Medical Resident in Obstetrics and Gynaecology at IRCCS Ospedale San Raffaele: Milan, Lombardia, Italy. IRCCS Ospedale San Raffaele: Milan, Lombardia, IT
Francesco Fedele is a Medical Resident in Obstetrics and Gynaecology at San Raffaele Hospital in Milan, Italy. Previously, he held the same position at Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico in Milan. He received his surgical training at Azienda Ospedaliera Universitaria Integrata in Verona, Italy from 2022 to 2024.
He graduated with honors from the 6-year International MD Program Degree in Medicine and Surgery at Vita-Salute San Raffaele University of Milan in 2019. His Medical Studies took him to prestigious institutions worldwide such as the Fetal Medicine Foundation in London, Yale University in New Haven, Churchill Hospital in Oxford and the Alexandra Hospital in Athens.
Dr. Fedele has authored many publications in leading journals and has presented his research at numerous international conferences. He serves on the editorial board of multiple peer-reviewed journals and he has peer-reviewed several articles, showcasing his commitment to the advancement of medi.
EDUCATION
International MD Program Degree in Medicine and Surgery at Vita-Salute San Raffaele University in 2019
RESEARCH, TEACHING, or OTHER INTERESTS
Obstetrics and Gynecology, Medicine, Surgery, Reproductive Medicine
33
Scopus Publications
525
Scholar Citations
11
Scholar h-index
13
Scholar i10-index
Scopus Publications
Lateral distribution of endometriotic lesions: The anatomical recesses hypothesis. A systematic review and meta-analysis Veronica Bandini, Sonia Cipriani, Chiara Pillinini, Stefano Angioni, Ludovica Bartiromo, et al. Human Reproduction Open, 2026 STUDY QUESTION Are endometriotic lesions affecting bilateral organs or anatomical structures distributed symmetrically on both sides of the body? SUMMARY ANSWER The left-sided preponderance of pelvic endometriotic lesions, and the right-sided dominance of thoracic and inguinal lesions, suggest that endometriotic lesions exhibit a non-random, asymmetric lateral distribution. WHAT IS KNOWN ALREADY Evaluating the anatomical distribution of endometriotic lesions may elucidate the underlying pathogenic mechanism(s) of the disease. If the coelomic metaplasia or embryonic cell remnant theory is correct, a symmetrical right-left pattern would be expected. Conversely, retrograde menstruation would likely result in asymmetrical distribution, influenced by gravity, peritoneal fluid circulation, and anatomical niches. STUDY DESIGN, SIZE, DURATION This systematic review with meta-analysis included full-length, English-language articles published up to 10 June 2024. Literature searches were performed in PubMed/Medline and Embase databases with the keyword ‘endometriosis’, ‘lateral’, ‘distribution’, ‘right’, ‘left’, and ‘asymmetry’. PARTICIPANTS/MATERIALS, SETTING, METHODS The review focused on anatomical structures commonly affected by endometriosis with surgically defined right or left laterality: ovaries, uterosacral ligaments, colon, ureters, inguinal regions, and hemithorax (diaphragm, pleura, lungs). Case reports were excluded. Risk of bias was assessed using ROBINS-I for non-randomized studies and a dedicated tool for case series. Meta-analyses of proportions were conducted in R. Heterogeneity was quantified using the I2 statistic. Funnel plots for publication bias and Egger tests were performed using Stata. MAIN RESULTS AND THE ROLE OF CHANCE Of 6356 articles screened, 154 met the inclusion criteria. A statistically significant left-sided preponderance was observed for ovarian (58%; 95% CI: 57–60%; P < 0.001), uterosacral ligament (56%; 95% CI: 54–59%; P < 0.001), ureteral (71%; 95% CI: 67–76%; P < 0.001), and bowel (72%; 95% CI: 64–79%; P < 0.001) lesions, whereas thoracic (98%; 95% CI: 96–100%; P < 0.001) and inguinal (92%; 95% CI: 83–98%; P < 0.001) lesions were predominantly right-sided. These findings were confirmed in the sensitivity analyses. Egger’s test indicated a possible small study effect only for ovarian lesions (P = 0.012). LIMITATIONS, REASONS FOR CAUTION The preponderance of retrospective studies, the variability in surgical procedures, and the potential difficulties in accurately distinguishing unilateral from bilateral lesions may have influenced the magnitude of the estimated difference. However, the large patient cohorts, geographical diversity, and consistent asymmetry across lesion types strengthen the results’ validity and generalizability. WIDER IMPLICATIONS OF THE FINDINGS The pattern of endometriotic lesion distribution, including the opposite asymmetry observed in the pelvis and upper abdomen/thorax, can be explained by factors influencing dissemination and implantation of refluxed endometrial cells. However, it cannot be explained as well by the coelomic metaplasia or embryonic cell remnant theories. This may have important clinical implications, providing a pathogenic basis for secondary prevention strategies. STUDY FUNDING/COMPETING INTEREST(S) The open access facility of this paper was funded by the Italian Ministry of Health, Current research IRCCS Ca’ Granda Ospedale Maggiore Policlinico. P.V. is a member of the Editorial Board of Human Reproduction Open, Journal of Obstetrics and Gynaecology Canada, and International Editorial Board of Acta Obstetricia et Gynecologica Scandinavica; has received royalties from Wolters Kluwer for chapters in UpToDate. All other authors declare no conflicts of interest. REGISTRATION NUMBER CRD42024511356 (PROSPERO).
The sitting men: A systematic review of spare and working time exposure to sedentariness in relation to semen parameters Vittoria Sterpi, Elena Ricci, Francesca Chiaffarino, Francesco Fedele, Giovanna Esposito, et al. Andrology, 2025 BackgroundOver the past few decades, several studies have found that semen quality parameters have steadily declined over time. Many hypotheses have been made to explain this finding, among which a sedentary lifestyle has been investigated. To synthesize the current evidence, we performed a systematic review of published papers reporting on the relationship between sedentary habits and semen parameters.MethodsEmbase and PubMed were systematically searched for papers published in English up to May 2023. We included all full‐text observational papers that reported the relationship between sedentariness and semen parameters. Article selection adhered to the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines.ResultsSixteen observational studies were ultimately included, six in healthy men and ten in men from Fertility Clinics. They encompassed a total of 13,509 men, with 9877 being healthy men and 3632 presenting at Fertility Clinics for initial assessment. In terms of semen volume, no association emerged in the six studies involving healthy men: however, results in men referring to fertility clinics mainly showed no association, with one indicating a decline and one higher volume. Twelve studies did not report differences in sperm concentration, while one study in men from Fertility Clinics and two in healthy men observed a decline in this parameter with increasing time spent on TV watching or sedentary posture in spare time. Total sperm count was found to be similar across groups of inactivity, except for one study that showed a significant decrease when men from Fertility Clinics spent more time watching TV. No significant differences were reported in sperm motility across all studies, with only one study, among those addressing sperm morphology, indicating a lower percentage of normal forms in men watching TV more than 3 h per day. Finally, three studies conducted in men referring to Fertility Clinics analyzed the sperm DNA fragmentation index. Two of these studies found a higher DNA fragmentation index in men spending more time per day in a sitting posture.ConclusionsThis review suggests a weak association between time spent sitting during spare time and sperm concentration, but the findings are inconsistent, highlighting the need for further research.
Adenomyosis among patients undergoing postpartum hysterectomy for uncontrollable uterine bleeding: A multicenter, observational, retrospective, cohort study on histologically-based prevalence and clinical characteristics Matteo Giorgi, Diego Raimondo, Martina Pacifici, Ludovica Bartiromo, Massimo Candiani, et al. International Journal of Gynecology and Obstetrics, 2024 ObjectiveTo assess the prevalence of adenomyosis at pathologic examination, and its association with obstetric complications, peripartum maternal clinical characteristics and neonatal birth weight in patients undergoing postpartum hysterectomy due to postpartum hemorrhage (PPH).MethodsA multicenter, observational, retrospective, cohort study was carried out including all women who underwent postpartum hysterectomy due to PPH at gestational week 23+0 or later, between January 2010 and May 2023. Patients were categorized into two groups based on the presence of adenomyosis at pathologic examination, and were compared for obstetric complications, peripartum maternal clinical characteristics, and neonatal birth weight.ResultsThe histologically‐based prevalence of adenomyosis in patients undergoing postpartum hysterectomy due to PPH was 39.4%. Adenomyosis was associated with a longer hospitalization time (regression coefficient: 4.43 days, 95% CI: 0.34–8.52, P = 0.034) and a higher risk of hypertensive disorders (OR: 5.82, 95% CI: 1.38–24.46, P = 0.016), threatened preterm labor (OR: 3.34, 95% CI: 1.08–10.31, P = 0.036), urgent/emergency C‐section (OR: 24.15, 95% CI: 2.60–223.96, P = 0.005), postpartum maternal complications (OR: 4.96, 95% CI: 1.48–16.67, P = 0.012), maternal intensive care unit admission (OR: 3.56, 95% CI: 1.05–12.05, P = 0.041), and low birth weight neonates (OR: 3.8, 95% CI: 1.32–11.02, P = 0.013).ConclusionIn patients undergoing postpartum hysterectomy due to PPH, adenomyosis is a highly prevalent condition among, and is associated with adverse obstetric, maternal, and neonatal outcomes.
Menopause: a trigger for simultaneous development of ulcerative colitis in sigmoid neovagina and residual colorectum? Massimo CANDIANI, Francesco FEDELE, Simona DI FATTA, Gianluca TACCAGNI, Carolina DOLCI, et al. Minerva Obstetrics and Gynecology, 2024 Vaginoplasty using sigmoid colon is a common technique used for the creation of a neovagina. However, the risk of adverse neovaginal bowel events is a common mentioned disadvantage. We report the case of a woman submitted to intestinal vaginoplasty for Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome at the age of 24 years who, with the onset of menopause, developed blood-stained vaginal discharge. Almost simultaneously, the patients complained chronic abdominal pain in lower left quadrant and prolonged diarrhea. General exams, Pap smear test, microbiological tests and viral test for HPV were negative. Neovaginal biopsies were suggestive for inflammatory bowel disease (IBD) of moderate activity and colonic biopsies were suggestive for ulcerative colitis (UC). The development of UC in the sigmoid neovagina and, almost simultaneously, in the remaining colon with onset of menopause raises important questions about etiology and pathogenesis of these diseases. Our case suggests that menopause may consider a trigger for the development of UC, due to the changes in the colon surface permeability related to menopause.
Endometriosis-Related Ovarian Cancer: Where Are We Now? A Narrative Review towards a Pragmatic Approach Gabriele Centini, Giorgia Schettini, Emilio Pieri, Matteo Giorgi, Lucia Lazzeri, et al. Journal of Clinical Medicine, 2024 Background: Endometriosis affects more than 10% of reproductive-aged women, causing pelvic pain and infertility. Despite the benign nature of endometriosis, ovarian endometriomas carry a higher risk of developing endometrioid carcinomas (EnOCs) and clear cell ovarian carcinomas (CCCs). Atypical endometriosis, defined as cytological atypia resembling intraepithelial cancer, is considered the precursor of endometriosis-associated ovarian cancer (EAOC). This narrative review aims to provide an overview of EAOC, proposing a practical approach to clinical and therapeutic decision making. Methods: An electronic literature search was conducted from inception up to January 2023, using the MEDLINE database via PubMed to evaluate the existing literature on EAOC, including its pathogenesis, the diagnostic process, and the therapeutic possibilities, with articles not relevant to the topic or lacking scientific merit being excluded. Results: Eighty-one articles were included in the review to present the current state of the art regarding EAOC. A pragmatic clinical flowchart is proposed to guide therapeutic decisions and improve patient outcomes. Conclusions: Endometriosis patients may have an increased risk of developing EAOC (either EnOC or CCC). Despite not being fully accepted, the concept of AE may reshape the endometriosis–ovarian cancer relationship. Further research is needed to understand the unaddressed issues.
The sitting men: A systematic review of spare and working time exposure to sedentariness in relation to semen parameters V Sterpi, E Ricci, F Chiaffarino, F Fedele, G Esposito, F Parazzini, ... Andrology 13 (7), 1683-1692 , 2025 2025 Citations: 1
Different loop diuretic dosing and administration in acute heart failure (DIUR-AHF): a multicenter prospective observational open-label study A Palazzuoli, F Pirrotta, A Stefanini, A Pagliaro, P Severino, A D’Amato, ... European Journal of Internal Medicine 138, 121-128 , 2025 2025 Citations: 5
O-031 The italian multicenter study on oncofertility: pregnancy outcomes after oocyte thawing comparing different cancer types G Paciotti, R Seracchioli, G Gennarelli, F Filippi, V Immediata, VS Vanni, ... Human Reproduction 40 (Supplement_1), deaf097. 031 , 2025 2025
Radiofrequency Ablation in Focal Uterine Adenomyoma: Long-Term Follow-up of 160 Cases S Scarperi, F Fedele, A Perandini, V Bergamini, F Parazzini Journal of Gynecologic Surgery 41 (1), 32-36 , 2025 2025 Citations: 1
Adenomyosis and obstetrical outcome: a narrative mini-review of the latest evidence N Berlanda, A Donati, F Fedele, M Lepri, P Vercellini Current Obstetrics and Gynecology Reports 13 (4), 289-300 , 2024 2024 Citations: 5
Assisted reproductive technology outcomes in women with congenital uterine anomalies: a systematic review F Fedele, A Bulfoni, F Parazzini, PE Levi-Setti, A Busnelli Archives of gynecology and obstetrics 310 (5), 2315-2332 , 2024 2024 Citations: 12
Systematic use of intraureteral indocyanine green: a game changer in endometriosis surgery. A proof-of-concept study G Centini, I Colombi, A Cannoni, N Habib, M Giorgi, A Ginetti, L Lazzeri, ... Minimally Invasive Therapy & Allied Technologies 33 (5), 287-294 , 2024 2024 Citations: 10
Endometriosis of the appendix: prevalence, associated lesions, and proposal of pathogenetic hypotheses. A retrospective cohort study with prospectively collected data G Centini, A Ginetti, I Colombi, A Cannoni, M Giorgi, H Ferreira, F Fedele, ... Archives of Gynecology and Obstetrics 310 (3), 1669-1675 , 2024 2024 Citations: 13
Adenomyosis among patients undergoing postpartum hysterectomy for uncontrollable uterine bleeding: A multicenter, observational, retrospective, cohort study on histologically … M Giorgi, D Raimondo, M Pacifici, L Bartiromo, M Candiani, F Fedele, ... International Journal of Gynecology & Obstetrics 166 (2), 849-858 , 2024 2024 Citations: 12
Heterotopic cervical and isthmic pregnancy. M Orsi, F Motta, F Fedele, MW Ossola, E Ferrazzi Ultrasound in Obstetrics & Gynecology 63 (6) , 2024 2024 Citations: 1
Minerva Obstetrics and Gynecology 2024 June; 76 (3): 293-7 M CANDIANI, F FEDELE, S DI FATTA, G TACCAGNI, C DOLCI, ... Minerva 76 (3), 293-7 , 2024 2024
Histological Features of neovaginal epithelium after vaginoplasty in Mayer-Rokitansky-Küster-Hauser syndrome M Candiani, F Fedele, AF Ruffolo, S Di Fatta, S Salvatore, F Parazzini Journal of Pediatric and Adolescent Gynecology 37 (3), 353-359 , 2024 2024 Citations: 4
Menopause: a trigger for simultaneous development of ulcerative colitis in sigmoid neovagina and residual colorectum? M Candiani, F Fedele, SDI Fatta, G Taccagni, C Dolci, AF Ruffolo Minerva obstetrics and gynecology 76 (3), 293-297 , 2024 2024 Citations: 1
Endometriosis-related ovarian cancer: where are we now? A narrative review towards a pragmatic approach G Centini, G Schettini, E Pieri, M Giorgi, L Lazzeri, FG Martire, V Mancini, ... Journal of clinical medicine 13 (7), 1933 , 2024 2024 Citations: 31
Neovagina creation methods in Müllerian anomalies and risk of malignancy: insights from a systematic review F Fedele, A Bulfoni, F Parazzini, A Busnelli Archives of gynecology and obstetrics 309 (3), 801-812 , 2024 2024 Citations: 6
Pregnancy-associated Cancers: A Narrative Review G Esposito, CVB LA VECCHIA, F Fedele, F Parazzini Epidemiology Biostatistics and Public Health 18 (2), 1-8 , 2024 2024 Citations: 1
Deep infiltrating endometriosis in adolescence: early diagnosis and possible prevention of disease progression FG Martire, M Giorgi, C D’Abate, I Colombi, A Ginetti, A Cannoni, F Fedele, ... Journal of clinical medicine 13 (2), 550 , 2024 2024 Citations: 51
Gynecologic reconstructive surgery: tailoring the postoperative care to the patient A Cannoni, F Marchetti, M Giorgi, I Colombi, A Ginetti, F Fedele, F Martire, ... Gynecology and Pelvic Medicine 7, 20 , 2024 2024
Ovarian torsion in a young adolescent with Rokitansky syndrome F Fedele, G Esposito, A Busnelli, F Parazzini Case Reports in Obstetrics and Gynecology 2024 (1), 1305476 , 2024 2024 Citations: 1
Probability of second live birth after first natural and medically assisted reproduction‐mediated live birth: A historical cohort study G Esposito, F Parazzini, P Viganò, M Franchi, S Cipriani, F Fedele, ... Acta Obstetricia et Gynecologica Scandinavica 103 (1), 121-128 , 2024 2024 Citations: 6
MOST CITED SCHOLAR PUBLICATIONS
Obstetric and perinatal outcomes following programmed compared to natural frozen-thawed embryo transfer cycles: a systematic review and meta-analysis A Busnelli, I Schirripa, F Fedele, A Bulfoni, PE Levi-Setti Human Reproduction 37 (7), 1619-1641 , 2022 2022 Citations: 130
Prevalence of polycystic ovary syndrome in European countries and USA: a systematic review and meta-analysis F Chiaffarino, S Cipriani, M Dalmartello, E Ricci, G Esposito, F Fedele, ... European Journal of Obstetrics & Gynecology and Reproductive Biology 279 … , 2022 2022 Citations: 83
Deep infiltrating endometriosis in adolescence: early diagnosis and possible prevention of disease progression FG Martire, M Giorgi, C D’Abate, I Colombi, A Ginetti, A Cannoni, F Fedele, ... Journal of clinical medicine 13 (2), 550 , 2024 2024 Citations: 51
Systematic review of the effect of D-mannose with or without other drugs in the treatment of symptoms of urinary tract infections/cystitis F Parazzini, E Ricci, F Fedele, F Chiaffarino, G Esposito, S Cipriani Biomedical Reports 17 (2), 69 , 2022 2022 Citations: 38
Endometriosis-related ovarian cancer: where are we now? A narrative review towards a pragmatic approach G Centini, G Schettini, E Pieri, M Giorgi, L Lazzeri, FG Martire, V Mancini, ... Journal of clinical medicine 13 (7), 1933 , 2024 2024 Citations: 31
Conservative treatment of Herlyn-Werner-Wunderlich syndrome: analysis and long-term follow-up of 51 cases M Candiani, P Vercellini, C Ferrero-Caroggio, F Fedele, S Salvatore, ... European Journal of Obstetrics & Gynecology and Reproductive Biology 275, 84-90 , 2022 2022 Citations: 21
Endometriosis of the appendix: prevalence, associated lesions, and proposal of pathogenetic hypotheses. A retrospective cohort study with prospectively collected data G Centini, A Ginetti, I Colombi, A Cannoni, M Giorgi, H Ferreira, F Fedele, ... Archives of Gynecology and Obstetrics 310 (3), 1669-1675 , 2024 2024 Citations: 13
Assisted reproductive technology outcomes in women with congenital uterine anomalies: a systematic review F Fedele, A Bulfoni, F Parazzini, PE Levi-Setti, A Busnelli Archives of gynecology and obstetrics 310 (5), 2315-2332 , 2024 2024 Citations: 12
Adenomyosis among patients undergoing postpartum hysterectomy for uncontrollable uterine bleeding: A multicenter, observational, retrospective, cohort study on histologically … M Giorgi, D Raimondo, M Pacifici, L Bartiromo, M Candiani, F Fedele, ... International Journal of Gynecology & Obstetrics 166 (2), 849-858 , 2024 2024 Citations: 12
Reconstructive surgery for congenital atresia of the uterine cervix: a systematic review F Fedele, F Parazzini, P Vercellini, V Bergamini, L Fedele Archives of gynecology and obstetrics 308 (3), 685-700 , 2023 2023 Citations: 11
Fertility options in Mayer-Rokitansky-Küster-Hauser syndrome F Fedele, A Bulfoni, S Salvatore, M Candiani Clinical and Experimental Obstetrics & Gynecology 48 (3), 453-460 , 2021 2021 Citations: 11
Systematic use of intraureteral indocyanine green: a game changer in endometriosis surgery. A proof-of-concept study G Centini, I Colombi, A Cannoni, N Habib, M Giorgi, A Ginetti, L Lazzeri, ... Minimally Invasive Therapy & Allied Technologies 33 (5), 287-294 , 2024 2024 Citations: 10
The peritoneal neovagina after Davydov's laparoscopic procedure in Mayer-Rokitansky-Küster-Hauser syndrome: Morphology and ultrastructure investigation of the new epithelium M Origoni, F Fedele, M Parma, S Di Fatta, V Bergamini, M Candiani, ... Journal of Minimally Invasive Gynecology 28 (10), 1795-1799 , 2021 2021 Citations: 10
Prevalence and factors associated with intertwin birth weight discordance among same-sex twins in Lombardy, Northern Italy G Esposito, A Cantarutti, PA Mauri, M Franchi, F Fedele, G Corrao, ... Twin Research and Human Genetics 26 (2), 177-183 , 2023 2023 Citations: 8
Conservative surgical repair in cervical atresia associated with partial or complete absence of the vagina L Fedele, P Vercellini, N Ciappina, S Salvatore, F Fedele, M Candiani Fertility and Sterility 118 (3), 593-595 , 2022 2022 Citations: 8
Neovagina creation methods in Müllerian anomalies and risk of malignancy: insights from a systematic review F Fedele, A Bulfoni, F Parazzini, A Busnelli Archives of gynecology and obstetrics 309 (3), 801-812 , 2024 2024 Citations: 6
Probability of second live birth after first natural and medically assisted reproduction‐mediated live birth: A historical cohort study G Esposito, F Parazzini, P Viganò, M Franchi, S Cipriani, F Fedele, ... Acta Obstetricia et Gynecologica Scandinavica 103 (1), 121-128 , 2024 2024 Citations: 6
Vitamin and carotenoid intake and outcomes of in vitro fertilization in women referring to an Italian fertility service: a cross-sectional analysis of a prospective cohort study V De Cosmi, S Cipriani, G Esposito, F Fedele, I La Vecchia, G Trojano, ... Antioxidants 12 (2), 286 , 2023 2023 Citations: 6
Periodontitis, female fertility and conception E Ricci, S Ciccarelli, P Agnese Mauri, S Gerli, A Favilli, S Cipriani, ... Biomedical Reports 17 (5), 86 , 2022 2022 Citations: 6
Systematic review of the effect of D-mannose with or without other drugs in the treatment of symptoms of urinary tract infections/cystitis (Review). Biomed Rep. 2022; 17 (2): 69 F Parazzini, E Ricci, F Fedele, F Chiaffarino, G Esposito, S Cipriani 2022 Citations: 6