The Italian National ART Register

The Italian National ART Register

Sexologies.book Page 36 Mercredi, 2. avril 2008 4:36 16 S36 is addresses. This research illuminates the complex interaction between the man with ED a...

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Sexologies.book Page 36 Mercredi, 2. avril 2008 4:36 16

S36 is addresses. This research illuminates the complex interaction between the man with ED and his female partner.

Speakers

The Italian National ART Register G. Scaravelli. Istituto Superiore di Sanità, Roma, Italy

Vaginism - Sexual satisfaction after treatment G. Santos, A. Gomes. Psychiatry Coimbra University Hospital, Clinic Sexology Unit, Coimbra, Portugal Purpose: The authors intended to analyze the clinical effectiveness of vaginism treatment (sex therapy and desensitization) in a Clinical Sexology Unit at Coimbra University Hospital. They also tried to identify clinical similarities and differences between patient that report sexual satisfaction after resolution of vaginism, and others that despite resolution of this problem refer other sexual difficulties. Methods: They assessed the clinical files of women who were treated for vaginism over the last two years. They also made a clinical follow up of those who were successfully treated for their vaginism, in order to evaluate current sexual satisfaction. Results and Conclusions: The authors made a reflection about their results and mention some conclusions.

Controversies in varicocele F. Sasso, R. Falabella, A. D’Onofrio, N. Foschi, A. Totaro. Department of Urology, Catholic University of the Sacred Heart, Rome, Italy Varicocele is the most common diagnosis in men presenting to fertility clinics. Traditional indications for correction of Varicocele include scrotal pain, testicular atrophy, and infertility without other apparent causes. Adolescent Varicocele correction is indicated if pain or testicular growth retardation is present. Following varicocelectomy most studies report improved semen parameters, increased semen testosterone, improvement in functional sperm defects, and the return of motile sperm in selected azoospermic men. However, conflicting data supporting the effectiveness of repairing subclinical varicoceles is sparse. Most authors generally agree that the primary effect of varicoceles is on testicular temperature. Varicoceles are diagnosed primarily by physical examination. Radiographic assessment are helpful when physical examination is inconclusive or when further objective documentation of a patient’s condition is necessary. Several surgical approaches to varicocelectomy exist, each with its own advantages and drawbacks, but the sub-inguinal approach to varicocelectomy is preferred by the clinic, also when there is a history of previous inguinal surgery. Routine use of an operating loops and a micro Doppler probe affords easier identification of vessels and lymphatics. Local anaesthesia is performed. Varicocele remains the most surgically treatable form of male infertility. Knowing the correct techniques of diagnosis and surgical correction ensures the best chance of successful outcomes in terms of post-operative morbidity, improved semen parameters, and pregnancy rates.

On February 19th 2004 in Italy was promulgate a law that regulates all assisted reproduction techniques (ART) (*). In this law is established the creation of the National ART Register (Registro Nazionale della Procreazione Medicalmente Assistita) at the National Institute of Health (Istituto Superiore di Sanità, ISS). The National Health Institute prepares an annual report to the Ministry of Health, with all the data from the ART clinics operating in Italy. Sending data to the Register is mandatory. The aims of the Register are: list all the authorized structures that apply ART techniques in Italy, collect and diffuse transparent information of these techniques and the results of their application. Diffuse the correct information to all citizens and infertile couples in particular on reproductive health, prevention of infertility and possible therapeutic interventions. The Register data collection is made on a specific web site (www.iss.it/rpma) create to allow ART clinics to complete and send out the annual summary data reports “on-line”. Each clinic has an username and a password that consent them the access to a private zone in this web site where they can communicate with the Italian National ART register. Actual law requires The Register to collect information also on children born after ART procedures. Actually all the ART clinics have big problems to recruit such kind of data, because not all the couples let them know if their treatments have been successfully. The data covering treatments and births starts during a specific year. The data are usually available two years after the end of the treatment period. The summaries of each clinic contain data regarding: number of ART procedures, pregnancies and deliveries by ART procedure including standard IVF, ICSI, FIVET, GIFT and FER; the number of cycles started, number of oocyte aspirations and of embryo transfers; abortions an ectopic pregnancies; the number of live born children; the number of IVF treatments, reported per ART procedure, the indications for treatment and women’s age (in five year intervals); the number of embryo replaced per procedure. Data collection take place twice a year: the first data collection regards ART treatments results and the other one for data regarding surveillance of children born after ART procedures. The Italian Register cooperate with other 29 countries sending data to the eim European IVF Monitoring. The European data collection is made once a year from all the participating countries and the results are published after two years. In addition, the Italian ART Register is trying to build up a report system of individual cycle data. As a matter of fact

* Gazzetta Ufficiale, February 24th 2004. Law n°40/2004, February 19th 2004 “Norme in materia della procreazione mediaclamente assistita”

Sexologies.book Page 37 Mercredi, 2. avril 2008 4:36 16

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it was created a specific software freely distribute among ART clinics to consent them the collection of individual cycle data and to administrate their own patients flow. Unfortunately the national privacy protection authorities (“Garante della Privacy”) until today has not gave the permission to collect this kind of data.

The Important Role of Conflict in Sexual Relationships D. Schnarch. Marriage and Evergreen, Colorado, USA

Family

Health

Center

Since the inception of modern sex therapy, and the groundbreaking work of Masters and Johnson and Singer-Kaplan, conflict has been ostracized conceptually and clinically. Conflict was traditionally considered a counter-indication for sex therapy, being more the province of marital therapy. Besides not treating conflict effectively, first generation sex therapy impeded understanding of the inherent dynamic role conflict plays in sexual relationships in particular, and in relationships more generally. The Crucible Approach is a second-generation sex therapy approach that harnesses the natural and inevitable conflicts of adult relationships to enhance sex, intimacy, differentiation, and love.

Sex Therapy vs. Couple Therapy: a distinction without a difference? D. Schnarch. Marriage and Evergreen, Colorado, USA

Family

Health

Center

The debate among clinicians, when sex therapy or couples therapy is more appropriate, has raged since the 1980s. However, this question reflects an iatrogenic problem, rather than a diagnostic conundrum. It is caused by the common state of the art of sex therapy and marital therapy, rather than characteristics of clients. Attempting sex therapy or couples therapy without the other encourage clinicians to conceptualize and practice archaically, weakens treatment of both sex and relationship problems, promotes ineffective amalgams approaches, and limits development of more effective therapies. The Crucible Approach avoids these problems with a core integration of sex, relationship, and individual therapies, differing from conventional treatment in each of these disciplines.

Adolescents and sexual risk behaviors C. Silvaggi1, C. Simonelli2. 1Institute of Clinical Sexology, Rome, Italy, 2 Università degli Studi “La Sapienza”, Roma, Italy Objectives: The first goal of the study is to give a general view on HIV infection knowledge. The second goal is to evaluate the impact of peer education considering their information on the virus, the changes in behavior relatively to condom utili-

zation their knowledge on efficient methods preventing from HIV infection and the Self-Regulatory Efficacy Scale. Methods: An ad hoc questionnaire and the Self -Regulatory Efficacy Scale, were administered to 1775 students (age mean 16.1±1.86 yr). The second objective has been reached by a three-time realization of the test (pre-test, post- test, follow-up) both on the experimental group (210 students; mean 15.3±0.63 yr) trained by peer education and on the non-trained control group (221 students; mean 15.4±074 yr). Results: The results of the first test (1775 students) have demonstrated that students display a quite adequate knowledge on HIV, in spite of some defaults regarding the symptoms, diagnosis or vaccination. In particular our data show a high percentage of teenagers that do not use condoms. The evaluation of the training has revealed a significant difference between trained vs non-trained group in HIV knowledge (F(1, 405)=18.8; p = .001) and information related to efficient preventive behaviors (F(1, 405)=10.1; p = .002). Conclusion: The intervention of peer education both increases the knowledge of and the behavior towards HIV/ AIDS infection and helps teenagers’capacity to evaluate risky behavior and exposures.

Mechanisms of moral disingagement in sex offenders C. Simonelli1, R. Rossi1, I. Petruccelli2, B. Turella3, F. Fabiani2. 1Università La Sapienza, Rome, Italy; 2Istituto di Sessuologia Clinica, Rome, Italy; 3 Università L.U.M.S.A., Rome, Italy Objectives: Moral disengagement (MD) consists of those social-cognitive strategies by which people disengage themselves from norms and responsibility. Through “dehumanization” victims are divested of human dignity so that they no longer arouse any feelings of identification, empathy and solidarity. In disengagement by “attribution of blame”, all responsibility for a given detrimental event is attributed to a presumed provocative attitude of the victim. This study aims to assess whether sex offenders (SO) have higher moral disengagement than non-offenders (NO) and if they show higher scores for “dehumanization” and “attribution of blame” than non-sexual offenders (NSO). Methods: Participants were fifty-three male subjects: 13 convicted of sexual offences, 15 convicted of non-sexual offences and 25 non-offenders. After an interview regarding personal history and crime committed (offenders only) the “Moral Disengagement Scale” was administered. ANOVA and post hoc analysis were performed on total disengagement score, on “dehumanization” and on “attribution of blame”. Repeated measure ANOVA was performed among SO. Results: The SO yielded a significantly lower score on total disengagement and “dehumanization”. The NSO scored significantly more highly on “attribution of blame”. Also, SO mostly utilize mechanisms of moral disengagement different from “dehumanization” and “attribution of blame”, i.e. “advantageous comparison”, “euphemistic labelling” and “moral justification”.