Minerva obstetrics and gynecology最新文献

{"title":"Highlights of the July-August 2025 issue.","authors":"Antonio La Marca","doi":"10.23736/S2724-606X.25.05816-6","DOIUrl":"https://doi.org/10.23736/S2724-606X.25.05816-6","url":null,"abstract":"","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":"77 4","pages":"261-263"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ovarian reserve, metabolic and neuroendocrine profiles of cadets from Air Force Academy: a pilot study.","authors":"Alessandro Conforti, Giulia A Guadalupi, Giuseppe Perruolo, Renata S Auriemma, Raffaella Di Girolamo, Luigi Carbone, Federica Cariati, Maria G Orsi, Antonio Raffone, Ida Strina, Pietro Formisano, Maurizio Guida, Gianfrancesco Capuano, Francesca Di Rella, Salvatore Longobardi, Carlo Alviggi, Antonio Mollo","doi":"10.23736/S2724-606X.24.05542-8","DOIUrl":"10.23736/S2724-606X.24.05542-8","url":null,"abstract":"<p><strong>Background: </strong>Intensive physical activity and rigid dietary regimes can act as modifiers of neuroendocrine axes in women, inducing hormonal disorders and related menstrual irregularities such as functional hypothalamic amenorrhea (FHA). It would be important to evaluate if such disturbances may worsen female fertility. The aim of this study was to evaluate ovarian reserve markers and neuroendocrine axis in young military academy female cadets with years of training and occurrence of FHA.</p><p><strong>Methods: </strong>This is a prospective pilot study involving young female cadets from the Military Academy training program. Ovarian reserve markers and metabolic and neuroendocrine factors in the early follicular phase were measured with blood tests and transvaginal ultrasound.</p><p><strong>Results: </strong>The study group consisted of 11 women belonging to the first year of training and the control group of 33 women belonging to the second to sixth year of training. No differences were found about ovarian reserve markers between the two groups. Moreover, the occurrence of FHA did not modify the ovarian reserve compared to eumenorrhea in both groups. Women from the study group showed significantly higher levels of fasting Insulin (42.18±26.14 uUI/mL versus 11.9±10.2 ng/mL, P value <0.001) and insulin-like growth factor 1 (310.06±67.90 uUI/mL versus 248.67±61.57 uUI/mL, P value = 0.015) compared with control group.</p><p><strong>Conclusions: </strong>Both intense physical training and FHA do not appear to impact the ovarian reserve of young female cadets. Although preliminary, these findings seem reassuring about the reproductive health of these women and their future fertility.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"270-278"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of platelet-rich plasma infusion in infertile women undergoing assisted reproduction: a systematic umbrella review of the best clinical evidence.","authors":"Flavia Costanzi, Ermanno Greco, Sara Fusco, Gianluca Dani, Giuseppe Grimaldi, Silvia Cacioppo, Ilaria Listorti, Pier F Greco","doi":"10.23736/S2724-606X.25.05656-8","DOIUrl":"10.23736/S2724-606X.25.05656-8","url":null,"abstract":"<p><strong>Introduction: </strong>To date, the application of platelet-rich plasma (PRP) to women in assisted reproductive technologies is a potential therapeutic method that has been developed. This umbrella review is designed to summarize the best evidence regarding the treatment potential of PRP in infertile patients.</p><p><strong>Evidence acquisition: </strong>A systematic literature search was conducted on the main database (PubMed, the Cochrane Library and Web of Science) for systematic reviews and meta-analyses describing the effect of PRP on fertility outcomes. The retrieved data was extracted, and the quality of the included studies was assessed using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) tool.</p><p><strong>Evidence synthesis: </strong>Seven systematic reviews were finally included. The quality of evidence was high in one review, moderate to low in five, and low in one. In terms of ovarian PRP, antral follicular count (AFC) and the number of retrieved oocytes were shown to have significant differences. Nonetheless, the livebirth rates did not demonstrate a clinically relevant improvement. Concerning endometrial PRP, an improvement in the clinical pregnancy rate both in cases of repeated implantation failure and thin endometrium was suggested; nonetheless, no effect on live birth rates and miscarriage rates was detected. Results of laboratory tests showed transient rises of AMH and fall in FSH with ovarian PRP, but this effect was not consistent over time.</p><p><strong>Conclusions: </strong>This umbrella review showed that PRP infusion was a potential technique for improving particular reproductive outcomes according to the available literature, particularly on premature ovarian insufficiency, poor ovarian response and recurrent implantation failure patients. However, the overall quality of the studies is low, and future studies should concentrate on more robust methodologies and higher standards of evidence and on the standardization of PRP protocols and the evaluation of both short- and long-term results to establish more clear recommendations for its use in assisted reproductive technologies.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"309-315"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cesarean section on maternal request: time to respect the choice of the woman.","authors":"Ilaria Marcacci, Emanuela Turillazzi, Marco DI Paolo","doi":"10.23736/S2724-606X.24.05495-2","DOIUrl":"10.23736/S2724-606X.24.05495-2","url":null,"abstract":"<p><p>Today, the rate of cesarean sections is increasing worldwide. An underlying important phenomenon is cesarean section on maternal request (CSMR). CSMR is an elective cesarean section without medical and/or obstetric indications. The CSMR rate is often unknown but increasing. Women claim their right to choose how to give birth. Forcing a woman to undergo a vaginal delivery can affect not only her physical well-being but also her psychological well-being, and therefore her health. Over the last 20 years, various countries have developed national and international guidelines for the recognition of the woman's right to choose childbirth, although clear guidelines in this direction have not been established. In Italy, the rate of CSMR is about 9% of all cesarean sections, but it is underestimate. In Italy, CSMR is currently contrary to good care practice, so the doctor has no professional obligations and is entitled to refuse the request for a cesarean section. However, the legislation does not explicitly state that the doctor must refuse such a request. As a result, choice is not available to all the women. In a perspective where women claim their right to health, not only physical but also psychological, the need to develop informed consent for childbirth in general and a guideline on CSMR are unavoidable. This is important both to ensure equal opportunities for all women and to clarify the medical responsibilities and the legal consequences of this choice.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"325-334"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-assisted hysterectomy for endometrial cancer.","authors":"Ahmad Awada, Nia Byrd, Sarfraz Ahmad","doi":"10.23736/S2724-606X.25.05680-5","DOIUrl":"10.23736/S2724-606X.25.05680-5","url":null,"abstract":"<p><p>Robotic-assisted surgery (RAS) has revolutionized the treatment of endometrial cancer (EC), providing a less invasive alternative to traditional open methods. In early-stage EC, RAS has shown similar oncological results compared to conventional techniques while offering notable improvements in perioperative outcomes, such as shorter hospital stays, less post-operative pain, and faster recovery times. Additionally, the robotic platform has seen widespread adoption in gynecologic oncology due to its ability to address the limitations of conventional laparoscopy, especially reduced conversion rate from minimally invasive surgery (MIS) to open/laparotomy. This approach is particularly beneficial for high-risk groups, including obese and elderly patients, where it has proven to be both safe and effective, presenting a favorable risk-benefit profile. Furthermore, robotic-assisted sentinel lymph node (SLN) mapping, utilizing the FireFly^® fluorescence imaging system with indocyanine green (ICG) dye, offers exceptional accuracy in detecting SLNs, enhancing the precision of nodal mapping, thereby decreasing the need for more invasive lymphadenectomy and reducing associated morbidity. It is essential to recognize physiological challenges that can arise during RAS, particularly when steep Trendelenburg position combined with pneumoperitoneum (increased intra-abdominal pressure due to CO<inf>2</inf> insufflation), can significantly affect both cardiovascular and respiratory systems. Although the upfront costs of robotic surgery are relatively higher, the long-term benefits, such as fewer complications and faster recoveries, make it a cost-effective solution. This review examines current evidence supporting the use of RAS as a standard option for managing patients with EC and its positive impact on their outcomes across diverse risk categories.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"316-324"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Granulosa-cumulus cells global transcriptome sequencing as a predictor of embryo development: a preliminary study.","authors":"Raoul Orvieto, Louisa Cohen, Chen Shimon, Adva Aizer, Efrat Glick Saar, Dan Dominissini, Omri Nayshool","doi":"10.23736/S2724-606X.25.05765-3","DOIUrl":"https://doi.org/10.23736/S2724-606X.25.05765-3","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study is to determine the human oocyte CCs global transcriptome sequencing and its correlation of embryo development to the blastocyst-stage.</p><p><strong>Methods: </strong>Expanded cumulus granulosa cells (CGC) that surround metaphase 2 were collected and cryopreserved until analysis. Their corresponding oocytes trajectories were followed up to the blastocyst stage. From each patient, CGCs of oocyte that developed to the blastocyst stage and one that was arrested (sibling oocytes) were analyzed. Global transcriptome sequencing (NEBNext^® Single Cell/Low Input RNA Library Prep Kit for Illumina) was compared between CGCs of oocytes that developed to the blastocyst stage and those that were arrested.</p><p><strong>Results: </strong>Seven patients aged 31.4+2.5 years donated CGCs. The Differential Gene Expression Analysis identified five genes that were differentially expressed between blastocyst and arrested CGCs. The most significantly differentially expressed gene was AL031598.1 (padj = 8.40e-03, log2FC = 5.76), followed by AC126773.5 (padj = 1.83e-02, log2FC = 6.63), CBLN2 (padj = 2.62e-02, log2FC = -6.24), AL022721.1 (padj = 3.28e-02, log2FC = 5.73), and AC093334.1 (padj = 8.53e-02, log2FC = 6.07). Among these genes, CBLN2 was the only one showing significant downregulation in the blastocyst group, while the other four genes demonstrated substantial upregulation.</p><p><strong>Conclusions: </strong>This study provides valuable insights into the transcriptional landscape of CGC from oocytes that develop to different stages, revealing key genes and long non-coding RNAs that may serve as markers for oocyte quality and its potential to develop to the blastocyst stage. Future research with larger cohorts and independent validation methods is necessary to confirm these findings and their potential application in fertility treatments.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cohort study of adverse pregnancy outcomes based on ROTEM profiles in early pregnancy.","authors":"Patrick Maher, Dan Katz, Omara Afzal, Sylviah Nyamu, Lynne Richardson","doi":"10.23736/S2724-606X.25.05675-1","DOIUrl":"https://doi.org/10.23736/S2724-606X.25.05675-1","url":null,"abstract":"<p><strong>Background: </strong>Hypercoagulability exceeding normal physiological changes in pregnancy may lead to adverse outcomes in select populations, but most prior studies have tested women outside of pregnancy. Rotational thromboelastometry (ROTEM), which performs a comprehensive clotting evaluation, may demonstrate abnormalities during early pregnancy that contribute to adverse outcomes. This study evaluated the relationship between ROTEM coagulation profiles during pregnancy with the outcome of miscarriage.</p><p><strong>Methods: </strong>This was a prospective cohort study from a single center. Patients in early pregnancy (less than 20 weeks) were recruited from the obstetric clinic and the Emergency Department for ROTEM testing using extrinsic thromboelastometry (EXTEM), intrinsic thromboelastometry (INTEM), and natural thromboelastometry (NATEM) tracings. The cohort was followed to determine pregnancy outcomes for association with ROTEM clot formation kinetics. Results were analyzed using univariate analysis and multiple linear regression, controlling for patient age and estimated gestational age (EGA) in weeks.</p><p><strong>Results: </strong>Over the study, 98 patients were recruited with 14 lost to follow-up and 7 having elective abortion. Miscarriage occurred in 26 patients, with live delivery without complications occurring in 51 patients. Both groups had similar mean patient age and racial and ethnic breakdown. ROTEM results were similar between groups on univariate analysis. After controlling the patient age and estimated gestational age, only EXTEM clotting time (CT) results differed between groups.</p><p><strong>Conclusions: </strong>In patients tested during early pregnancy, ROTEM profiles were not associated with adverse pregnancy outcomes in this cohort except for EXTEM CT. This suggests that ROTEM clotting profiles may not be useful in identifying patients at higher risk for adverse pregnancy outcomes.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polycystic ovary syndrome as a risk factor for cancer.","authors":"Alessandro Gambera, Giulia Rodondi, Giulia Oliveri, Federico Ferrari, Michele Vignali, Anna Fichera, Franco Odicino","doi":"10.23736/S2724-606X.25.05719-7","DOIUrl":"https://doi.org/10.23736/S2724-606X.25.05719-7","url":null,"abstract":"<p><strong>Introduction: </strong>Polycystic ovary syndrome (PCOS) is a common endocrinological disorder and is frequently associated with other medical conditions such as hyperinsulinemia and obesity. The aim of this review is to identify the role of PCOS as a potential risk factor for endometrial, breast and ovarian cancer.</p><p><strong>Evidence acquisition: </strong>A literature search was conducted including most relevant peer-reviewed articles regarding the possible association between PCOS and gynecological cancer published from 1996 to the present.</p><p><strong>Evidence synthesis: </strong>A narrative synthesis was performed. PCOS is linked to an increased risk of endometrial cancer. However, the risk varies based on factors like BMI, parity, and phenotype. The association between PCOS and ovarian cancer is uncertain. Some studies suggest a two-fold increased risk, particularly in women with infertility or treated for infertility, but more recent reviews find no clear association. The role of androgen and estrogen imbalances in different ovarian cancer types remains debated. Even the link between PCOS and breast cancer is unclear. While high androgen levels are theorized to play a role, local hormone conversion and factors like weight, environment, and genetics are likely more important.</p><p><strong>Conclusions: </strong>The association between PCOS and gynecological cancers is complex. Further reviews and new studies that control individual confounding factors are needed to accurately establish the real oncological risk of PCOS.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uterus transplantation: from mice to human clinical procedure.","authors":"Panagiotis Tsiartas, Randa Akouri, Milan Milenkovic, Elias Tsakos, Mats Brännström","doi":"10.23736/S2724-606X.25.05721-5","DOIUrl":"https://doi.org/10.23736/S2724-606X.25.05721-5","url":null,"abstract":"<p><p>Uterus transplantation (UTx) emerged as a groundbreaking solution for women facing absolute uterine factor infertility (AUFI), offering hope for childbearing since the first proof-of-concept of UTx in 2014 by the first live birth from a woman with uterine graft. This review provides a comprehensive overview of the evolution of UTx from foundational animal research to current clinical trials and cases. Recent advancements in surgical techniques, including a shift towards robotic approaches, have improved graft removal and transplantation, though challenges persist in optimizing immunosuppressive strategies and rejection monitoring. Given the absence of Fallopian tube transplantation in UTx, in vitro fertilization (IVF) is an integral part of the process. This review delves into the intricacies of combining UTx with IVF, addressing crucial questions about the timing of oocyte retrieval, cryopreservation of oocytes or embryos, and the optimal timing for the first embryo transfer post-UTx. The significance of the International Society Uterus Transplantation (ISUTx) registry is highlighted for evaluating overall success rates, complications, and live births. Examining the long-term health outcomes for donors, recipients, partners, and children born from transplanted grafts, the review acknowledges the life-giving nature of UTx. Cost considerations are explored, anticipating a potential decrease in costs with enhanced efficiency. The discussion emphasizes the evolving landscape of UTx, proposing a scheme for program setup and outlining future directions. This comprehensive analysis marks a significant milestone in the field, transitioning UTx from experimental to mainstream clinical practice. As criteria widen and outcomes improve, UTx is poised to become a realistic and accessible alternative for treating AUFI, representing a significant advancement in reproductive medicine worldwide.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assisted reproduction technique with gamete donation: a focus on the emotional experience faced by patients.","authors":"Roberta Spoletini, Roberto DE Luca, Giulia Scaravelli, Michela DI Trani, Alessia Renzi, Fabiola Fedele","doi":"10.23736/S2724-606X.25.05688-X","DOIUrl":"https://doi.org/10.23736/S2724-606X.25.05688-X","url":null,"abstract":"<p><strong>Background: </strong>In Italy from 2015 to 2022, couples undergoing ART treatment with gamete donation are steadily increasing. This choice may have a negative impact on their personal and relational well-being. The aim of this study was to explore the emotional experience of couples undergoing gamete donation assisted reproduction treatment (ART).</p><p><strong>Methods: </strong>An online ad-hoc survey with 25 questions (1 open-ended) was emailed to the physicians in charge of Italian ART centers. Physicians and psychologists invited patients undergoing ART with gamete donation to complete it. The survey ran from May to December 2023.</p><p><strong>Results: </strong>A total of 256 questionnaires were completed. Among respondents, 87.5% underwent an egg donation cycle, while the remainder used sperm donation or double donation. About 90% reported being informed about psychological support services at the ART center, yet only half attended at least one session. Women more often reported emotions such as \"sadness,\" \"fear,\" and \"anger,\" while men expressed more \"joy.\" \"Sadness\" was more pronounced in individuals trying to conceive for less than 3 years. The emotional complexity of patients emerges from the writings.</p><p><strong>Conclusions: </strong>Some patients' characteristics appear to influence their emotional state. Being female, not receiving psychological counseling at the ART center, and spending less time attempting to conceive are conditions associated with greater negative emotions toward oneself or one's partner. A thematic qualitative analysis of patient narratives reveals several topics that reflect the emotional complexity of these patients. The emerging results may inspire the design of future psychological interventions focusing on the emotional needs of ART patients undergoing ART treatment with gamete donation.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}