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Article ; Online: A step closer to parenthood with non-obstructive azoospermia: Unveiling the impact of microdissection testicular sperm extraction in Australia's largest single-centre study.

Elzeiny, Hossam / Agresta, Franca / Stevens, John / Gardner, David K

The Australian & New Zealand journal of obstetrics & gynaecology

2024

Abstract: Background: Non-obstructive azoospermia (NOA) diagnosis poses challenges for couples seeking parenthood. Microdissection testicular sperm extraction (MD-TESE) excels in retrieving testicular sperm cells for NOA cases. However, limited live birth data in ...

Abstract	Background: Non-obstructive azoospermia (NOA) diagnosis poses challenges for couples seeking parenthood. Microdissection testicular sperm extraction (MD-TESE) excels in retrieving testicular sperm cells for NOA cases. However, limited live birth data in Australian NOA patients hinders accurate counselling. Aims: This study aimed to determine the likelihood of infertile couples with a male partner diagnosed with NOA conceiving biological children using MD-TESE / intracytoplasmic sperm injection (ICSI). Materials and methods: A retrospective cohort study included 108 NOA men treated at a public fertility unit and a private fertility centre (May 2009-May 2022). Primary outcome: live birth rate (LBR); secondary outcomes: sperm retrieval rate, pregnancy rate, and neonatal outcomes. Results: Among 108 patients undergoing MD-TESE, the positive sperm retrieval rate (PSRR) was 64.8% (70/108). Histology best predicted sperm retrieval success, with hypo-spermatogenesis yielding a 94.1% PSRR. Age, testicular volume, and hormonal parameters had no significant impact. Mean male age: 35.4 years; mean partner age: 32.7 years. Fertilisation rate: 50.7%. LBR per initiated cycle: 58.7% (37/63); per embryo transfer: 63.8% (37/58); per initially diagnosed NOA man: 34.3% (37/108). Cumulative LBR: 74.1% (43/58); twin rate: 10.8% (4/37). No neonatal deaths or defects were observed among 47 live offspring. Conclusion: This study provides valuable data for counselling NOA couples on the probability of conceiving biological offspring. MD-TESE and ICSI yielded favourable PSRR (64.8%) and LBR (63.8%). However, couples should be aware that once NOA is confirmed, the chance of taking home a baby is 34%.
Language	English
Publishing date	2024-02-17
Publishing country	Australia
Document type	Journal Article
ZDB-ID	390815-x
ISSN	1479-828X ; 0004-8666
ISSN (online)	1479-828X
ISSN	0004-8666
DOI	10.1111/ajo.13800
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Article ; Online: Controlled ovarian hyperstimulation in breast cancer patients: Does oestrogen receptor status make a difference?

Sii, Stephanie / Polyakov, Alex / Rozen, Genia / Agresta, Franca / Stern, Kate

The Australian & New Zealand journal of obstetrics & gynaecology

2023 Volume 63, Issue 6, Page(s) 774–779

Abstract: Background: The presence of different breast cancer receptor status may impact ovarian stimulation outcomes.: Aim: To study the association between oestrogen receptor (ER) status in breast cancer patients and fertility preservation outcomes in a ... ...

Abstract	Background: The presence of different breast cancer receptor status may impact ovarian stimulation outcomes. Aim: To study the association between oestrogen receptor (ER) status in breast cancer patients and fertility preservation outcomes in a major tertiary referral centre. Materials and methods: Women who underwent fertility preservation following the diagnosis of breast cancer from 2008 to 2018 were included in the study. Patient age, ovarian stimulation parameters and laboratory outcomes were recorded and compared between the ER positive and negative groups. The primary outcome was total number of oocytes frozen. Secondary outcomes included total number of oocytes collected, mature oocytes, and embryos frozen. Results: The women included in the study (n = 214) were analysed in the following groups based on their fertility preservation method: oocyte freezing (n = 131), embryo freezing (n = 70), and both embryo and oocyte freezing (n = 13). There was an increase in the mean (but not mature) number of oocytes frozen (12.4 and 9.2, P-value = 0.03) favouring the ER positive group, even though the women in this group were older (35.0 and 33.4, P-value of 0.03). There is no difference in the starting follicle-stimulating hormone dose, duration of stimulation, mature oocytes collected, and embryos frozen in both groups. Conclusion: Patients with ER positive breast cancer may have more positive ovarian stimulation outcomes.
MeSH term(s)	Humans ; Female ; Breast Neoplasms/therapy ; Cryopreservation ; Fertility Preservation ; Follicle Stimulating Hormone ; Oocytes ; Ovulation Induction ; Receptors, Estrogen ; Oocyte Retrieval ; Retrospective Studies
Chemical Substances	Follicle Stimulating Hormone (9002-68-0) ; Receptors, Estrogen
Language	English
Publishing date	2023-06-14
Publishing country	Australia
Document type	Journal Article
ZDB-ID	390815-x
ISSN	1479-828X ; 0004-8666
ISSN (online)	1479-828X
ISSN	0004-8666
DOI	10.1111/ajo.13721
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Article: A rare case of mosaic Klinefelter syndrome in a 45-year-old man leading to successful live birth through ejaculated spermatozoa: a case report and literature review.

Elzeiny, Hossam / Agresta, Franca / Stevens, John / Gardner, David K

Frontiers in genetics

2023 Volume 14, Page(s) 1242180

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2023-09-13
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2606823-0
ISSN	1664-8021
ISSN	1664-8021
DOI	10.3389/fgene.2023.1242180
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Article ; Online: The ovarian hyperstimulation that truly matters: Admissions, severity and prevention strategies.

Medwin, Chase / Rozen, Genia / Agresta, Franca / Nassar, Nassar / Polyakov, Alex

The Australian & New Zealand journal of obstetrics & gynaecology

2023 Volume 63, Issue 4, Page(s) 583–587

Abstract: Introduction: Ovarian hyperstimulation syndrome (OHSS) is a common but serious complication of in vitro fertilisation. Despite available strategies to reduce OHSS incidence, a small proportion of patients will develop the clinically significant disease ... ...

Abstract	Introduction: Ovarian hyperstimulation syndrome (OHSS) is a common but serious complication of in vitro fertilisation. Despite available strategies to reduce OHSS incidence, a small proportion of patients will develop the clinically significant disease with substantial morbidity. Efforts toward better understanding and the prevention of severe disease are required to improve patient outcomes. Aims: The aims are to: (1) formulate clinically relevant OHSS classification for inpatient settings and data collection/reporting; (2) estimate OHSS prevalence requiring hospital admission in Victoria; and (3) determine the extent of OHSS preventability with clinical strategies. Materials and methods: This retrospective cohort study included all OHSS admissions in a tertiary referral centre, January 2016-December 2021, which included approximately 40% of all cases of hospitalisation for OHSS in the State of Victoria. Patient characteristics, treatment regimes, fertility treatment outcomes, timing classification, and clinical markers of disease severity were studied. Patients were classified as having mild, moderate, or severe OHSS with a novel inpatient classification system. Results: Of 199 OHSS cases presenting to the tertiary institution, 107 were classified as moderate/severe, with no significant difference between age, body mass index, length of stimulation and follicle number between mild/moderate and severe groups. There were more cases of early hyperstimulation (137) compared to late (62) presentation, of which 53% were severe. The average length of stay overall was 3.1 days, and 5.2 days for severe presentations. In 15% of severe cases, an agonist trigger was used. Conclusions: The overall prevalence of OHSS requiring hospital admission appears to be low (approximately 0.6% of all stimulated cycles). Established risk factors may not accurately predict clinically relevant OHSS risk. Further monitoring, clinician and patient education are required to minimise the risk of significant OHSS that results in hospital admissions.
MeSH term(s)	Female ; Humans ; Ovarian Hyperstimulation Syndrome/epidemiology ; Ovarian Hyperstimulation Syndrome/etiology ; Ovarian Hyperstimulation Syndrome/prevention & control ; Retrospective Studies ; Fertilization in Vitro ; Risk Factors ; Incidence ; Ovulation Induction/adverse effects
Language	English
Publishing date	2023-04-16
Publishing country	Australia
Document type	Journal Article
ZDB-ID	390815-x
ISSN	1479-828X ; 0004-8666
ISSN (online)	1479-828X
ISSN	0004-8666
DOI	10.1111/ajo.13688
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Article ; Online: Improved immediate postoperative pain following laparoscopic inguinal herniorrhaphy using self-adhering mesh: the importance of clinical practice guidelines.

Agresta, F / Podda, M / Silecchia, G

Hernia : the journal of hernias and abdominal wall surgery

2018 Volume 23, Issue 4, Page(s) 821–822

Language	English
Publishing date	2018-06-04
Publishing country	France
Document type	Letter
ZDB-ID	1388125-5
ISSN	1248-9204 ; 1265-4906
ISSN (online)	1248-9204
ISSN	1265-4906
DOI	10.1007/s10029-018-1787-z
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Zs.A 5390: Show issues

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Article ; Online: Another Brick in the Wall: We Need More Education!

Montori, Giulia / Botteri, Emanuele / Sartori, Alberto / Ortenzi, Monica / Podda, Mauro / Agresta, Ferdinando

Surgical laparoscopy, endoscopy & percutaneous techniques

2023 Volume 33, Issue 1, Page(s) 2–3

Language	English
Publishing date	2023-02-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1475108-2
ISSN	1534-4908 ; 1530-4515 ; 1051-7200
ISSN (online)	1534-4908
ISSN	1530-4515 ; 1051-7200
DOI	10.1097/SLE.0000000000001129
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Article ; Online: Setting up a fertility preservation programme.

Stern, Catharyn / Agresta, Franca

Best practice & research. Clinical obstetrics & gynaecology

2018 Volume 55, Page(s) 67–78

Abstract: With improved survival rates from cancer, young people can expect to lead a normal life, including having their own children. However, cancer or other serious disease itself, and more often its treatment, often leads to a significant reduction in ... ...

Abstract	With improved survival rates from cancer, young people can expect to lead a normal life, including having their own children. However, cancer or other serious disease itself, and more often its treatment, often leads to a significant reduction in fertility or premature gonadal insufficiency. There is increasing acknowledgement for the importance of fertility preservation (FP) options to be discussed and offered to young people whose fertility is at risk, ideally before the gonadotoxic therapy begins. FP options currently include oocyte, embryo and ovarian tissue cryopreservation; ovarian protection during chemotherapy and semen, sperm and testicular tissue cryopreservation. A multidisciplinary team consisting of committed and enthusiastic doctors, scientists, nurses, counsellors, administrators and researchers is required to provide a holistic FP service with rapid response capacity for acute consultation and procedures and a robust system for long-term follow-up. This speciality is developing rapidly with exciting scientific advances that have relevance for the whole spectrum of reproductive medicine.
MeSH term(s)	Female ; Fertility Preservation/methods ; Gonadal Disorders/etiology ; Gonadal Disorders/therapy ; Humans ; Infertility/etiology ; Infertility/therapy ; Male ; Neoplasms/complications ; Patient Care Team ; Program Development ; Referral and Consultation ; Reproductive Medicine/methods
Language	English
Publishing date	2018-08-01
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2050090-7
ISSN	1532-1932 ; 1521-6934
ISSN (online)	1532-1932
ISSN	1521-6934
DOI	10.1016/j.bpobgyn.2018.07.007
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Article ; Online: Telemedicine in surgery during COVID-19 pandemic: are we doing enough?

Sartori, Alberto / Balla, Andrea / Agresta, Ferdinando / Guerrieri, Mario / Ortenzi, Monica

Minerva surgery

2021 Volume 77, Issue 1, Page(s) 50–56

Abstract: Introduction: The aim of this systematic review was to report and to analyze if there is and what is the impact of telemedicine in the surgical practice during COVID-19 pandemic. Many authors have posited that the pandemic urged a high implementation of ...

Abstract	Introduction: The aim of this systematic review was to report and to analyze if there is and what is the impact of telemedicine in the surgical practice during COVID-19 pandemic. Many authors have posited that the pandemic urged a high implementation of the telemedicine service even in surgical specialties, however, the impact of this change of the clinical practice has been variably reported and its utilization in general surgery is uncertain. Evidence acquisition: All articles from any country written in English, Italian, Spanish, or French, about the use of telemedicine for indication to surgical treatment or for 30-day postoperative follow-up in general surgery during the COVID 19 outbreak, from the March 1, 2020, to December 1, 2020, were included. Evidence synthesis: Two hundred nine articles were fully analyzed, and 207 further articles were excluded. Finally, 2 articles, both published in October 2020, were included in the present systematic review. Conclusions: In conclusion, the rapid spread of SARS-CoV-2 pandemic has forced to review the traditional methods to deliver surgical assistance and urged surgeons to find alternative methods to continue their practice. The literature about this topic is yet scarce and many questions regarding its efficacy in improving patients' health, cost-effectiveness and user satisfaction remain unsolved.
MeSH term(s)	Aftercare/statistics & numerical data ; COVID-19/epidemiology ; General Surgery/statistics & numerical data ; Humans ; Pandemics ; Postoperative Care/statistics & numerical data ; SARS-CoV-2 ; Telemedicine/statistics & numerical data
Language	English
Publishing date	2021-10-25
Publishing country	Italy
Document type	Journal Article ; Systematic Review
ZDB-ID	3067899-7
ISSN	2724-5438
ISSN (online)	2724-5438
DOI	10.23736/S2724-5691.21.09100-0
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Article ; Online: Minimally invasive versus open adrenalectomy for adrenocortical carcinoma: the keys surgical factors influencing the outcomes-a collective overview.

Giordano, Alessio / Feroci, Francesco / Podda, Mauro / Botteri, Emanuele / Ortenzi, Monica / Montori, Giulia / Guerrieri, Mario / Vettoretto, Nereo / Agresta, Ferdinando / Bergamini, Carlo

Langenbeck's archives of surgery

2023 Volume 408, Issue 1, Page(s) 256

Abstract: Purpose: Adrenocortical carcinoma (A.C.C.) is a rare tumour, often discovered at an advanced stage and associated with a poor prognosis. Surgery is the treatment of choice. We aimed to review the different surgical approaches trying to compare their ... ...

Abstract	Purpose: Adrenocortical carcinoma (A.C.C.) is a rare tumour, often discovered at an advanced stage and associated with a poor prognosis. Surgery is the treatment of choice. We aimed to review the different surgical approaches trying to compare their outcome. Methods: This comprehensive review has been carried out according to the PRISMA statement. The literature search was performed in PubMed, Scopus, the Cochrane Library and Google Scholar. Results: Among all studies identified, 18 were selected for the review. A total of 14,600 patients were included in the studies, of whom 4421 were treated by mini-invasive surgery (M.I.S.). Ten studies reported 531 conversions from M.I.S. to an open approach (OA) (12%). Differences were reported for operative times as well as for postoperative complications more often in favour of OA, whereas differences for hospitalization time in favour of M.I.S. Some studies showed an R0 resection rate from 77 to 89% for A.C.C. treated by OA and 67 to 85% for tumours treated by M.I.S. The overall recurrence rate ranged from 24 to 29% for A.C.C. treated by OA and from 26 to 36% for tumours treated by M.I.S. Conclusions: OA should still be considered the standard surgical management of A.C.C. Laparoscopic adrenalectomy has shown shorter hospital stays and faster recovery compared to open surgery. However, the laparoscopic approach resulted in the worst recurrence rate, time to recurrence and cancer-specific mortality in stages I-III ACC. The robotic approach had similar complications rate and hospital stays, but there are still scarce results about oncologic follow-up.
MeSH term(s)	Humans ; Adrenocortical Carcinoma/surgery ; Adrenalectomy ; Hospitalization ; Length of Stay ; Adrenal Cortex Neoplasms/surgery
Language	English
Publishing date	2023-06-30
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-023-02997-z
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Article ; Online: The development and phase 1 evaluation of a Decision Aid for elective egg freezing.

Sandhu, Sherine / Hickey, Martha / Lew, Raelia / Hammarberg, Karin / Braat, Sabine / Agresta, Franca / Parle, Anna / Allingham, Catherine / Peate, Michelle

BMC medical informatics and decision making

2023 Volume 23, Issue 1, Page(s) 83

Abstract: Background: Elective egg freezing decisions are complex. We developed a Decision Aid for elective egg freezing and conducted a phase 1 study to evaluate its acceptability and utility for decision-making.: Methods: The online Decision Aid was ... ...

Abstract	Background: Elective egg freezing decisions are complex. We developed a Decision Aid for elective egg freezing and conducted a phase 1 study to evaluate its acceptability and utility for decision-making. Methods: The online Decision Aid was developed according to International Patient Decision Aid Standards and evaluated using a pre/post survey design. Twenty-six Australian women aged 18-45 years, interested in receiving elective egg freezing information, proficient in English, and with access to the internet were recruited using social media and university newsletters. Main outcomes were: acceptability of the Decision Aid; feedback on the Decision Aid design and content; concern raised by the Decision Aid, and; utility of the Decision Aid as measured by scores on the Decisional Conflict Scale and on a study-specific scale assessing knowledge about egg freezing and age-related infertility. Results: Most participants found the Decision Aid acceptable (23/25), balanced (21/26), useful for explaining their options (23/26), and for reaching a decision (18/26). Almost all reported satisfaction with the Decision Aid (25/26) and the level of guidance it provided (25/26). No participant reported serious concerns about the Decision Aid, and most would recommend it to other women considering elective egg freezing (22/26). Median Decisional Conflict Scale score decreased from 65/100 (Interquartile range: 45-80) pre-Decision Aid to 7.5/100 (Interquartile range: 0-37.5) post-Decision Aid review (p < 0.001). Median knowledge score increased from 8.5/14 (Interquartile range: 7-11) pre-Decision Aid to 11/14 (Interquartile range: 10-12) post-Decision Aid review (p = 0.01). Conclusion: This elective egg freezing Decision Aid appears acceptable and useful for decision-making. It improved knowledge, reduced decisional conflict and did not raise serious concerns. The Decision Aid will be further evaluated using a prospective randomised control trial. Study registration: ACTRN12618001685202 (retrospectively registered: 12 October 2018).
MeSH term(s)	Humans ; Female ; Fertility Preservation ; Decision Support Techniques ; Prospective Studies ; Australia ; Knowledge
Language	English
Publishing date	2023-05-05
Publishing country	England
Document type	Randomized Controlled Trial ; Clinical Trial, Phase I ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2046490-3
ISSN	1472-6947 ; 1472-6947
ISSN (online)	1472-6947
ISSN	1472-6947
DOI	10.1186/s12911-023-02178-4
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