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Article: Ovarian Torsion in a Young Adolescent with Rokitansky Syndrome.

Fedele, Francesco / Esposito, Giovanna / Busnelli, Andrea / Parazzini, Fabio

Case reports in obstetrics and gynecology

2024 Volume 2024, Page(s) 1305476

Abstract: A case report of a premenarcheal patient with ovarian torsion and mullerian agenesis is presented. A 12-year-old prepubertal girl is presented with severe right lower quadrant abdominal pain and mild rebound. Laparoscopy showed mullerian agenesis and ... ...

Abstract	A case report of a premenarcheal patient with ovarian torsion and mullerian agenesis is presented. A 12-year-old prepubertal girl is presented with severe right lower quadrant abdominal pain and mild rebound. Laparoscopy showed mullerian agenesis and twisted right adnexa. Detorsion and cystectomy of the right ovary were done, and the ovary was fixed to the pelvic sidewall. The postoperative course was uneventful. An association between the lax attachment of the adnexa and torsion may be a contributing factor in this condition.
Language	English
Publishing date	2024-02-22
Publishing country	United States
Document type	Case Reports
ZDB-ID	2627654-9
ISSN	2090-6692 ; 2090-6684
ISSN (online)	2090-6692
ISSN	2090-6684
DOI	10.1155/2024/1305476
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Article ; Online: Efficacy and safety of follitropin delta for ovarian stimulation in vitro fertilization/ intracytoplasmic sperm injection cycles: a systematic review with meta-analysis.

Palomba, Stefano / Caserta, Donatella / Levi-Setti, Paolo Emanuele / Busnelli, Andrea

Journal of ovarian research

2024 Volume 17, Issue 1, Page(s) 60

Abstract: Background: Follitropin delta is a novel recombinant follicle stimulating hormone preparation uniquely expressed in a human fetal retinal cell line by recombinant DNA technology. To date, no systematic review was available about the safety and the ... ...

Abstract	Background: Follitropin delta is a novel recombinant follicle stimulating hormone preparation uniquely expressed in a human fetal retinal cell line by recombinant DNA technology. To date, no systematic review was available about the safety and the efficacy of the follitropin delta. The objective of this study was systematically reviewing the available literature and to provide updated evidence regarding the efficacy-safety profile of follitropin delta when compared to other gonadotropin formulations for ovarian stimulation in in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles. Methods: An extensive search was performed to identify phase 1, phase 2 and phase 3 RCTs in humans focused on follitropin delta use for ovarian stimulation in IVF/ICSI cycles. The risk of bias and the overall quality of the evidence was analyzed. All data were extracted and analyzed using the intention-to-treat principle and expressed per woman randomized. Results: A total of 7 RCTs (1 phase 1 RCT, 2 phase 2 RCTs and 4 phase 3 RCTs) were included in the qualitative analysis, whereas data of three phase 3 RCTs were meta-analyzed. All trials compared personalized recombinant follitropin delta treatment versus conventional recombinant follitropin alfa/beta administration in potentially normo-responder patients who receive ovarian stimulation in GnRH antagonist IVF/ICSI cycles. No difference between two regimens was detected for clinical pregnancy rate [odds ratio (OR) 1.06; 95% confidence intervals (CI): 0.90, 1.24; P = 0.49; I Conclusion: Personalized follitropin delta treatment is associated with a lower risk of OHSS compared to conventional follitropin alfa/beta administration in potentially normo-responder patients who receive ovarian stimulation in GnRH antagonist IVF/ICSI cycles. The absence of cumulative data does not allow definitive conclusions to be drawn regarding the comparison of the effectiveness of the two treatments. Protocol study registration: CRD42023470352 (available at http://www.crd.york.ac.uk/PROSPERO ).
MeSH term(s)	Pregnancy ; Female ; Humans ; Male ; Sperm Injections, Intracytoplasmic ; Semen ; Fertilization in Vitro/methods ; Ovulation Induction/methods ; Ovarian Hyperstimulation Syndrome/prevention & control ; Follicle Stimulating Hormone ; Gonadotropin-Releasing Hormone ; Recombinant Proteins ; Follicle Stimulating Hormone, Human
Chemical Substances	follitropin delta (076WHW89TW) ; Follicle Stimulating Hormone (9002-68-0) ; Gonadotropin-Releasing Hormone (33515-09-2) ; Recombinant Proteins ; Follicle Stimulating Hormone, Human
Language	English
Publishing date	2024-03-14
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	2455679-8
ISSN	1757-2215 ; 1757-2215
ISSN (online)	1757-2215
ISSN	1757-2215
DOI	10.1186/s13048-024-01372-w
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Article ; Online: Neovagina creation methods in Müllerian anomalies and risk of malignancy: insights from a systematic review.

Fedele, Francesco / Bulfoni, Alessandro / Parazzini, Fabio / Busnelli, Andrea

Archives of gynecology and obstetrics

2023 Volume 309, Issue 3, Page(s) 801–812

Abstract: Purpose: This systematic review aims to provide a data synthesis about the risk of neovaginal cancer in women with Müllerian anomalies and to investigate the association between the adopted reconstructive technique and the cancer histotype.: Methods: ...

Abstract	Purpose: This systematic review aims to provide a data synthesis about the risk of neovaginal cancer in women with Müllerian anomalies and to investigate the association between the adopted reconstructive technique and the cancer histotype. Methods: PubMed, MEDLINE, Embase, Scopus, ClinicalTrials.gov and Web of Science databases were searched from inception to March 1st, 2023. Studies were included if: (1) only women affected by Müllerian malformations were included, (2) the congenital defect and the vaginoplasty technique were clearly reported, (3) the type of malignancy was specified. Results: Literature search yielded 18 cases of squamous cell carcinoma and two cases of vaginal intraepithelial neoplasia 3 (VAIN 3). Of these, 3 had been operated on according to the Wharton technique, 8 according to the McIndoe technique, 3 with a split-skin graft vaginoplasty, 2 according to the Davydov technique, 2 with a simple cleavage technique, 1 according to the Vecchietti technique and 1 with a bladder flap vaginoplasty. A total of 17 cases of adenocarcinoma and 1 case of high-grade polypoid dysplasia were also described. Of these, 15 had undergone intestinal vaginoplasty, 1 had been operated on according to the McIndoe technique and 1 had undergone non-surgical vaginoplasty. Finally, 1 case of verrucous carcinoma in a woman who had undergone a split-skin graft vaginoplasty, was reported. Conclusion: Although rare, neovaginal carcinoma is a definite risk after vaginal reconstruction, regardless of the adopted technique. Gynaecologic visits including the speculum examination, the HPV DNA and/or the Pap smear tests should be scheduled on an annual basis.
MeSH term(s)	Humans ; Female ; Vagina/pathology ; Plastic Surgery Procedures ; Vaginal Neoplasms/surgery ; Vaginal Neoplasms/pathology ; Carcinoma, Squamous Cell/pathology ; Adenocarcinoma/pathology ; Mullerian Ducts/surgery ; Mullerian Ducts/abnormalities ; 46, XX Disorders of Sex Development/surgery ; Congenital Abnormalities/surgery ; Congenital Abnormalities/pathology ; Gynecologic Surgical Procedures/methods ; Treatment Outcome
Language	English
Publishing date	2023-07-19
Publishing country	Germany
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	896455-5
ISSN	1432-0711 ; 0932-0067
ISSN (online)	1432-0711
ISSN	0932-0067
DOI	10.1007/s00404-023-07086-6
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Article: Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature.

Palomba, Stefano / Colombo, Carla / Busnelli, Andrea / Caserta, Donatella / Vitale, Giovanni

Frontiers in endocrinology

2023 Volume 14, Page(s) 1251866

Abstract: Background: Published data on the relationship between polycystic ovary syndrome (PCOS) and thyroid dysfunction are sparse and confusing.: Objective: To comprehensively review data available in the literature regarding the relationship between PCOS ... ...

Abstract	Background: Published data on the relationship between polycystic ovary syndrome (PCOS) and thyroid dysfunction are sparse and confusing. Objective: To comprehensively review data available in the literature regarding the relationship between PCOS and the thyroid function, and its abnormalities. Methods: Nine main areas of interest were identified and analyzed according to the available evidence: 1) Evaluation of thyroid function for PCOS diagnosis; 2) Epidemiology data on thyroid function/disorders in patients with PCOS, and vice versa; 3) Experimental data supporting the relationship between thyroid function/disorders and PCOS; 4) Effects of thyroid function/disorders on PCOS features, and vice versa; 5) Effect of thyroid alterations on the cardiometabolic risk in women with PCOS; 6) Effect of thyroid abnormalities on reproductive outcomes in women with PCOS; 7) Relationship between thyroid function/abnormalities in patients with PCOS who are undergoing fertility treatment; 8) Effect of treatments for thyroid diseases on PCOS; and 9) Effect of treatments for PCOS on thyroid function. An extensive literature search for specific keywords was performed for articles published from 1970 to March 2023 using PubMed and Web of Science. Data were reported in a narrative fashion. Results: PCOS is a diagnosis of exclusion for which diagnosis is possible only after excluding disorders that mimic the PCOS phenotype, including thyroid dysfunctions. However, the tests and the cutoff values used for this are not specified. Many experimental and clinical data suggest a relationship between perturbations of the thyroid function and PCOS. Direct and unequivocal evidence on the effects of thyroid function/disorders on PCOS features are lacking. High thyroid-stimulating hormone levels and subclinical hypothyroidism may be associated with significant worsening of several intermediate endpoints of cardiometabolic risk in women with PCOS. Thyroid abnormalities may worsen reproductive outcomes, especially in patients undergoing fertility treatment. To date, there are no data demonstrating the efficacy of thyroid medications on fertility and cardiometabolic risk in women with PCOS. Lifestyle modification changes, metformin, and vitamin D seem to improve thyroid function in the general population. Conclusion: PCOS and thyroid disorders are closely related, and their coexistence may identify patients with a higher reproductive and metabolic risk. Regular screening for thyroid function and thyroid-specific autoantibodies in women with PCOS, particularly before and during pregnancy, is highly recommended.
MeSH term(s)	Female ; Humans ; Pregnancy ; Polycystic Ovary Syndrome/complications ; Polycystic Ovary Syndrome/diagnosis ; Thyroid Diseases/complications ; Thyroid Diseases/epidemiology ; Hypothyroidism ; Thyroid Dysgenesis ; Antibodies ; Cardiovascular Diseases
Chemical Substances	Antibodies
Language	English
Publishing date	2023-08-11
Publishing country	Switzerland
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2023.1251866
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Article ; Online: Artificial cycle frozen embryo transfer and obstetric adverse outcomes: association or causation?

Busnelli, Andrea / Di Simone, Nicoletta / Levi-Setti, Paolo Emanuele

Human reproduction update

2023 Volume 29, Issue 5, Page(s) 694–696

MeSH term(s)	Pregnancy ; Infant, Newborn ; Female ; Humans ; Luteal Phase ; Embryo Transfer/adverse effects ; Fertilization in Vitro
Language	English
Publishing date	2023-07-17
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	1286738-x
ISSN	1460-2369 ; 1355-4786
ISSN (online)	1460-2369
ISSN	1355-4786
DOI	10.1093/humupd/dmad020
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Article: Qualitative and Quantitative Ovarian and Peripheral Blood Mitochondrial DNA (mtDNA) Alterations: Mechanisms and Implications for Female Fertility.

Busnelli, Andrea / Navarra, Annalisa / Levi-Setti, Paolo Emanuele

Antioxidants (Basel, Switzerland)

2021 Volume 10, Issue 1

Abstract: The reduction of female fertility over time is considered as a natural consequence of ovarian aging. The exact mechanism underlying this process is not fully elucidated. However, it is becoming increasingly evident that qualitative and quantitative ... ...

Abstract	The reduction of female fertility over time is considered as a natural consequence of ovarian aging. The exact mechanism underlying this process is not fully elucidated. However, it is becoming increasingly evident that qualitative and quantitative mitochondrial genome alterations might play a relevant role. The former include mitochondrial DNA (mtDNA) damage caused by oxidative stress, the accumulation of acquired mtDNA mutations, the effects of inherited mtDNA mutations, and alterations in the mitochondrial stress response mechanism. The latter refer to alterations in the oocytes, granuolosa cells, and embryonic cells mtDNA content. The present review aims to investigate the evidence about: (1) the effect of qualitative and quantitative mtDNA alterations on female fertility, paying particular attention to those with a pathophysiology characterized by a relevant role of oxidative stress; (2) the use of oocytes, granulosa cells (GCs), embryonic cells, and peripheral blood cells mtDNA copy number as a female fertility surrogate biomarker; (3) experimental therapies tested to try to subvert the ovarian aging process with particular reference to antioxidant treatments.
Language	English
Publishing date	2021-01-05
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2704216-9
ISSN	2076-3921
ISSN	2076-3921
DOI	10.3390/antiox10010055
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Article ; Online: Thyroid function modifications in women undergoing controlled ovarian hyperstimulation for in vitro fertilization: a systematic review and meta-analysis.

Busnelli, Andrea / Cirillo, Federico / Levi-Setti, Paolo Emanuele

Fertility and sterility

2021 Volume 116, Issue 1, Page(s) 218–231

Abstract: Objective: To investigate the impact of controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF) on thyroid function.: Design: Systematic review and meta-analysis.: Setting: Not applicable.: Patient(s): Infertile women ... ...

Abstract	Objective: To investigate the impact of controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF) on thyroid function. Design: Systematic review and meta-analysis. Setting: Not applicable. Patient(s): Infertile women undergoing conventional IVF or intracytoplasmic sperm injection. Intervention(s): Systematic search of PubMed, MEDLINE, Embase, Scopus, and Web of Science from inception until November 2020. Studies could be included only if they met the following criteria: subjects were classified as euthyroid or hypothyroid; serum thyroid-stimulating hormone (TSH) and/or free thyroxine (FT4) levels were evaluated before COH; and the same thyroid function test was reassessed after COH (i.e., at the time of trigger for final follicle maturation and/or at pregnancy test). Main outcome measure(s): Mean difference (MD) between the serum TSH or FT4 levels assessed after COH and before COH. Result(s): In euthyroid women, the serum TSH levels assessed at the time of trigger and at the time of pregnancy test were significantly higher than those at baseline (MD: 0.69 mIU/L, 95% confidence interval [CI]: 0.30-1.08, I Conclusion(s): Pooling of the results showed a significant increase in serum TSH level in women undergoing COH for IVF. This change was particularly pronounced in women treated for hypothyroidism. New thyroid function screening strategies for women undergoing COH are warranted.
MeSH term(s)	Biomarkers/blood ; Female ; Fertility/drug effects ; Fertilization in Vitro ; Humans ; Hypothyroidism/blood ; Hypothyroidism/diagnosis ; Hypothyroidism/physiopathology ; Infertility, Female/diagnosis ; Infertility, Female/drug therapy ; Infertility, Female/physiopathology ; Male ; Ovulation/drug effects ; Ovulation Induction/adverse effects ; Pregnancy ; Risk Factors ; Sperm Injections, Intracytoplasmic ; Thyroid Gland/drug effects ; Thyroid Gland/metabolism ; Thyroid Gland/physiopathology ; Thyrotropin/blood ; Thyroxine/blood ; Treatment Outcome
Chemical Substances	Biomarkers ; Thyrotropin (9002-71-5) ; Thyroxine (Q51BO43MG4)
Language	English
Publishing date	2021-04-07
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	80133-1
ISSN	1556-5653 ; 0015-0282
ISSN (online)	1556-5653
ISSN	0015-0282
DOI	10.1016/j.fertnstert.2021.01.029
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Article ; Online: Recurrent implantation failure: a plea for a widely adopted rational definition.

Somigliana, Edgardo / Busnelli, Andrea / Kalafat, Erkan / Viganò, Paola / Ata, Baris

Reproductive biomedicine online

2022 Volume 45, Issue 2, Page(s) 183–185

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, ...

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.
MeSH term(s)	Embryo Implantation ; Female ; Fertilization in Vitro ; Humans ; Oocyte Retrieval
Language	English
Publishing date	2022-01-31
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2113823-0
ISSN	1472-6491 ; 1472-6483
ISSN (online)	1472-6491
ISSN	1472-6483
DOI	10.1016/j.rbmo.2022.01.011
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Article ; Online: Vesicouterine Fistula After Cesarean Delivery at Full Cervical Dilation.

Bulfoni, Alessandro / Bonavina, Giulia / Acerboni, Stefano / Schirripa, Irene / Casale, Paolo / Busnelli, Andrea

Urogynecology (Philadelphia, Pa.)

2023 Volume 29, Issue 12, Page(s) 974–979

Abstract: Importance: Vesicouterine fistula (VUF) is an iatrogenic consequence of cesarean section in the vast majority of cases. The worldwide increase of cesarean delivery rates is likely to be accompanied by a rise of this complication, and surgery is the ... ...

Abstract	Importance: Vesicouterine fistula (VUF) is an iatrogenic consequence of cesarean section in the vast majority of cases. The worldwide increase of cesarean delivery rates is likely to be accompanied by a rise of this complication, and surgery is the mainstay treatment. Objective: The aim of the study is to assess current evidence on VUF pathogenesis and management. Study design: The study is a case report and literature review on PubMed and Embase spanning over the past 2 decades. Results: An early VUF developed after a cesarean section at full cervical dilation and concurrent incidental bladder injury. A transabdominal extravesical repair was performed 3 months after cesarean delivery. Both the cystotomy and hysterotomy were repaired in a double-layer fashion with no interposition flap. A contemporary literature review including 25 patients showed that VUF was repaired transabdominally in 21 patients (84%), and an open approach was adopted in 18 patients (85.7%). In most patients, the uterine side was closed with a single-layer suture and an interposition flap was used to reinforce the repair. Concomitant hysterectomy was performed in 6 patients (24%). Overall, successful term pregnancies were reported in 2 patients after VUF repair. Conclusions: Vesicouterine fistula is a rare event and is commonly associated with cesarean sections, especially those with a concurrent bladder injury. Careful and meticulous surgical technique may prevent the occurrence of this condition. Delayed repair and double-layer closure of both bladder and uterus, with or without an interposition flap, are recommended.
MeSH term(s)	Female ; Humans ; Pregnancy ; Abdominal Injuries/complications ; Cesarean Section/adverse effects ; Dilatation ; Fistula/etiology ; Urinary Bladder Diseases/complications ; Urinary Bladder Fistula/etiology ; Uterine Diseases/etiology
Language	English
Publishing date	2023-07-29
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ISSN	2771-1897
ISSN (online)	2771-1897
DOI	10.1097/SPV.0000000000001398
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Article ; Online: Reply: A paradox? Which paradox?

Somigliana, Edgardo / Chinè, Alessandra / Reschini, Marco / Fornelli, Gianfranco / Basili, Ludovica / Busnelli, Andrea / Viganò, Paola / Muzii, Ludovico

Human reproduction open

2024 Volume 2024, Issue 1, Page(s) hoae007

Language	English
Publishing date	2024-02-15
Publishing country	England
Document type	Journal Article
ISSN	2399-3529
ISSN (online)	2399-3529
DOI	10.1093/hropen/hoae007
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