Publications by authors named "Simone Palini"

Research Question: What effect does the use of a rapid warming method of vitrified embryos have on survival and pregnancy?

Design: A comparison of two different warming embryos protocols: long protocol (group 1, n = 486) and a new fast protocol (group 2, n = 413) for blastocyst and cleavage stage frozen embryo transfers at two IVF centres: Assisted Reproductive Technology Centre, Careggi University Hospital Firenze and IVF Unit, 'Cervesi' Hospital Cattolica. Total pregnancy rate was considered primary outcome, and embryo survival rate, clinical pregnancy rate, miscarriage rate, ongoing pregnancy rate and mean time required for warming procedure were considered secondary outcomes.

Results: The same embryo survival rate was observed in the two groups.

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Background And Aims: Vaginal microbiomes have been classified into five different general categories, termed Community State Type (CSTs), with CST-III and CST-IV often associated with vaginal dysbiosis which makes women more prone to recurrent infections and assisted reproductive technology (ART) failure. Since a healthy microbiome is one of the key steps for successful reproduction, we investigated the impact of modulating the vaginal microbiota through the oral administration of probiotic formula consisting of a consortium of vaginal-specific lactobacilli and prebiotics (Personal Flora 2).

Methods: We recruited 32 women who had previous failed IVF cycles and were scheduled to undergo ART.

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Purpose: The paper aims to investigate the biological role of microRNAs secreted by preimplantation embryo into the blastocoel fluid and to detect a distinctive molecular signature for identifying embryos with the highest implantation potential.

Methods: We carried on a multicenter retrospective study involving five European IVF centers. We collected 112 blastocoel fluid samples from embryos on day 5 post-fertilization, cultured individually, along with data on blastocyst grade and embryo transfer outcomes.

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Today, women's infertility is considered a social disease in females, occurring not only as an effect of POF (premature ovarian failure) but also as CTRI (cancer treatment-related infertility) in oncologic patients. Several procedures for FP (fertility preservation) are currently adopted to prevent this condition, mostly based on utilization of retrieved eggs from the patients with subsequent IVF (in vitro fertilization) or cryopreservation. However, great interest has recently been devoted to OSCs (ovarian stem cells), whose isolation from female ovaries, followed by their in vitro culture, led to their maturation to OLCs (oocyte-like cells), namely, neo-oocytes comparable to viable eggs suitable for IVF.

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Introduction: Fertility preservation (FP) and monitoring has considerable relevance in the multidisciplinary approach to cancer patients. In these consensus-based practical recommendations, the scientific societies Fondazione Italiana Linfomi (FIL) and Società Italiana della Riproduzione Umana (SIRU) reviewed the main aspects and identified the optimal paths which aim to preserve and monitor fertility in patients diagnosed with lymphoma at the different phases of the disease and during long-term survivorship.

Methods: For the Panel, eleven experts were selected for their expertise in research and clinical practice on onco-fertility and lymphoma.

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Follitropin delta (Δ) is a recombinant human follicle-stimulating hormone (rFSH), like natural human FSH, that can stimulate the development and growth of multiple follicles. Treatment with Follitropin-Δ may cause mild to severe adverse reactions, such as the risk of developing ovarian hyperstimulation syndrome, resulting in nausea, vomiting and diarrhea, weight loss, respiratory difficulty, stomach swelling and discomfort of the pelvic area, headaches, and fatigue. To date, the effects of a Follitropin-Δ overdosage are unknown, and no data are reported in the scientific literature or in the drug data sheet.

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Article Synopsis
  • The vaginal microbiota is essential for female reproductive health, influencing gynecological disorders and infertility.
  • Lactobacilli are key beneficial bacteria, producing substances that inhibit harmful microorganisms and maintain a balanced environment.
  • This review discusses how factors like hormonal changes and antibiotic use can disrupt vaginal health, affecting Assisted Reproductive Technology (ART) outcomes, and suggests strategies to restore a healthy microbiota.
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Article Synopsis
  • Intracytoplasmic sperm injection (ICSI) was originally developed to address severe male infertility issues that conventional in-vitro fertilization (cIVF) could not solve, but it is increasingly being used for other infertility cases.
  • Various non-male factor reasons for using ICSI include previous failed fertilizations, poor-quality or few oocytes, advanced maternal age, preimplantation genetic testing, and unexplained infertility.
  • Despite the growing popularity of ICSI, there is limited data to support better outcomes compared to cIVF, and it's important to consider factors such as fertilization failure risk, procedure costs, and associated risks when choosing between the two techniques.
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The success of an assisted reproduction cycle should be the achievement of a healthy singleton live birth following the replacement of one embryo. Therefore, one of the most critical points for embryologists has been the selection criteria and how to choose the best embryo to transfer with high implantation potential. In this vein, morphological evaluation has been historically the method applied.

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After the controlled ovarian stimulation (COS), the number of cumulus oocyte complexes collected is lower than predicted. The aim of this study is to understand if there is a possible reason for that deficient ovarian response. It was hypothesized that this is associated with the SNP (single-nucleotide polymorphism) of the FSH receptor (FSHr), specifically c.

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Aims: The well-documented relationship between sperm oxidation and male infertility strongly encourages the development of assays for reactive oxygen species detection in semen samples. The present study aims to apply the microplate-based 2',7'-dichlorofluorescein diacetate assay to the evaluation of oxidative stress in unprocessed whole semen, thus avoiding sample centrifugations and other manipulations that may cause significant reactive oxygen species increments.

Main Methods: The fluorescence assay consisted in the quantification of both intracellular and extracellular reactive oxygen species levels in unwashed semen specimens by using the probe 2',7'-dichlorofluorescein diacetate into a 96-well plate.

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Article Synopsis
  • Clinical embryologists in Europe work in various roles within Medically Assisted Reproduction (MAR) centres but lack a standardized educational pathway.* -
  • In Italy, these professionals must complete a 3-4 year unpaid postgraduate specialization in fields like Genetics, Microbiology, Clinical Pathology, or Nutrition, with limited access to such programs.* -
  • The reliance on senior colleagues for training and the lack of uniformity in training curricula across Europe complicate recruitment and educational consistency for clinical embryologists.*
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Background And Aims: Failure of the embryo to implant causes about three-fourths of lost pregnancies. Female genital tract microbiota has been associated to Assisted Reproductive Technologies (ART) outcomes. The objective of this study was to analyze the microbiota of human cervical swab and to correlate these findings with the ART outcomes.

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Background: Total fertilization failure represents a particularly frustrating condition for couples undergoing in vitro fertilization. With the aim of reducing the occurrence of total fertilization failure, intracytoplasmic sperm injection (ICSI) has become the first choice over conventional in vitro fertilization (IVF) procedures although evidence of improved results is still debated and its use in couples without male factor infertility is not recommended. Among the strategies potentially useful to promote the use of conventional IVF, we herein call attention to the late rescue ICSI, which consists in performing ICSI after 18-24 h from conventional insemination on oocytes that show no signs of fertilization.

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Article Synopsis
  • Novel anti-cancer treatments have improved survival rates for young female cancer patients, but many still face infertility due to treatment-related effects, especially from gonadotoxic therapies like radiation.
  • Existing methods for preserving fertility include hormonal stimulation for egg freezing, use of GnRH agonists during treatment, and gonadal shielding during radiation; however, new innovative techniques are emerging that don't require hormone stimulation.
  • These advancements include ovarian cortex cryopreservation for future reimplantation and utilizing ovarian stem cells to create oocytes in the lab, offering potential for selecting the healthiest eggs for fertility restoration.
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Background: Letrozole is widely employed as ovulation induction agent in women with PCOS, but its use in mild stimulation (MS) protocols for IVF is limited. Aim of the present study was to evaluate the feasibility of a MS protocol with letrozole plus hMG in non-obese PCOS women undergoing IVF after a metformin pre-treatment.

Methods: We retrospectively evaluated the data of 125 non-obese PCOS undergoing MS with letrozole plus hMG, 150 IU as starting dose, (group 1, N = 80) compared to those undergoing a conventional IVF stimulation protocols (CS) (group 2, N = 45) prior to IVF.

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  • This study aimed to assess the effectiveness of the micro swim-up method for sperm preparation in ICSI treatments, comparing it to a traditional centrifuge method.
  • In a multicentric study with 140 ICSI cycles, two groups were formed based on the sperm preparation techniques used: one used discontinuous gradients and the other used the micro swim-up method.
  • Results showed no significant difference in fertilization rates, but the micro swim-up group had higher blastulation and pregnancy rates, suggesting it may be a cost-effective and efficient alternative to traditional methods.
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The aim of this pilot study was to assess if array comparative genomic hybridization (aCGH), non-invasive preimplantation genetic screening (PGS) on blastocyst culture media is feasible. Therefore, aCGH analysis was carried out on 22 spent blastocyst culture media samples after polar body PGS because of advanced maternal age. All oocytes were fertilized by intracytoplasmic sperm injection and all embryos underwent assisted hatching.

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Background: Preimplantation genetic diagnosis (PGD) currently relies on biopsy of one or few embryo cells. Our aim was to evaluate the embryo extracellular matrices (spent medium and blastocoele fluid) as source of DNA for embryo genotyping.

Results/methodology: We first evaluated the amplifiability and the amount of genomic DNA in spent embryo culture media from day 3 (n = 32) and day 5/6 (n = 54).

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Objective: This study aimed to assess the levels of microbial contamination in semen samples before and after the micro swim-up (MSU) procedure in intra-cytoplasmic sperm injection (ICSI). The new method is an upgrade to the classic wash swim-up procedure.

Methods: Semen analysis and microbiological tests were carried out before and after the MSU procedure.

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Since 1989, the year of the first pre-implantation genetic diagnosis (PGD), many developments occurred both in assisted reproduction techniques and in molecular tools. While PGD is a well-established and documented application, pre-implantation genetic screening (PGS) for the detection of aneuploid embryos is still debated due to the presence of mosaicism in the embryo, but especially to the knowledge of the limits that label an embryo as healthy or as appropriate to the life. The aim of this review is to present the state-of-the-art in the field of PGD and PGS, illustrating its benefits and limitations, along with biopsy techniques and the use of new high-throughput technologies.

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Purpose: To evaluate whether the in vitro incubation of spermatozoa with myoinositol may improve the fertilization rate in ICSI cycles.

Methods: This is a prospective, bicentric, randomized study on 500 MII sibling oocytes injected in 78 ICSI cycles performed between March and October 2013. Randomization of the oocytes into two groups was performed at the time of the denudation.

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Article Synopsis
  • - The study investigates how ovarian stimulation during IVF/ICSI affects antioxidant levels in women, focusing on changes at three different stages: baseline, after pituitary suppression, and on the day of oocyte retrieval.
  • - Key findings show significant drops in plasma levels of vitamins C and E, and carotenoids between the suppression stage and oocyte retrieval, implying increased oxidative stress.
  • - Higher levels of plasma vitamin E were linked to better outcomes, with women who became pregnant showing higher concentrations of this antioxidant, indicating its potential importance for improving IVF/ICSI success rates.
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Oxidative stress plays a fundamental role in the aetiology of male infertility by negatively affecting sperm quality and function. Assessment of blood and seminal plasma oxidative profiles might be a valuable tool to improve evaluation of sperm reproductive capacity and functional competence. This study examined the lipid-soluble antioxidant profile and levels of lipid peroxidation both in blood and seminal plasma samples of infertile and fertile males, in relation to semen parameters.

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