Vpliv zdravljenja kroničnega endometritisa na uspešnost postopkov zunajtelesne oploditve – sistematični pregled literature

Izhodišča: Kronični endometritis (KE) poteka z blagimi kliničnimi znaki in naj bi bil povezan z neplodnostjo, s ponavljajočimi se splavi in ponavljajočo se neuspelo ugnezditvijo zarodka v postopkih oploditve z biomedicinsko pomočjo (OBMP). Ker si mnenja o ugotavljanju in zdravljenju KE v postopkih OBMP medsebojno nasprotujejo, smo si zastavili cilj sistematično pregledati članke o vplivu zdravljenja KE na reproduktivni izid pri neplodnih ženskah v postopkih OBMP. Metode: Pregledali smo zbirko Medline. Uporabili smo deskriptorje iz tezavra Medical subject headings (Mesh), ki so vključevali ključne besede kronični endometritis (angl. chronic endometritis) in zdravljenje (angl. treatment) ter nosečnost (angl. pregnancy). Vključili smo raziskave od januarja 1971 do marca 2022. Rezultati: V pregled smo vključili 8 raziskav, ki so uporabile različne sheme zdravljenja. Večina raziskav je ugotavljala statistično pomembne razlike v reproduktivnem izidu po zdravljenju KE. Zaključek: Zdravljenje KE lahko pozitivno vpliva na izid v sledečih si OBMP postopkih, vendar so še potrebne nadaljnje večje randomizirane študije

Slovenska priporočila za rabo nujne kontracepcije

Nujna kontracepcija (KC) je kontracepcija za zaščito pred neželeno nosečnostjo neposredno po nezaščitenem spolnem odnosu kot izhod v sili. Na voljo sta dve metodi nujne KC: oralna nujna KC in nujna vstavitev materničnega vložka z bakrom. V priporočilih so pojasnjene indikacije za nujno KC, vrste nujne KC, mehanizem delovanja, učinkovitost nujne KC ter previdnostni ukrepi, medsebojno delovanje z zdravili in neželeni učinki. Posebej je predstavljeno svetovanje nujne KC ter raba nujne KC pri različnih stanjih in boleznih žensk. Slovenska priporočila za rabo nujne KC povzemajo mednarodna priporočila in vključujejo prilagoditve za naše razmere

Review of Clinical Trials on Effects of Oral Antioxidants on Basic Semen and Other Parameters in Idiopathic Oligoasthenoteratozoospermia

Infertility affects 50 to 80 million people worldwide. Male factor is a cause of infertility in almost half of cases, mainly due to oligoasthenoteratozoospermia (OAT). With common diagnostic methods no cause can be found in approximately 30% of cases of male infertility due to OAT and these are considered idiopathic. Reactive oxygen species (ROS) play an important role in male infertility and are proved to be higher in infertile men; antioxidants could oppose their effect. The aim of this paper was to review the literature on clinical trials in the period from year 2000 to year 2013 studying the effects of various types of antioxidant supplements on basic and other sperm parameters and pregnancy rates in subfertile males with idiopathic OAT. The majority of studies were randomized and placebo controlled and confirmed beneficial effect of antioxidants on at least one of the semen parameters; the biggest effect was determined on sperm motility. In many of these trials combinations of more antioxidants were assessed. The optimal dosages of one or more antioxidants were not defined. We concluded that antioxidants play an important role in protecting semen from ROS and can improve basic sperm parameters in case of idiopathic OAT

CHALLENGES IN REPRODUCTIVE HEALTH CARE OF ADOLESCENTS IN SLOVENIA

Background: Slovenia is one of the most successful European countries in the prevention of adolescent pregnancy and the country with a relative early sexual engagement of adolescents. Every year new generations of adolescents are entering puberty, thus reproductive health care of adolescents should be our continuous priority. Methods: The most important challenges in reproductive health care of adolescents in Slovenia are early sexual engagement of adolescents, low double method use at sexual intercourse and inadequate detection of sexually transmitted infections. Possible responses should be found on a micro-level of physician (recognition of a new role of physician, promotion of ABC ap- proach) and on a macro-level of society (development of national strategy of reproductive health care, introduction of systematic sexuality education in the schools). Conclusions: Challenges in reproductive health care of adolescents are several and possible responses are integral. A response on challenges demand that every physician recognizes his/her new role and develops his/her competency. Responses on challenges will be feasible with inter- connection of physicians with other physicians and professionals and with collaboration of profession and politics

Polycystic Ovary Syndrome and Endocrine Disruptors (Bisphenols, Parabens, and Triclosan)—A Systematic Review

Exposure to endocrine disrupting chemicals (EDCs) can result in alterations of the female reproductive system, including polycystic ovary syndrome (PCOS). The aim of this review was to summarize the knowledge about the association of EDCs (bisphenols, parabens, and triclosan) with PCOS. We conducted an electronic literature search using PubMed for studies published between January 2007 and October 2022 on EDCs related to PCOS, and evaluated the association of PCOS with bisphenols, parabens and triclosan in 15 articles. Most studies revealed significantly higher plasma, urinary or follicular fluid levels of bisphenol A (BPA) in women with PCOS, and some showed a positive correlation of BPA with insulin resistance, polycystic morphology on ultrasound, hepatic steatosis, bilirubin levels, as well as free androgen index, androstenedione and testosterone serum levels, and markers of low-grade chronic inflammation. There was a negative correlation of BPA with markers of ovarian reserve, sex hormone binding globulin and vitamin D–binding protein. Parabens and triclosan have been studied in only one study each, with no significant associations with PCOS observed. Our review revealed an association of BPA with PCOS and negative effects of BPA on human ovaries; more research is needed to assess the potential associations of parabens and triclosan with PCOS

The outcomes of pregnancy and childbirth in adolescents in Slovenia

The objective of the study was to determine the course and outcomes of pregnancy and childbirth in adolescents compared to women aged 20–24 years in Slovenia

From Oxidative Stress to Male Infertility: Review of the Associations of Endocrine-Disrupting Chemicals (Bisphenols, Phthalates, and Parabens) with Human Semen Quality

Exposure to endocrine-disrupting chemicals (EDCs) may result in oxidative stress and endocrine system disturbance, which can have an impact on human reproduction and development. In male reproductive health, EDCs have been related to impaired reproductive function and male infertility, altered fetal development, and testicular germ-cell, prostate, and breast cancers. We conducted an electronic search using PubMed on endocrine disruptors related to oxidative stress and male infertility, and evaluated their association with endocrine-disrupting chemicals (bisphenols, phthalates, and parabens) in 25 articles. Higher levels of urinary bisphenols showed correlation with impaired semen quality and increased DNA damage. Considering phthalates and their metabolites, all studies found a positive association between urinary levels of phthalates and at least one semen parameter indicative of low semen quality; some studies also revealed sperm DNA damage. The studies on parabens less often revealed correlation of urinary parabens concentrations with a decrease in sperm count, as well as motility and DNA damage. Moreover, EDCs can elevate ROS production and lipid peroxidation, increase apoptosis, induce epigenetic modifications, and change the Y:X sperm chromosome ratio and sperm protein composition. Our review revealed detrimental effects of EDCs on semen quality and sperm DNA integrity—especially in BPA and phthalates, but also in parabens