PAULO CESAR SERAFINI
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina - Docente
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
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bookPart Investigação básica do casal infértil(2016) MIYADAHIRA, Eduardo Hideki; BIANCHI, Paulo Homem de Mello; SERAFINI, Paulo César- Human reproduction: current status(2015) IZZO, Carlos Roberto; MONTELEONE, Pedro Augusto Araujo; SERAFINI, Paulo C.The concern about the maintenance of the human species has existed since the earliest civilizations. Progress in the diagnosis and treatment of infertility has led to the development of assisted reproductive techniques (ART) which, along with the evolution of genetics and molecular biology studies, have contributed in a concrete way to the management of infertile couples. Classic in vitro fertilization was initially developed 35 years ago for the treatment of women with tubal blockage, however, it remains inaccessible to a significant proportion of infertile couples around the world. This can be explained by the lack of specialized clinics in some countries and by the high cost of the procedures. Efforts have been employed to increase the number of treatment cycles for assisted reproduction, as for example, the creation of low-cost programs. Even today, infertility remains a problem of global proportions, affecting millions of couples. The estimate of the incidence of infertility is uncertain, mainly because of the criteria used for its definition. This article aims to review the most important aspects, succinctly, regarding the incidence, etiology, and treatment options available to infertile couples.
- Blind aspiration biopsy versus a guided hysteroscopic technique for investigation of the endometrium in infertile women(2016) EJZENBERG, Dani; SIMOES, Manuel de Jesus; PINHEIRO, Walter; SOARES JUNIOR, Jose Maria; SERAFINI, Paulo Cesar; BARACAT, Edmund ChadaEmbryo implantation failure and recurrent abortion are common indications for endometrial evaluation to determine the implantation window and diagnose endometrial anomalies. There are few research studies comparing the efficacy of different techniques used for endometrial sampling in infertile females during the luteal phase. Likewise, morphometric studies of the endometrium through aspiration biopsy are scant. A cross-sectional study of 30 infertile and 10 fertile females was carried out. The study participants underwent hysteroscopic and aspiration biopsies (pipelle) at the midluteal phase. Computer-assisted morphometric and pathological anatomy analyses were conducted independently by two pathologists blinded to the study. The two endometrial sampling biopsy techniques were compared through morphometric and pathological anatomy analyses using three parameters: a) the amount of material collected for the endometrial studies; b) the scope and origin of sampled materials; and c) the quality of the sample. Both biopsy techniques produced sufficient material for analysis. The directed biopsies yielded higher quality samples from targeted segments of the uterine cavity because samples were homogeneous and had no architectural distortion (p<0.05). Blood was present only in the samples obtained through a Pipelle. Endometritis was detected in 10% of the infertile women. Our findings suggest that hysteroscopic biopsies are superior to blinded aspiration biopsies.
- THE INSULIN SIGNALING PATHWAY IS DYSREGULATED IN CUMULUS CELLS FROM OBESE, INFERTILE WOMEN WITH POLYCYSTIC OVARIAN SYNDROME WITH AN ABSENCE OF CLINICAL INSULIN RESISTANCE.(2018) CHEHIN, M. B.; LORENZON, A. R.; BONETTI, T. C.; SERAFINI, P. C.; MOTTA, E. L.
conferenceObject Melatonin action on luteal - granulosa cells in women with marital infertility undergoing in vitro fertilization(2016) MAGANHIN, Carla; CARVALHO, Katia; TURCO, Edson Lo; SERAFINI, Paulo; GARCIA, Natalia; CIPOLLA-NETTO, Jose; SIMOES, Manuel; BARACAT, Edmund; SOARES-JUNIOR, Jose Maria- Ovarian reserve in adult patients with childhood-onset lupus: a possible deleterious effect of methotrexate?(2014) ARAUJO, D. B. de; YAMAKAMI, L. Y. S.; AIKAWA, N. E.; BONFA, E.; VIANA, V. S. T.; PASOTO, S. G.; PEREIRA, R. M. R.; SERAFIN, P. C.; BORBA, E. F.; SILVA, C. A.Objectives: To assess ovarian reserve markers and anti-corpus luteum antibodies (anti-CoL) in adult patients with childhood-onset systemic lupus erythematosus (c-SLE). Method: Fifty-seven adult c-SLE female patients and 21 healthy controls were evaluated for anti-CoL. Ovarian reserve was assessed by: follicle stimulating hormone (FSH), luteinizing hormone (LH), oestradiol, anti-Mullerian hormone (AMH), and antral follicle count (AFC). Demographic data, menstrual abnormalities, disease activity, damage, and treatment were also analysed. Results: The median current age was similar in adult c-SLE patients and controls (27.7 vs. 27.7 years, p = 0.414). The medians of AMH (1.1 vs. 1.5 ng/mL, p = 0.037) and AFC (6 vs. 16, p < 0.001) were significantly reduced in SLE patients compared to controls without significant menstrual abnormalities. Anti-CoL were solely observed in c-SLE patients (16% vs. 0%, p = 0.103) and were not associated with demographic data, ovarian reserve parameters, disease activity/damage, and treatment. Further evaluation of c-SLE patients treated with cyclophosphamide revealed a higher median of FSH levels compared to c-SLE patients not treated with cyclophosphamide and controls (8.8 vs. 5.7 vs. 5.6 IU/L, p = 0.032) and lower median AMH (0.4 vs. 1.5 vs. 1.5 ng/mL, p = 0.004) and AFC (4.0 vs. 6.5 vs. 16 IU/L, p = 0.001) levels. Nineteen patients treated exclusively with methotrexate demonstrated a negative correlation between the cumulative dose and AMH levels (p = 0.027, r = -0.507). Conclusions: The present study demonstrated for the first time that a high cumulative methotrexate dose is a possible cause of subclinical ovarian dysfunction in adult c-SLE patients. Further studies are required to confirm this deleterious effect in other rheumatic diseases, particularly juvenile idiopathic arthritis and idiopathic inflammatory myopathy.
bookPart Tratamento da infertilidade por disfunções endócrinas(2017) SERAFINI, Paulo César; PADILLA, Cláudia Gomes; MACIEL, Gustavo Arantes Rosa; BARACAT, Edmund ChadabookPart Doenças monogenéticas - distrofia muscular de Duchenne(2013) SERAFINI, Paulo César; BARACAT, Edmund Chada- Systematic review of cell adhesion molecules and estrogen receptor expression in the endometrium of patients with polycystic ovary syndrome(2015) BARACAT, Maria Candida P.; SERAFINI, Paulo C.; SIMOES, Ricardo dos S.; MACIEL, Gustavo A. R.; SOARES- JR., Jose M.; BARACAT, Edmund C.Background: Infertility associated with polycystic ovary syndrome (PCOS) could be related to many mechanisms including endometrial factors. Objectives: To review cell adhesion molecule and estrogen receptor expression in the endometrium. Search strategy: A systematic review was performed of the Medline and Cochrane databases for papers published in any language between 2004 and 2014. The search term was ""'polycystic ovary syndrome' OR 'Stein Leventhal syndrome' OR 'anovulation' AND 'endometrium' OR 'endometria."" Selection criteria: Research studies on endometrial cell adhesion molecules and estrogen receptor expression among women with PCOS diagnosed according to the Rotterdam criteria were included. Data collection and analysis: Data were extracted from identified studies and the quality of assessment was analyzed. Main results: Six studies were included. Data were controversial with respect to MUC1 and alpha V beta 3 integrin expression with significantly higher and lower levels, respectively, in women with PCOS. Estrogen receptor expression was enhanced among patients with PCOS as compared with healthy women. Conclusions: Endometrial factors influence embryo receptivity as indicated by the molecular mediators identified in the studies, including cell adhesion molecules and the estrogen receptor.
bookPart Infertilidade por fator ovulatório(2016) FETTBACK, Paula; BIANCHI, Paulo Homem de Mello; YAMAKAMI, Lucas Yugo Shiguehara; IZZO, Carlos; SERAFINI, Paulo César