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Your search keyword '"Orvieto, Raoul"' showing total 761 results
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761 results on '"Orvieto, Raoul"'

23. A simple and practical approach to elective egg freezing to control costs and expand access to care.

Author

Orvieto, Raoul and Gleicher, Norbert

Abstract

Social elective egg freezing (EEF) is now widely used globally but in many countries is unaffordable to many women because of high costs and lacking insurance coverage. Efforts to reduce costs, therefore, are of importance. Surprisingly, a simple, well-defined and practical approach ensuring optimal outcomes for EEF has, however, so-far not been published. We, therefore, conducted a narrative review of the literature for relevant articles regarding the different steps of ovarian stimulation (OS) in the EEF process, in order to define such a standard protocol. This review revealed that in order to maximize oocyte yields with minimal number of OS cycles - while ensuring patient safety - a multiple-dose GnRH antagonist protocol with a daily gonadotropin dose of 300 IU appears best, unless patients demonstrate a polycystic ovarian phenotype, suggestive of likely high responses. The initial gonadotropin should be recFSH, while LH supplementation should be co-administered with the addition of GnRH antagonist. Final follicular maturation should be triggered by GnRH agonist trigger, with a dual trigger (1000–1500 IU hCG) considered for suboptimal responders to GnRH agonist trigger, optionally with Cabergoline to mitigate ovarian hyperstimulation syndrome (OHSS) in high responders. [ABSTRACT FROM AUTHOR]

Published
2024
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24. Patients with low prognosis in ART: a Delphi consensus to identify potential clinical implications and measure the impact of POSEIDON criteria.

Author

Alviggi, Carlo, Humaidan, Peter, Fischer, Robert, Conforti, Alessandro, Dahan, Michael H., Marca, Antonio La, Orvieto, Raoul, Polyzos, Nikolaos P., Roque, Matheus, Sunkara, Sesh K., Ubaldi, Filippo Maria, Vuong, Lan, Yarali, Hakan, D'Hooghe, Thomas, Longobardi, Salvatore, and Esteves, Sandro C.

Subjects
DELPHI method, INDUCED ovulation, REPRODUCTIVE technology, BIRTH rate, OVUM
Abstract

Background: Currently, there is no consensus on the optimal management of women with low prognosis in ART. In this Delphi consensus, a panel of international experts provided real-world clinical perspectives on a series of literature-supported consensus statements regarding the overall relevance of the POSEIDON criteria for women with low prognosis in ART. Methods: Using a Delphi-consensus framework, twelve experts plus two Scientific Coordinators discussed and amended statements and supporting references proposed by the Scientific Coordinators (Round 1). Statements were distributed via an online survey to an extended panel of 53 experts, of whom 36 who voted anonymously on their level of agreement or disagreement with each statement using a six-point Likert-type scale (1 = Absolutely agree; 2 = More than agree; 3 = Agree; 4 = Disagree; 5 = More than disagree; 6 = Absolutely disagree) (Round 2). Consensus was reached if > 66% of participants agreed or disagreed. Results: The extended panel voted on seventeen statements and subcategorized them according to relevance. All but one statement reached consensus during the first round; the remaining statement reached consensus after rewording. Statements were categorized according to impact, low-prognosis validation, outcomes and patient management. The POSEIDON criteria are timely and clinically sound. The preferred success measure is cumulative live birth and key management strategies include the use of recombinant FSH preparations, supplementation with r-hLH, dose increases and oocyte/embryo accumulation through vitrification. Tools such as the ART Calculator and Follicle-to-Oocyte Index may be considered. Validation data from large, prospective studies in each POSEIDON group are now needed to corroborate existing retrospective data. Conclusions: This Delphi consensus provides an overview of expert opinion on the clinical implications of the POSEIDON criteria for women with low prognosis to ovarian stimulation. [ABSTRACT FROM AUTHOR]

Published
2024
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43. Recombinant human luteinizing hormone co-treatment in ovarian stimulation for assisted reproductive technology in women of advanced reproductive age: a systematic review and meta-analysis of randomized controlled trials

Author

Conforti, Alessandro, Esteves, Sandro C., Humaidan, Peter, Longobardi, Salvatore, D’Hooghe, Thomas, Orvieto, Raoul, Vaiarelli, Alberto, Cimadomo, Danilo, Rienzi, Laura, Ubaldi, Filippo Maria, Zullo, Fulvio, and Alviggi, Carlo

Published
2021
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