Somigliana, Edgardo, Mangili, Giorgia, Martinelli, Fabio, Noli, Stefania, Filippi, Francesca, Bergamini, Alice, Bocciolone, Luca, Buonomo, Barbara, and Peccatori, Fedro
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- 2020
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7. The impact of IVF on deep invasive endometriosis
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Berlanda, Nicola, Benaglia, Laura, Bottelli, Lara, Torri, Chiara, Busnelli, Andrea, Somigliana, Edgardo, and Vercellini, Paolo
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- 2019
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8. Oocyte quality in women with thalassaemia major: insights from IVF cycles
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Mensi, Laura, Borroni, Raffaella, Reschini, Marco, Cassinerio, Elena, Vegetti, Walter, Baldini, Marina, Cappellini, Maria Domenica, and Somigliana, Edgardo
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- 2019
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9. Potential benefits of pregnancy on endometriosis symptoms
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Alberico, Daniela, Somigliana, Edgardo, Bracco, Benedetta, Dhouha, Dridi, Roberto, Anna, Mosconi, Paola, Facchin, Federica, and Vercellini, Paolo
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- 2018
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10. Is endometrioma-associated damage to ovarian reserve progressive? Insights from IVF cycles
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Benaglia, Laura, Castiglioni, Marta, Paffoni, Alessio, Sarais, Veronica, Vercellini, Paolo, and Somigliana, Edgardo
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- 2017
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11. The complex interface between economy and healthcare: An introductory overview for clinicians
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Ottolini, Federica Liliana, Buggio, Laura, Somigliana, Edgardo, and Vercellini, Paolo
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- 2016
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12. Serum anti-mullerian hormone in reproductive aged women with benign ovarian cysts
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Somigliana, Edgardo, Marchese, Maria Antonietta, Frattaruolo, Maria Pina, Berlanda, Nicola, Fedele, Luigi, and Vercellini, Paolo
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- 2014
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13. Depleted mitochondrial DNA content in peripheral blood of women with a history of HELLP syndrome
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Lattuada, Debora, Crovetto, Francesca, Trespidi, Laura, Mangano, Sveva, Acaia, Barbara, Somigliana, Edgardo, Fedele, Luigi, and Bolis, Giorgio
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- 2013
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14. Endometriosis, staging, infertility and assisted reproductive technology: time for a rethink.
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Ata, Baris and Somigliana, Edgardo
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REPRODUCTIVE technology , *ENDOMETRIOSIS , *SEXUAL cycle , *INFERTILITY , *BIRTH rate , *SURGICAL excision - Abstract
How endometriosis causes infertility, with the exception of tubal dysfunction caused by adhesions, is unclear. The inflammatory milieu in the pelvis and impaired receptivity of the eutopic endometrium are considered to be possible factors. Anatomical staging systems fail to predict the fertility status of endometriosis patients. Data from assisted reproductive technology cycles consistently suggest that oocytes from patients with endometriosis have a normal potential to develop into euploid blastocysts. Moreover, oocyte or embryo recipients with endometriosis seem to have similar or slightly lower pregnancy and live birth rates compared with recipients without endometriosis, suggesting that eutopic endometrium is not or is only minimally affected, which may be caused by undiagnosed adenomyosis. In-vivo observations from women with endometriomas provide evidence against a detrimental effect of endometriomas on oocytes. Combined with the absence of an obvious improvement in fertility following the surgical destruction or excision of peritoneal endometriosis or from temporary medical suppression of the disease and the associated inflammation, the available evidence makes endometriosis-associated infertility questionable in the absence of tubal dysfunction caused by adhesions. It is likely that no anatomical staging will correlate with fertility beyond assessing tubal function. In patients with endometriosis assisted reproductive technology is as effective as for other indications. [ABSTRACT FROM AUTHOR]
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- 2024
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15. Fertility preservation in women with peritoneal surface malignancies: A case series.
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Filippi, Francesca, Kusamura, Shigeki, Martinelli, Fabio, Somigliana, Edgardo, and Deraco, Marcello
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FERTILITY preservation ,HYPERTHERMIC intraperitoneal chemotherapy ,PERITONEAL cancer ,OVERALL survival ,CYTOREDUCTIVE surgery ,OVUM - Abstract
The advent of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has improved survival in patients with peritoneal surface malignancies. Not surprisingly, there is now a growing interest on the possible means to preserve fertility to ensure future childbearing. In this study, we report on five women with peritoneal surface malignancies who performed ovarian hyper-stimulation and oocytes cryostorage prior to undergo CRS and HIPEC. The presence of the disease complicated follicular growth monitoring but the oocytes retrievals could be always performed and were uneventful. At last follow-up, all women were alive and disease-free. None has yet returned to thaw her oocytes. Overall, these cases suggest that oocytes cryopreservation before CRS and HIPEC should be considered. [ABSTRACT FROM AUTHOR]
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- 2021
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16. Postsurgical ovarian failure after laparoscopic excision of bilateral endometriomas
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Busacca, Mauro, Riparini, Jennifer, Somigliana, Edgardo, Oggioni, Giulia, Izzo, Stefano, Vignali, Michele, and Candiani, Massimo
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Surgery ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2006.03.064 Byline: Mauro Busacca (a)(b), Jennifer Riparini (b)(c), Edgardo Somigliana (c), Giulia Oggioni (a)(b), Stefano Izzo (b)(c), Michele Vignali (a)(b), Massimo Candiani (b)(c) Abstract: This study was undertaken to determine the frequency of postsurgical ovarian failure in patients undergoing laparoscopic excision of bilateral endometriomas. Author Affiliation: (a) Department of Obstetrics and Gynecology, Ospedale Macedonio Melloni (b) Universita degli Studi di Milano (c) Department of Obstetrics, Gynecology and Neonatology, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli and Regina Elena, Milan, Italy Article History: Received 19 November 2005; Revised 1 February 2006; Accepted 18 March 2006 Article Note: (footnote) Reprints not available from the authors.
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- 2006
17. Recurrent implantation failure: a plea for a widely adopted rational definition.
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Somigliana, Edgardo, Busnelli, Andrea, Kalafat, Erkan, Viganò, Paola, and Ata, Baris
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EMBRYO implantation , *OOCYTE retrieval , *EMBRYO transfer , *DEFINITIONS , *SCIENTIFIC community - Abstract
Most proposed definitions of recurrent implantation failure (RIF) are based on clinical judgement, probably affected by patients' demands. They are not based on robust statistical considerations. As a result, a diagnosis of RIF is commonly made too early, exposing couples to the risk of overdiagnosis and overtreatment. However, the situation is changing, and three statistical approaches have recently been proposed. The first is a probability model based on the chances of success per cycle and suggests for the definition three failed oocyte retrieval cycles with all embryos being transferred in women younger than 40 years of age. The second approach suggests an individualized diagnosis that takes into consideration multiple factors, while the third is also based on individualization but mainly relies on anticipated euploidy rates across the female age range. All these approaches have their pros and cons. Regardless of the specific peculiarities, they represent steps in the right direction, with the intent of providing a statistically sound definition. However, these attempts will not be useful unless endorsed by the scientific community in general. There is a pressing need for a rigorous and shared definition of RIF that will be widely accepted by researchers, scientific societies and other stakeholders, including patients. [ABSTRACT FROM AUTHOR]
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- 2022
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18. Damage to ovarian reserve associated with laparoscopic excision of endometriomas: a quantitative rather than qualitative injury
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Ragni, Guido, Restelli, Liliana, Somigliana, Edgardo, Crosignani, Pier Giorgio, Benedetti, Francesca, Paffoni, Alessio, and Vegetti, Walter
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Laparoscopic surgery -- Health aspects ,Fertilization in vitro -- Research ,Pregnant women -- Health aspects ,Pregnant women -- Care and treatment ,Endometriosis -- Health aspects ,Endometriosis -- Care and treatment ,Health - Abstract
A study to evaluate ovarian response to hyperstimulation in women selected for in vitro fertilization and intracytoplasmic sperm injection cycles and have previously undergone laparoscopic enucleation of a monolateral endometrioma is presented. It is found that laparoscopic excision of endometriomas is associated with a quantitative but not qualitative damage to ovarian reserve.
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- 2005
19. Early invasive diagnostic techniques in pregnant women who are infected with the HIV: A multicenter case series
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Somigliana, Edgardo, Bucceri, Anna Maria, Tibaldi, Cecilia, Alberico, Salvatore, Ravizza, Marina, Savasi, Valeria, Matrone, Roberta, and Pardi, Giorgio
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Pregnant women -- Health aspects ,HIV infection -- Diagnosis ,Pregnancy, Complications of -- Diagnosis ,Health - Abstract
The vertical transmission rate and other maternal and neonatal complications among HIV-infected pregnant women who underwent early invasive diagnostic techniques (EDIT) are examined. Findings reported lower risk of HIV vertical transmission associated with EDIT.
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- 2005
20. Fibroids and natural fertility: a systematic review and meta-analysis.
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Somigliana, Edgardo, Reschini, Marco, Bonanni, Valentina, Busnelli, Andrea, Li Piani, Letizia, and Vercellini, Paolo
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FERTILITY , *MALE infertility , *INFERTILITY , *EMBRYO implantation , *ODDS ratio , *PREGNANCY - Abstract
Available evidence from IVF studies supports a detrimental effect of submucosal and intramural fibroids on embryo implantation. It is misleading, however, to infer evidence obtained in IVF settings to natural fertility. Therefore, a systematic review and meta-analysis was conducted on the effect of fibroids on natural fertility. Studies comparing fertile and infertile women, and those investigating whether the presence of fibroids was a risk factor, were reviewed, as well as studies comparing women with and without fibroids. The aim was also to establish whether the frequency of infertility differed between the two groups. Seven out of 11 selected studies did not aim to establish whether fibroids caused infertility but, rather, whether a history of infertility could be a risk factor for fibroids. A meta-analysis of the four remaining studies that concomitantly evaluated the presence of fibroids and infertility studies highlighted a common odds ratio of fibroids in subfertile women of 3.54 (95% CI 1.55 to 8.11). When focusing on the two most informative studies, i.e. the studies comparing time to pregnancy in women with and without fibroids, the common OR was 1.93 (95% CI 0.89 to 4.18). In conclusion, the association between fibroids and infertility has been insufficiently investigated. Epidemiological studies suggest, but do not demonstrate, that fibroids may interfere with natural fertility. Given the high prevalence of these lesions in women seeking pregnancy, further evidence is urgently needed. [ABSTRACT FROM AUTHOR]
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- 2021
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21. A randomized comparison of tension-free vaginal tape and endopelvic fascia plication in women with genital prolapse and occult stress urinary incontinence
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Meschia, Michele, Pifarotti, Paola, Spennacchio, Maurizio, Buonaguidi, Arturo, Gattei, Umberto, and Somigliana, Edgardo
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Urinary incontinence -- Analysis ,Women -- Analysis ,Prolapse -- Analysis ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2003.09.027 Byline: Michele Meschia, Paola Pifarotti, Maurizio Spennacchio, Arturo Buonaguidi, Umberto Gattei, Edgardo Somigliana Keywords: Prolapse; stress incontinence; tension-free vaginal tape; fascia plication Abstract: The purpose of this study was to compare 2 anti-incontinence procedures in women who had severe genital prolapse and potential stress incontinence. Author Affiliation: Department of Obstetrics and Gynecology, Urogynecology Unit, University of Milan, Milano, Italy Article History: Received 18 May 2003; Revised 20 August 2003; Accepted 5 September 2003
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- 2004
22. Bladder Endometriosis: A Systematic Review of Pathogenesis, Diagnosis, Treatment, Impact on Fertility, and Risk of Malignant Transformation [figure presented]
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Leone Roberti Maggiore, Umberto, Ferrero, Simone, Candiani, Massimo, Somigliana, Edgardo, Viganò, Paola, Vercellini, Paolo, Leone Roberti Maggiore, Umberto, Ferrero, Simone, Candiani, Massimo, Somigliana, Edgardo, Viganò, Paola, and Vercellini, Paolo
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Bladder ,Diagnosis ,Endometriosis ,Fertility ,Treatment ,Urology ,Urinary Bladder ,Cystoscopy ,Cystectomy ,Urinary Bladder Disease ,Gonadotropin-Releasing Hormone ,Progestin ,Contraceptives, Oral, Combined ,Cell Transformation, Neoplastic ,Urologic Surgical Procedure ,Aromatase Inhibitor ,Female ,Endometriosi ,Infertility, Female ,Diagnosi ,Human ,Ultrasonography - Abstract
Context The bladder is the most common site affected in urinary tract endometriosis. There is controversy regarding the pathogenesis, clinical management (diagnosis and treatment), impact on fertility, and risk of malignant transformation of bladder endometriosis (BE). Objective To systematically evaluate evidence regarding the pathogenesis, diagnosis, medical and surgical treatment, impact on female fertility, and risk of malignant transformation of BE. Evidence acquisition A systematic review of PubMed/Medline from inception until October 2016 was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement and was registered in the PROSPERO registry (www.crd.york.ac.uk/prospero; CRD42016039281). Eighty-seven articles were selected for inclusion in this analysis. Evidence synthesis BE is defined as the presence of endometrial glands and stroma in the detrusor muscle. Ultrasonography is the first-line technique for assessment of BE owing to its accuracy, safety, and cost. Clinical management can be conservative, using hormonal therapies, or surgical. When conservative treatment is preferred, estrogen-progestogen combinations and progestogens should be chosen because of their favorable profile that allows long-term therapy. Surgery should guarantee complete removal of the bladder nodule to minimize recurrence, so transurethral surgery alone should be avoided in favor of segmental bladder resection. There is not a strong rationale for hypothesizing a detrimental impact of BE per se on fertility. Furthermore, current evidence does not support the removal of bladder endometriotic lesions because of the potential risk of malignant transformation since this phenomenon is exceedingly rare. Conclusions BE is a challenging condition, and the common coexistence of other types of endometriosis means that clinical management of BE should involve collaboration between gynecologists and urologists. Patient summary In this article we review available knowledge on bladder endometriosis. The review provides a useful tool to guide physicians in the management of this complex condition.
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- 2017
23. Reply of the Authors: Adenomyosis and endometriosis in infertility—how do we optimize the house and the garden?
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Somigliana, Edgardo, Viganò, Paola, Bandini, Veronica, Buggio, Laura, Berlanda, Nicola, and Vercellini, Paolo
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ENDOMETRIOSIS , *INFERTILITY , *GARDENS , *AUTHORS - Published
- 2024
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24. The neglected emotional drawbacks of the prioritization of embryos to transfer.
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Spinelli, Gaia, Somigliana, Edgardo, Micci, Laila Giorgia, Vigano, Paola, Facchin, Federica, and Gramegna, Maria Giada
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EMBRYO transfer , *ARTIFICIAL intelligence , *EMBRYO implantation , *COUPLES , *GENETIC testing - Abstract
In recent years, increasing efforts have been made to develop advanced techniques that could predict the potential of implantation of each single embryo and prioritize the transfer of those at higher chance. The most promising include non-invasive preimplantation genetic testing for aneuploidy and artificial intelligence-based algorithms using time lapse images. The psychological effect of these add-ons is neglected. One could speculate that embarking on another transfer after one or more failures with the prospect of receiving an embryo of lower potential may be distressing for the couple. In addition, the symbolic and mental representation of an embryo with 'lower capacity to implant' is currently unknown but could affect couples' choices and wellbeing. These emotional responses may also undermine adherence to the programme and, ultimately, its real effectiveness. Future trials aimed at evaluating the validity of prioritization procedures must also consider the emotional burden on the couples. [ABSTRACT FROM AUTHOR]
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- 2024
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25. Effects of the early phase of the COVID-19 pandemic on natural and ART-mediated birth rates in Lombardy Region, Northern Italy.
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Somigliana, Edgardo, Esposito, Giovanna, Viganò, Paola, Franchi, Matteo, Corrao, Giovanni, and Parazzini, Fabio
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COVID-19 pandemic , *BIRTH rate , *COVID-19 , *REPRODUCTIVE technology - Abstract
What effects did the early phase of the COVID-19 pandemic have on natural and assisted reproductive technology (ART)-mediated birth rates? Regional registries were consulted with permission from the Health Authorities of Lombardy Region, Northern Italy, an area particularly affected by the early phase of the epidemic. Deliveries occurring in the area between 1 January 2019 and 31 December 2020 from women beneficiaries of the National Health System and resident in Lombardy were identified. Comparisons mainly focused on December 2020, when women who conceived after 8 March (the start of the stringent lockdown imposed by the authorities) were expected to deliver. When comparing the periods January to November in 2019 and 2020, a 5.1% reduction of monthly general birth rate (from 5732 in 2019 to 5438 in 2020) was observed. The contribution of ART births was similar in 2019 and 2020, being 4.4% and 4.5%, respectively. In December 2020, a notable drop in natural (–17.8%), ART-mediated (–86.6%) and overall (–21.0%) births was observed compared with December 2019. After adjusting for the expected 5.1% reduction, the inferred effect of the COVID-19 crisis corresponded to a 16.7% reduction in birth rate, of which 76% was related to natural (707 births) and 24% to ART (218 births) conceptions. This is the first study providing population-based evidence on the effects of COVID-19 and its related stringent restrictions on birth rates. The birth rate was dramatically reduced following the critical period, and the closure of ART centres played only a marginal role (24%) in the overall detrimental effect. [ABSTRACT FROM AUTHOR]
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- 2021
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26. The impact of endometrioma size on ovarian responsiveness.
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Somigliana, Edgardo, Palomino, Maria Cruz, Castiglioni, Marta, Mensi, Laura, Benaglia, Laura, Vercellini, Paolo, and Garcia-Velasco, Juan
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INDUCED ovulation , *OVARIAN cysts , *STATISTICAL power analysis , *OVARIES , *CONFIDENCE intervals - Abstract
Available evidence shows that the presence of ovarian endometriomas does not interfere with the ovarian response to ovarian stimulation. However, the mean size of the endometriomas in these studies is generally small, and two recent investigations suggested that follicular development could be impaired when focusing on larger endometriomas. However, these studies could not identify a clear threshold above which endometriomas could become detrimental. To identify this threshold, the study retrospectively selected women without a history of surgery for ovarian cysts who underwent IVF in the presence of unilateral endometriomas with a mean diameter between 20 and 49 mm. Selected women were divided into three categories of endometrioma size: 20–29 mm (group 1, n = 23), 30–39 mm (group 2, n = 2323), and 40–49 mm (group 3, n = 2321). Recruitment for each category was censored at about 21 women to ensure equal statistical power for each group. The response to ovarian stimulation was equal or superior in the affected gonads in eight women (35%, 95% confidence interval [CI] 16–57%), seven women (30%, 95% CI 13–53%) and two women (10%, 95% CI 2–30%) in groups 1, 2 and 3, respectively. The median (interquartile range) number of developed follicles in the affected and intact ovaries was 6 (3–7) and 5 (4–9) in group 1 (P = 0.21), 4 (1–6) and 4 (3–7) in group 2 (P = 0.08), 5 (3–7), and 7 (4–8) in group 3 (P = 0.01), respectively. The threshold to be used to distinguish between endometriomas that might and might not interfere with ovarian response is 4 cm in diameter. [ABSTRACT FROM AUTHOR]
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- 2020
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27. Is early initiation of infertility treatment justified in women over the age of 35 years?
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Somigliana, Edgardo, Busnelli, Andrea, Vigano, Paola, Vegetti, Walter, Goisis, Alice, and Vercellini, Paolo
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INFERTILITY treatment , *INTRACYTOPLASMIC sperm injection , *INFERTILITY , *OLDER women , *CHILDBIRTH - Abstract
Natural fecundity and the success of IVF and intracytoplasmic sperm injection (ICSI) rate both decrease with age. For this reason, in women older than 35 years, it is generally recommended to start the infertility work-up after only 6 months. This assumption, however, may expose couples to over-diagnosis and over-treatment. A theoretical model aimed at assessing the effects of starting the infertility work-up after 6 rather than 12 months of trying to conceive naturally was developed. The assumptions of the model were as follows: infertile women are treated with IVF/ICSI for up to three cycles; IVF/ICSI success rate at first cycle linearly declines with age (3% per year between the ages of 35 and 45 years); the drop-out rate after the first and second cycle is 18% and 25%, respectively; the relative reduction of the success rate at second and third cycle is 16% and 26%, respectively. Early initiation of treatment moderately improved the cumulative chances of live birth resulting from a full IVF/ICSI programme. This improvement is dependent on age. Specifically, it increased from 2.0% at age 35 years to 3.0% at age 43 years. Conversely, the incremental success rate per single IVF cycle was mainly stable, varying only from 1.4% at age 35 years to 1.3% at age 43 years. In women older than 35 years, early initiation of the infertility work-up is associated with only a modest increase in the rate of success of IVF/ICSI. In most scenarios, this advantage may compare unfavourably with the chances of natural conception during the 6-month period. [ABSTRACT FROM AUTHOR]
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- 2020
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28. Cost-effectiveness of preimplantation genetic testing for aneuploidies.
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Somigliana, Edgardo, Busnelli, Andrea, Paffoni, Alessio, Vigano, Paola, Riccaboni, Alessandra, Rubio, Carmen, and Capalbo, Antonio
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GENETIC testing , *BIRTH rate , *CHILDBIRTH , *COST analysis , *COST of living , *GENETIC disorder diagnosis , *INFERTILITY treatment , *ANEUPLOIDY , *COST control , *COST effectiveness , *CRYOPRESERVATION of organs, tissues, etc. , *EMBRYO transfer , *FERTILIZATION in vitro , *GENETIC disorders , *HUMAN reproductive technology , *INFERTILITY , *MEDICAL care costs , *PREIMPLANTATION genetic diagnosis , *PREDICTIVE tests , *STATISTICAL models - Abstract
Objective: To evaluate the economical benefit of preimplantation genetic testing of aneuploidies (PGT-A) when applied in an extended culture and stringent elective single ET framework.Design: Theoretical cost-effectiveness study.Setting: Not applicable.Patients/animal(s): None.Intervention(s): Comparison of the cost-effectiveness between two IVF treatment strategies: serial transfer of all available blastocysts without genetic testing (first fresh transfer and subsequent frozen-thawed transfer); and systematic use of genetic testing (trophectoderm biopsy, freeze-all, and frozen-thawed transfers of euploid blastocysts). The costs considered for this analysis are based on regional public health system provider.Main Outcome Measure(s): Costs per live birth.Result(s): Cost-effectiveness profile of PGT-A improves with female age and number of available blastocysts. Sensitivity analyses varying the costs of ET, the costs of genetic analyses, the magnitude of the detrimental impact of PGT-A on live birth rate, and the crude live birth rates change to some extent the thresholds for effectiveness but generally confirm the notion that PGT-A can be economically advantageous in some specific subgroups.Conclusion(s): PGT-A can be cost-effective in specific clinical settings and population groups. Economic considerations deserve attention in the debate regarding the clinical utility of PGT-A. [ABSTRACT FROM AUTHOR]- Published
- 2019
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29. Ovarian stimulation and endometriosis progression or recurrence: a systematic review.
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Somigliana, Edgardo, Viganò, Paola, Benaglia, Laura, Busnelli, Andrea, Paffoni, Alessio, and Vercellini, Paolo
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META-analysis , *PAIN , *ENDOMETRIOSIS , *REPRODUCTIVE technology - Abstract
Abstract Available evidence on the impact of ovarian stimulation on the progression of endometriosis or its recurrence was systematically reviewed. Data from ovarian stimulation alone, or associated with intrauterine insemination (IUI) or IVF, were included. Sixteen studies were selected. Initial case reports (n = 11) documented some severe clinical complications. However, subsequent observational studies were more reassuring. Overall, five conclusions can be drawn: (i) IVF does not worsen endometriosis-related pain symptoms (moderate quality evidence); (ii) IVF does not increase the risk of endometriosis recurrence (moderate quality evidence); (iii) the impact of IVF on ovarian endometriomas, if present at all, is mild (low quality evidence); (iv) IUI may increase the risk of endometriosis recurrence (low quality evidence); (v) deep invasive endometriosis might progress with ovarian stimulation (very low quality evidence). In conclusion, available evidence is generally reassuring (at least for IVF) and does not justify aggressive clinical approaches such as prophylactic surgery before assisted reproductive technology treatment to prevent endometriosis progression or recurrence. However, further evidence is required before being able to reach definitive conclusions. In particular, the potential effects on deep invasive endometriosis and the possible synergistic effect of stimulation and pregnancy are two areas that need to be explored further. [ABSTRACT FROM AUTHOR]
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- 2019
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30. Maternal blood mitochondrial DNA content during normal and intrauterine growth restricted (IUGR) pregnancy
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Colleoni, Francesca, Lattuada, Debora, Garretto, Ambra, Massari, Maddalena, MandA[sup.2], Chiara, Somigliana, Edgardo, and Cetin, Irene
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Pregnancy -- Growth ,Mitochondrial DNA ,Pregnant women ,Company growth ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2010.05.027 Byline: Francesca Colleoni (a), Debora Lattuada (b), Ambra Garretto (a)(c), Maddalena Massari (a), Chiara MandA[sup.2] (a), Edgardo Somigliana (b), Irene Cetin (a) Keywords: intrauterine growth restriction; maternal blood; mitochondrial DNA; pregnancy Abstract: We investigated mitochondrial DNA (mtDNA) content in the maternal circulation of normal pregnancies of different gestational ages and in pregnancies complicated by intrauterine growth restriction (IUGR). Author Affiliation: (a) Unit of Obstetrics and Gynecology, Department of Clinical Sciences 'L.Sacco' and Center for Fetal Research Giorgio Pardi, University of Milan, Milan, Italy (b) Department of Mother and Infant Sciences, University of Milan, Foundation Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (c) Division of Obstetrics and Gynecology, San Paolo Hospital, Milan, Italy Article History: Received 11 March 2010; Revised 4 May 2010; Accepted 18 May 2010 Article Note: (footnote) Supported by the Sixth Framework Programme of the European Union (Pregenesys, Contract No. LSHB CT 2006 037244), Ministero della Salute (finalized project 'Role of new inflammatory molecules in pregnancy pathologies and in maternal-neonatal health') and by Associazione Italiana per lo Studio delle Malformazioni., Cite this article as: Colleoni F, Lattuada D, Garretto A, et al. Maternal blood mitochondrial DNA content during normal and intrauterine growth restricted (IUGR) pregnancy. Am J Obstet Gynecol 2010;203:365.e1-6.
- Published
- 2010
31. Postoperative oral contraceptive exposure and risk of endometrioma recurrence
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Vercellini, Paolo, Somigliana, Edgardo, Daguati, Raffaella, Vigano, Paola, Meroni, Francesca, and Crosignani, Pier Giorgio
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Oral contraceptives ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2007.11.010 Byline: Paolo Vercellini (a)(b), Edgardo Somigliana (b)(c), Raffaella Daguati (a)(b), Paola Vigano (a)(b), Francesca Meroni (a), Pier Giorgio Crosignani (a) Keywords: endometrioma; oral contraceptive pill; recurrence Abstract: The purpose of this study was to compare the postoperative risk of endometrioma recurrence in women using oral contraception and in those undergoing simple observation. Author Affiliation: (a) Department of Obstetrics and Gynecology, University of Milan, Milan, Italy (b) Center for Research in Obstetrics and Gynecology, Fondazione Ospedale Maggiore Policlinico, Mangiagalli, Regina Elena, Milan, Italy (c) Infertility Unit, Fondazione Ospedale Maggiore Policlinico, Mangiagalli, Regina Elena, Milan, Italy. Article History: Received 6 November 2006; Revised 12 June 2007; Accepted 6 November 2007 Article Note: (footnote) This study was supported by the University of Milan School of Medicine Research Grant FIRST no. 12-01-5068118-00067., Cite this article as: Vercellini P, Somigliana E, Daguati R, et al. Postoperative oral contraceptive exposure and risk of endometrioma recurrence. Am J Obstet Gynecol 2008;198:504.e1-504.e5.
- Published
- 2008
32. "We Can Work It Out:" The Hundred Years' War between Experts of Surgical and Medical Treatment for Symptomatic Deep Endometriosis.
- Author
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Vercellini, Paolo, Viganò, Paola, Buggio, Laura, and Somigliana, Edgardo
- Published
- 2018
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33. Repeated implantation failure at the crossroad between statistics, clinics and over-diagnosis.
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Somigliana, Edgardo, Vigano, Paola, Busnelli, Andrea, Paffoni, Alessio, Vegetti, Walter, and Vercellini, Paolo
- Subjects
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EMBRYO implantation , *OVERDIAGNOSIS , *DISEASE prevalence , *HUMAN in vitro fertilization , *PREGNANCY complications - Abstract
The most common definition of repeated implantation failure (RIF) is the failure to obtain a clinical pregnancy after three completed IVF cycles. This definition, however, may lead to misuse of the diagnosis. To disentangle this, we set up a mathematical model based on the following main assumptions: rate of success of IVF constant and set at 30%; and RIF postulated to be a dichotomous condition (yes or no) with a prevalence of 10%. On this basis, the expected cumulative chance of pregnancy after three and six cycles was 59% and 79%, respectively. Consequently, the false–positive rate of a diagnosis of RIF is 75% and 51%, respectively. Increasing the rate of success of IVF or the prevalence of RIF lowers but does not make unremarkable the rate of false–positive diagnoses. Overall, this model shows that the commonly used definition of RIF based on three failed attempts in a standard population with good prognosis leads to over-diagnosis and, potentially, to over-treatments. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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34. Surgery versus hormonal therapy for deep endometriosis: is it a choice of the physician?
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Berlanda, Nicola, Somigliana, Edgardo, Frattaruolo, Maria Pina, Buggio, Laura, Dridi, Dhouha, and Vercellini, Paolo
- Subjects
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TREATMENT of endometriosis , *HORMONE therapy , *REPRODUCTIVE technology , *DISEASES in women , *FOLLOW-up studies (Medicine) - Abstract
Deep endometriosis, occurring approximately in 1% of women of reproductive age, represents the most severe form of endometriosis. It causes severe pain in the vast majority of affected women and it can affect the bowel and the urinary tract. Hormonal treatment of deep endometriosis with progestins, such as norethindrone acetate or dienogest, or estroprogestins is effective in relieving pain in more than 90% of women at one year follow up. Progestins and estroprogestins can be safely administered in the long-term, may be not expensive and are usually well tolerated. Therefore, they should represent the first-line treatment of deep endometriosis associated pain in women not seeking natural conception. However, hormonal treatment is ineffective or not tolerated in about 30% of women, the most common side effects being erratic bleeding, weight gain, decreased libido and headache. Surgical excision of deep endometriosis is mandatory in presence of symptomatic bowel stenosis, ureteral stenosis with secondary hydronephrosis, and when hormonal treatments fail. Surgical treatment is similarly effective as compared to hormonal treatment in relieving dismenorhea, dyspareunia and dyschezia at one year follow up in more than 90% of women with deep endometriosis. Surgical removal of the nodules may require resection of the bowel, ureter or bladder, with possible severe complications such as rectovaginal or ureterovaginal fistula and anastomotic leakage. A thorough counsel with the patient is necessary in order to pursue a therapeutic plan centered not on the endometriotic lesions, but on the patient's symptoms, priorities and expectations. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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- View/download PDF
35. Postoperative hormonal therapy after surgical excision of deep endometriosis.
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Somigliana, Edgardo, Busnelli, Andrea, Benaglia, Laura, Viganò, Paola, Leonardi, Marta, Paffoni, Alessio, and Vercellini, Paolo
- Subjects
- *
TREATMENT of endometriosis , *HORMONE therapy , *POSTOPERATIVE care , *SURGICAL excision , *DISEASES in women , *MEDICAL decision making - Abstract
The clinical management of women with deep peritoneal endometriosis remains controversial. The debate focuses mainly on the precise role of hormonal medical treatment and surgery and on the most suitable surgical technique to be used. In particular, considering the risks of second-line surgery, prevention of recurrences after first-line surgery is a priority in this context. Post-surgical medical therapy has been advocated to improve the effectiveness of surgery and prevent recurrences. However, adjuvant therapy, i.e. a short course of 3-6 months of hormonal therapy after surgery, has been proven to be of limited or no benefit for endometriosis in general and for deep peritoneal endometriosis in particular. On the other hand, two cohort studies suggest a beneficial effect of prolonged hormonal therapy after surgery for deep endometriosis. Even if this evidence is too weak to confidently advocate systematic administration of prolonged medical therapy after surgery, we argue in favour of this approach because of the strong association of deep endometriosis with other disease forms. In fact, women operated on for deep endometriosis may also face recurrences of endometriomas, superficial peritoneal lesions and pelvic pain in general. The demonstrated high effectiveness of prolonged postoperative therapy for the prevention of endometriomas' formation and dysmenorrhea recurrence should thus receive utmost consideration in the decision-making process. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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36. Fertility preservation in women with borderline ovarian tumours.
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Mangili, Giorgia, Somigliana, Edgardo, Giorgione, Veronica, Martinelli, Fabio, Filippi, Francesca, Petrella, Maria Cristina, Candiani, Massimo, and Peccatori, Fedro
- Abstract
Borderline ovarian tumours (BOT) may occur in young women and have an excellent survival rate. Therefore, there is the obligation to put emphasis on fertility preservation in affected women. On the other hand, it has also been underlined that the disease should be managed with caution because these tumours can relapse and, albeit rare, malignant transformation can also occur. Unfortunately, evidence on fertility preservation in women with BOT is scanty. In this opinion paper, we tried to draw some clinical indications based on the few available studies on the clinical management of BOT and their possible relation with controlled ovarian hyper-stimulation (COH). We ultimately came to the following conclusions: (1) Fertility counselling should become an integral part of the clinical management of women with BOT. Conservative management without pre-surgical counselling may expose women without reasonable chances of future conceptions to undue risks. (2) Despite some epidemiological concerns on the possible relation between COH and BOT, the conservative surgical treatment should be associated to oocyte cryopreservation considering the high risk of recurrence of the disease. (3) Letrozole during COH should be considered to temper the theoretical risk of increased recurrences. (4) Pregnancy should not be delayed in women at low-moderate risk of recurrences. Fertility preservation may be avoided in these women provided that they start active pregnancy seeking early. (5) Albeit experimental, oocytes retrieval from affected ovaries removed at the time of surgery can be considered. Conversely, ovarian cortex cryopreservation is not justified given the possible risks of malignant reseeding. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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37. Endometriosis as a detrimental condition for granulosa cell steroidogenesis and development: From molecular alterations to clinical impact.
- Author
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Sanchez, Ana Maria, Somigliana, Edgardo, Vercellini, Paolo, Pagliardini, Luca, Candiani, Massimo, and Vigano, Paola
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ENDOMETRIOSIS , *GRANULOSA cells , *CLINICAL trials , *MOLECULAR genetics , *AROMATASE , *GENE expression - Abstract
Endometriosis is an estrogen-dependent chronic inflammatory condition that affects women in their reproductive period. Alterations in ovarian follicle morphology and function have been documented in affected women. The local intrafollicular environment has been as well examined by various groups. In the present review, we aimed to summarize the molecular evidence supporting the idea that endometriosis can negatively influence growth, steroidogenesis and the function of the granulosa cells (GCs). Reduced P450 aromatase expression, increased intracellular ROS generation and altered WNT signaling characterize the GCs of women with endometriosis. Clear evidence for an increased level of GC apoptosis has been provided in association with the downregulation of pro-survival factors. Other potentially negative effects include decreased progesterone production, locally decreased AMH production and lower inflammatory cytokine expression, although these have been only partially clarified. The possibility that endometriosis per se may influence IVF clinical results as a consequence of the detrimental impact on the local intrafollicular environment is also discussed. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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38. Treatment of infertility associated with deep endometriosis: definition of therapeutic balances.
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Somigliana, Edgardo and Garcia-Velasco, Juan Antonio
- Subjects
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INFERTILITY treatment , *ENDOMETRIOSIS , *COMPARATIVE studies , *PNEUMOTHORAX , *MEDICAL decision making , *PREGNANCY complications , *PAIN , *TREATMENT of endometriosis , *BIRTH rate , *FERTILIZATION in vitro , *INFERTILITY , *SEVERITY of illness index , *DISEASE complications - Abstract
Deep endometriosis is a demanding condition that is associated with infertility. However, evidence supporting a direct link between deep endometriosis and infertility is weak. In fact, infertility in affected patients is more likely to be explained by the strong association between deep endometriosis and adhesions, superficial endometriotic implants, ovarian endometriomas, and adenomyosis. The purported beneficial effects of surgery on infertility are mainly based on the 40%-42% pregnancy rate (PR) after surgery observed in published case series. However, this level of evidence is questionable and overestimates the benefits of the intervention. Even if comparative studies are lacking, IVF may be a valid alternative. The procedure may be less effective in affected women compared with other indications and it is not without additional deep endometriosis-related risks. Some case reports suggest that lesions might progress during IVF causing ureteral or intestinal complications or can decidualize during pregnancy causing intestinal perforation, pneumothorax, and pelvic vessels rupture. Finally, in the decision-making process, physicians should also consider that women with a history of deep endometriosis may face an increased risk of pregnancy complications. In conclusion, clear recommendation for the management of infertile women with deep endometriosis cannot be extrapolated from the literature. The therapeutic decision should be based on a comprehensive evaluation that includes clinical history, instrumental findings, pain symptoms, risks of pregnancy complications, and the woman's wishes. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
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39. Postoperative Medical Therapy After Surgical Treatment of Endometriosis: From Adjuvant Therapy to Tertiary Prevention.
- Author
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Somigliana, Edgardo, Vercellini, Paolo, Vigano, Paola, Benaglia, Laura, Busnelli, Andrea, and Fedele, Luigi
- Abstract
Abstract: The high rate of disease recurrence after surgery is critical and frustrating for women with endometriosis. Adjuvant treatments using a 3- to 6-months course of hormone therapy after surgery have been extensively investigated during the last 2 decades; however, results have been unsatisfactory, primarily because the benefits of hormone therapy rapidly vanish once treatment is discontinued. The protective effect is limited to the period of use. Accordingly, it is recognized that suppressive hormone therapy after surgery markedly prevents recurrent episodes only if given over the long term. The emerging view is that estroprogestins do not ameliorate the effects of surgery but demonstrate tertiary prevention of the disease. They prevent ovulation and reduce retrograde menstrual flow, two crucial events in the pathogenesis of endometriosis. The available literature strongly supports the benefits of prolonged administration of estroprogestins after surgery in preventing recurrence of endometriomas and dysmenorrhea. In contrast, data on dyspareunia and nonmenstrual pelvic pain remain scanty and unconvincing, and there is no information about recurrence of other forms of endometriosis such as peritoneal implants and adhesions. Overall, estroprogestin therapy after surgery to treat endometriosis should be recommended in women who do not seek to become pregnant. Further evidence is warranted to better delineate the beneficial effects of this emerging but convincing strategy. [Copyright &y& Elsevier]
- Published
- 2014
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40. IVF outcome in poor responders failing to produce viable embryos in the preceding cycle.
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Somigliana, Edgardo, Paffoni, Alessio, Busnelli, Andrea, Cardellicchio, Lucia, Leonardi, Marta, Filippi, Francesca, Ragni, Guido, and Fedele, Luigi
- Subjects
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EMBRYO transfer , *FERTILIZATION in vitro , *CLOMIPHENE , *WOMEN'S health , *REPRODUCTIVE health , *THERAPEUTICS - Abstract
This study postulated that poor-responder women failing to obtain viable embryos would represent a subgroup of subjects with extremely poor prognosis. To elucidate this aspect, women in this condition over a 4-year period were retrospectively identi¬fied and their IVF outcomes in subsequent cycles were evaluated. A total of 108 women satisfied the selection criteria and under¬went at least one further IVF cycle. There were 19 women excluded because they opted for a mild approach using clomiphene citrate alone, leaving 89 women for data analyses. Four women had a live birth during this first cycle, corresponding to a delivery rate per started cycle of 4.5% (95% C11.5-10.0%). From a public health perspective, the mean cost per delivery was €124,540. Youn¬ger age emerged as the unique predictive factor of success. In conclusion, women with poor ovarian response failing to obtain viable embryos have extremely low chances of success in subsequent cycles. Considering the costs and risks of IVF, the appropriateness of pursuing treatments in these women is questionable. Younger women may represent a possible exception since their chances of delivery are higher. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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- View/download PDF
41. Surgical excision of endometriomas and ovarian reserve: a systematic review on serum antimüllerian hormone level modifications
- Author
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Somigliana, Edgardo, Berlanda, Nicola, Benaglia, Laura, Viganò, Paola, Vercellini, Paolo, and Fedele, Luigi
- Subjects
- *
SURGICAL excision , *ENDOMETRIOSIS , *SYSTEMATIC reviews , *SERUM , *HEALTH outcome assessment , *MEDICAL statistics , *DATA analysis , *HETEROGENEITY - Abstract
Objective: To evaluate serum antimüllerian hormone (AMH) level modification after surgical excision of ovarian endometriomas. Design: Systematic review. MEDLINE search from January 1990 to April 2012 using the combination of medical terms endometriosis, endometrioma, endometriotic cyst, and AMH or antimüllerian hormone, MIF or müllerian inhibiting factor. Reference lists of selected studies were checked for additional potential contributions. Setting: Not applicable. Patient(s): Women with ovarian endometriomas requiring surgery. Intervention(s): Serum AMH level assessment. Main Outcome Measure(s): Serum AMH level modifications. Result(s): Eleven articles satisfied our selection criteria. Data pooling were deemed inopportune owing to the heterogeneity of the study designs and of the reported parameters. Nine of 11 studies documented a statistically significant reduction of serum AMH level after surgery. The two studies failing to document this decrease were published by the same study group and partly overlapped. The magnitude of the decline was more evident in women operated on for bilateral endometriomas. Conclusion(s): Evidence deriving from the evaluation of serum AMH level modifications after surgical excision of endometriomas supports a surgery-related damage to ovarian reserve. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
42. Adhesion prevention in endometriosis: a neglected critical challenge.
- Author
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Somigliana E, Vigano P, Benaglia L, Busnelli A, Vercellini P, Fedele L, Somigliana, Edgardo, Vigano, Paola, Benaglia, Laura, Busnelli, Andrea, Vercellini, Paolo, and Fedele, Luigi
- Abstract
Prevention of adhesions, whether de novo or by re-formation, is one of the most important and surprisingly neglected aspect of the treatment of endometriosis. Adhesions may cause infertility, dyspareunia, chronic pelvic pain but also intestinal obstruction and complications at subsequent surgery. They may play a role in the development of some forms of the disease such as ovarian endometriomas and possibly also deep invasive nodules. Three randomized controlled trials have been published documenting some partial success with Interceed, Oxiplex/AP gel or Adept solution in reducing adhesions extent at second look laparoscopy performed a few weeks after initial surgery. However, data on relevant long-term outcomes such as fertility, pelvic pain or disease recurrences or other adhesions-related complications is lacking. Noteworthy, endometriosis is a chronic inflammatory disorder and the insult causing adhesions is expected to persist after surgery. Therefore preventing adhesion formation with exclusively agents at the time of surgery may be insufficient. Future studies should focus on a 2-step strategy that includes measures applied at the time of surgery and subsequent administration of agents able to prevent the development of new adhesions. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
43. High Rate of Endometriosis Recurrence in Young Women
- Author
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Tandoi, Iacopo, Somigliana, Edgardo, Riparini, Jennifer, Ronzoni, Stefania, Vigano’, Paola, and Candiani, Massimo
- Subjects
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ENDOMETRIOSIS , *DISEASE relapse , *RETROSPECTIVE studies , *GYNECOLOGY , *SYMPTOMS , *LAPAROSCOPY , *FOLLOW-up studies (Medicine) - Abstract
Abstract: Objective: To evaluate rate and determinants of long-term recurrence of endometriosis in a population of young women. Design: Retrospective cohort study. Setting: University tertiary care referral center for women with benign gynecologic diseases. Participants: Young women undergoing first-line conservative surgery for endometriosis were eligible for the study. Data on age at surgery, disease stage, anatomical characteristics of endometriotic lesions, and endometriosis-related symptoms were collected. After diagnosis, patients were treated according to the standard care of the center. The protocol required all women to be followed up 1 month after surgery, and every 6 months afterward, with an interview to investigate persistence of symptoms, a clinical examination, and an ultrasound pelvic assessment. Results: Fifty-seven women aged ≤ 21 (mean age at diagnosis ± SD: 19.0 ± 1.1 years) entered the study. During a 5-year follow-up, 32 (56%, 95% confidence interval [CI]: 43%-68%) recurrences of endometriosis were diagnosed. A second laparoscopy to treat the recurrence was performed in 11 (34%) cases and confirmed the presence of the disease in all of them. In the remaining 21 (66%) cases, the recurrence was based on the reappearance of the symptoms or clinical or sonographic findings. The recurrence rate increased constantly with time from first surgery. No association emerged between recurrence rate and endometriosis-related symptoms, site/stage of the disease, type of surgery, and post-surgical medical treatment. Conclusions: The recurrence rate of endometriosis in young women appears higher than in older women. Since no determinants for recurrence have been detected among the factors examined, a profile of women at increased risk cannot be drawn. [Copyright &y& Elsevier]
- Published
- 2011
- Full Text
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44. Tonsillectomy in Children with Periodic Fever with Aphthous Stomatitis, Pharyngitis, and Adenitis Syndrome.
- Author
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Garavello, Werner, Pignataro, Lorenzo, Gaini, Lorenzo, Torretta, Sara, Somigliana, Edgardo, and Gaini, Renato
- Abstract
Objective: To seek evidence supporting a role for tonsillectomy or adenotonsillectomy in the management of affected children with periodic fever with aphthous stomatitis, pharnygitis, and adenitis (PFAPA) syndrome. Study design: A comprehensive literature search was conducted to identify all published English-language observational and randomized studies evaluating the efficacy of tonsillectomy or adenotonsillectomy on PFAPA syndrome. A combination of keywords was used to identify relevant articles. Results: A total of 15 studies including 149 treated children were found, including 13 observational noncomparative studies and 2 randomized controlled trials. The pooled rate of complete resolution emerging from the combined analysis of all treated children was 83% (95% CI, 77%-89%). A meta-analysis of the two randomized controlled trials showed homogeneity of the results (P = .37, Breslow-Day test) and a common odds ratio for complete resolution of 13 (95% CI, 4-43; P < .001). Conclusions: Surgery appears to be a possible option for management of PFAPA syndrome. Available evidence is limited, however, and the precise role of surgery remains to be clarified. We suggest considering this option when symptoms markedly interfere with the child’s quality of life and medical treatment has failed. [Copyright &y& Elsevier]
- Published
- 2011
- Full Text
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45. The impact of IVF procedures on endometriosis recurrence
- Author
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Benaglia, Laura, Somigliana, Edgardo, Vercellini, Paolo, Benedetti, Francesca, Iemmello, Roberta, Vighi, Valentina, Santi, Giulia, and Ragni, Guido
- Subjects
- *
FERTILIZATION in vitro , *ENDOMETRIOSIS , *DISEASE relapse , *SCIENTIFIC observation , *HEALTH outcome assessment , *OVARIAN hyperstimulation syndrome , *LONGITUDINAL method , *INDUCED ovulation , *TREATMENT effectiveness , *RETROSPECTIVE studies - Abstract
Objective: In infertile women with endometriosis requiring an in vitro fertilization (IVF) procedure, the potential risk of an IVF-related progression of the disease remains a matter of debate. Thus, since available data on this issue are scanty and controversial, an observational study has been herein conducted in order to clarify this issue.Study Design: We recruited 233 women with endometriosis who underwent IVF cycles in our unit. Patients were contacted to assess whether they experienced recurrences of the disease after IVF. The main outcome was to evaluate the impact of the number of IVF cycles and the responsiveness to ovarian hyperstimulation on the likelihood of recurrence. Clinical characteristics of women who did and did not have a recurrence were compared.Results: One hundred and eighty-nine women were included, 41 of whom (22%) had a diagnosis of endometriosis recurrence. The 36 months cumulative recurrence rate was 20%. The number of IVF cycles and the responsiveness to ovarian hyperstimulation were not associated with the risk of disease recurrence. The adjusted OR for recurrences according to the number of started cycles was 0.92 (95% CI: 0.77-1.10) per cycle (p=0.35). The adjusted OR for recurrences in women with intact versus compromised ovarian reserve was 0.80 (95% CI: 0.40-1.58) (p=0.52).Conclusions: IVF procedures do not seem to influence the likelihood of endometriosis recurrence. [ABSTRACT FROM AUTHOR]- Published
- 2010
- Full Text
- View/download PDF
46. The use and effectiveness of in vitro fertilization in women with endometriosis: the surgeon's perspective
- Author
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Somigliana, Edgardo, Daguati, Raffaella, Vercellini, Paolo, Barbara, Giussy, Benaglia, Laura, and Crosignani, Pier Giorgio
- Subjects
- *
FERTILIZATION in vitro , *ENDOMETRIOSIS , *ENDOMETRIAL surgery , *TREATMENT of diseases in women , *SURGEONS , *PREGNANCY , *FEMALE infertility , *ENDOMETRIAL diseases , *HEALTH outcome assessment , *THERAPEUTICS - Abstract
Objective: To assess the use and effectiveness of IVF in a cohort of women undergoing surgery for endometriosis. Design: Cohort study. Setting: University hospital. Patient(s): Four hundred thirty-eight patients who attempted to become pregnant after conservative surgery for endometriosis. Intervention(s): Interview. Main Outcome Measure(s): Pregnancy and IVF use. Result(s): One hundred ninety-four women conceived in vivo (44%). One hundred twenty-four women did not undergo IVF despite their infertility status (51% of the group of women who failed to conceive in vivo). One hundred thirty-nine women underwent at least one IVF attempt. The cumulative rate of IVF use at 36 months of infertility was 33%. The live-birth/ongoing pregnancy rate per started cycle and per patient was 10% and 20%, respectively. Conclusion(s): In a large tertiary care and referral center, IVF played only a minor role in the treatment of endometriosis-associated infertility. [Copyright &y& Elsevier]
- Published
- 2009
- Full Text
- View/download PDF
47. Endometrioma and oocyte retrieval–induced pelvic abscess: a clinical concern or an exceptional complication?
- Author
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Benaglia, Laura, Somigliana, Edgardo, Iemmello, Roberta, Colpi, Elisabetta, Nicolosi, Anna Elisa, and Ragni, Guido
- Subjects
- *
ENDOMETRIUM , *OVUM , *ABSCESSES , *FERTILIZATION in vitro - Abstract
The authors evaluated the risk of developing a pelvic abscess in a series of 214 in vitro fertilization cycles that were performed in women with endometriomas. This complication was never recorded, indicating that its risk is very low (0.0; 95% confidence interval, 0.0–1.7%). [Copyright &y& Elsevier]
- Published
- 2008
- Full Text
- View/download PDF
48. Bias versus causality: interpreting recent evidence of association between endometriosis and ovarian cancer
- Author
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Viganò, Paola, Somigliana, Edgardo, Parazzini, Fabio, and Vercellini, Paolo
- Subjects
- *
ENDOMETRIOSIS , *INTERNET in medicine , *MUCOUS membranes , *CANCER patients - Abstract
Objective: To establish whether causality versus biases may explain the association of endometriosis and ovarian cancer. Design: We employ the nine criteria proposed by Austin Bradford Hill, which still stand as foundation milestones for causal inference. Setting: University-based clinic. Patient(s): None. Intervention(s): Search strategies included online searching of the MEDLINE database and hand searching of relevant publications and reviews. Additional reports were collected by systematically reviewing all references from retrieved papers. Main Outcome Measure(s): Examination of the causal relationship between endometriosis and ovarian cancer. Result(s): Based on the present analysis, the criterion of strength has not been fulfilled. There were insufficient or mixed data for four criteria (biological gradient, biological plausibility, analogy, coherence), and four criteria were fulfilled (consistency, temporality, specificity, experimental evidence in animal model). Conclusion(s): A causal relationship between endometriosis and specific histotypes of ovarian cancer should be recognized, but the low magnitude of the risk observed is consistent with the view that ectopic endometrium undergoes malignant transformation with a frequency similar to its eutopic counterpart. [Copyright &y& Elsevier]
- Published
- 2007
- Full Text
- View/download PDF
49. Bladder endometriosis: getting closer and closer to the unifying metastatic hypothesis
- Author
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Somigliana, Edgardo, Vercellini, Paolo, Gattei, Umberto, Chopin, Nicolas, Chiodo, Ilda, and Chapron, Charles
- Subjects
- *
ENDOMETRIOSIS , *FEMALE reproductive organ diseases , *BLADDER , *METASTASIS - Abstract
Objective: It has been hypothesized that bladder endometriotic nodules are an independent form of endometriosis that should be considered a distinct clinical entity. If this is true, the frequency of nonvesical endometriotic lesions in affected patients should be similar to the prevalence of the disease in the general population (about 10%). The aim of the study was to evaluate the presence of other forms of endometriosis in patients with bladder endometriotic nodules. Design: Case series. Setting: Two gynecologic surgical units. Patient(s): Fifty-eight women with large bladder endometriotic nodules. Intervention(s): To evaluate the concomitant presence of other forms of endometriosis. Main Outcome Measure(s): Presence of superficial peritoneal implants, ovarian endometriomas, adhesions, and extravesical deep peritoneal endometriosis. Result(s): The presence of superficial peritoneal implants, ovarian endometriomas, adhesions, and extravesical deep peritoneal endometriosis was observed in 58.6% (95% confidence interval [CI]: 45.2–71.2), 44.8% (95% CI: 32.2–58.2), 81.0% (95% CI: 68.4–89.6), and 27.6% (95% CI: 16.7–40.8) of cases, respectively. The presence of at least one of them was documented in 87.9% of cases (95% CI: 76.7–94.3). Conclusion(s): Endometriotic nodules of the bladder are frequently associated with other forms of pelvic endometriosis. This result does not support the vision that bladder endometriotic nodules should be considered an independent form of the disease. [Copyright &y& Elsevier]
- Published
- 2007
- Full Text
- View/download PDF
50. Fertility preservation in women with endometriosis: speculations are finally over, the time for real data is initiated.
- Author
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Somigliana, Edgardo and Vercellini, Paolo
- Subjects
- *
FERTILITY preservation , *INFERTILITY , *OVUM donation , *FERTILIZATION in vitro , *SPECULATION , *CRYOPRESERVATION of organs, tissues, etc. , *ENDOMETRIOSIS , *OVUM - Published
- 2020
- Full Text
- View/download PDF
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