Andrea Matera – Gynecological and Reproductive Endocrinology & Metabolism

Higher risk of hypertensive disorders of pregnancy and preeclampsia in pregnancies following frozen embryo transfer: a systematic review and meta-analysis

Introduction Nowadays, more than 3% of infants born in developed countries are conceived through assisted reproductive technology (ART) [1]. It has been suggested that ART pregnancies are related to poorer pregnancy outcomes compared with natural conceptions [2,3]. Recent studies have shown that singleton pregnancies after in vitro fertilization (IVF) treatment have an increased risk of […]

Four pregnancies and three successful vaginal deliveries in a patient with Turner Syndrome

Introduction Turner syndrome (TS) occurs in 1 in 2500 births and involves the complete or partial loss of one X chromosome (deletions, translocations, inversions, isochromosomes, and mosaicisms)1. TS is characterised by hypergonadotropic hypogonadism. Affected women are usually born with a normal number of primordial follicles that undergo accelerated atresia2. The majority of cases have primary […]

Factors leading to primary ovarian insufficiency: a literature overview

Introduction Premature ovarian insufficiency (POI) is a disease characterized by oligomenorrhea, hypoestrogenism and a follicle-stimulating hormone (FSH) level higher than 25 IU/L that occurs in women younger than 40 years of age.[1,2] It has been suggested that POI may affect 1% of women under 40.[1,3,4] The term POI has replaced the older “premature ovarian failure” […]

The genetic background of coagulation factors is associated with the presence of amenorrhea in girls with anorexia nervosa: a pilot study

Introduction Anorexia nervosa (AN) is a serious eating disorder. A distorted self-perception of body image and an excessive fear of gaining weight result in restrictive eating habits and extreme underweight. On top of decreased body mass index (BMI), a number of other criteria are used to establish a diagnosis of AN [1]. The prevalence of […]

Bone, metabolic and anthropometric changes in very young women with premature ovarian insufficiency or complete androgen insensitivity syndrome with removed gonads using oral estradiol valerate, transdermal estradiol or oral ethinylestradiol: a pilot study

Introduction Background Premature ovarian insufficiency (POI) is a clinical syndrome characterized by the loss of ovarian activity before the age of 40; it is associated with hypoestrogenism and oligo- or amenorrhea 1. POI can have different etiopathogenetic causes: it can be iatrogenic, as after chemotherapy and radiotherapy or surgery, but it can also be associated […]

Exceptional association of Leydig cell ovarian tumor and primary hyperparathyroidism in a postmenopausal patient

Introduction Leydig cell tumor is an uncommon clinical entity and accounts for less than 0.1% of all ovarian tumors [1, 2]. These tumors are usually unilateral and benign [3, 4]. Leydig cell tumors are functional tumors, which lead to hyperandrogenism and virilization as a consequence of high production of testosterone. Symptoms and signs may include […]

A novel quartile scoring-based methodology for assessing combinatorial association of prenatal cortisol and DHEA-S with birth outcome among pregnant women

 Introduction Adrenal gland secreted stress hormones such as cortisol & DHEA-S play an important role during pregnancy and parturition [1-4]. However, imbalance of maternal cortisol levels due to prenatal stress or adrenal insufficiency can lead to complications in pregnancy and poor birth outcome, including preterm birth and infants born with low birth weight [3]. Some […]

Total testosterone significantly correlates with insulin resistance in polycystic ovary syndrome

Introduction Polycystic ovary syndrome (PCOS), which is common worldwide, is an endocrine condition characterized by chronic anovulation, clinical and/or biochemical hyperandrogenism, and/or polycystic ovaries [1]. Many experts consider hyperandrogenism to be the main characteristic of PCOS. Several theories propound different mechanisms to explain PCOS manifestations: (i) a primary enzymatic defect in ovarian and/or adrenal steroidogenesis; […]

Surrogacy – a worldwide demand. Implementation and ethical considerations

Introduction Surrogacy means that a woman becomes pregnant and gives birth to a child with the intention of giving this child to another person or couple, commonly referred to as the ‘intended’ or ‘commissioning’ parents. [1]   A surrogate mother is the woman who carries and gives birth to the child, and the intended parent is […]

Smell and taste dysfunctions after COVID-19: sexual issues from the patient perspective. A paradigmatic case

Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the third recorded highly pathogenic coronavirus infecting humans, and the first to cause a global pandemic 1. This exceptionally insidious virus displays three main features: high rates of infection; high rates of mutation (typical of single-stranded RNA viruses); and the ability to infect multiple organs in […]

Priming with estradiol hemihydrate in the luteal phase prior to ovarian stimulation with GnRH antagonists: outcomes of IVF cycles in patients with previous poor response to ovarian stimulation

Background and Purpose In in vitro fertilization (IVF) cycles, various ovarian stimulation protocols are used with the aim of obtaining a sufficient number of oocytes. However, these protocols often do not achieve the desired result. Patients with low ovarian reserve and insufficient response to ovarian stimulation, unfortunately, constitute the most numerous cohorts in IVF clinics. […]

Endometriosis-related infertility: does surgery improve IVF outcomes? A single-center observational retrospective analysis

Introduction Endometriosis is defined as the presence of endometrial glands and stroma outside the uterine cavity, predominantly, but not exclusively, in the pelvic compartment. It is an oestrogen-dependent chronic inflammatory condition that affects women of reproductive age, and it is associated with pelvic pain and infertility [1]. Endometriosis is one of the most controversial diseases […]

Effect on vitrification on same number of oocytes from different oocytes cohorts in donors’ cycles

Introduction   The use of oocyte donation in the treatment of infertility has increased constantly in recent years (1). The main indications for the use of egg donation, proposed by the American Society for Reproductive Medicine, include primary ovarian failure, prevention of genetic diseases in offspring, decreased ovarian function, persistence of poor oocyte/embryo quality, and […]

Comparison between retrospective premenstrual symptoms and prospective late-luteal symptoms among college students

Introduction Menstruation, a natural physiological phenomenon, includes proliferation and desquamation of the uterine endometrium on a monthly, repetitive basis [1]. Regular menstrual cycles offer a window into women’s overall reproductive health. A majority of women from all cultures and socioeconomic levels, however, experience regular recurrence of various symptoms during the days prior to menstruation, with […]

Treatment of acne vulgaris with 2 mg dienogest/0.03 mg ethinylestradiol: satisfaction among Portuguese women

Introduction Acne vulgaris, or acne, is a common skin condition that affects 9.4% of the world population [1]. More than 85% of adolescents suffer from acne, which is moderate to severe in about 15–20% of patients [2]. Acne often persists into adulthood. 64% of individuals in their 20s and 43% of individuals in their 30s […]

Abnormal Uterine Bleeding (AUB): an Uncommon Presentation of Ovarian Cancer

Introduction Abnormal uterine bleeding (AUB) occurs in approximately 5% of postmenopausal women. Since 7 to 9% of AUB cases are due to endometrial cancer, the primary aim of the evaluation in all post-menopausal women with AUB is to exclude malignancy. (1,2) Ovarian carcinoma is the third most common gynecologic cancer. Epithelial tumors account for 95% […]

Vitamin D and infertility: a narrative review

Introduction Vitamin D is a steroid hormone. Around of 80-90% of our vitamin D is synthesized in the skin through sunlight exposure; the rest derives from food1. It is well established that vitamin D maintains calcium homeostasis and promotes bone mineralization1. However, increasing evidence suggests that there are also several non-skeletal benefits of vitamin D. […]

Premature ovarian insufficiency in adolescents: an update

Introduction Premature ovarian insufficiency (POI) was formerly known as premature ovarian failure (POF), a term which referred to the cessation of ovarian function before the expected age of natural menopause (1). It has been questioned whether the old term, “ovarian failure”, is correct, since a significant percentage of affected women have evidence of follicular activity, […]

Effects of different menopause hormone therapy routes of administration on insulin levels in early menopausal non-diabetic subjects

Introduction Hypoestrogenism and hyperinsulinism are independent risk factors for metabolic syndrome, dyslipidemia, endothelial dysfunction, inflammation, autonomic system disturbances, cardiovascular diseases, etc.[1]. Insulin resistance is defined as decreased sensitivity and/or responsiveness to the metabolic action of insulin, responsible for promoting glucose disposal. The etiology of insulin resistance can be: genetic (mutations in the insulin receptor gene, […]

Vaginal Lactobacillus species and recurrent vulvovaginal candidiasis

Introduction The composition of the vaginal microbiome is dynamic and undergoes several changes corresponding with hormonal fluctuations throughout a woman’s reproductive life. The vagina harbors several microorganisms that exist in a regulated and mutualistic relationship within the microbiome (1). The composition of the bacterial species in the vaginal microbiome changes significantly in response to several […]

Satisfaction on the use of a transdermal spray containing 1.53 mg estradiol for the treatment of symptoms associated with menopause

INTRODUCTION Menopause is defined as the complete cessation of menstruation, for a period of at least 12 months, due to reduced production of estrogen and progesterone hormones by a woman’s ovaries [1]. Menopause can occur spontaneously (natural menopause) or be induced by surgery, chemotherapy or radiotherapy, leading to estrogen deficiency and loss of reproductive function […]

Plasma cytokine profile during pregnancy in overweight and obese women undergoing a behavioral program versus standard care

INTRODUCTION Obesity is characterized by an excessive amount of adipose tissue that leads to a chronic systemic inflammatory status. A high pre-pregnancy body mass index (BMI), currently the most widely accepted method for classifying the state of adiposity, and an excessive gestational weight gain (GWG), are independently associated with several adverse pregnancy outcomes [1], both […]

The effect of supplementation with vitamin D plus calcium on fetal growth. An ultrasound and clinical study.

INTRODUCTION The association between maternal vitamin D levels and fetal growth is a matter of debate. A systematic review concluded that evidence in favor of a direct relationship is conflicting because of the heterogeneity of existing studies [1]. A series of physiological mechanisms, though, supports the association. The promoters of some amino acid transporter genes […]

Bilateral uterine artery chemoembolization with methotrexate for cesarean scar pregnancy: a follow-up proposal

Introduction Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy implanted in the region of a previous cesarean section scar at the level of the uterine isthmus, where the myometrium is narrower and thinner [1]. The prevalence of CSP strongly depends on the rate of cesarean deliveries, which is estimated to have reached its highest peak in 2009 (32.9%) after […]

Role of myo-inositol in polycystic ovary syndrome

Introduction Polycystic ovary syndrome (PCOS) is a chronic and multisystemic metabolic-endocrine disorder that affects reproductive health and increases the risk of female neoplasms. Classically, PCOS is characterized by clinical and/or biochemical hyperandrogenism and anovulation [1]. Its estimated prevalence is highly variable and ranges between 4.5 and 11.2% in adult women, based on different series [1]. […]

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