Section of Obstetrics and Gynecology

Perugia, Italy

Section of Obstetrics and Gynecology

Perugia, Italy
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Domar A.,Beth Israel Deaconess Medical Center | Gordon K.,Merck And Co. | Garcia-Velasco J.,Rey Juan Carlos University | La Marca A.,Section of Obstetrics and Gynecology | And 2 more authors.
Human Reproduction | Year: 2012

Background Infertility can significantly impact womens lives and personal relationships. Despite the negative impact of infertility, a significant number of women who are struggling to conceive do not consult a physician. This cross-sectional survey was conducted to determine the emotional impact of infertility on women to identify which aspects of fertility treatment contribute to the psychological stress experienced by so many patients and to identify barriers to seeking treatment.Methods Women (n = 445; 1844 years) who had received fertility treatment within the past 2 years or were having trouble conceiving but had not received treatment, completed a 15-min survey online. Results Participants were from France (n = 108), Germany (n = 111), Italy (n = 112) and Spain (n = 114). Responses indicated that infertility causes a range of emotions and can strain relationships. Women who had received treatment were more likely to feel hopeful (26 versus 21) and closer to their partner than women not in treatment (33 versus 19, P < 0.05). Most women delayed starting treatment because of a desire to conceive naturally, and on the advice of physicians. Women aged <35 years took longer to seek help with their fertility issues. Injection-related anxiety was the second greatest barrier to treatment. Conclusion s This study has provided insight into the physical and psychological challenges of infertility treatments and permitted a better understanding of the factors that impact patient lives. A treatment protocol with minimal injections and provision of additional information may lessen the emotional impact and challenges of infertility and contribute to patient satisfaction with fertility treatment protocols. © 2012 The Author.


Polisca A.,Section of Obstetrics and Gynecology | Scotti L.,Section of Obstetrics and Gynecology | Orlandi R.,Section of Obstetrics and Gynecology | Brecchia G.,University of Perugia | Boiti C.,University of Perugia
Theriogenology | Year: 2010

The aim of this work was to evaluate the hemodynamic changes in the utero-placental arterial vessels in rabbits (Orictolagus cuniculus) throughout pregnancy as well as those in the umbilical cord, aorta, and caudal vena cava of fetuses to establish their normal reference ranges for systolic peak velocity (SPV), end diastolic velocity (EDV), pulsatility index (PI), and resistance index (RI). The blood flow waveforms were monitored every 4 d in 10 rabbits from Day 10 of pregnancy onward by means of color and pulsed wave Doppler ultrasonography using a 5.5-7.5 MHz microconvex transabdominal probe. The utero-placental blood flow was characterized by steep increases and decrease in the SPV with a slow diastolic wave and relatively high EDV, whereas that of the umbilical artery was discontinuous until Day 22 of pregnancy, when a diastolic waveform was also detectable. From Day 10 to 22 of pregnancy, the fetal aorta blood flow was discontinuous, but thereafter a diastolic peak was measurable. The blood flow of the fetal caudal vena cava was characterized by a systolic peak followed by a small diastolic peak. Throughout the gestation, the SPV and the EDV of maternal and fetal vessels increased (α < 0.05), whereas the PI and the RI decreased (α < 0.05), except for the utero-placental vessels. This work confirms that the rabbit could also be a valid experimental animal model to study, by Doppler ultrasonography, functional hemodynamic changes of the fetuses and placenta vessels in both normal and pathophysiologic conditions. © 2010 Elsevier Inc. All rights reserved.


Peroni D.G.,Section of Pediatrics | Chirumbolo S.,University of Verona | Veneri D.,Section of Haematology | Piacentini G.L.,Section of Pediatrics | And 5 more authors.
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2013

Colostrum contains cellular components that convey immunological protection to offspring. In the present study the main subsets of lymphocytes present in colostrum and in peripheral blood of healthy screened mothers were compared through the evaluation of >15 different flow cytometry markers. Colostrum and peripheral blood samples were collected within 3 days after full-term delivery. Flow cytometry assays and laboratory tests were performed soon after collection. Among B cells, percentages of CD19+CD5+ cells, pertaining to natural immunity system, were significantly higher in colostrum than in peripheral blood (33 vs. 5%, p = 0.047). CD4+ T cells, effector cells (CD45RA+/CD27-) and effector memory cells (CD45RA-/CD27-) were significantly higher in colostrum (p < 0.001) than in peripheral blood, as well as activated CD4+ T cells (HLA-DR+) (36% vs. 6% p = 0.0022) and CD4 + terminally differentiated effector T cells (CD57+) (p < 0.001). With regards to CD8+ T cells, a comparable significant increase in effector (p < 0.02) and effector memory cells (p < 0.001) was also observed. Moreover, an increased surface expression of HLA-DR and CD57 (p < 0.001) on CD8+ T cells in colostrum was detected. Colostrum contains a different distribution of lymphocyte subsets with respect to peripheral blood from mothers, confirming the observation that lymphocytes probably migrate in milk in a selective way. Colostrum T and B lymphocytes appear to be enriched with subsets possessing effector functions or belonging to the innate immune system, what could transfer a prompt line of defence to offspring. © 2013 Informa UK, Ltd.


Vesce F.,Section of Obstetrics and Gynecology | Giugliano E.,Section of Obstetrics and Gynecology | Bignardi S.,Section of Obstetrics and Gynecology | Cagnazzo E.,Section of Obstetrics and Gynecology | And 6 more authors.
Gynecologic and Obstetric Investigation | Year: 2014

Aim: To verify the eventual efficacy of lactoferrin (LF), an iron-binding glycoprotein, to decrease the amniotic concentration of interleukin-6 (IL-6). Methods: We prospectively enrolled 60 Caucasian patients at the 16th week of their singleton physiological gestation. A vaginal compound containing 300 mg of LF was administered randomly 4 or 12 h prior to amniocentesis, as to obtain 3 groups: A, 20 untreated patients; B, 20 treated 4 h before amniocentesis; C, 20 treated 12 h before amniocentesis. Results: A normal karyotype was registered in all cases. The comparison of the distribution of IL-6 among the 3 groups showed a highly significant difference (p = 0.001). The difference between mean values of group B and both groups C and A was shown to be highly significant (p = 0.006 and p = 0.03, respectively). In contrast, there was no significant difference between mean values of groups A and C. Conclusion: Vaginal LF administration decreases amniotic IL-6 concentration. We therefore suggest that the glycoprotein may exert a protective role against ominous pregnancy complications linked to an increased level of the cytokine, such as abortion secondary to amniocentesis. © 2014 S. Karger AG, Basel.

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