Biomedical subjects

Alberto Revelli

Publications and source records attributed to Alberto Revelli.

8 recordsLinked to original sources

PubMed2006

Recombinant versus highly-purified, urinary follicle-stimulating hormone (r-FSH vs. HP-uFSH) in ovulation induction: a prospective, randomized study with cost-minimization analysis.

BACKGROUND: Both recombinant FSH (r-FSH) and highly-purified, urinary FSH (HP-uFSH) are frequently used in ovulation induction associated with timed sexual intercourse. Their effectiveness is reported to be similar, and therefore the costs of treatment represent a major issue to be considered. Although several studies about costs in IVF have been published, data obtained in low-technology infertility treatments are still scarce. METHODS: Two hundred and sixty infertile women (184 with unexplained infertility, 76 with CC-resistant polycystic ovary syndrome) at their first treatment cycle were randomized and included in the study. Ovulation induction was accomplished by daily administration of rFSH or HP-uFSH according to a low-dose, step-up regimen aimed to obtain a monofollicular ovulation. A bi- or tri-follicular ovulation was anyway accepted, whereas hCG was withdrawn and the cycle cancelled when more than three follicles greater than or equal to 18 mm diameter were seen at ultrasound. The primary outcome measure was the cost of therapy per delivered baby, estimated according to a cost-minimization analysis. Secondary outcomes were the following: monofollicular ovulation rate, total FSH dose, cycle cancellation rate, length of the follicular phase, number of developing follicles (>12 mm diameter), endometrial thickness at hCG, incidence of twinning and ovarian hyperstimulation syndrome, delivery rate. RESULTS: The overall FSH dose needed to achieve ovulation was significantly lower with r-FSH, whereas all the other studied variables did not significantly differ with either treatments. However, a trend toward a higher delivery rate with r-FSH was observed in the whole group and also when results were considered subgrouping patients according to the indication to treatment. CONCLUSION: Considering the significantly lower number of vials/patient and the slight (although non-significant) increase in the delivery rate with r-FSH, the cost-minimization analysis showed a 9.4% reduction in the overall therapy cost per born baby in favor of r-FSH.

Adult↗

PubMed2005

Intracytoplasmic sperm injection: a novel selection method for sperm with normal frequency of chromosomal aneuploidies.

OBJECTIVE: To test a newly invented intracytoplasmic sperm injection (ICSI) sperm selection method based on sperm hyaluronic acid (HA) binding. DESIGN: Comparison of chromosomal disomy and diploidy frequencies in sperm arising from semen and in HA-bound sperm. SETTING: Academic andrology laboratory. PATIENT(S): Men presenting for semen analysis. INTERVENTION(S): Washed sperm fractions of 32 semen samples were applied to Petri dishes or glass slides coated with immobilized HA. The unbound sperm were rinsed gently, and the HA-bound sperm were removed with an ICSI pipette. The control sperm population was the unselected sperm. Both HA-selected and unselected sperm were treated with fluorescence in situ hybridization with centromeric probes for the X, Y, and 17 chromosomes. MAIN OUTCOME MEASURE(S): Chromosomal disomy and diploidy frequencies. RESULT(S): In the HA-bound sperm (495-2,079 per man, 41,670 in all) compared with unselected sperm (4,770 per man, 162,210 in all), the chromosomal disomy frequencies were reduced to 0.16% from 0.52%, diploidy to 0.09% from 0.51%, and sex chromosome disomy to 0.05% from 0.27% (a 5.4-fold reduction vs. 4-fold respective increase in ICSI offspring). CONCLUSION(S): The HA sperm selection method for ICSI, which is based on a relationship between sperm receptors for zona pellucida and HA, will likely reduce the potential genetic complications and adverse public health effects of ICSI.

Andrology↗

PubMed2005

Seasonality and human in vitro fertilization outcome.

Seasonal changes in spontaneous fecundity have been observed in several human populations, but it is not clear whether the same applies to human in vitro fertilization-embryo transfer (IVF) procedures. In the present study, 2067 patients undergoing their first IVF attempt between the years 1998 and 2003 were grouped into four 'seasons' (December-February, March-May, June-August, September-November) according to the day on which they were administered human chorionic gonadotropin. Several parameters known to affect IVF outcome (including ovarian response to gonadotropins, sperm and oocyte quality, fertilization rate, embryo quality, pregnancy and implantation rates) were considered and potential changes among the four seasonal periods were analyzed. Moreover, some confounding variables (sperm quality, age, duration of infertility, indications for IVF) were controlled for. Overall, pregnancy rate per oocyte pick-up and per embryo transfer of 32.5% and 35.8%, respectively, as well as implantation rate of 18.9%, were recorded. None of the observed IVF-related parameters showed any significant change clearly related to a specific seasonal period, their fluctuations throughout the year being randomly determined. Ovarian responsiveness to gonadotropins, quality of gametes and embryos, and fertilization and implantation processes were apparently not significantly affected by seasonality. It is concluded that the results of a good-quality IVF program in humans are not significantly affected by the season of the year in which the IVF attempt is accomplished; therefore, season is not a relevant factor to be considered when planning an IVF treatment.

Adult↗

PubMed2004

Fallopian tube sperm perfusion versus intrauterine insemination in unexplained infertility: a randomized, prospective, cross-over trial.

OBJECTIVE: To compare the results of fallopian tube sperm perfusion (FSP) versus standard intrauterine insemination (IUI) in patients with unexplained infertility undergoing controlled ovarian hyperstimulation (COH). DESIGN: Randomized, prospective, cross-over study. SETTING: Reproductive medicine unit of a university hospital. PATIENT(S): Fifty-six couples with unexplained infertility. INTERVENTION(S): COH was induced by recombinant FSH and monitored by serial transvaginal ultrasound. On the day of hCG administration during the first treatment cycle, patients were randomized to either IUI or FSP. Thereafter, in case no pregnancy was achieved, patients went on being treated with FSP and IUI in alternate cycles. A maximum of four treatment cycles per couple was performed. FSP was performed using a pediatric Foley's catheter inseminating 4 mL of sperm-enriched suspension; a Kremer-Delafontaine catheter delivering 0.5 mL of sperm suspension was used for IUI. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate per cycle. RESULT(S): One hundred twenty-seven cycles (58 FSP, 69 IUI) were performed. The clinical pregnancy rate per cycle was 21.7% for IUI and 8.6% for FSP, respectively. No major adverse effects were recorded for either technique. CONCLUSION(S): After COH, FSP is less effective than IUI in couples with unexplained infertility.

Cross-Over Studies↗

PubMed2003

Nitric oxide synthesis in human nonpregnant myometrium and uterine myomas.

OBJECTIVE: To clarify whether nitric oxide (NO) synthesis in myomas differs from that in parental human myometrium. DESIGN: Prospective study. SETTING: Academic research institution. PATIENT(S): Twenty-one patients undergoing laparoscopy or laparotomy for uterine myoma. MAIN OUTCOME MEASURE(S): Measurement of NO synthase activity in homogenates from myoma and parental myometrium biopsies, and NO synthesis assessment in cultured smooth-muscle cells. RESULT(S): Nitric oxide synthase activity in homogenates did not significantly differ between myoma and healthy myometrium. The medium taken from myoma cultures showed a significant increase in nitrite concentration compared with that taken from control myometrium cultures, but 24-hour incubation of both cell types with physiologic concentrations of 17beta-estradiol or progesterone did not significantly modify nitrite production. CONCLUSION(S): The maximal activity of NO synthase does not differ in myoma cells and in normal myometrial cells, but basal NO synthesis seems to be enhanced by an unknown signaling pathway that is not controlled by 17beta-estradiol or progesterone.

Adult↗

PubMed2002

Germinal vesicle transfer between fresh and cryopreserved immature mouse oocytes.

BACKGROUND: We assessed the maturational competence and the chromosomal pattern of mouse oocytes reconstructed by germinal vesicle (GV) transfer technique using nuclear and/or cytoplasmic components from cryopreserved GV stage oocytes. METHODS: From 657 GV oocytes (326 fresh and 331 frozen/thawed), four groups of reconstructed oocytes were obtained by micromanipulation and electrofusion: fresh GV-fresh cytoplast (FF), thawed GV-thawed cytoplast (TT), fresh GV-thawed cytoplast (FT), thawed GV-fresh cytoplast (TF). All reconstructed oocytes were cultured in vitro to metaphase II. RESULTS: Survival rate after manipulation and electrofusion, as well as progression to metaphase II, did not differ significantly among the four groups. Comparing reconstructed oocytes with fresh and thawed control pools, the only difference was a slightly but significantly higher maturation rate in the TT pool versus matched controls (P < 0.01). Cytogenetic analysis of 25 reconstructed oocytes showed the expected number of 20 chromosomes in 88% of them. CONCLUSIONS: We conclude that both nuclear and cytoplasmic components derived from cryopreserved immature oocytes are suitable for GV transfer procedure, and generate chromosomally normal oocytes able to progress to metaphase II in vitro. The possibility of using cryostored immature oocytes as a source of nuclei and cytoplasm could help in applying GV transfer procedure, both in research and clinical settings.

Animals↗

PubMed2002

Guanylate cyclase activity and sperm function.

In species with external fertilization, the guanylate cyclase family is responsible for the long-distance interaction between gametes, as its activation allows sperm chemotaxis toward egg-derived substances, gamete encounter, and fertilization. In species with internal fertilization, guanylate cyclase-activating substances, which are secreted by several tissues in the genital tracts of both sexes, deeply affect sperm motility, capacitation, and acrosomal reactivity, stimulating sperm metabolism and promoting the ability of the sperm to approach the oocyte, interact with it, and finally fertilize it. A complex system of intracellular pathways is activated by guanylate cyclase agonists in spermatozoa. Sperm motility appears to be affected mainly through an increase in intracellular cAMP, whereas the acrosome reaction depends more directly on cyclic GMP synthesis. Both cyclic nucleotides activate specific kinases and ion signals. A complex cross-talk between cAMP- and cyclic GMP-generating systems occurs, resulting in an upward shift in sperm function. Excessive amounts of certain guanylate cyclase activators might exert opposite, antireproductive effects, increasing the oxidative stress on sperm membranes. In view of the marked influence exerted by guanylate cyclase-activating substances on sperm function, it seems likely that guanylate cyclase activation or inhibition may represent a new approach for the diagnosis and treatment of male and/or female infertility.

Animals↗

PubMedDate not supplied

Ovarian tissue cryostorage and grafting: an option to preserve fertility in pediatric patients with malignancies.

Fertility preservation in childhood cancer has become an important area of investigation due to increasing survival rates after cancer therapy. For these patients with an increased risk of infertility and premature ovarian failure, cryopreservation of ovarian tissue is a promising tool to preserve at least part of the reproductive potential. In recent years significant improvements have been achieved in this area, and 2 live births after autografting of frozen-thawed ovarian tissue have been reported. However, further research is needed to assess the clinical effectiveness of ovarian cryopreservation, to optimize the technique, and to limit the risk of reintroducing cancer cells in the patient with the graft.

Adolescent↗