biotechnologies of human reproduction

At the end of the course, students will have acquired an integrated understanding of the molecular and cellular mechanisms underlying reproductive diseases and will be able to critically interpret current scientific evidence in reproductive pathology.
Knowledge and understanding
Students will be able to:

• explain the molecular and cellular mechanisms involved in inflammation, immune responses, metabolic dysfunction and carcinogenesis in reproductive tissues; - describe the pathophysiological basis of major reproductive disorders, including infertility, uterine fibroids and pregnancy-related immune alterations;
• discuss the biological rationale underlying current strategies for fertility preservation;
• explain the contribution of genetic, epigenetic and environmental factors to reproductive health and disease.
  Applying knowledge and understanding
  Students will be able to:
• integrate concepts from pathology, immunology, molecular biology and reproductive medicine to interpret disease mechanisms;
• apply pathophysiological knowledge to analyse reproductive disorders and their biological determinants;
• interpret experimental findings reported in biomedical literature and relate them to reproductive pathology;
• critically evaluate the translational relevance of molecular and cellular mechanisms for reproductive medicine.
  Making judgements
  Students will be able to:
• critically analyse scientific literature in reproductive pathology;
• evaluate the quality and limitations of experimental evidence;
• formulate evidence-based interpretations of biomedical research findings;
• develop independent scientific reasoning when discussing pathogenetic mechanisms and emerging therapeutic perspectives.
  Communication skills
  Students will be able to:
• communicate complex scientific concepts using appropriate biomedical terminology;
• present and critically discuss scientific articles in a clear, structured and evidence-based manner;
• actively participate in scientific discussions, supporting arguments with current literature.
  Learning skills
  Students will be able to:
• independently retrieve and evaluate scientific information using biomedical databases (e.g. PubMed);
• integrate knowledge from different biomedical disciplines to address complex problems in reproductive pathology;
• develop autonomous learning strategies necessary for advanced studies and research in reproductive biotechnology.
  e of autonomy.

The course provides an integrated overview of the molecular and cellular mechanisms underlying reproductive diseases, focusing on the interplay between inflammation, immune responses, metabolism and reproductive function.
The main topics include: cellular and molecular mechanisms of inflammation; acute and chronic inflammatory responses; inflammation in reproductive physiology and pathology; obesity, metabolic dysfunction and reproductive health; molecular mechanisms of carcinogenesis, including oncogenes, tumour suppressor genes, microRNAs and epigenetic regulation; immunology of reproduction and pregnancy; immune-mediated reproductive disorders; principles of fertility preservation; and the critical analysis of recent scientific literature in reproductive pathology.

Students are expected to have a solid background in human anatomy, physiology, cell biology, molecular biology and biochemistry.
As all teaching activities and learning materials are provided in English, students should possess English language proficiency equivalent to at least CEFR B1.

The course combines interactive lectures with student-centred learning activities.
Teaching methods include multimedia-supported lectures, guided discussions, critical appraisal of scientific literature, flipped classroom activities, student presentations and independent literature searches using PubMed and other biomedical databases.
Students are expected to actively participate in classroom discussions, analyse scientific evidence and present research papers, developing critical thinking, scientific communication and evidence-based reasoning skills.

The final grade is expressed on a 30-point scale and is based on two assessment components.
Written examination (80%): multiple-choice and short open-ended questions designed to assess knowledge and understanding of the molecular mechanisms underlying reproductive diseases, the ability to integrate concepts from pathology, immunology, metabolism and cancer biology, and the appropriate use of scientific terminology.
Scientific paper presentation (20%): oral presentation and critical discussion of a scientific article selected from the international literature. The assessment evaluates understanding of the scientific background, critical interpretation of results, ability to relate the findings to reproductive pathology, quality of scientific communication and participation in discussion.
The final mark corresponds to the weighted average of the two assessment components. Honours (30 cum laude) may be awarded for outstanding performance demonstrating excellent scientific knowledge, critical thinking, independent judgement and effective scientific communication.

Teaching materials include lecture slides, selected review articles and original research papers from peer-reviewed international journals. Additional learning resources will be provided through the University's Moodle platform.
Students are expected to consult biomedical databases, particularly PubMed, to retrieve and critically evaluate current scientific literature and to support independent learning.

Il corso si propone di fornire conoscenze e competenze relative alla fisiologia e immunofisiologia della riproduzione umana riguardo ai concetti base di regolazione endocrina e sistema immunitario nella riproduzione, sistemi di controllo fisiologico e governo della funzione gonadica; sistemi riproduttivi maschili e femminili; gravidanza e allattamento, invecchiamento e riproduzione. Approcci sperimentali basati su articoli scientifici rilevanti per la fisiologia e la fisiologia immunitaria della riproduzione.

Concetti di base della regolazione endocrina. Regolazione ipotalamica delle funzioni ormonali La ghiandola pituitaria Funzione del sistema riproduttivo femminile Funzione del sistema riproduttivo maschile Gravidanza e allattamento Invecchiamento e riproduzione Fisiologia immunitaria e riproduzione Approcci sperimentali basati su articoli scientifici rilevanti per la fisiologia e la fisiologia immunitaria della riproduzione.

Secondo il regolamento didattico del corso

Lezioni frontali e lezioni interattive con gli studenti su argomenti emersi durante le lezioni frontali

Esame finale orale con votazione in trentesimi

Ganong’s Review of Medical Physiology Articoli scientifici selezionati

The course aims to explore elements of fertility and public health (epidemiological, demographic). This is done through reading and reviewing scientific articles that can make the thematic knowledge of the course as current as possible.
Understanding of the readings will be preceded by lectures in which students will be provided with statistical epidemiological and research methodology fundamentals.

Definition, objectives and fields of action of epidemiology

• Definition of health and public health.
• Definition and purpose of demography.
• Censuses: composition of populations by gender and age; demographic movements; standardization of rates; mortality.
• Data sources and their quality.
• Risk factors
• Epidemiological measures and data sources
• Types of epidemiological measures: description of the number of events; reports; proportions; rates;
• Incidence and prevalence
• Relative Risk, Odds Ratio, Attributable Risk.
• The criteria of association
• Epidemiological Studies: Descriptive and analytical studies
• Confounder and interaction. BIAS
• Preparation for writing a scientific paper.
• Research of literatures - PubMed
  •Critical reading of scientific papers; for example: physical activity and relation with fertility, obesity affects and spontaneous pregnancy, diet and lifestyle in the prevention of infertility, alcoholic beverage and ovulatory disorder infertility.

None

Lecture
Paper presentation
Exercise

Paper evaluation and comments on human reproduction issues

“Basic Statistics and Epidemiology: A Practical Guide” 4th ed. di A. STEWART - Radcliffe Medical Press, 2016, Oxford
Articoli presentati a lezione dal docente
Presentazioni del docente

Al termine del corso lo studente sarà in grado di:
Conoscenza e comprensione
-Descrivere i principi fondamentali della genetica umana e della genetica della riproduzione.
-Spiegare i meccanismi genetici ed epigenetici coinvolti nella determinazione e differenziazione sessuale.
-Conoscere le principali anomalie cromosomiche e genetiche associate all'infertilità e alla poliabortività.
Capacità di applicare conoscenza e comprensione
-Interpretare i principali risultati di analisi genetiche e citogenetiche.
-Applicare concetti di genetica medica alla consulenza preconcezionale e ai test genetici preimpianto.
Autonomia di giudizio
-Valutare criticamente dati scientifici e casi studio relativi alla genetica della riproduzione.
Abilità comunicative
-Presentare e discutere in modo appropriato temi scientifici e articoli della letteratura specialistica.
Capacità di apprendimento
-Approfondire autonomamente argomenti di genetica della riproduzione mediante consultazione della letteratura scientifica internazionale.

L'insegnamento fornisce le conoscenze fondamentali della genetica applicata alla medicina della riproduzione umana. Saranno affrontati i principi della genetica classica e molecolare, i meccanismi genetici ed epigenetici coinvolti nella determinazione e differenziazione sessuale, le principali cause genetiche di infertilità maschile e femminile e le moderne tecniche di analisi genetica utilizzate nell'ambito della medicina riproduttiva.
Argomenti:
-Genetica di base: mitosi, meiosi, DNA, RNA, struttura dei geni e dei cromosomi;
-Gametogenesi;
-Leggi di Mendel ed ereditarietà;
-Probabilità delle malattie genetiche;
-Anomalie cromosomiche e poliabortività;
-Tecniche citogenetiche;
-Cause molecolari dell'infertilità maschile e femminile;
-Genetica mitocondriale nella medicina della -riproduzione;
-Analisi genetica preconcezionale;
-Test genetici preimpianto (PGT).

Non sono previsti prerequisiti formali. Sono raccomandate conoscenze di base di biologia cellulare, biologia molecolare e genetica.

Lezioni frontali supportate da presentazioni multimediali, immagini e materiale audiovisivo. Durante il corso sono promosse attività di apprendimento attivo e discussioni guidate.
L'insegnamento include attività di flipped classroom, nelle quali gli studenti preparano e presentano criticamente un argomento o un articolo scientifico selezionato dalla letteratura internazionale, sviluppando capacità di analisi critica, comunicazione scientifica e apprendimento autonomo.

La valutazione finale, espressa in trentesimi, è basata su una valutazione continua che comprende:
1-Presentazione individuale (flipped classroom) di un argomento o articolo scientifico selezionato dalla letteratura internazionale.
Valuta capacità di analisi critica, sintesi, approfondimento, esposizione scientifica e partecipazione attiva.
2-Prova scritta finale
Verifica la conoscenza e la comprensione degli argomenti trattati nel corso.
Valuta la capacità di applicare i principi della genetica umana e riproduttiva all'interpretazione di problematiche biologiche e cliniche.

Testo consigliato:
-Juan A. Garcia-Velasco, Emre Seli, Human Reproductive Genetics, Academic Press, 2020.
-Articoli scientifici originali forniti dal docente durante il corso.

The Integrated Course in Reproductive Biology and Assisted Reproductive Technology aims to provide students with comprehensive theoretical knowledge and practical understanding of human reproductive biology, fertilization mechanisms, and laboratory management in clinical embryology and biotechnology.
Upon successful completion of the integrated course, students will achieve the following learning outcomes:
Knowledge and Understanding: Students will acquire deep, integrated knowledge of the physiological and molecular mechanisms governing sperm maturation, fertilization, early embryo cleavage, and implantation, including embryo-endometrial interactions. Furthermore, students will master the operational and environmental standards of an ART laboratory according to international guidelines and the WHO Laboratory Manual, alongside the clinical principles of 1st Level (IUI) and 2nd Level (IVF/ICSI) ART procedures, gamete/embryo cryopreservation techniques, and embryo biopsy protocols for Preimplantation Genetic Testing (PGT).
Applying Knowledge and Understanding: Students will learn how to apply theoretical biological concepts to modern clinical and biotechnological scenarios. They will understand how physiological pathways of gametes and embryos are replicated, monitored, and evaluated in vitro, acquiring essential competencies required to operate in reproductive medicine, biotechnological laboratories, and clinical embryology settings.
Critical Thinking: Through the critical analysis of complex biological pathways, morphokinetic time-lapse data, omics evaluations, and clinical protocols, students will develop the capacity to independently assess scientific challenges and formulate evidence-based decisions. They will learn to evaluate embryo quality and laboratory outcomes critically using up-to-date scientific literature, peer-reviewed databases (e.g., PubMed), and official clinical guidelines.
Communication Skills: Students will master specific, highly technical scientific terminology in the field of reproductive biology and ART. This enables them to articulate complex biological and clinical concepts clearly, present data logically, and communicate effectively with both specialist audiences (medical professionals, embryologists) and non-specialists.
Learning Skills: Students will develop high-level autonomous learning strategies. They will gain the ability to navigate, critically appraise, and synthesize primary scientific literature, international scientific guidelines (e.g., ESHRE, ASRM), and specialized online educational resources, establishing a foundation for continuous professional development in reproductive health and biotechnology.
Support for Students with Specific Needs:
Students requiring compensatory tools or exempting measures due to specific learning differences or disabilities can schedule an individual meeting at the beginning of the course to align their learning path with the course objectives. Please refer to the UNISI Student Inclusion Office for support.

Module 1: Reproductive Physiology and Maternal-Fetal Interaction
The first section examines sperm modifications within the female genital tract, focusing on capacitation, hyperactivation, and the acrosome reaction. Students learn the molecular mechanisms of fertilization, including sperm-oocyte attraction, recognition, and egg activation, alongside the corresponding laboratory assessment of pronuclear formation. The module concludes with early embryonic development, covering cleavage dynamics, oviductal interactions, implantation immunology, and the molecular dialogue governing endometrial receptivity.
Module 2: ART Laboratory Standards, Gamete Processing, and Clinical Procedures
This module introduces current operational standards, quality control protocols, and safety guidelines for the Assisted Reproductive Technology (ART) laboratory, aligned with the WHO Laboratory Manual. It covers gamete preparation and selection methods tailored for first-level procedures, leading into clinical protocols for Intrauterine Insemination (IUI). Advanced processing of male and female gametes is then addressed for second-level procedures, culminating in the execution of traditional In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI).
Module 3: Embryo Evaluation, Cryobiology, and Preimplantation Diagnostics
The final section explores methods for assessing embryo quality, combining classic morphological and physiological grading with time-lapse morphokinetic imaging and emerging omic profiling strategies. Students study cryobiology principles applied to the cryopreservation and vitrification of male gametes, female gametes, and embryos. The course concludes with preimplantation genetic testing (PGT), emphasizing embryo biopsy techniques across polar body, blastomere, and trophectoderm stages.

To successfully engage with the course material, students should possess a solid foundational background in general biology, human physiology, genetics, and the pathology of human reproduction. In particular, students must be familiar with the molecular principles of cellular biology, including key signal transduction pathways and the regulatory mechanisms controlling the cell cycle.
Language Requirements & Academic Environment: A working proficiency in English, approximately equivalent to a B2 level, is recommended to allow students to read scientific literature, review digital course materials, and follow lecture presentations. No official language certification is required. English is treated purely as an operational learning tool rather than an academic hurdle; formal grammar and linguistic perfection will not be assessed during exams. Students should feel completely comfortable communicating, asking questions, and engaging in course activities without any fear of making language errors.

The course adopts an interactive, student-centered approach designed to foster active learning, critical thinking, and collaborative knowledge building. Educational activities consist of frontal lectures supported by detailed presentations, diagrams, and video demonstrations, alongside dedicated practical laboratory sessions. Several of these practical activities are jointly designed and integrated across both modules to bridge theoretical biology with laboratory application.
Active participation is strongly encouraged throughout all sessions, with student questions, observations, and discussions forming an integral part of the learning experience. Alongside independent study of reference textbooks and instructor-curated scientific papers, students engage in group work, collaborative problem-solving, and peer-to-peer evaluation. As part of their coursework, each student prepares and delivers a oral presentation on an assigned topic, while also serving as a critical discussant for a peer's presentation to develop analytical appraisal and scientific debate skills.

The final evaluation for the Integrated Course is expressed on a 30-point scale (out of 30, with possible honors) and represents an integrated, continuous summative assessment of the student's learning across both modules.
The evaluation combines ongoing in-itinere activities—such as flipped-classroom presentations, critical discussions of scientific literature, and active classroom participation—with final written examinations containing both multiple-choice and open-ended questions. These assessment tools collectively measure theoretical knowledge, analytical problem-solving, clinical reasoning, and scientific communication skills.
For the specific evaluation criteria, weighting schemes, and grade calculation mechanics of each individual teaching module, please refer to their respective course syllabus.
Integrated Grading Scale:
30 cum laude: Exceptional mastery of the subject matter, flawless technical terminology, and outstanding capability to integrate concepts and solve complex biological and clinical problems.
27 – 29: Excellent knowledge across all topics with strong analytical skills and the ability to address medium-to-high complexity problems.
24 – 26: Good comprehension of course content with solid problem-solving skills applied to standard scenarios.
21 – 23: Satisfactory knowledge focused primarily on core topics, demonstrating basic independence in applying concepts.
18 – 20: Minimal required knowledge of essential topics with basic problem-solving abilities.
Fail (<18): Inadequate understanding of core concepts and insufficient ability to apply foundational principles.

Since no single textbook covers the entire scope of this integrated course, students should consult a combination of core reference texts, scientific literature, and lecture materials.
Core Reference Books
Textbook of Assisted Reproductive Technology (ART)
Authors: David K. Gardner, Ariel Weissman, Colin M. Howles, Zeev Shoham (CRC Press, 2nd Edition or later) — Available via Moodle and the University Library
WHO Laboratory Manual for the Examination and Processing of Human Semen
Publisher: World Health Organization (WHO, 2010 / latest edition)
Principles of IVF Laboratory Practice: Optimizing Performance and Outcomes
Authors: Markus H.M. Montag, Dean E. Morbeck
The Art & Science of Assisted Reproductive Technology (ART)
Authors: Gautam N. Allahbadia, Goral Gandhi
Human Embryology and Developmental Biology
Author: Bruce M. Carlson (5th Edition) — Available in the University Library
Students must integrate the primary reference textbooks with the official teaching materials and scientific literature provided throughout the course.
All core teaching materials—including lecture slides, selected book chapters, and curated scientific articles—are regularly uploaded to the university Moodle platform at elearning.unisi.it. The complete list of recommended readings and library holdings can be accessed directly via the UNISI Leganto References Portal. Additionally, students are expected to engage in independent literature searches using databases such as PubMed, consulting peer-reviewed international journals and clinical practice guidelines issued by major scientific societies like ESHRE and ASRM.

Knowledge of normal and pathological spermatogenesi and oogenesis, sperm and oocyte pathologies. Oxidative damage of gametes. The spermatozoon from epididymis to oocytes: sperm maturation during epididymal transit, sperm capacitation, fertilizing ability acquisition in the female genital tract, acrosome reaction. Knowledge of the mechanisms involved in fertilization. Optical and electron microscopy of testis, ovary and human gametes. Fluorescence in situ hybridization applied to human gametes. Immunocytochemistry applied to human gametes. The objective will be to know the biology of gametes and their interactions also through the study of animal models; he knows embryonic development and infertility genetics.

Normal and pathological spermatogenesis and oogenesis. The spermatozoon and the oocyte. Sperm pathologies. Oocyte pathologies. Oxidative damage of gametes. Sperm capacitation and acrosome reaction. Fertilization. Optical and electron microscopy of testis, ovary and human gametes. Fluorescence in situ hybridization applied to human gametes. Immunocytochemistry applied to human gametes.

Basic knowledge of biology, physiology, pathology and genetics

The course comprises lectures during which the students can intervene with suggestions and questions. All the lectures are supported by powerpoint presentations with graphic images and light and electron microscopy pictures. Animations and videos will be proposed to understand . The students are encouraged to give presentations based on recent papers concerning the subjects under study.

Learning assessment will be done through a written test presented with multiple choice questions. The students will be evaluated also considering the lecture given during the lesson concerning topics suggested by the teacher. Power point presentation. The final evaluation will be the mathematical average of the grades obtained in the individual modules.

Textbook of Assisted reproductive techniques (ART) Gardner et al. Second Edition.WHO Laboratory Manual for the examination and processing of human semen (WHO, 2010). Scientific articles; slides of Lessons.

Microbiology:
Knowledge and scientific skills
At the end of the course, students will be able to describe the microbial communities present in the male and female reproductive tracts; identify the main microbial pathogens responsible for sexually transmitted infections; understand the impact of the genital tract microbiota and microbial dysbiosis on reproductive health and fertility; and apply acquired knowledge to the analysis and discussion of relevant scientific and clinical cases.
Transferable skills
The course will also enable students to develop the ability to critically evaluate scientific evidence, independently search for and interpret scientific literature, formulate evidence-based judgements, communicate scientific concepts clearly and appropriately, and work effectively in small groups through the discussion and presentation of scientific material
Histology and stem cell in reproduction:
At the end of the course the student must be able to: • describe the structure of differentiated cells and know how to relate to their physiological role. • describe the cell structure of the different tissues of the human body correlating it with the functional characteristics of the tissues. • Know the properties of embryonic stem cells and their application potential

Microbiology:
General introduction: main concepts of bacteriology, virology, mycology and immunology; antimicrobial therapies; sampling and microbial identification techniques, including microbial culture, molecular techniques and next-generation sequencing; interactions between microorganisms and the host immune system; prophylactic approaches, including vaccination.
Interaction between microbiota and the genital tract: microbiota of the female and male genital tracts; genital tract-associated immune system and its interaction with the microbial community; microbial dysbiosis and therapeutic approaches; role of the microbiota in pregnancy.
Clinical microbiology of sexually transmitted infections (STIs): HIV infection and other bacterial and viral pathogens responsible for STIs; major infectious diseases during pregnancy and mechanisms of vertical transmission; vaccines and therapeutic approaches for sexually transmitted infections.
Histology and stem cell in reproduction:
The course aims to familiarize students with the histological features of the male and female reproductive systems, the fundamental processes of embryonic development and organogenesis, and the molecular mechanisms underlying the formation of differentiated cells that give rise to the tissues of the adult organism. The course also aims to provide students with a solid foundation in the basic concepts of tissue organization, as well as the morphological and functional characteristics of human tissues, cells, and subcellular structures, including their classification and their derivation from the embryonic germ layers. Additional topics include stem cells, with particular emphasis on embryonic stem cells and induced pluripotent stem cells (iPSCs), as well as the molecular factors regulating cell differentiation, the maintenance of differentiated tissue homeostasis, and tissue repair. A detailed course syllabus is provided in the "Additional Information" section.

Microbiology:
Knowledge of cell biology and basic microbiology
Histology and stem cell in reproduction:
Students must have knowledge of the general principles of biochemistry, molecular biology, citology and anatomy

Microbiology:
Lectures; analysis and discussion of scientific publications related to the main topics of the course; interactive and case-based activities; group work with peer feedback
Histology and stem cell in reproduction:
Traditional Lectures.
Students with specific needs can request a personal meeting at the beginning of the course to plan any compensatory and/or exempting measures, based on the educational objectives and their specific requirements. It is also recommended to contact the Student Inclusion section at the following link: https://orientarsi.unisi.it/studio/struttura/settore-inclusione-comunita-studentesca.”

Microbiology:
The final assessment consists of a written test and an oral examination.
Final written test: 20 multiple-choice questions (10 with only one correct answer; 10 with one or more correct answers). The required answering method will be clearly indicated in each question. Passing the written test is a prerequisite for admission to the oral examination.
Oral examination: the examination will begin with a review of the questions answered incorrectly in the written test, giving students the opportunity to explain and correct their reasoning and demonstrate their understanding of the mistakes. The oral examination will then cover the topics addressed during the course.
Students may also take an optional mid-term written examination on the General Part, consisting of 8 multiple-choice questions (4 with only one correct answer; 4 with one or more correct answers). Students who pass the mid-term examination will take a reduced final written test consisting of 12 multiple-choice questions (6 with only one correct answer; 6 with one or more correct answers), covering the course content excluding the General Part, followed by the oral examination.
Final grade: the final grade will be calculated as the average of the grades obtained in all the assessment components completed by the student (mid-term examination, final written test and oral examination).
Histology and stem cell in reproduction:
Final written examination consisting of 126 questions covering the topics presented and discussed throughout the course. The examination includes 120 true/false questions and six images depicting histological tissues and/or stages of embryonic development, which students are required to identify.
The final grade for the integrated course (I.C. MICROENVIRONMENT OF REPRODUCTIVE SYSTEM), which will be officially recorded, shall be determined by the arithmetic mean of the two grades obtained in the respective examinations.

Microbiology:
Brock Biology of Microorganisms, 14th Edition Scientific publications discussed during the course and slides will be provided by the teacher and upoloaded on the moodle platform
Histology and stem cell in reproduction:
1) Langman's Medical Embryology, ed. Wolters Kluwer 2) Histology: Ross & Pawlina, ed. Williams&Wilki
https://sbart-unisi.alma.exlibrisgroup.com/leganto/public/39SBART_SBS_MAIN/lists/23879312030003297?auth=LOCAL

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