USPJEŠNO OSTVARENJE POTOMSTVA NAKON KRIOPREZERVACIJE SPERMIJA ZBOG MA- LIGNE BOLESTI TESTISA

Nowadays the number of couples who fail to conceive naturally is constantly increasing. There are many reasons for infertility and the most common one is the age of the mother. Medically assisted reproduction also enables people suffering from malignant diseases to freeze their gametes to have offspring later. Two main forms of infertility treatments include intrauterine insemination and in vitro fertilization.U suvremenom svijetu učestalost parova koji ne uspijevaju na prirodan način ostvariti potomstvo u stalnom je porastu. Razlozi za neplodnost su mnogi, a najčešći jest visoka dob majke. Medicinski pomognuta oplodnja također omogućuje da osobe koje boluju od malignih bolesti zamrznu spolne stanice te kasnije ostvare potomstvo. Dva temeljna oblika liječenja neplodnosti obuhvaćaju intrauterinu inseminaciju i izvantjelesnu oplodnju

Pneumonitis as a side effect of breast cancer treatment: T-DXd and/or SBRT?

Breast cancer that overexpresses the human epidermal growth factor receptor 2 (HER2) is considered to be HER2-positive. The novel HER2- directed antibody drug conjugate, trastuzumab deruxtecan (T-DXd), is formed by covalently joining the monoclonal antibody trastuzumab with the topoisomerase I inhibitor deruxtecan. It exhibits significant anti-tumor activity in previously overtreated patients

Induction of ovulation in patients with hypogonadotropic hypogonadism

Kontinuiranim naporima liječnika nastoji se smanjiti neplodnost u suvremenom svijetu. Budući da su uzroci neplodnosti raznoliki, stvaraju se protokoli liječenja neplodnosti za svaki pojedini uzrok. Od izuzetne su važnosti klinička istraživanja dosadašnjeg iskustva liječenja neplodnosti određene etiologije kako bi se bolje usmjerilo buduće liječenje. U ovome je radu prikazan pristup obradi i liječenju neplodnosti u bolesnica s hipogonadotropnim hipogonadizmom. Hipogonadotropni hipogonadizam je poremećaj reproduktivnog sustava i jedan od uzroka neplodnosti karakteriziran sniženim gonadotropinima, hipogonadizmom, anovulacijom i amenorejom. Uzroci mogu biti organskog i funkcionalnog podrijetla te urođeni i stečeni. U dijagnostičkom postupku važno je isključiti po život opasna stanja kao što su tumori u području hipotalamusa i hipofize. Promjena životnih navika prvi je pristup liječenju funkcionalnog hipogonadotropnog hipogonadizma te je ujedno i priprema za ostvarenje trudnoće. Ukoliko promjene životnih navika ne dovedu do oporavka hipotalamusno-hipofizno-ovarijske osi, pristupa se indukciji ovulacije gonadotropinima ili GnRH pumpom. Ukoliko se navedenim metodama ne ostvari trudnoća ili postoji dodatni uzrok neplodnosti indicirana je medicinski pomognuta oplodnja. Budući da je izolirana hipotalamička amenoreja jedna od rjeđih indikacija za IVF, potrebna su daljnja klinička istraživanja u ovome području.Doctors are continuously trying to reduce infertility in the modern world. Since there are various causes of infertility, infertility approach protocols have been created for each individual cause. Clinical research and experience of treating infertility of a certain etiology is extremely important in order to improve future treatment. This paper summarizes approach and guidelines about treatment of infertility in patients with hypogonadotropic hypogonadism. Hypogonadotropic hypogonadism is a condition of reproductive system and one of the cause of infertility with low gonadotropins, hypoestrogenism, anovulation and amenorrhea. Hypogonadotropic hypogonadism can have organic or functional origin, as well as it can be congenital and acquired. During the diagnostic procedure, it is important to exclude life-threatening conditions such as hypothalamic and pituitary tumors. Lifestyle changes are the first treatment option of functional hypogonadotropic hypogonadism and are also a preparation for pregnancy. If lifestyle changes are not sufficient, ovulation is being induced by gonadotropins or GnRH pumps. ovulation induction, hypogonadotropic hypogonadism, amenorrhea, GnRH pump, FSH, LH, IVFIf these methods do not result in pregnancy or if the couple has another cause of infertility as well, the next possibility is assisted reproductive technology. Since isolated hypothalamic amenorrhea is infrequent indication for IVF, further clinical research is needed

Induction of ovulation in patients with hypogonadotropic hypogonadism

Kontinuiranim naporima liječnika nastoji se smanjiti neplodnost u suvremenom svijetu. Budući da su uzroci neplodnosti raznoliki, stvaraju se protokoli liječenja neplodnosti za svaki pojedini uzrok. Od izuzetne su važnosti klinička istraživanja dosadašnjeg iskustva liječenja neplodnosti određene etiologije kako bi se bolje usmjerilo buduće liječenje. U ovome je radu prikazan pristup obradi i liječenju neplodnosti u bolesnica s hipogonadotropnim hipogonadizmom. Hipogonadotropni hipogonadizam je poremećaj reproduktivnog sustava i jedan od uzroka neplodnosti karakteriziran sniženim gonadotropinima, hipogonadizmom, anovulacijom i amenorejom. Uzroci mogu biti organskog i funkcionalnog podrijetla te urođeni i stečeni. U dijagnostičkom postupku važno je isključiti po život opasna stanja kao što su tumori u području hipotalamusa i hipofize. Promjena životnih navika prvi je pristup liječenju funkcionalnog hipogonadotropnog hipogonadizma te je ujedno i priprema za ostvarenje trudnoće. Ukoliko promjene životnih navika ne dovedu do oporavka hipotalamusno-hipofizno-ovarijske osi, pristupa se indukciji ovulacije gonadotropinima ili GnRH pumpom. Ukoliko se navedenim metodama ne ostvari trudnoća ili postoji dodatni uzrok neplodnosti indicirana je medicinski pomognuta oplodnja. Budući da je izolirana hipotalamička amenoreja jedna od rjeđih indikacija za IVF, potrebna su daljnja klinička istraživanja u ovome području.Doctors are continuously trying to reduce infertility in the modern world. Since there are various causes of infertility, infertility approach protocols have been created for each individual cause. Clinical research and experience of treating infertility of a certain etiology is extremely important in order to improve future treatment. This paper summarizes approach and guidelines about treatment of infertility in patients with hypogonadotropic hypogonadism. Hypogonadotropic hypogonadism is a condition of reproductive system and one of the cause of infertility with low gonadotropins, hypoestrogenism, anovulation and amenorrhea. Hypogonadotropic hypogonadism can have organic or functional origin, as well as it can be congenital and acquired. During the diagnostic procedure, it is important to exclude life-threatening conditions such as hypothalamic and pituitary tumors. Lifestyle changes are the first treatment option of functional hypogonadotropic hypogonadism and are also a preparation for pregnancy. If lifestyle changes are not sufficient, ovulation is being induced by gonadotropins or GnRH pumps. ovulation induction, hypogonadotropic hypogonadism, amenorrhea, GnRH pump, FSH, LH, IVFIf these methods do not result in pregnancy or if the couple has another cause of infertility as well, the next possibility is assisted reproductive technology. Since isolated hypothalamic amenorrhea is infrequent indication for IVF, further clinical research is needed

USPJEŠNO OSTVARENJE POTOMSTVA NAKON KRIOPREZERVACIJE SPERMIJA ZBOG MA- LIGNE BOLESTI TESTISA

Nowadays the number of couples who fail to conceive naturally is constantly increasing. There are many reasons for infertility and the most common one is the age of the mother. Medically assisted reproduction also enables people suffering from malignant diseases to freeze their gametes to have offspring later. Two main forms of infertility treatments include intrauterine insemination and in vitro fertilization.U suvremenom svijetu učestalost parova koji ne uspijevaju na prirodan način ostvariti potomstvo u stalnom je porastu. Razlozi za neplodnost su mnogi, a najčešći jest visoka dob majke. Medicinski pomognuta oplodnja također omogućuje da osobe koje boluju od malignih bolesti zamrznu spolne stanice te kasnije ostvare potomstvo. Dva temeljna oblika liječenja neplodnosti obuhvaćaju intrauterinu inseminaciju i izvantjelesnu oplodnju