2019 - IDENTIFICATION OF RESEARCH PRIORITIES IN INFERTILITY AND ASSISTED REPRODUCTION AN INTERNATIO - Prof. Antonio La Marca
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Prof. La Marca receives by appointment at the Policlinico di Modena.

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Prof. Antonio La Marca

2019 - IDENTIFICATION OF RESEARCH PRIORITIES IN INFERTILITY AND ASSISTED REPRODUCTION AN INTERNATIO

Published in: Biomedicine online

Research question: What are the main research interests among patients of assisted reproductive technologies (ART)? Design: Cross-sectional study consisting of an anonymous online survey sent to 2112 patients from eight centres in four countries in 2018. Patients were asked to identify research questions relevant to them in the field of infertility and ART. Answers were categorised into topics and ranked by frequency. A long list of the top 30 research topics was extracted from the aggregate results, from which a short list of the top 10 research topics was created. Ten research questions were finally formulated. Results: A total of 945 responses were analysed. Main interests were side-effects, success rates, infertility prevention and emotional support. The 10 research questions were: 1. What are the side-effects of drugs used in ART treatments? (51.6%). What are the most effective methods to cope with infertility from the psychological point of view? (35.7%). What effects could diet have on fertility? (25.9%). What are ART success rates per clinical profile? (24.8%). 5. Are there some habits and lifestyle factors that could prevent infertility? (20.0%). What are the long-term risks associated with ART in mother and child? (18.5%). 7. Are alternative therapies such as acupuncture, yoga and meditation effective to treat/prevent infertility? (18.5%). 8. What is the impact of exercise on fertility? (15.4%). How does oocyte quantity and quality affect fertility? (9.5%). What are the genetic patterns or hereditary conditions causing/related to infertility? (9.5%). Conclusions: Researchers and clinicians should keep in mind that, in addition to success rates and safety, patients greatly value yield.

Performances

Myolysis or thermoablation of uterine fibroids

Myolysis or Thermoablation is a technique currently only performed in a few centres. Prof La Marca personally handles the method and receives patients from all over the country to perform this innovative therapy.

Radiofrequency and microwaves for gynaecological pathology

Radiofrequency and microwaves have been introduced into our clinical practice with excellent results. Prof La Marca is considered among the pioneers for the use of this procedure in gynaecology and receives patients from all over the country for the ultra minimally invasive treatment of uterine fibroids and adenomyosis.

In vitro fertilisation

In vitro fertilisation is a therapeutic strategy that is far from standardised. Like all medical and surgical practices, it is greatly affected by the technical skills and cultural updating of the practitioners involved. The results are therefore by far operator-dependent. This aspect is very little known, both by clinicians and patients.

Gynaecological endocrinology

The ovarian and menstrual function of women is extremely delicate and responds to a complex interaction between the centres (hypothalamus-pituitary) and the periphery (ovary-uterus).

Transfer to the blastocyst stage

In in vitro fertilisation, fertilised oocytes (zygotes) are kept in the laboratory, in incubators, under controlled temperature conditions (37°C) and an atmosphere with 5% oxygen and 6% carbon dioxide.

Infertility

It is well known that a considerable percentage of couples experience difficulties in conceiving. It is estimated that 10-15% of the population can be classified as infertile.

Recurrent abortion

Miscarriage is defined as a termination of pregnancy that occurs spontaneously within 24 weeks of gestation.

Diagnostic and operative hysteroscopy

Diagnostic Hysteroscopy is an endoscopic technique that can be performed in an outpatient setting using a hysteroscope.

Heterologous fertilisation

For certain clinical conditions, couples desiring offspring must resort to gametes (oocytes and/or spermatozoa) from voluntary and disinterested donors in order to fulfil their reproductive desire.

Fertility preservation

Over the past three decades, a phenomenon has taken hold in the Western world that is likely to have major implications for birth rates: the scheduling of births at a significantly older age than in the past.

Gynaecology and obstetrics

Gynaecology and Obstetrics is the medical discipline par excellence in the care of women. The aim of this clinical speciality has always been to care for the patient in all phases of her life.

Diagnosis and treatment of adenomyosis

At our clinic, the diagnosis and therapy of adenomyosis is performed to the most up-to-date standards. Prof La Marca is among the clinicians with the most experience in treating adenomyosis with thermoablation, an innovative therapeutic strategy for this disease.

Diagnostic examinations

Diagnostic examinations in gynaecology and obstetrics are nowadays very accurate and their correct execution and interpretation are the basis for the right clinical picture of the patient and the most appropriate therapeutic strategy.

Fibroids therapy

Uterine leiomyomas, more commonly called fibroids, are benign solid neoformations and represent the most frequent gynaecological neoplasm in women of childbearing age.

Uterine anomalies

An arrest of the organogenic stages can cause uterine and vaginal abnormalities of varying degrees.

Endometriosis

Endometriosis is a chronic, oestrogen-dependent inflammatory disease characterised by the presence of functional endometrial tissue (glands and stroma) in extrauterine sites.

Menstrual cycle disorders

It represents the most obvious and measurable clinical sign of pubertal maturation and in most women it occurs about two to three years after the onset of telarche with an average age of around 12½ years.

Intrauterine insemination

A Level I medically assisted procreation procedure based on the deposition of spermatozoa directly inside the uterine cavity. This procedure is carried out after ovulation induction.

Outpatient ultrasound aspiration of ovarian cysts

At our clinic, Prof La Marca personally handles the method. Ultrasound-guided aspiration of ovarian cysts is an ultra-mini-invasive method that is only available in very few centres nationwide. If there are the right indications, the method allows a rapid and non-invasive solution for the pathology in question

Tubal recanalisation

At our clinic, Prof La Marca personally handles the method. Endoscopic tubal recanalisation, where indicated, is today performed in only a few centres throughout Europe. The expertise is therefore concentrated in a limited number of experts capable of performing it correctly.

Assisted laser hatching

Laser-assisted hatching (LAH) is a laboratory technique that consists of cutting a small section of the zona pellucida (ZP).

IMSI, intracytoplasmic sperm injection

This is a level II technique used in the field of in vitro fertilisation. It takes the form of a variant of traditional ICSI, both of which consist of the direct injection of a spermatozoon into the cytoplasm of the oocyte.