Minerva obstetrics and gynecology最新文献

{"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}

{"title":"Immunological interventions in recurrent implantation failure: a systematic review and SWOT analysis.","authors":"Giosuè G Incognito, Erika Pittana, Danilo Cimadomo, Alessandro Ruffa, Oriana Osetti, Marilena Taggi, Ilenia Mappa, Giuseppe Gullo, Marco Palumbo, Giuseppe Rizzo, Laura Rienzi, Filippo Maria Ubaldi, Alberto Vaiarelli","doi":"10.23736/S2724-606X.25.05657-X","DOIUrl":"https://doi.org/10.23736/S2724-606X.25.05657-X","url":null,"abstract":"<p><strong>Introduction: </strong>Recurrent implantation failure (RIF) occurs when pregnancy is not achieved after multiple embryo transfers. The lack of standardized diagnostic criteria among clinicians makes RIF a particularly challenging condition, leading to the use of various procedures, including immunological ones, often without robust evidence. This study aims to provide an overview of the main characteristics of existing research on the role of interventions in relation to in vitro fertilization (IVF) outcomes in patients with RIF.</p><p><strong>Evidence acquisition: </strong>A comprehensive bibliographic search was systematically conducted from inception to November 2024, focusing on studies that evaluated the impact of immunological treatments in RIF cases, comparing IVF outcomes between case and control groups.</p><p><strong>Evidence synthesis: </strong>A total of 77 studies were included. The diagnostic criteria for RIF were heterogeneous, with only 36 studies (47%) defining RIF as three or more failed embryo transfers. Moreover, the studies generally had small sample sizes.</p><p><strong>Conclusions: </strong>There is not yet sufficient evidence to support the routine use of immunological interventions in clinical practice for RIF. The existing research is marked by methodological inconsistencies, which limit the reliability and generalizability of the results.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540899","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":"Association between maternal serum analytes and third trimester fetal growth restriction.","authors":"Anna Ung, Chieko Kimata, Andrea M Siu, Kelly Yamasato","doi":"10.23736/S2724-606X.25.05664-7","DOIUrl":"https://doi.org/10.23736/S2724-606X.25.05664-7","url":null,"abstract":"<p><strong>Background: </strong>Given associations between abnormal maternal serum analytes and small for gestational age, 3^rd trimester fetal growth ultrasounds are commonly obtained despite lack of evidence. We evaluated associations between isolated abnormal analytes, 3^rd trimester fetal growth restriction, and neonatal complications.</p><p><strong>Methods: </strong>This retrospective, single institution cohort study included women with analytes from 2010-2019. Multiple gestation, delivery <28 weeks gestation, and those with another indication for a 3^rd trimester US were excluded. Fetal growth restriction prevalence at the first 3^rd trimester US with abnormal analytes was calculated, as well as its association with small for gestational age. Associations between abnormal analytes and neonatal outcomes (small for gestational age, intensive care, umbilical artery pH <7.0, 5-minute APGAR <7, preterm delivery, neonatal death) were also evaluated.</p><p><strong>Results: </strong>Among 11,092 pregnancies, 1136 had isolated abnormal analytes, of which 613 had 3^rd trimester ultrasounds. Of these, 10 (1.6%) had growth restriction at the first 3^rd trimester ultrasound, and 99 (16.1%) were small for gestation. Abnormal analytes were associated with increased small for gestational age, intensive care admit, and preterm delivery. Only 9.1% of small for gestational age neonates had growth restriction at the first 3^rd trimester ultrasound.</p><p><strong>Conclusions: </strong>Third trimester fetal growth restriction is uncommon with isolated abnormal analytes, and early 3^rd trimester ultrasound for this indication may commonly miss small for gestational age. These findings contribute to 1) evidence-based fetal surveillance in this setting, and 2) knowledge regarding potential implications on growth restriction detection by replacing serum analyte screening with cell free fetal DNA.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528733","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":"Technical aspects of embryo transfer: a literature review.","authors":"Arianna D'Angelo, Alessia Mahoney, Valerio Pisaturo, Alessandra Alteri","doi":"10.23736/S2724-606X.25.05621-0","DOIUrl":"https://doi.org/10.23736/S2724-606X.25.05621-0","url":null,"abstract":"<p><strong>Introduction: </strong>Assisted reproductive technologies (ART) aim to address the underlying causes of infertility, resulting in a healthy live birth. One aspect that appears receiving less attention yet is equally crucial as any other steps in the ART process, is embryo transfer (ET). Even with optimal embryos, a successful live birth cannot be achieved without a precise and atraumatic transfer to the correct location within the uterine cavity. Compared to other advancements in laboratory and clinic, relatively few innovations have occurred in ET.</p><p><strong>Evidence acquisition: </strong>This literature review aimed to summarize the latest evidence in four main sections: requirements and preparations for ET, the ET procedure, complications, training and competence.</p><p><strong>Evidence synthesis: </strong>The review emphasizes the need for appropriate equipment, including soft-tip catheters and high-resolution ultrasound machines, to minimize trauma and enhance ET precision. Additionally, rigorous quality control in the laboratory is essential for achieving optimal clinical outcomes. Despite the technical simplicity of ET, complications such as cervical trauma, retained embryos, and rare expulsion from the cervix highlight the need for further research and improvement in this critical step of the process. Finally, the necessity for well-trained practitioners and embryologists, with competence regularly evaluated through performance indicators, is crucial.</p><p><strong>Conclusions: </strong>Further research is needed to standardize ET techniques and improve ART outcomes, suggesting that each step of ET may significantly influence the procedure's success. Attention to detail and adherence to key factors are critical to optimizing the transfer of an embryo to the uterus, leading to higher pregnancy rates and better patient outcomes.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528734","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 role of colposcopy in HPV vaccination era.","authors":"Jacopo DI Giuseppe, Leonardo Natalini, Carolina Marzocchini, Irene Lubinski, Jasmine Saee, Luca Giannella, Giovanni Delli Carpini, Andrea Ciavattini","doi":"10.23736/S2724-606X.24.05592-1","DOIUrl":"10.23736/S2724-606X.24.05592-1","url":null,"abstract":"<p><p>Colposcopy has traditionally played a crucial role in the assessment and management of abnormal cervical cytology and human papillomavirus (HPV) -related lesions. However, with the reduction in high-risk (HR) HPV types due to vaccination, the role of colposcopy in the HPV vaccination era is being questioned. The aim of this narrative review was to highlight the latest evidence from the world of HPV vaccination and the future role of colposcopy in the HPV vaccination era. PubMed, MEDLINE, Scopus, Web of Science were searched for relevant articles up to June 2024. HPV vaccination may influence colposcopic practice by reducing HR-HPV vaccine type, colposcopy referrals, colposcopic positive predictive value for CIN 2+, and by changing referral patterns, colposcopic performance, and procedures. The relative incidence of HPV-negative adenocarcinoma and its precursors may be increasing, presenting a new challenge that may increase the difficulty of colposcopic assessment. The role of colposcopy in the management of cervical abnormalities will vary according to vaccination status, vaccine type and timing of vaccination. As this evolves, colposcopy will need to adapt to provide optimal care tailored to individual risk profiles and to maintain the key role in cervical cancer prevention that it has acquired over the past decades. There will certainly be a need to improve the quality and performance of colposcopy by reducing inter- and intra-observer variability in colposcopic practice, including more objective patient selection, greater knowledge, expertise and skill, with the aim of achieving reproducible, sensitive and less biased assessment of cervical appearance.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"219-236"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604118","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":"Highlights of the May-June 2025 issue.","authors":"Antonio La Marca","doi":"10.23736/S2724-606X.25.05800-2","DOIUrl":"https://doi.org/10.23736/S2724-606X.25.05800-2","url":null,"abstract":"","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":"77 3","pages":"145-147"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528735","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":"Is menopausal hormone therapy still a modern social issue? Women's experience in a northern Italian city.","authors":"Carmen I Aquino, Viviana Stampini, Elena Osella, Libera Troìa, Clarissa Rocca, Maurizio Guida, Fabrizio Faggiano, Valentino Remorgida, Daniela Surico","doi":"10.23736/S2724-606X.24.05500-3","DOIUrl":"10.23736/S2724-606X.24.05500-3","url":null,"abstract":"","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"259-260"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291099","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":"Intraovarian injection of autologous platelet-rich-plasma: myth or reality?","authors":"Giuseppe Loverro, Edoardo DI Naro, Matteo Loverro, Antonio D'Amato, Maria T Loverro, Amerigo Vitagliano, Luca M Schounauer, Gianluca R Damiani","doi":"10.23736/S2724-606X.24.05480-0","DOIUrl":"10.23736/S2724-606X.24.05480-0","url":null,"abstract":"<p><strong>Introduction: </strong>The diminished ovarian reserve (DOR) relates to a condition in which the ovary experiences a decline in its typical reproductive capacity. Despite notable advancements in understanding the pathophysiology of reduced ovarian reserve in recent years, significant unresolved challenges remain, particularly concerning the optimal therapeutic approaches for this complex condition. The main aim of this study was to investigate the potential of platelet-rich plasma (PRP) in enhancing ovarian follicle numbers by assessing changes in ovarian reserve markers.</p><p><strong>Evidence acquisition: </strong>A comprehensive literature search was conducted on the following databases: PubMed/MEDLINE, SCOPUS, The Cochrane Library, Science Direct and Web of Science. All the relevant studies published till October 2023 were screened. After removing duplicates, and full-text evaluation, 9 articles were eventually included in the present review.</p><p><strong>Evidence synthesis: </strong>The pregnancy rate (PR) among patients with poor ovarian reserve (POR) ranged from 13% to 40%, indicating the potential effectiveness of PRP as a rejuvenating treatment. The live birth rate (LBR) ranged from 13% to 20%, comparable to or not lower than the LBR of a matched healthy population aged between 38 and 42 years. Furthermore, the data presented thus far support the notion that PRP may lead to an average clinical PR of 10% in women affected by premature ovarian insufficiency (POI) and perimenopause.</p><p><strong>Conclusions: </strong>PRP can not be regarded as a gamete replacement therapy, but rather as an 'additional' therapeutic tool in the management of women with DOR or POR, as well as in peri-menopausal women. Additional qualitative studies are required to validate the existing evidence, as the literature currently lacks randomized controlled trials (RCTs) in this regard.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"192-204"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469861","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":"Impact of endometriosis on oocyte quality in women undergoing assisted reproduction.","authors":"Parimala Chinta, Treasa Joseph, Nadia Imam, Nivedita Gupta, Hemapriya Mohan, Mohan S Kamath","doi":"10.23736/S2724-606X.24.05552-0","DOIUrl":"10.23736/S2724-606X.24.05552-0","url":null,"abstract":"<p><p>Endometriosis is a chronic gynecological condition which can lead to infertility in women during reproductive age. Endometriosis influences the assisted reproductive technology (ART) outcomes by its impact on oocyte and embryo quality, oocyte numbers and subsequently the embryo numbers and endometrial receptivity. There has been clinical dilemma as to whether it is predominantly the oocyte, or the endometrium which affects the pregnancy outcomes in women with endometriosis. In this review we provide an overview of the effect of endometriosis on the oocyte molecular mechanism, the overall effect of endometriosis and its various stages as well as the effect of endometrioma on the oocyte quality in autologous study models. We have also provided a review of the donor oocyte models to study the effect of endometriosis on the endometrium. While initial small donor oocyte-based model studies suggested a possible major detrimental impact of oocyte quality on ART outcomes in women with endometriosis, the more recent studies have found minimal or no impact of oocyte quality on treatment outcomes. There is growing evidence to suggest an important contributory role of reduced oocyte yield on ART success in women with endometriosis. There is a need to explore whether oocyte yield and not the oocyte quality or endometrial receptivity, is the main reason for lower success in women with endometriosis following ART.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"205-214"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770193","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":"Antenatal toxoplasmosis screening and treatment in Northern Italy: update on the clinical effectiveness.","authors":"Marta Ruggiero, Lea Testa, Alice Ronchi, Valeria Meroni, Lorenza Pugni, Andrea Ronchi, Carlo Pietrasanta, Edgardo Somigliana, Beatrice Tassis","doi":"10.23736/S2724-606X.24.05471-X","DOIUrl":"10.23736/S2724-606X.24.05471-X","url":null,"abstract":"<p><strong>Background: </strong>Antenatal universal screening for toxoplasmosis is recommended in most affluent countries worldwide. Despite evidence is not robust, detected cases are typically treated during pregnancy. Affected newborns are also treated to temper clinical consequences. However, this established mode of management warrants careful and continuous re-evaluation. The epidemiology of the infection is changing and there is the need to monitor the clinical scenario.</p><p><strong>Methods: </strong>This is an observational retrospective study conducted at a referral hospital in Northern Italy. Every woman referred from January 2011 to December 2021 for suspected toxoplasmosis in pregnancy was eligible. All women were managed according to a local standardized protocol. Clinical and laboratory findings were obtained from patients' charts.</p><p><strong>Results: </strong>Out of 347 women referred, 191 (55%) were discharged as false positive at initial assessment. We identified 141 women with suspected infection and 15 with confirmed infection. The number of women treated with antibiotics was 136 (96%) and 15 (100%), respectively. A total of 118 amniocenteses were performed, all of which were negative. There were two spontaneous miscarriages and five therapeutic terminations of pregnancy (of whom four were consequent to parental concerns related to the toxoplasmic infection), all among suspected cases. Vertical transmission occurred in a single case, a patient with confirmed infection diagnosed by seroconversion at 28 weeks' gestation. The course of this pregnancy was uneventful, and the infant is healthy at 7 years follow-up. Overall, the incidence of vertical transmission was 7% (95% CI: 1-30%) in confirmed cases and 0% (95% CI: 0-0.2%) in suspected cases.</p><p><strong>Conclusions: </strong>The current policy of universal screening and prompt management of toxoplasmosis infection is efficient. However, undue invasive procedures and terminations of pregnancy could occur. Future studies are warranted to improve clinical management.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"166-172"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311104","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}