Anna Baggiani - Academia.edu (original) (raw)

Papers by Anna Baggiani

Research paper thumbnail of The effect of parnaparin sodium on in vitro fertilization outcome: A prospective randomized controlled trial

Thrombosis Research, Nov 1, 2017

Introduction: In-vitro and in-vivo models suggest the influence of low-molecular weight heparin o... more Introduction: In-vitro and in-vivo models suggest the influence of low-molecular weight heparin on conception in infertile women undergoing in vitro fertilization procedures (IVF). In this randomized controlled trial we assessed whether a low-molecular weight heparin (parnaparin) could affect IVF outcomes. Materials and methods: 271 cycles were analyzed in 247 women having a first or subsequent IVF cycle at Fertility Center of Humanitas Research Hospital. Patients, without severe thrombophilia and hormonal or active untreated autoimmune disorders, were randomly allocated (1:1) to receive for the whole cycle parnaparin, or routine hormonal therapy only. The primary endpoint was the clinical pregnancy rate and the secondary endpoints included implantation rate and live birth rate. Results: The clinical pregnancy and the live birth rate were similar in treated and controls (21.5% vs. 26.7%, p = 0.389; 18.5% vs. 20.6%, p = 0.757). The abortion rate was 10.3% vs 22.9%, p = 0.319, respectively. The subgroups analysis, ≤ 35, 36-38, 39-40 years, showed the following: comparable clinical pregnancy rate (22.5% vs 38.8%, p = 0.124; 21.8% vs 17.3%, p = 0.631; 19.4% vs 23.3%, p = 0.762 respectively) and live birth rate (16.3% vs 32.7%, p = 0.099; 20.0% vs 13.5%, p = 0.443; 19.4% vs 13.3%, p = 0.731 respectively) in treated vs controls. Sensitivity analyses on women with ≥ 3 previous attempts and first enrolment only, and subgroup analyses according to trial conclusion conditioning a small sample size with low statistical power. Conclusions: Our study excludes positive effect of parnaparin, once a day for the whole cycle, on clinical pregnancy rate in infertile women undergoing in vitro fertilization techniques.

Research paper thumbnail of The effect of parnaparin sodium on in vitro fertilization outcome: A prospective randomized controlled trial

Thrombosis Research, 2017

Introduction: In-vitro and in-vivo models suggest the influence of low-molecular weight heparin o... more Introduction: In-vitro and in-vivo models suggest the influence of low-molecular weight heparin on conception in infertile women undergoing in vitro fertilization procedures (IVF). In this randomized controlled trial we assessed whether a low-molecular weight heparin (parnaparin) could affect IVF outcomes. Materials and methods: 271 cycles were analyzed in 247 women having a first or subsequent IVF cycle at Fertility Center of Humanitas Research Hospital. Patients, without severe thrombophilia and hormonal or active untreated autoimmune disorders, were randomly allocated (1:1) to receive for the whole cycle parnaparin, or routine hormonal therapy only. The primary endpoint was the clinical pregnancy rate and the secondary endpoints included implantation rate and live birth rate. Results: The clinical pregnancy and the live birth rate were similar in treated and controls (21.5% vs. 26.7%, p = 0.389; 18.5% vs. 20.6%, p = 0.757). The abortion rate was 10.3% vs 22.9%, p = 0.319, respectively. The subgroups analysis, ≤ 35, 36-38, 39-40 years, showed the following: comparable clinical pregnancy rate (22.5% vs 38.8%, p = 0.124; 21.8% vs 17.3%, p = 0.631; 19.4% vs 23.3%, p = 0.762 respectively) and live birth rate (16.3% vs 32.7%, p = 0.099; 20.0% vs 13.5%, p = 0.443; 19.4% vs 13.3%, p = 0.731 respectively) in treated vs controls. Sensitivity analyses on women with ≥ 3 previous attempts and first enrolment only, and subgroup analyses according to trial conclusion conditioning a small sample size with low statistical power. Conclusions: Our study excludes positive effect of parnaparin, once a day for the whole cycle, on clinical pregnancy rate in infertile women undergoing in vitro fertilization techniques.

Research paper thumbnail of FSH and LH together in ovarian stimulation

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2004

The authors review the physiology of the ovulatory cycle and the role of the gonadotrophins in ov... more The authors review the physiology of the ovulatory cycle and the role of the gonadotrophins in ovulation induction in patients with anovulatory disorders and in multifollicular development for assisted reproductive technologies. The use of gonadotrophins with luteinizing hormone (LH) activity and the use of recombinant LH associated with follicle stimulating hormone (FSH) are discussed. The authors point out that administration of gonadotrophins with LH activity is essential in hypogonadotropic hypogonadal anovulation, and data available in the medical literature allow the conclusion that recombinant LH may be added to all ovarian stimulation protocols because it is difficult to determine which patients will benefit from LH administration and there is no evidence that LH affects adversely the outcome of ovarian stimulation. The use of recombinant LH in addition to recombinant FSH may be particularly useful when a GnRH antagonist is associated with the ovarian stimulation regimen, by preventing the fall in estradiol and diminishing FSH requirements.

Research paper thumbnail of Maturation of Hypothalamic-Pituitary-Gonadal Function in Normal Human Fetuses: Circulating Levels of Gonadotropins, Their Common a-Subunit and Free Testosterone, and Discrepancy between Immunological and Biological Activities of Circulating Follicle-Stimulating Hormone*

The Journal of Clinical Endocrinology & Metabolism, 1991

The recent availability of both cordocentesis, a low risk and effective technique for fetal blood... more The recent availability of both cordocentesis, a low risk and effective technique for fetal blood sampling, and ultrasensitive/highly specific two-site immunofluorometric assays (IFMA) for pituitary and chorionic glycoprotein hormone (I-LH, I-FSH, and I-CG) measurement prompted us to study the maturation of hypothalamic-pituitary-gonadal function in 114 normal human fetuses (49 females and 65 males) from 17-40 weeks gestation. The subjects were selected from 216 consecutive cordocenteses carried out for rapid karyotyping and diagnosis of fetal infection or hematological disorders. In addition, FSH bioactivity (B-FSH) was measured by rat Sertoli cell aromatase induction assay, glycoprotein hormone alpha-subunit (alpha-SU) by RIA, and circulating free testosterone (fT) by direct analog technique. No significant cross-reactions were recorded in the different measurement methods. In particular, alpha-SU did not interfere in any IFMA, and CG cross-reactivity in LH IFMA was 0.5%. Circulating I-LH, I-FSH, and B-FSH levels at 17-24 weeks gestation were significantly higher in female than in male fetuses (I-LH, 48 +/- 4 vs. 6.3 +/- 0.7 U/L; I-FSH, 35 +/- 2 vs. 0.7 +/- 0.1 U/L; B-FSH, 131 +/- 17 vs. 43.4 +/- 5.4 U/L). During the last weeks of gestation, a significant decrease in I-LH and I-FSH levels was seen in both female and male fetuses (I-LH, 0.24 +/- 0.05 and 1.0 +/- 0.3 U/L; I-FSH, 0.45 +/- 0.1 and 0.5 +/- 0.1 U/L), while serum B-FSH remained elevated, but the previously recorded difference between sexes disappeared (54.3 +/- 7.2 and 58.7 +/- 7.3 U/L). Circulating I-CG and alpha-SU levels at midgestation were elevated in both female and male fetuses (I-CG, 117 +/- 29 and 191 +/- 44 U/L; alpha-SU, 143 +/- 16 and 105 +/- 9 micrograms/L, respectively) and decreased thereafter (I-CG, 42 +/- 9 and 26 +/- 6 U/L; alpha-SU, 60 +/- 15 and 37 +/- 6 micrograms/L). Serum fT levels at midgestation were significantly lower in females than in males (4.3 +/- 0.9 vs. 10.0 +/- 0.8 pmol/L) and increased until term, when the difference between sexes disappeared (16.2 +/- 1.8 vs. 17.6 +/- 1.6 pmol/L).(ABSTRACT TRUNCATED AT 400 WORDS)

Research paper thumbnail of Laparoscopic management of infertility patients using 5-mm optic. The Humanitas Clinical Institute experience with 1406 consecutive cases

Placenta, 2011

Results: Endpoint detection of SYBR Ò green dye fluorescence demonstrated the presence of double-... more Results: Endpoint detection of SYBR Ò green dye fluorescence demonstrated the presence of double-stranded DNA into some elutes. Melting curve analysis and microfluidic electrophoresis technology suggested that the size of purified DNA molecules ranged between dozens and thousands of base pairs. We used primer set for 18S ribosomal RNA matching on multiple sites of genomic DNA to detect DNA by qPCR. Row fluorescence data and quantification plot showed the presence of detectable DNA in some elutes from embryo media. Moreover, after linear whole nuclear DNA amplification, high quality of amplified DNA (r A260/A280 >1.8, r A260/A230 >2) was obtained, with size ranging from 100-1000 bp (mean size w400 bp). In our pilot study we also defined correlations between amounts of total and nuclear cell-free DNA and embryo viability. For this purpose, for each embryo whose culture medium was analyzed, we collected data about its morphology and cleavage stage. Our preliminary results mirrored that the amount of DNA released in culture medium was higher for those embryos with a bad quality cleavage. Conclusions: Although the small size of the pilot study, the technology we are proposing may provide a novel, non-invasive tool for selection of embryos with the highest healthy development potential and thereby to allow a single-embryo transfer approach. Acknowledgments This project is funded by Merk Serono (Grant for Fertility Innovation 2011).

Research paper thumbnail of Fetal-maternal amino acid relationships in normal and intrauterine growth retarded (IUGR) pregnancies

Research paper thumbnail of In Vivo Placental Transport of Glycine and Leucine in Human Pregnancies

Pediatric Research, 1995

L-[I-13 C]Glycine and L-[I-13 C]leucine were infused as a bolus into 12 pregn ant patients carryi... more L-[I-13 C]Glycine and L-[I-13 C]leucine were infused as a bolus into 12 pregn ant patients carrying normal fetuses before fetal blood sampling at gestational ages ranging from 20 to 37 wk. Maternal venous samples were obtained every 2-3 min for 15 min after the bolus infusion . Fetal samples were obtained from the umbilical vein within 15 min of the bolus. Amino acid plasma enrichments (molar percent enrichment) were determined by gas chromatography-mass spectroscopy and their concentrations by ion exchang e chromatography. The ratios of glycine and leucine transfer were assessed from fetal/maternal enrichment ratios for each amino acid. We now report that over the gestational age range of 20-37 wk, under relativel y undisturbed fetomat ernal conditions (fetal blood sampling) , human placental glycine transfer is limited , with a glycinelleucine ratio = 0.16 ± 0.02. We

Research paper thumbnail of An evaluation of fetal glucogenesis in intrauterine growth-retarded pregnancies

Metabolism, 1993

The presence of fetal glucogenesis was evaluated in nine patients with pregnancies complicated by... more The presence of fetal glucogenesis was evaluated in nine patients with pregnancies complicated by intrauterine growth retardation (IUGR) at the time of fetal blood sampling (FBS) between 29 and 35 weeks of pregnancy. Eight were singleton pregnancies and one was a twin pregnancy in which blood samples were obtained from both twins. A maternal primed-constant infusion of D(U-13C]glucose was performed, and the presence of fetal glucogenesis was assessed by a comparison of steady-state maternal and fetal glucose enrichments. No significant difference was present between maternal and fetal molar percent excess ([MPE] P = .97), and the mean fetal to maternal (F/M) MPE ratio (0.99 +/- 0.01) was not significantly different from 1 (P = .76). F/M MPE ratio was independent of the time of FBS and umbilical venous glucose and lactate concentrations. Thus fetal glucogenesis is not demonstrable in a group of fairly severe growth-retarded fetuses after an overnight fast with this relatively noninvasive approach.

Research paper thumbnail of Maturation of Hypothalamic-Pituitary-Gonadal Function in Normal Human Fetuses: Circulating Levels of Gonadotropins, Their Common a-Subunit and Free Testosterone, and Discrepancy between Immunological and Biological Activities of Circulating Follicle-Stimulating Hormone*

The Journal of Clinical Endocrinology & Metabolism, 1991

The recent availability of both cordocentesis, a low risk and effective technique for fetal blood... more The recent availability of both cordocentesis, a low risk and effective technique for fetal blood sampling, and ultrasensitive/highly specific two-site immunofluorometric assays (IFMA) for pituitary and chorionic glycoprotein hormone (I-LH, I-FSH, and I-CG) measurement prompted us to study the maturation of hypothalamic-pituitary-gonadal function in 114 normal human fetuses (49 females and 65 males) from 17-40 weeks gestation. The subjects were selected from 216 consecutive cordocenteses carried out for rapid karyotyping and diagnosis of fetal infection or hematological disorders. In addition, FSH bioactivity (B-FSH) was measured by rat Sertoli cell aromatase induction assay, glycoprotein hormone alpha-subunit (alpha-SU) by RIA, and circulating free testosterone (fT) by direct analog technique. No significant cross-reactions were recorded in the different measurement methods. In particular, alpha-SU did not interfere in any IFMA, and CG cross-reactivity in LH IFMA was 0.5%. Circulating I-LH, I-FSH, and B-FSH levels at 17-24 weeks gestation were significantly higher in female than in male fetuses (I-LH, 48 +/- 4 vs. 6.3 +/- 0.7 U/L; I-FSH, 35 +/- 2 vs. 0.7 +/- 0.1 U/L; B-FSH, 131 +/- 17 vs. 43.4 +/- 5.4 U/L). During the last weeks of gestation, a significant decrease in I-LH and I-FSH levels was seen in both female and male fetuses (I-LH, 0.24 +/- 0.05 and 1.0 +/- 0.3 U/L; I-FSH, 0.45 +/- 0.1 and 0.5 +/- 0.1 U/L), while serum B-FSH remained elevated, but the previously recorded difference between sexes disappeared (54.3 +/- 7.2 and 58.7 +/- 7.3 U/L). Circulating I-CG and alpha-SU levels at midgestation were elevated in both female and male fetuses (I-CG, 117 +/- 29 and 191 +/- 44 U/L; alpha-SU, 143 +/- 16 and 105 +/- 9 micrograms/L, respectively) and decreased thereafter (I-CG, 42 +/- 9 and 26 +/- 6 U/L; alpha-SU, 60 +/- 15 and 37 +/- 6 micrograms/L). Serum fT levels at midgestation were significantly lower in females than in males (4.3 +/- 0.9 vs. 10.0 +/- 0.8 pmol/L) and increased until term, when the difference between sexes disappeared (16.2 +/- 1.8 vs. 17.6 +/- 1.6 pmol/L).(ABSTRACT TRUNCATED AT 400 WORDS)

Research paper thumbnail of Prospective randomized study comparing two soft catheters for embryo transfer

Fertility and Sterility, 2002

Prospective randomized study comparing two soft catheters for embryo transfer.

Research paper thumbnail of Fetal amino acids in normal pregnancies and in pregnancies complicated by intrauterine growth retardation

Early Human Development, 1992

Plasma amino acid concentrations were measured in normal (AGA) and intrauterine growth retarded (... more Plasma amino acid concentrations were measured in normal (AGA) and intrauterine growth retarded (IUGR) percutaneous umbilical blood sampling (PUBS) performed for prenatal diagnosis or at elective cesarean section. IUGR fetuses present significantly lower concentrations of most amino acids, with a significant reduction of the umbilical veno-arterial difference for total alpha-amino nitrogen. These findings are present early in growth retarded fetuses and may be potentially responsible for the growth retardation.

Research paper thumbnail of A study of the serum 3,5,3'-triiodothyronine sulfate concentration in normal and hypothyroid fetuses at various gestational stages

The Journal of Clinical Endocrinology & Metabolism, 1993

We have studied T3 sulfate (T3S) levels, blindly, in coded plasma samples from 21 normal and 3 hy... more We have studied T3 sulfate (T3S) levels, blindly, in coded plasma samples from 21 normal and 3 hypothyroid fetuses at different stages of gestation (19-42 weeks). Fetal plasma samples were obtained by cordocentesis. T3S was detectable in all samples studied, with values ranging from 50-294 (mean +/- SD, 130 +/- 62 pmol/L). Plasma T3S was low (< 45 pmol/L) in all 4 normal adult control subjects studied simultaneously; serum T3S ranged from less than 20 to 130 in another set of 18 control subjects (mean +/- SD, 63 +/- 32 pmol/L). Fetal T3S values were positively correlated with gestational age (r = 0.43; P < 0.05), but not with free T4 (FT4), FT3, or TSH values. In the 3 hypothyroid fetuses at 31, 38, and 40 weeks gestation, respectively, plasma TSH was elevated (26, 98, and 24 mU/L, respectively), FT4 was low (10, 6.7, and 7.5 pmol/L, respectively), and FT3 was normal or high (3.2, 8.2, and 2.2 pmol/L, respectively). However, T3S values in hypothyroid fetuses (88, 133, and 252 pmol/L, respectively) were similar to those in normal fetuses at corresponding gestational ages. We conclude that 1) T3S is detectable in fetal circulation from at least 19 weeks gestation, and its concentration increases with fetal-age; 2) plasma T3S concentrations in the fetus at 19-40 weeks gestation are at least comparable to but generally higher than those in the adult; and 3) plasma T3S levels in hypothyroid fetuses are similar to those in normal fetuses. Recent studies demonstrating the ability of some fetal rat tissues (e.g. cerebral cortex) to desulfate T3S to T3 have suggested a possible role of T3S as a source of T3. Normal T3S in fetal hypothyroidism suggests that T3S may contribute to attenuation of the effects of hypothyroidism during intrauterine life.

Research paper thumbnail of The effect of parnaparin sodium on in vitro fertilization outcome: A prospective randomized controlled trial

Thrombosis Research, Nov 1, 2017

Introduction: In-vitro and in-vivo models suggest the influence of low-molecular weight heparin o... more Introduction: In-vitro and in-vivo models suggest the influence of low-molecular weight heparin on conception in infertile women undergoing in vitro fertilization procedures (IVF). In this randomized controlled trial we assessed whether a low-molecular weight heparin (parnaparin) could affect IVF outcomes. Materials and methods: 271 cycles were analyzed in 247 women having a first or subsequent IVF cycle at Fertility Center of Humanitas Research Hospital. Patients, without severe thrombophilia and hormonal or active untreated autoimmune disorders, were randomly allocated (1:1) to receive for the whole cycle parnaparin, or routine hormonal therapy only. The primary endpoint was the clinical pregnancy rate and the secondary endpoints included implantation rate and live birth rate. Results: The clinical pregnancy and the live birth rate were similar in treated and controls (21.5% vs. 26.7%, p = 0.389; 18.5% vs. 20.6%, p = 0.757). The abortion rate was 10.3% vs 22.9%, p = 0.319, respectively. The subgroups analysis, ≤ 35, 36-38, 39-40 years, showed the following: comparable clinical pregnancy rate (22.5% vs 38.8%, p = 0.124; 21.8% vs 17.3%, p = 0.631; 19.4% vs 23.3%, p = 0.762 respectively) and live birth rate (16.3% vs 32.7%, p = 0.099; 20.0% vs 13.5%, p = 0.443; 19.4% vs 13.3%, p = 0.731 respectively) in treated vs controls. Sensitivity analyses on women with ≥ 3 previous attempts and first enrolment only, and subgroup analyses according to trial conclusion conditioning a small sample size with low statistical power. Conclusions: Our study excludes positive effect of parnaparin, once a day for the whole cycle, on clinical pregnancy rate in infertile women undergoing in vitro fertilization techniques.

Research paper thumbnail of The effect of parnaparin sodium on in vitro fertilization outcome: A prospective randomized controlled trial

Thrombosis Research, 2017

Introduction: In-vitro and in-vivo models suggest the influence of low-molecular weight heparin o... more Introduction: In-vitro and in-vivo models suggest the influence of low-molecular weight heparin on conception in infertile women undergoing in vitro fertilization procedures (IVF). In this randomized controlled trial we assessed whether a low-molecular weight heparin (parnaparin) could affect IVF outcomes. Materials and methods: 271 cycles were analyzed in 247 women having a first or subsequent IVF cycle at Fertility Center of Humanitas Research Hospital. Patients, without severe thrombophilia and hormonal or active untreated autoimmune disorders, were randomly allocated (1:1) to receive for the whole cycle parnaparin, or routine hormonal therapy only. The primary endpoint was the clinical pregnancy rate and the secondary endpoints included implantation rate and live birth rate. Results: The clinical pregnancy and the live birth rate were similar in treated and controls (21.5% vs. 26.7%, p = 0.389; 18.5% vs. 20.6%, p = 0.757). The abortion rate was 10.3% vs 22.9%, p = 0.319, respectively. The subgroups analysis, ≤ 35, 36-38, 39-40 years, showed the following: comparable clinical pregnancy rate (22.5% vs 38.8%, p = 0.124; 21.8% vs 17.3%, p = 0.631; 19.4% vs 23.3%, p = 0.762 respectively) and live birth rate (16.3% vs 32.7%, p = 0.099; 20.0% vs 13.5%, p = 0.443; 19.4% vs 13.3%, p = 0.731 respectively) in treated vs controls. Sensitivity analyses on women with ≥ 3 previous attempts and first enrolment only, and subgroup analyses according to trial conclusion conditioning a small sample size with low statistical power. Conclusions: Our study excludes positive effect of parnaparin, once a day for the whole cycle, on clinical pregnancy rate in infertile women undergoing in vitro fertilization techniques.

Research paper thumbnail of FSH and LH together in ovarian stimulation

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2004

The authors review the physiology of the ovulatory cycle and the role of the gonadotrophins in ov... more The authors review the physiology of the ovulatory cycle and the role of the gonadotrophins in ovulation induction in patients with anovulatory disorders and in multifollicular development for assisted reproductive technologies. The use of gonadotrophins with luteinizing hormone (LH) activity and the use of recombinant LH associated with follicle stimulating hormone (FSH) are discussed. The authors point out that administration of gonadotrophins with LH activity is essential in hypogonadotropic hypogonadal anovulation, and data available in the medical literature allow the conclusion that recombinant LH may be added to all ovarian stimulation protocols because it is difficult to determine which patients will benefit from LH administration and there is no evidence that LH affects adversely the outcome of ovarian stimulation. The use of recombinant LH in addition to recombinant FSH may be particularly useful when a GnRH antagonist is associated with the ovarian stimulation regimen, by preventing the fall in estradiol and diminishing FSH requirements.

Research paper thumbnail of Maturation of Hypothalamic-Pituitary-Gonadal Function in Normal Human Fetuses: Circulating Levels of Gonadotropins, Their Common a-Subunit and Free Testosterone, and Discrepancy between Immunological and Biological Activities of Circulating Follicle-Stimulating Hormone*

The Journal of Clinical Endocrinology & Metabolism, 1991

The recent availability of both cordocentesis, a low risk and effective technique for fetal blood... more The recent availability of both cordocentesis, a low risk and effective technique for fetal blood sampling, and ultrasensitive/highly specific two-site immunofluorometric assays (IFMA) for pituitary and chorionic glycoprotein hormone (I-LH, I-FSH, and I-CG) measurement prompted us to study the maturation of hypothalamic-pituitary-gonadal function in 114 normal human fetuses (49 females and 65 males) from 17-40 weeks gestation. The subjects were selected from 216 consecutive cordocenteses carried out for rapid karyotyping and diagnosis of fetal infection or hematological disorders. In addition, FSH bioactivity (B-FSH) was measured by rat Sertoli cell aromatase induction assay, glycoprotein hormone alpha-subunit (alpha-SU) by RIA, and circulating free testosterone (fT) by direct analog technique. No significant cross-reactions were recorded in the different measurement methods. In particular, alpha-SU did not interfere in any IFMA, and CG cross-reactivity in LH IFMA was 0.5%. Circulating I-LH, I-FSH, and B-FSH levels at 17-24 weeks gestation were significantly higher in female than in male fetuses (I-LH, 48 +/- 4 vs. 6.3 +/- 0.7 U/L; I-FSH, 35 +/- 2 vs. 0.7 +/- 0.1 U/L; B-FSH, 131 +/- 17 vs. 43.4 +/- 5.4 U/L). During the last weeks of gestation, a significant decrease in I-LH and I-FSH levels was seen in both female and male fetuses (I-LH, 0.24 +/- 0.05 and 1.0 +/- 0.3 U/L; I-FSH, 0.45 +/- 0.1 and 0.5 +/- 0.1 U/L), while serum B-FSH remained elevated, but the previously recorded difference between sexes disappeared (54.3 +/- 7.2 and 58.7 +/- 7.3 U/L). Circulating I-CG and alpha-SU levels at midgestation were elevated in both female and male fetuses (I-CG, 117 +/- 29 and 191 +/- 44 U/L; alpha-SU, 143 +/- 16 and 105 +/- 9 micrograms/L, respectively) and decreased thereafter (I-CG, 42 +/- 9 and 26 +/- 6 U/L; alpha-SU, 60 +/- 15 and 37 +/- 6 micrograms/L). Serum fT levels at midgestation were significantly lower in females than in males (4.3 +/- 0.9 vs. 10.0 +/- 0.8 pmol/L) and increased until term, when the difference between sexes disappeared (16.2 +/- 1.8 vs. 17.6 +/- 1.6 pmol/L).(ABSTRACT TRUNCATED AT 400 WORDS)

Research paper thumbnail of Laparoscopic management of infertility patients using 5-mm optic. The Humanitas Clinical Institute experience with 1406 consecutive cases

Placenta, 2011

Results: Endpoint detection of SYBR Ò green dye fluorescence demonstrated the presence of double-... more Results: Endpoint detection of SYBR Ò green dye fluorescence demonstrated the presence of double-stranded DNA into some elutes. Melting curve analysis and microfluidic electrophoresis technology suggested that the size of purified DNA molecules ranged between dozens and thousands of base pairs. We used primer set for 18S ribosomal RNA matching on multiple sites of genomic DNA to detect DNA by qPCR. Row fluorescence data and quantification plot showed the presence of detectable DNA in some elutes from embryo media. Moreover, after linear whole nuclear DNA amplification, high quality of amplified DNA (r A260/A280 >1.8, r A260/A230 >2) was obtained, with size ranging from 100-1000 bp (mean size w400 bp). In our pilot study we also defined correlations between amounts of total and nuclear cell-free DNA and embryo viability. For this purpose, for each embryo whose culture medium was analyzed, we collected data about its morphology and cleavage stage. Our preliminary results mirrored that the amount of DNA released in culture medium was higher for those embryos with a bad quality cleavage. Conclusions: Although the small size of the pilot study, the technology we are proposing may provide a novel, non-invasive tool for selection of embryos with the highest healthy development potential and thereby to allow a single-embryo transfer approach. Acknowledgments This project is funded by Merk Serono (Grant for Fertility Innovation 2011).

Research paper thumbnail of Fetal-maternal amino acid relationships in normal and intrauterine growth retarded (IUGR) pregnancies

Research paper thumbnail of In Vivo Placental Transport of Glycine and Leucine in Human Pregnancies

Pediatric Research, 1995

L-[I-13 C]Glycine and L-[I-13 C]leucine were infused as a bolus into 12 pregn ant patients carryi... more L-[I-13 C]Glycine and L-[I-13 C]leucine were infused as a bolus into 12 pregn ant patients carrying normal fetuses before fetal blood sampling at gestational ages ranging from 20 to 37 wk. Maternal venous samples were obtained every 2-3 min for 15 min after the bolus infusion . Fetal samples were obtained from the umbilical vein within 15 min of the bolus. Amino acid plasma enrichments (molar percent enrichment) were determined by gas chromatography-mass spectroscopy and their concentrations by ion exchang e chromatography. The ratios of glycine and leucine transfer were assessed from fetal/maternal enrichment ratios for each amino acid. We now report that over the gestational age range of 20-37 wk, under relativel y undisturbed fetomat ernal conditions (fetal blood sampling) , human placental glycine transfer is limited , with a glycinelleucine ratio = 0.16 ± 0.02. We

Research paper thumbnail of An evaluation of fetal glucogenesis in intrauterine growth-retarded pregnancies

Metabolism, 1993

The presence of fetal glucogenesis was evaluated in nine patients with pregnancies complicated by... more The presence of fetal glucogenesis was evaluated in nine patients with pregnancies complicated by intrauterine growth retardation (IUGR) at the time of fetal blood sampling (FBS) between 29 and 35 weeks of pregnancy. Eight were singleton pregnancies and one was a twin pregnancy in which blood samples were obtained from both twins. A maternal primed-constant infusion of D(U-13C]glucose was performed, and the presence of fetal glucogenesis was assessed by a comparison of steady-state maternal and fetal glucose enrichments. No significant difference was present between maternal and fetal molar percent excess ([MPE] P = .97), and the mean fetal to maternal (F/M) MPE ratio (0.99 +/- 0.01) was not significantly different from 1 (P = .76). F/M MPE ratio was independent of the time of FBS and umbilical venous glucose and lactate concentrations. Thus fetal glucogenesis is not demonstrable in a group of fairly severe growth-retarded fetuses after an overnight fast with this relatively noninvasive approach.

Research paper thumbnail of Maturation of Hypothalamic-Pituitary-Gonadal Function in Normal Human Fetuses: Circulating Levels of Gonadotropins, Their Common a-Subunit and Free Testosterone, and Discrepancy between Immunological and Biological Activities of Circulating Follicle-Stimulating Hormone*

The Journal of Clinical Endocrinology & Metabolism, 1991

The recent availability of both cordocentesis, a low risk and effective technique for fetal blood... more The recent availability of both cordocentesis, a low risk and effective technique for fetal blood sampling, and ultrasensitive/highly specific two-site immunofluorometric assays (IFMA) for pituitary and chorionic glycoprotein hormone (I-LH, I-FSH, and I-CG) measurement prompted us to study the maturation of hypothalamic-pituitary-gonadal function in 114 normal human fetuses (49 females and 65 males) from 17-40 weeks gestation. The subjects were selected from 216 consecutive cordocenteses carried out for rapid karyotyping and diagnosis of fetal infection or hematological disorders. In addition, FSH bioactivity (B-FSH) was measured by rat Sertoli cell aromatase induction assay, glycoprotein hormone alpha-subunit (alpha-SU) by RIA, and circulating free testosterone (fT) by direct analog technique. No significant cross-reactions were recorded in the different measurement methods. In particular, alpha-SU did not interfere in any IFMA, and CG cross-reactivity in LH IFMA was 0.5%. Circulating I-LH, I-FSH, and B-FSH levels at 17-24 weeks gestation were significantly higher in female than in male fetuses (I-LH, 48 +/- 4 vs. 6.3 +/- 0.7 U/L; I-FSH, 35 +/- 2 vs. 0.7 +/- 0.1 U/L; B-FSH, 131 +/- 17 vs. 43.4 +/- 5.4 U/L). During the last weeks of gestation, a significant decrease in I-LH and I-FSH levels was seen in both female and male fetuses (I-LH, 0.24 +/- 0.05 and 1.0 +/- 0.3 U/L; I-FSH, 0.45 +/- 0.1 and 0.5 +/- 0.1 U/L), while serum B-FSH remained elevated, but the previously recorded difference between sexes disappeared (54.3 +/- 7.2 and 58.7 +/- 7.3 U/L). Circulating I-CG and alpha-SU levels at midgestation were elevated in both female and male fetuses (I-CG, 117 +/- 29 and 191 +/- 44 U/L; alpha-SU, 143 +/- 16 and 105 +/- 9 micrograms/L, respectively) and decreased thereafter (I-CG, 42 +/- 9 and 26 +/- 6 U/L; alpha-SU, 60 +/- 15 and 37 +/- 6 micrograms/L). Serum fT levels at midgestation were significantly lower in females than in males (4.3 +/- 0.9 vs. 10.0 +/- 0.8 pmol/L) and increased until term, when the difference between sexes disappeared (16.2 +/- 1.8 vs. 17.6 +/- 1.6 pmol/L).(ABSTRACT TRUNCATED AT 400 WORDS)

Research paper thumbnail of Prospective randomized study comparing two soft catheters for embryo transfer

Fertility and Sterility, 2002

Prospective randomized study comparing two soft catheters for embryo transfer.

Research paper thumbnail of Fetal amino acids in normal pregnancies and in pregnancies complicated by intrauterine growth retardation

Early Human Development, 1992

Plasma amino acid concentrations were measured in normal (AGA) and intrauterine growth retarded (... more Plasma amino acid concentrations were measured in normal (AGA) and intrauterine growth retarded (IUGR) percutaneous umbilical blood sampling (PUBS) performed for prenatal diagnosis or at elective cesarean section. IUGR fetuses present significantly lower concentrations of most amino acids, with a significant reduction of the umbilical veno-arterial difference for total alpha-amino nitrogen. These findings are present early in growth retarded fetuses and may be potentially responsible for the growth retardation.

Research paper thumbnail of A study of the serum 3,5,3'-triiodothyronine sulfate concentration in normal and hypothyroid fetuses at various gestational stages

The Journal of Clinical Endocrinology & Metabolism, 1993

We have studied T3 sulfate (T3S) levels, blindly, in coded plasma samples from 21 normal and 3 hy... more We have studied T3 sulfate (T3S) levels, blindly, in coded plasma samples from 21 normal and 3 hypothyroid fetuses at different stages of gestation (19-42 weeks). Fetal plasma samples were obtained by cordocentesis. T3S was detectable in all samples studied, with values ranging from 50-294 (mean +/- SD, 130 +/- 62 pmol/L). Plasma T3S was low (< 45 pmol/L) in all 4 normal adult control subjects studied simultaneously; serum T3S ranged from less than 20 to 130 in another set of 18 control subjects (mean +/- SD, 63 +/- 32 pmol/L). Fetal T3S values were positively correlated with gestational age (r = 0.43; P < 0.05), but not with free T4 (FT4), FT3, or TSH values. In the 3 hypothyroid fetuses at 31, 38, and 40 weeks gestation, respectively, plasma TSH was elevated (26, 98, and 24 mU/L, respectively), FT4 was low (10, 6.7, and 7.5 pmol/L, respectively), and FT3 was normal or high (3.2, 8.2, and 2.2 pmol/L, respectively). However, T3S values in hypothyroid fetuses (88, 133, and 252 pmol/L, respectively) were similar to those in normal fetuses at corresponding gestational ages. We conclude that 1) T3S is detectable in fetal circulation from at least 19 weeks gestation, and its concentration increases with fetal-age; 2) plasma T3S concentrations in the fetus at 19-40 weeks gestation are at least comparable to but generally higher than those in the adult; and 3) plasma T3S levels in hypothyroid fetuses are similar to those in normal fetuses. Recent studies demonstrating the ability of some fetal rat tissues (e.g. cerebral cortex) to desulfate T3S to T3 have suggested a possible role of T3S as a source of T3. Normal T3S in fetal hypothyroidism suggests that T3S may contribute to attenuation of the effects of hypothyroidism during intrauterine life.