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Biomedical subjects

C Flamigni

Publications and source records attributed to C Flamigni.

At least 55 records · Page 3Linked to original sources
PubMed1997

T-helper 2 type cytokine and soluble interleukin-2 receptor levels in seminal plasma of infertile men.

PROBLEM: The role of cell-mediated immunity (CMI) in unexplained male infertility and impaired sperm function has been explored. METHOD OF STUDY: The presence of cytokines, namely, interleukin-4 (IL-4), interleukin-6 (IL-6), and the soluble interleukin-2 receptor (SIL-2R), was investigated in seminal plasma of 18 fertile and 20 infertile subjects, using specific enzyme-linked immunoadsorbent assays. RESULTS: IL-4 was not detected. SIL-2R was detected, but the concentration difference between the fertile and infertile group was not significant. IL-6 was detected with significantly higher levels in the infertile group compared to the fertile group. IL-6 levels in seminal plasma correlated positively with leukocyte count and negatively with sperm count, motility, and morphology. CONCLUSIONS: These findings show: a) a lack of IL-4 in seminal plasma; b) similar SIL-2R levels in fertile and infertile seminal plasma; c) increased IL-6 secretion in seminal plasma of infertile subjects; and d) specific correlations of IL-6 with the main semen parameters.

Adult↗
PubMed1997

Is vestibular micropapillomatosis associated with human papillomavirus infection?

The aetiology and clinical significance of vulvar papillomatosis is still controversial. To verify the association of micropapillomatosis labialis with certain types of HPV-related lower genital tract infections, 25 patients with colposcopic aspects of vulvar papillomatosis were recruited and vulvar biopsies were obtained for histologic examination and in situ hybridization. Sixteen patients with vulvodynia, without any pathologic vulvar aspects, served as a control group. Histologic evidence of HPV was found in 20 cases (80%) of vulvar papillomatosis while only one (4%) of the study patients was positive for HPV-DNA. These results seem to confirm the scarse correlation between vestibular papillomatosis and HPV. In our opinion physicians must be cautions when treating these lesions even in cases with positive histologic results. Colposcopy is, therefore, of fundamental importance for an accurate diagnosis of vestibular papillomatosis and successful management.

Adult↗
PubMed1996

Treatment strategies of the borderline ovarian tumors.

The present study was undertaken to establish the role of surgical procedures, histologic type, and stage of the tumor on the survival rate of patients with borderline ovarian tumors in a 5 to 15 years of follow-up. Data reported in the literature have shown the low malignancy of this cancer and that only the stage, but not the pathological diagnosis, is significantly influencing the survival rate of the patients. After 5 years, the survival rate of patients with tumors of stage I to stage II is 98.2% (n=567) and 81.4% (n=46), respectively, with no statistical difference. After 5 years, survival rate between tumors of stage I to stage III is 98.2% (n=567) and 79.1% (n=96), respectively (p< 0.05). The data shows that for borderline ovarian tumors, a minimally invasive surgery is warranted.

Female↗
PubMed1996

The effect of leuprorelin on steroidogenesis of human preovulatory granulosa cells in vitro.

PURPOSE: LHRH analogues are commonly used in in vitro fertilization protocols to induce hypogonadotropic hypogonadism. The aim of our study was to evaluate the action of the LHRH agonist leuprorelin on the E2 steroidogenesis of human preovulatory granulosa cells. RESULTS: FSH causes a significant increase in E2 production which is double that of the basal condition (P < 0.01). At concentrations of 1, 10, and 100 ng/ml, leuprorelin does not produce any modification with respect to the basal condition during the 24- or 72-hr culture period. The FSH, added at different analogue concentrations, produces a significant increase in E2 production as compared to the basal condition (P < 0.05) and the E2 production percentage is similar to the values obtained with FSH alone during the 24- or 72-hr culture period. CONCLUSIONS: Leuprorelin has no effect on the in vitro E2 production at any concentration. The treatment with different doses of leuprorelin does not suppress FSH-stimulated E2 production. Our findings suggest that human granulosa cells are not acutely sensitive to a direct action on E2 steroidogenesis by LHRH analogues.

Estradiol↗
PubMed1996

Oocyte donation program: pregnancy and implantation rates in women of different ages sharing oocytes from single donor.

OBJECTIVE: To investigate the importance of uterus age as regards of pregnancy, implantation, and abortion rates using the oocyte donation model. DESIGN: Retrospective data analysis of cases where recipients of different ages shared oocytes from single donor. SETTING: A tertiary infertility center. PATIENTS: One hundred fourteen women (21 to 49 years of age) undergoing a total of 114 cycles of oocyte donation were divided into two groups according to age (group A < = or 39 years: group B between 40 and 49 years). INTERVENTIONS: Hormonal replacement therapy was given using increasing doses of 17 beta-E2 (2, 4, and 6 or 8 mg) and either 100 mg of P in oil or 600 mg of micronized P through the vaginal route. MAIN OUTCOME MEASURES: Pregnancy, abortion, and implantation rates. RESULTS: Fifty-seven transfer cycles were performed per age group. Twenty-seven clinical pregnancies were achieved in Group A and 14 in group B, with pregnancy rates (PRs) of 47.3% and 24.5%, respectively. There were four abortions in group A and one in group B, resulting in abortion rates of 14.8% and 7%, respectively. Thirty-four of 137 transferred embryos in group A and 20 of 134 in group B implanted, resulting in implantation rates of 24.8% and 14.9%, respectively. CONCLUSION: This study seems to suggest that there are differences in pregnancy and implantation rates in recipients of different ages because of uterine receptivity. Fertility therefore does not depend merely on oocyte age and quality but also on uterine age.

Adult↗
PubMed1996

The efficacy of drugs in the management of endometriosis.

STUDY OBJECTIVE: To establish the crude effects of danazol and gonadotropin-releasing hormone (GnRH) analogs in the management of endometriosis. DESIGN: Prospective case-control study. SETTING: Unit of the Pathophysiology of Reproduction outpatient department. PATIENTS: Two groups of 110 women each with endometriosis (American Fertility Society score 1-3) who received danazol and GnRH analogs, and a control group who did not receive any drugs. INTERVENTIONS: Women in the treatment groups received danazol 200 mg every 8 hours for 6 months, or a different GnRH agonist at standard dosages for 6 months. Laparoscopy was performed twice, at the time of diagnosis and just before the end of treatment (or no therapy for controls). Surgical treatment of the implants was performed at the second laparoscopy. MEASUREMENTS AND MAIN RESULTS: Samples of both eutopic and ectopic endometrium were collected during both laparoscopies. Both danazol and GnRH agonists were useful in reducing the AFS scores to inactive endometriotic implants, and there were no significant differences between the effects (p <0.001). Fibrosis was found after 6 months of observation in the implants in one control woman (0.9%), in 20 patients (18.2%) treated with danazol (p <0.001 vs controls), and in 4 patients (3.6%) treated with GnRH agonists (NS vs controls). A correlation between a clinical diagnosis of AFS score zero and histologic features of fibrosis in the ectopic specimens after therapies was observed in 28% of women, with poor agreement (k = 0.07). CONCLUSIONS: Fibrosis, which represent the absence of endometrial cells within the specimens of endometriotic lesions or eutopic endometrium, did not appear in eutopic endometria but it was found in some endometriotic implants. Danazol and GnRH agonists reduced the clinical AFS scores of endometriosis, but their histologic effects in completely and permanently eliminating endometriotic implants were unacceptable.

Adolescent↗
PubMed1996

Adhesion formation after laparoscopic myomectomy.

STUDY OBJECTIVE: To determine the frequency of adhesion formation after myomectomy performed by operative laparoscopy or laparotomy. DESIGN: Case-control study. Setting. Academic women's hospital. PATIENTS: Thirty-two premenopausal women scheduled for myomectomy by one of two techniques. INTERVENTIONS: Surgical removal of myomata. MEASUREMENTS AND MAIN RESULTS: Of the 32 women, 16 underwent laparotomy and 16 laparoscopy. Second-look laparoscopy was performed in 28 patients, at which time adhesions were lysed. Compared with laparotomy, laparoscopy resulted in adhesions in significantly fewer patients, and in significantly lower scores when adhesions were detected. CONCLUSION: Laparoscopic removal of uterine myomata is associated with fewer adhesions than removal by laparotomy.

Adult↗
PubMed1996

The Financial Impact of Laparoscopy versus Laparotomy in the Treatment of Uterine Leiomyomata

To compare the efficiency of two surgical techniques to remove uterine myomata, 120 premenopausal women were included in this case control study based on the criteria of no previous operations, size of leiomyoma, and age. Sixty patients were treated by laparoscopy (group 1) and 60 by laparotomy (group 2). The hospital stay for group 1 was shorter than that for group 2 (3.53 &plusmn; 1.33 and 7.98 &plusmn; 2.05 days, p <0.001). The rate of total complications (body temperature >38&deg; C, hemoglobin <8.5 g/100 ml, infiltration of abdominal sutures, dysuria, reduction in blood platelets) was 13% in group 1 versus 53% in group 2 (p <0.001). The mean cost for each surgical treatment was $628.71 and $652.40, respectively. The mean entire cost (surgery plus hospital stay) was $1357.23 and $2298.90, respectively (p <0.001). The savings were detectable after 9 and 52 operations, respectively, whether including all expenditures or only the cost of surgery. The cost saving of the entire treatment for 60 operations was $56,500.12.

Journal Article↗
PubMed1996

Uterine Contractility in Patients with Endometriosis

Uterine contractility was evaluated in 30 women, 16 with endometriosis and 14 controls. Two catheters were introduced into the uterine cavity, one next to the fundus and the other in proximity of internal os. They were connected to a pressure transducer that transforms mechanical events into an electrical signal, and analyzed by a system dedicated to this purpose. Data were analyzed by unpaired Student's t and McNemar tests. Frequency and amplitude of oscillations and mean pressure uterine tone were evaluated. Frequency of oscillations in the fundus (mean &plusmn; SD) were significantly higher in women with endometriosis than in controls: 21.86 &plusmn; 9.75% at 10 minutes versus 10.20 &plusmn; 5.26%, respectively (p <0.04). The mean basal pressure tone was also higher than in controls: 55.54 &plusmn; 21.04 mm Hg and 25.28 &plusmn; 19.94 mm Hg, respectively (p <0.04). Abnormal uterine contractility in women with endometriosis may be associated with a possible tubal efflux of endometrial tissue and its ectopic implants.

Journal Article↗
PubMed1996

Financial impact in the Italian Health Service of laparoscopic versus laparotomic surgery for the treatment of ovarian cysts.

To assess the cost of two procedures for the removal of ovarian cysts, 200 pre-menopausal women were recruited for the surgical removal of ovarian cysts by laparoscopy (n = 100) and laparotomy (n = 100) according to case-control criteria. Patients operated by laparoscopy (mean age +/- SD 32.22 +/- 9.98 years) and laparotomy (mean age +/- SD 29.57 +/- 6.62 years) for ovarian cysts (mean diameters +/- SD 4.98 +/- 3.62 and 4.83 +/- 2.78 cm) had a post-surgical hospital stay of 3.12 +/- 0.41 and 7.25 +/- 1.08 days (P < 0.001) respectively. The total rate of complications occurring in patients operated by laparoscopy was 9 versus 53% (P < 0.001) of those operated by laparotomy; body temperature > 38 degrees C was recorded in 52/100 of patients operated by laparotomy versus 6/100 of those operated by laparoscopy. The mean cost for each pure surgical treatment performed by laparoscopy was US $498.17 versus US $642.47 when it was performed by laparotomy (P < 0.001). The laparoscopic surgical approach is more expensive in the first 36 operations, thereafter becoming cheaper. The mean of the entire overall expenditure was US $1142.08 and US $2138.72 for laparoscopy and laparotomy (P < 0.001) respectively. The entire expenditure for laparoscopy is higher than laparotomy only until eight operations. In conclusion, laparoscopy versus laparotomy has resulted in a saving of US $14,429.3 for 100 operations while the saving on entire costs was US $99,664.8.

Adult↗
PubMed1996

Oocyte donation programme: results obtained with intracytoplasmic sperm injection in cases of severe male factor infertility or previous failed fertilization.

Intracytoplasmic sperm injection was carried out in 15 oocyte donation cycles of 15 infertile couples where oocytes had failed to fertilize after in-vitro fertilization (IVF) procedures or where the male partner had severe male factor infertility. A total of 62 oocytes were donated, but only 46 of these, in metaphase II, were injected. Of the injected oocytes, 31 (67.3%) had two pronuclei the morning after the injection procedure. On the following day, 29 embryos were obtained (93% of the fertilized oocytes) and 25 were transferred. Two patients were not successful and consequently did not undergo embryo transfer. A total of five clinical pregnancies were obtained, giving pregnancy rates of 33.3 and 38.4% per started cycle and embryo transfer respectively.

Adult↗
PubMed1996

Characterization of human sperm antigens reacting with sperm antibodies from autologous serum and seminal plasma in an infertile population.

Immunoblotting techniques were used to characterize the reactivity of human sperm antigens with sperm antibodies from an infertile population. Sperm antigens of each individual were tested with autologous sperm antibodies present in serum and seminal plasma in order to construct a preliminary map of the antigens of the infertile spermatozoon and to compare the qualitative differences in the antigenic profile between fertile and infertile subjects. A total of 61 infertile males, comprising 51 subjects having poor semen quality and 10 subjects with no abnormalities in semen analysis, entered the study; 55 subjects with proven fertility served as controls. Infertile subjects often showed specific immunoreactivity to 50-, 55-, 57-, 62-, and 72-kDa proteins in serum and to 57- and 62-kDa proteins in seminal plasma. As to comparison of immunoreactivities between fertile and infertile individuals, the sperm antigens may be divided into three groups. Group 1 antigens (50-, 69-, and 72-kDa proteins) were recognized by sperm antibodies present in both populations; group 2 antigens (57- and 62-kDa proteins), by sperm antibodies typical of the infertile population; group 3 antigens (45-, 55-, and 85-kDa proteins), by sperm antibodies typical of the fertile population. This classification shows that the infertile spermatozoon differs substantially at the immunogenic level from the fertile spermatozoon. The group 2 antigens seem to be involved in a relevant step in the reproductive process and hence have been termed "fertility-related antigens."

Autoantibodies↗
PubMed1996

Characterization of human sperm antigens reacting with antisperm antibodies from autologous sera and seminal plasma: comparison among infertile subpopulations.

Immunoblotting techniques were used to characterize the reactivity of human sperm antigens with sperm antibodies from different groups of infertile subjects. Sperm antigens of each subject were tested with autologous sperm antibodies present in serum and seminal plasma in order to assess whether there were qualitative differences in the antigenic structure of spermatozoa among the various infertile groups. Sixty-one infertile males, divided into six groups according to changes in the two main semen parameters (sperm concentration and motility), entered the study. Immunoreactivity to several antigens, in both serum and seminal plasma, was usually demonstrated in infertile subjects. Using a complex statistical package no significant difference was found in the distribution of antigens between groups; this included previously termed "fertility-related antigens' (28, 35, 57 and 62kDa proteins). This suggests that the most relevant sperm antigens involved in reproduction have no particular relationship to sperm concentration and motility.

Antigen-Antibody Reactions↗
PubMed1996

A combined regimen of cyproterone acetate and testosterone enanthate as a potentially highly effective male contraceptive.

In this study we tested the effectiveness of the combined administration of cyproterone acetate (CPA) and testosterone enanthate (TE) in suppressing spermatogenesis. After a control phase of 3 months, 15 normal men were randomized to receive TE (100 mg/week) plus CPA at a dose of 100 mg/day (CPA-100; n = 5) or 50 mg/day (CPA-50; n = 5) or TE (100 mg/week) alone (n = 5) for 16 weeks. Semen analysis was performed every 2 weeks. Every 4 weeks, fasting blood samples were drawn for the measurement of LH, FSH, testosterone, estradiol, and biochemical and hematological parameters; subjects underwent a physical examination; and they and their partners filled in a sexual and behavioral questionnaire. Regardless of the dose, each of the 10 subjects receiving CPA plus TE became azoospermic, whereas only 3 of 5 subjects treated with TE alone achieved azoospermia. Times to azoospermia were 6.8 +/- 0.5, 8.4 +/- 1.0, and 14.0 +/- 1.2 weeks in groups CPA-100, CPA-50, and TE alone, respectively (P = NS). Throughout treatment, both gonadotropins tended to be higher in the TE alone group than in the other groups. This difference was mostly due to the higher gonadotropin levels present in the 2 men treated with TE alone that remained oligospermic. No difference in testosterone or estradiol levels was found among the groups. No significant change in lipoprotein levels or liver function tests could be detected. In the CPA-100 and CPA-50 groups, hemoglobin, hematocrit, and red blood cells were lower at the end of the treatment phase, whereas no change was detected in TE alone group. A tendency for a decrease in body weight was detected in subjects treated with CPA, whereas there was no change in subjects receiving TE alone. At the end of the treatment phase, a decrease in testis size was present in all groups. There was no significant change in sexual function, aggressive behavior, mood states, or satisfaction with relationship in any group. These results suggest that the combined administration of CPA and TE is very effective in suppressing spermatogenesis and may represent a promising regimen for reversible contraception in males.

Adult↗
PubMed1996

Transforming growth factor-beta 1 in the human endometrium.

Transforming growth factor-beta 1 (TGF-beta 1) is a polypeptide involved in a variety of important physiological and pathophysiological processes such as the implantation of the embryo into the endometrium. Many factors seem to be related to this event. TGF-beta 1 is involved in many mechanisms both in endometrial and in embryonic tissues: it induces proliferation and differentiation, it regulates proteolytic activity and it modulates the maternal immune response. This study evaluated the presence of TGF-beta 1 in the endometrium during normal menstrual cycles and in the uterine fluids during induction of ovulation in the framework of an in vitro fertilization program. Immunohistochemistry was used to identify TGF-beta 1 in the endometrium and immunodot-blot to quantitate TGF-beta 1 in the uterine cavity fluid. The study shows that TGF-beta 1 is present in the endometrial tissue and its secretion is modulated during the menstrual cycle, as demonstrated immunohistochemically; its production seems to be controlled by ovarian steroids. In conclusion, TGF-beta 1 influences the growth and differentiation of the embryo, as well as the activation of embryonic proteolytic enzymes, and it modulates the maternal-embryonic immune response. Its variability in the uterine cavity is demonstrated in this study, and the underexpression of TGF-beta 1 in the uterine cavity might be responsible for failed implantation.

Cytoplasm↗
PubMed1996

Different gonadotropin and leuprorelin ovulation induction regimens markedly affect follicular fluid hormone levels and folliculogenesis.

OBJECTIVES: To clarify the endocrine mechanisms underlying the outcome of different ovulation induction regimens with gonadotropins and GnRH agonists (GnRH-a). DESIGN: Prospective study. SETTING: Reproductive Endocrinology Center, University of Bologna. PATIENTS: Forty eumenorrheic women randomly assigned to four groups of 10 subjects each. INTERVENTIONS: Ovulation induction regimens: group A, purified FSH only; group B, purified FSH and flare-up GnRH-a; group C, purified FSH and long GnRH-a; and group D, hMG and long GnRH-a. MAIN OUTCOME MEASURES: Pelvic ultrasound and hormone levels in daily serum samples and in follicular fluid drawn immediately before hCG administration. RESULTS: Exogenous gonadotropin dose did not differ among groups. Group B had fewer preovulatory follicles than group C. Group B had higher serum LH, FSH, E2, P, T, and follicular fluid LH, E2, T, and alpha-inhibin than groups C and/or D. Groups C and D did not differ. CONCLUSIONS: Long GnRH-a regimens improved follicle yield and the endocrine milieu in spite of comparable exogenous gonadotropin dose and lower serum FSH and thus appear to be preferable in assisted reproduction. Reduced folliculogenesis found in flare-up GnRH-a regimens could be mediated by the atretic effects of high intraovarian androgens. Efficacy of purified FSH and hMG was comparable.

Adult↗
PubMed1995

Comparison between depot leuprorelin and daily buserelin in IVF.

OBJECTIVES: To compare the effects of depot and daily forms of GnRH analogs in IVF programs. METHODS: One hundred seventeen patients undergoing IVF, with no severe male factor, were randomized between two treatment groups. Pituitary desensitization was obtained in group 1 (60 patients) with a single IM injection of leuprorelin (3.75 mg), and in group 2 (57 patients) with buserelin (0.3 mg SC twice daily). In a subgroup of 10 patients (5 for the depot form and 5 for the daily form) several GnRH tests were performed to investigate pituitary desensitization. RESULTS: No differences were found in the time to reach desensitization. Resumption of pituitary activity occurred in 7 days with the daily form and in about 2 months with the depot form. No significant differences were found in the stimulation pattern, oocyte quality, percentage of fertilization. The pregnancy rate per transfer was slightly, but not significantly, better in the depot group (29.4% vs 25.9%). Implantation rate (11.9% vs 12.3%) and the percentage of miscarriages (26.6% vs 28.5%) were similar. CONCLUSION: Depot and daily forms of GnRH analogs are equally effective in superovulation induction for IVF. Considering improved patient compliance and preference, depot forms are advantageous.

Abortion, Spontaneous↗