Sonia Cipriani

Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico | Policlinico Maggiore · Gynecology

Since the 1970s, several studies found that sperm concentration (SC) and total sperm count (TSC) constantly worsened over time, mainly in high‐income countries. To evaluate whether the decreasing trend in sperm count is continuing in Western European countries and USA, we performed a systematic review and meta‐regression analysis. Embase and Pubmed...

Background: Nutrition may impact reproductive health and fertility potential. The role of dietary antioxidants in affecting conception and birth outcomes is a topic of emerging interest. Methods: This cross-sectional analysis from a prospective cohort study aims to explore the relationship between the intake of antioxidants, vitamins, and carotenoi...

PurposeThe main aim of this study was to investigate the long-term risk of disease recurrence in women treated for high-grade vaginal intraepithelial neoplasia (HG-VaIN).Methods We conducted a retrospective analysis on a cohort of 82 women diagnosed with HG-VaIN between 2010 and 2021 at the “Regional Referral Center for Prevention, Diagnosis and Tr...

We conducted a systematic review and meta-analyses of the prevalence of Polycystic Ovary Syndrome (PCOS) and the frequency of its phenotypes in Europe and the USA, also focusing on temporal trends of the condition, to compare the PCOS prevalence among populations with a similar level of diagnostic resources availability and attitudes toward health...

Endometriosis is a complex and chronic disease, whose multifactorial nature has encouraged a deep investigation on the role of lifestyle factors. A strong association between alcohol intake and endometriosis risk has already been shown. We aimed to confirm this association, considering the updated literature. 23 eligible studies were identified thr...

Periodontal disease (PD) has been shown to increase the risk of preterm birth, preeclampsia and low birth weight. These observations have suggested that PD may also affect the early phase of pregnancy, including conception. The present study aimed to evaluate whether an association exists between oral health status and the chance of clinical pregna...

Objective To assess the impact of Assisted Reproductive Techniques (ART) on the risk of preterm birth (PTB). Study Design: This retrospective population-based study used healthcare utilization databases of the Lombardy Region to select all the deliveries occurred between 2007 and 2020. Log-binomial regression models were fitted to estimate prevalen...

In this study, we analyzed the estimated frequency of monozygotic (MZ) and dizygotic (DZ) spontaneous twins in Lombardy during the period 2007−2017. This is a population-based study using the regional healthcare utilization databases of the Lombardy Region. The total number of spontaneous twin deliveries, in separate strata of like and unlike sex,...

Several studies, reviews and meta-analyses have documented that D-mannose use lowers the risk of recurrent urinary tract infections (UTI), but its role in the treatment of UTI/cystitis-related symptoms is unclear. In particular, no systematic review has analyzed the role of treatment with D-mannose in acute UTI/cystitis. In this paper, we systemati...

Abstract Background All over the world, especially in the developed countries, maternal age at birth is rising. This study aimed to assess the role of maternal age on the occurrence of preterm birth (PTB) in a large birth cohort of Lombardy Region, Northern Italy. Methods This population-based study used data from regional healthcare utilization da...

Background Infertility involves 15% of couples in Italy and approximately 10-12% worldwide.Focusing on female fertility, it can underline multiple causes, among them the diet has a great influence. Methods We investigated whether the consumption of some fatty acids affects four outcomes of the assisted reproduction techniques. From September 2014 t...

Folic acid (FA) supplementation prevents neural tube defects (NTDs), but the effects on other reproductive outcomes are unclear. While common recommendation is 0.4 mg/day in addition to regular nutrition, the most appropriate dose of FA is still under debate. We investigated the effects of a higher dose of periconception FA on reducing adverse repr...

Several studies suggested that male's diet affects fertility. This cross-sectional analysis from a prospective cohort study aims to explore the relation between antioxidants intake and sperm parameters in sub-fertile couples referring to a Fertility center. Socio-demographic characteristics, health history, lifestyle habits, and diet information we...

Objectives: The purpose of this cross-sectional study was to prepare a reliable and easy-to-use architectural classification for vulvar lichen sclerosus (VLS) aimed at defining the morphological patterns of this condition. Materials and methods: An expert panel composed by 7 physicians with expertise in clinical care of vulvar conditions outline...

Objective To summarise the available evidence on frequency of ovarian cyst development during mammalian target of rapamycin inhibitors (mTORi) treatment. Methods PubMed/Medline and EMBASE databases were searched, from 1990 up to March 2020, using the following keywords: ‘tacrolimus’, ‘sirolimus’, ‘temsirolimus’, ‘everolimus’, ‘deforolimus’, ‘mTOR’...

Purpose: Irritable bowel disease and endometriosis are two common diseases characterized by chronic inflammation state and recurrent abdominal pain. As a consequence of sharing of symptoms and chronic inflammation, endometriosis and IBS may coexist and be misdiagnosed and this leads to delays in diagnosis, mismanagement, and unnecessary testing. I...

Objective We investigated whether lifestyle affects assisted reproduction technology (ART) outcomes. Design Cohort study. Setting Italian fertility unit. Participants From September 2014 to December 2016, women from couples presenting for evaluation and eligible for ART were invited to participate. Information on alcohol intake, current smoking...

Objective: During the lockdown period, the fear about the risk of infection in hospital has reduced the admission to Emergency Services (ES) with possible negative health effects. We have investigated the changes in the emergency flow occurred during SARS-CoV-2 pandemic in an obstetrics and gynecological ES and the short-term adverse outcomes on w...

Objective To determine the impact of women’s age on the cesarean section (CS) rate according to Robson groups 1, 2A, 3 and 4A. Study design Retrospective cohort study of term, livebirth, singleton pregnancies with spontaneous or induced labor who delivered at the San Paolo Hospital from 1996 through 2019, and had the Robson group assigned. Women w...

Background In this article, we have reviewed available data on the frequency of endometriosis considering separately the incidence and the prevalence of the disease using data from papers published from 2000 to June 2019. Study design Systematic review and meta-analysis. PubMed and EMBASE were searched for observational studies reporting data on t...

Research Question Is there an association between diet and poor ovarian response to controlled hyperstimulation in women with normal biomarkers of ovarian reserve? Design Women eligible for IVF at an Academic Fertility Center were invited to participate to this prospective cross-sectional study. Main inclusion criteria were: age 18-39 years, BMI 1...

The potential link between endometriosis and Inflammatory Bowel Disease (IBD) has been investigated over the last twenty years. Endometriosis shares with IBD features and symptoms so to become a significant diagnostic challenge, resulting in a delayed or indeterminate diagnosis. We conducted a systematic review to summarize the available data in li...

In recent decades, increasing attention has been paid to the influence of diet on reproductive health. Carbohydrates in diet affect glucose metabolism and multiple evidences showed the key role of insulin sensitivity in regulating female fertility. We designed a prospective cohort study to investigate the relation between dietary carbohydrate intak...

Diet has been suggested as a factor affecting sperm quality, both in healthy and infertile men. To study whether specific food groups and fatty acids (FA) intake were associated with sperm parameters of men from couples referring to an Italian Fertility Clinic, we conducted a cross‐sectional analysis. A semen sample was collected and analysed befor...

Aim of this study is to analyze determinants of breech presentation using information from two regional databases of Lombardy (Italy) including data on consecutive singleton breech and vertex deliveries occurred in the Region, between January 2010 and December 2015. Breech presentation occurred in 3.8% of all single deliveries. Main determinants of...

Background. Detrimental lifestyle habits have been indicated as potential causes of reduced fertility. Recently, studies have suggested an association between healthy diets and increased live birth rates after assisted reproduction techniques (ART). However, the issue remains under debate, and evidence is still accumulating. Objective. To study the...

Introduction We investigated the role of body mass index (BMI) and maternal age on the risk of late-term induction, prolonged induction time and caesarean section (CS) after induction. Material and Methods This is a retrospective, observational study. All women without any fetal or maternal pathological condition, uterine scars or any other indica...

In response to the letter of Pace and Multani, in general, we cannot disagree with their considerations about the use of odds ratios, risk ratios, and rate ratios. [...]

Caffeine intake, a frequent lifestyle exposure, has a number of biological effects. We designed a cohort study to investigate the relation between lifestyle and assisted reproduction technique (ART) outcomes. From September 2014 to December 2016, 339 subfertile couples referring to an Italian fertility clinic and eligible for ART procedures were en...

Background The association between alcohol intake and male reproductive function is still controversial. In the frame of a prospective cohort study, designed to investigate the relation between life style and fertility, we performed a cross‐sectional analysis of semen quality. Methods Men of subfertile couples, referring to an Italian Infertility...

Riassunto Prove valide dei rischi e benefici di un intervento sono essenziali per migliorare la qualità delle cure, definire le linee guida, informare le politiche sanitarie. Gli studi clinici controllati randomizzati (RCT) e le metanalisi di RCT sono considerate il gold standard nel fornire le prove di efficacia di un intervento. Gli RCT sono spes...

Semen quality and male fertility are declining worldwide. As it was observed that physiologic and pathologic processes of spermatogenesis can be influenced by diet, the relation between dietary habits and semen parameters has been the focus of much interest. To review the human observational studies on this issue, we performed a systematic literatu...

The published data about alcohol consumption and uterine myoma are scanty and controversial: some studies found positive association whereas other studies showed no association.To conduct a systematic review and meta-analysis to determine whether alcohol is a risk factor for myoma.A MEDLINE/EMBASE search was carried out, supplemented by manual sear...

Queries Embase/Medline_May2017. (XLSX)

PRISMA 2009 checklist. (PDF)

Objective: There is no consensus in current practice guidelines whether IVF/ICSI conception represents an indication for performing a fetal echocardiogram. The aim of the study is to assess whether CHD occurs more often with the use of in-vitro-fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) techniques as compared to spontaneous pregn...

Background: Alcohol consumption, a common habit worldwide, may affect estrogen levels. A relation between alcohol intake and endometriosis risk has been suggested. Materials and Methods: Case-control study including 80 infertile women with histologically confirmed endometriosis and 90 women, admitted for a wide spectrum of acute conditions unrelate...

Background Semen quality, a predictor of male fertility, has been suggested to be declining worldwide. Among other life style factors, male caffeine/coffee consumption was hypothesized to influence semen parameters, but also sperm DNA integrity. To summarize available evidence, a systematic review of observational studies on the relation between co...

So far data on the effect of assisted reproductive technologies (ART) on the components of first trimester combined screening for Down syndrome are still controversial. A systematic search of the literature was performed in order to identify the effect of ART, particularly IVF and ICSI with fresh embryo transfer, on the nuchal translucency (NT), fr...

Objective This prospective study aims to analyse the relation between PM10 exposure during pregnancy and birth weight (BW), placental weight (PW) and umbilical artery PH (UAPH). Study design Population included 3614 women born in Italy, living in Lombardia Region, consecutively admitted to the Clinica Mangiagalli for an elective cesarean section fr...

Alcohol consumption is widespread in the Western world. Some studies have suggested a negative association between alcohol intake and semen quality although others have not confirmed this. MEDLINE and Embase were searched using ‘alcohol intake’ OR ‘alcohol consumption’ OR ‘alcohol drinking’ OR ‘lifestyle’ combined with ‘semen quality’ OR ‘sperm qua...

Background: The potential association between endometriosis and physical activity (PA) has been suggested in several epidemiological studies. We aimed to establish whether PA influences endometriosis risk. Methods: MEDLINE and EMBASE were searched using “physical activity” OR “exercise” combined with “endometriosis,” in Medical Subject Headings and...

Among preterm births, different clinical conditions are included: mainly spontaneous and medical induced. In fact, about 30% of preterm (particularly late preterm) births are medically indicated and the birth weight of these cases may differ from spontaneous preterm birth. In this paper, we have analyzed separately the percentiles of weight at birt...

Objective: to analyze respiratory distress syndrome (RDS) incidence and risk factors at different gestational age. Methods: we considered data from 321,327 infants born in Lombardy, a Northern Italian Region. We computed multivariate analysis to identify risk factors for RDS by dividing infants in early and moderate preterm, late preterm and ter...

Elective caesarean section (CS) before 39 completed weeks of gestation increases likelihood of respiratory morbidity in newborns and admissions in neonatal intensive care. Thus, guidelines have recommended that planned caesarean section should not be routinely carried out before 39 completed weeks of gestation. In this paper, we have analyzed the t...

Country specific birthweight curves may reflect the ethnic composition of that population and may offer information on the “true“ birth weight distribution of new births from native and foreign mothers. In consideration of the fact that in Italy now about 30% new births born in foreigners, we analyzed the centiles of weight at birth separately for...

Recent studies have suggested that ovarian stimulation and assisted reproductive techniques (ART) may increase the frequency of monozygotic twins. In this article, we present the analysis of the estimated frequency of twin deliveries following in vitro fertilization (IVF) in Lombardy during the period 2010–2014 for a total of 450,949 pregnancies. M...

Objective: To review the literature on the relationship between smoking and the risk of uterine myoma, we conducted a systematic review and a meta-analysis of published studies. In this meta-analysis, we included all identified studies of association between smoking and uterine myoma where these were case-control or cohort studies, reporting origi...

Background. Spontaneous abortions (SA) were analyzed in an industrialized Italian region over a 15-year period to evaluate time trends. Retrospective cohort study. Methods. Since 1991, in Lombardy a standard form has been used to register all discharges from public or private hospitals. This study analyzed the Lombardy Region registry of hospital a...

Background: Using data from the Hospital Discharge data-base (SDO) and from the Certificate of Delivery Assistance data-base (CedAP) we analysed mode of delivery and neonatal care in public and private hospitals in Lombardy Region during 2012. Methods: In Lombardy a standard form is used to register all discharges from public or private hospital...

Aim of this study was to investigate the association between congenital malformations and type of conception (spontaneous or medically assisted). This is a population based study using data from the regional data base of Lombardy, a Northern Italian Region with a population of about 10 million inhabitants. Included in the study were 277,043 neonate...

Objective To investigate the impact of intimate partner violence (IPV) on the risk of repeat induced abortion (RIA), we compared IPV history among women with and without previous induced abortion (IA). Methods All consecutive women aged 18 years or more requiring IA in 12 Italian abortion clinics were eligible for inclusion in the study. They were...

Since conflicting results have been published on the role of tobacco smoking on the risk of endometriosis, we provide an up-to-date summary quantification of this potential association. We performed a PubMed/MEDLINE search of the relevant publications up to September 2014, considering studies on humans published in English. We searched the referenc...

Objective: Cohort and case-control studies have suggested that adult physical activity (PA) may lower endometriosis risk and improve symptoms, but evidence is still controversial. To add information on leisure and occupational PA impact, if any, on endometriosis risk, we have analyzed data from a small case-control study conducted in Milan (Italy)....

Aim: The aim was to study prevalence of menstrual symptoms and their presenting patterns, and to assess nutrition and behaviours correlates. Methods: The study enrolled 108 women, who were prospectively assessed for menstrual symptoms; a 212 items questionnaire about lifestyle and nutrition was administered. Diagnosis and intensity of symptoms w...

Objective Endometrioid and clear cell ovarian tumors have been referred to as “endometriosis associated ovarian cancers”. However, very few studies have compared clinical and prognostic features of endometriosis- or not associated cancers according to specific histotypes. We have investigated clinical and histologic features of the largest publishe...

To analyse the hysterectomy rates (HR) temporal trends for gynecological benign conditions in Lombardy, Northern Italy. Since 1991, discharges from public or private hospitals have been registered in a standard form (Lombardy Region registry). Women aged ≥20 years, residing in Lombardy, who underwent hysterectomy for benign conditions, were include...

The potential association between endometriosis and coffee/caffeine consumption has been analysed in several epidemiological studies. In order to establish whether caffeine influences the risk of endometriosis, we provide to summarize the evidence from published studies on this issue. We performed a meta-analysis of epidemiological studies publishe...

To analyze the effects of pregnancy and early events in the newborn on the risk of subsequent atopic dermatitis (AD) during the first year of life. This is a prospective multicenter cohort study of newborns during the first year of life. Newborns identified on random days in three obstetrics departments in the area of Bergamo, Lombardy, Northern It...

Objective: To offer a general figure of the available data on the relation between alcohol intake and risk of endometriosis, we conducted a systematic review and a metaanalysis of studies published up to May 2012. Study design: We carried out a literature search of all case-control and cohort studies published as original articles in English up...

Background: In recent years, epidemiological data showed that the incidence of ectopic pregnancies (EP) is decreasing, but few data are available on the time trend in Southern European populations. Methods: Using data from the Lombardy Region Database, we calculated and standardized the EP rates/10,000 resident women and the ratios/1,000 pregnan...

Objectives To estimate the cost of chronic pain in Italian general practice from a payer perspective. Design A retrospective study of two months’ duration. Methods 48 General Practitioners (GPs) in Italy recruited 543 patients who attended a consultation during the period January–September 2001. Afterwards, patients were classified in three group...

Endometrial cancer (EC) is the seventh most common female cancer in the world and the fourth in developed countries, where the age-standardised incidence rates are more than twice that of developing countries. About 290,000 new cases of EC are diagnosed every year worldwide, 90% in women older than 50. About 74,000 women die every year for EC. Beca...

Objective: To compare two staining methods to assess sperm morphology: Diff-Quik (DQ), which is the fastest of the recommended techniques, and Testsimplets (TS), a technique that uses prestained slides and is quite popular in in vitro fertilization (IVF) centers. Design: Prospective study. Setting: Patients at the Sterility Center of the Obste...

ABSTRACT Objectives Data from southern European countries concerning teenage pregnancy have not been properly analysed so far. We provide the temporal trend of adolescent pregnancy rates in Lombardy, Northern Italy. Methods Using the hospital discharge register (1996-2010), teenage pregnancy-related admission rates per 1000 girls aged 13 to 19 year...

Objective: This study aimed to analyze long-term survival of clear cells (CCs) and endometrioid (E) ovarian cancer cases according to presence of endometriosis in the pathologic report. Methods: This is a retrospective analysis of 47 CC and 66 E ovarian cancer cases observed consecutively at our center between 1990 and 2010.All cases had first s...

Purpose: To analyze the temporal trends of peripartum hysterectomy (PH) in the period 1996-2010 in Lombardy, Italy. Methods: Using data from the Regional Database, PH ratios/1,000 deliveries were calculated from 1996 to 2010, in strata of age and mode of delivery among women resident in Lombardy, Italy. PH cases were identified searching the dat...

Please cite this paper as: Vercellini P, Parazzini F, Pietropaolo G, Cipriani S, Frattaruolo M, Fedele L. Pregnancy outcome in women with peritoneal, ovarian and rectovaginal endometriosis: a retrospective cohort study. BJOG 2012;119:1538–1543. We retrospectively assessed pregnancy outcome in 419 women who achieved a first spontaneous singleton pre...

To analyze in the real life clinical setting the effect offluorchinolones treatment in the management of elevated (4-10 ng/ml) prostate-specific antigen level we conducted an observational prospective cohort study. Eligible for the study were subjects aged 45-75 years with a PSA level 4-10 ng/ml, consecutively observed during their routine practice...