Browsing by Author "Terzic, Sanja (56734282900)"

Endometriosis, a common condition in women of reproductive age, is very frequently associated with infertility. The causes of infertility in women with endometriosis range from anatomical distortions to endocrine abnormalities and immunological disturbances: a) disturbance of pelvic anatomy especially in women with severe disease; b)prostaglandin overproduction and inflammatory mediators determining a hostile peritoneal environment; c) altered endometrial receptivity; d) myometrium structure changes in adenomyosis; e) decreased ovarian reserve and oocyte quality due to the presence of endometrioma or as a consequence of the surgically related damage; and f) hormonal dysregulation with anovulation and premature luteinization. Despite the extensive and interdisciplinary investigations already conducted, all the listed pathophysiological mechanisms in infertility patients with endometriotic ovarian cyst have not always been clearly understood. Nonetheless, endometriosis significantly interferes with women's overall health and well-being, and it is also linked with a decreased ovarian reserve and adverse outcomes of infertility management procedures. Treatment strategies for endometriotic ovarian cyst in infertility patients are different, depending on a number of factors. The surgical approach remains controversial, as it has been associated with ovarian reserve impairment. Medications alone have little or no effect and should be combined with assisted reproductive technology procedures. IVF is an efficient treatment option in patients with a mild and moderate stage of the disease. Although recently published studies have shown that a combination of medical, surgical, and psychological treatment was found beneficial in patients suffering from endometriosis-related infertility, there is still a lack of consensus that this specific combination can enhance the fertility success rate. Generally, management of endometriotic ovarian cyst in infertility patients includes a surgical procedure (usually with a minimally invasive approach) and ovulation induction with intrauterine insemination or in vitro fertilization. Fertility preservation technologies also include oocyte or embryo freezing and ovarian tissue cryopreservation. As the management of patients with endometriotic cysts remain controversial, a multidisciplinary approach is a key factor in achieving the best outcome, along with appropriate patient counselling. © 2021 by Nova Science Publishers, Inc. All rights reserved.

Approximately 15% of the world population is impacted by infertility. Recent research has shown that environmental and occupational factors have profound effects on the population's overall health and fertility status. While cigarette smoking and its component chemicals are known toxic agents affecting the quality and quantity of oocytes, other toxic substances ubiquitous in our environment appear to have toxic effects on the reproductive system at environmentally relevant levels. Certain industrial chemicals, environmental pollutants, and radiation are known to contribute to or cause infertility. Lead poisoning, for example, has long been associated with infertility in both men and women. Chemotherapy and x-ray therapy used in cancer treatment can be extremely toxic to sperm and oocytes and can cause permanent infertility. In some countries, fertility programs recommend that men who will be undergoing chemotherapy store their sperm before treatment. Similarly, oocyte retrieval before a woman's cancer treatment and freezing the oocytes or embryos for later use, is also advised. Long soaks in the bathtub or hot tub or long hours of sitting and excessive bicycling can cause the temperature in the scrotum to increase enough to impair sperm production. A febrile illness can also lead to a significant decline in sperm motility. Considering all these elements, the influence of environmental and occupational conditions on reproductive well-being has generated a considerable amount of interest among researchers. Recent studies have aimed to clarify the association and possible mechanisms between reduced fertility and exposure to environmental and occupational contaminants. This chapter summarizes the recently published, epidemiological findings referring to the impact of environmental (air pollution, heavy metals, pesticides, endocrine disruptors and other chemicals, radiation) and occupational factors on fecundity and fertility. Daily exposure to environmental and occupational hazards has negative ramifications for fertility via several sources such as biological, physical (radiation), and toxic (chemicals, endocrine-disrupting chemicals, heavy metals). Future studies are needed to better elucidate the additional associations and potential mechanisms between these environmental chemicals and fertility outcomes in men and women. © 2021 by Nova Science Publishers, Inc. All rights reserved.

Objective: There are still contradictory opinions on the success rates of uterine artery embolization (UAE) for the treatment of myomas. In this scenario, our study aims to assess the effect of UAE on myoma shrinkage. Materials and Methods: The study included 337 women in reproductive age affected by a single symptomatic intramural myoma and declined surgery, undergoing UAE. The uterus and myoma diameters and volumes were determined on ultrasonographic scans before and 3, 6, and 12 months after the procedure. Results: The mean uterine volume before intervention was 226.46 ± 307.67 mm3, whereas myoma volume was 51.53 ± 65.53 mm3. Further myoma progression was registered in only four patients. In remaining women, uterus volume in average decreased for 149.99 ± 156.63 mm3, whereas myomas decreased for 36.57 ± 47.96 mm3. The mean volume reduction rate of the uterus was 49.54 ± 35.62 and for myoma was 57.58 ± 30.71. A significant decrease in both uterine and myoma volume was registered in every stage of the follow-up. The highest average decrease in uterine volume was in the first 3 months and myoma volume between 3 and 6 months following UAE. After 12 months follow-up, successful outcome (volume regression >50% respect to the baseline) was registered for uterus in 97.4% and for myoma in 67.9% of investigated patients. Conclusion: UAE was proven to allow a good success rate and can be considered as an effective alternative procedure for myoma treatment. © 2019 Gynecology and Minimally Invasive Therapy.

Background: Ionizing radiation causes detrimental health effects such as cancer and genetic damage. The study aim was to determine predictors for micronuclei (MN) occurrence and frequency in peripheral blood lymphocytes of health workers professionally exposed to radiation. Methods: Health workers, age matched, selected for the study on regular check-ups, were divided according to the radiation exposure. The exposed group involved nuclear medicine department employees (54) and the control group comprised workers from other departments (36). Data about workers characteristics and habits, received annual doses (AD), total years of service (TYS) and exposed years of service (EYS) were taken from each subject. Blood samples were taken and micronuclei (MN) number in peripheral blood lymphocytes was calculated using CBMN assay according to standard protocols. Results: Most workers were female, technicians, with mean age of 45.67 years and EYS about 15 years. Health workers exposed to radiation had significantly more MN than controls (p∈=∈0.001). Female gender, older age, higher received annual doses, longer EYS and TYS increased the MN number. Technicians and laboratory workers have higher risk for MN occurrence. Significant predictors of MN formation according to constructed model were workers age, sex, AD and EYS. One EYS year increases MN frequency 1.017 times, while receiving 0.1 mSy raises MN frequency by 26 %. EYS accurately predicts 86.30 % of MN frequencies and AD 64.60 %. Conclusions: The model, developed for the first time in this study, showed that received annual doses and duration of exposure to radiation can be used for prediction of MN numbers. © 2015 Terzic et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License.

Background: Ionizing radiation causes detrimental health effects such as cancer and genetic damage. The study aim was to determine predictors for micronuclei (MN) occurrence and frequency in peripheral blood lymphocytes of health workers professionally exposed to radiation. Methods: Health workers, age matched, selected for the study on regular check-ups, were divided according to the radiation exposure. The exposed group involved nuclear medicine department employees (54) and the control group comprised workers from other departments (36). Data about workers characteristics and habits, received annual doses (AD), total years of service (TYS) and exposed years of service (EYS) were taken from each subject. Blood samples were taken and micronuclei (MN) number in peripheral blood lymphocytes was calculated using CBMN assay according to standard protocols. Results: Most workers were female, technicians, with mean age of 45.67 years and EYS about 15 years. Health workers exposed to radiation had significantly more MN than controls (p∈=∈0.001). Female gender, older age, higher received annual doses, longer EYS and TYS increased the MN number. Technicians and laboratory workers have higher risk for MN occurrence. Significant predictors of MN formation according to constructed model were workers age, sex, AD and EYS. One EYS year increases MN frequency 1.017 times, while receiving 0.1 mSy raises MN frequency by 26 %. EYS accurately predicts 86.30 % of MN frequencies and AD 64.60 %. Conclusions: The model, developed for the first time in this study, showed that received annual doses and duration of exposure to radiation can be used for prediction of MN numbers. © 2015 Terzic et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License.

The study aimed to review the role of basal, trigger, and aspiration day progesterone levels (PLs) as predictors of in vitro fertilization (IVF) success for patients with and without endometriosis. A non-systematic review was conducted by searching papers published in English during the period of 1990–2023 in MEDLINE and PubMed, Embase, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register), and Web of Science. The most widely used IVF predictor success was the trigger day progesterone serum level. Many studies utilize the threshold level of 1.5–2.0 ng/ml. However, the predictive power of only progesterone level failed to show high sensitivity and specificity. Contrary, progesterone level on the trigger day combined with the number of mature retrieved oocytes had the highest predictive power. High baseline progesterone level was associated with poor IVF outcomes. Research on progesterone and IVF success in patients with endometriosis is limited but indicates that endometriosis patients seem to benefit from higher progesterone concentrations (≥ 37.1 ng/ml) in IVF cycles. Currently, there is limited data for a definitive insight into the mportance of progesterone in the estimation of IVF success. Nonetheless, this summarized evidence could serve as up-to-date guidance for the role of progesterone in the prediction of IVF outcomes, both in patients with and without endometriosis. © The Author(s), under exclusive licence to Society for Reproductive Investigation 2024.

Introduction: It has been estimated that approximately 16% of pregnancies worldwide are affected by preexisting or gestational insulin-dependent (type 1) or independent (type 2) diabetes mellitus (DM). Diabetes mellitus in pregnancy remains a high-risk condition for both mother and child. This study aimed to investigate pregnancy outcomes regarding DM types. Material and methods: The study included 323 DM patients delivered for 6 years (2012–2017). General and obstetric history data and all complications throughout the pregnancy and the early neonatal period were noted. Based on DM type, women were divided into 4 groups: pre-pregnancy/pre-existing DM, insulin-dependent or independent, and gestational diabetes mellitus with or without insulin therapy. Results: The majority of women had pre-existing insulin-independent DM (type II 62%). Some types of pregnancy/maternal complications were registered in almost 85% of examined pregnancies. However, all babies were live born and mostly with good outcome (36.85% with early neonatal complications). Diabetes mellitus type could not predict the occurrence of neonatal complications (p = 0.342). Pre-existing insulin-dependent DM increased the risk for pregnancy complications (p = 0.031; OR = 1.656). Conclusions: Diabetes mellitus type has a limited impact on pregnancy outcomes and the occurrence of maternal and neonatal complications. With adequate therapy the pregnancy outcome can be good regardless of DM type. © 2022 Termedia Publishing House Ltd.. All rights reserved.

Infertility affects about 9% of reproductive-age couples or more than 186 million people worldwide and up to 15% of couples in the USA. Infertility is a life event that results in significant psychological stress and women with decreased fertility have been found to have elevated levels of anxiety and depression. Moreover, stress and stress-related factors have an influence on the autonomic, neuroendocrine, and immune systems. In the past, psychological stress as a causative factor of infertility has been poorly investigated, however, several recent studies have shown that lowering psychological distress is linked with a significant increase in pregnancy rate. It has also been confirmed that stress stimulates and deregulates the hypothalamic-pituitary-adrenal axis and the sympathetic-adrenal-medullary axis, which in turn plays a crucial role in women's reproductive functioning. There are studies that have further suggested an association between psychosocial stress and a diminished ovarian reserve and negative fertility outcomes. This chapter presents up to date information related to psychological factors and infertility, highlighting the impact of stress, anxiety, and depression on conception, impaired fertility, and infertility. Understanding the mechanisms behind the detrimental effects of psychological factors on female reproductive status is critically important knowledge for women's health care providers when screening for fertility risk factors and treating women with infertility. Women with fertility issues undergoing assisted reproductive technology procedures should be carefully evaluated for levels of stress, anxiety, and depression. Following evaluation, they should be offered appropriate counselling interventions to mitigate the adverse effects of psychological factors and to increase the success rate of infertility management procedures. © 2021 by Nova Science Publishers, Inc. All rights reserved.

Cervical cancer is one of the leading causes of cancer-related death in women of reproductive age. The established fertility-sparing approaches for the management of early-stage cervical cancer for women who plan pregnancy are associated with a decline in fecundity and an increased risk of pregnancy complications. This article aims to offer an overview of fertility-sparing approaches and the management of potential subfertility and pregnancy complications after these treatments. An extensive search for the available data about infertility and cervical cancer, fertility-sparing techniques in patients with cervical cancer, fertility treatment, obstetrical complications, and pregnancy outcomes in cervical cancer patients was completed. Fertility-preserving procedures such as loop electrosurgical excision procedure (LEEP), cold-knife conization, and trachelectomy in women diagnosed with cervical cancer can be considered as safe and effective treatments that preserve reproductive potential. Current fertility-preserving procedures, based on the balance of the oncological characteristics of patients as well as their desire for reproduction, allow one to obtain acceptable reproductive and obstetric outcomes in women treated for cervical cancer. Nevertheless, careful monitoring of pregnancies obtained after fertility-preserving procedures is recommended, since this cohort of patients should be considered at higher risk compared with a healthy population. © 2023 by the authors.

Introduction: Older women are at greater risk of suffering from a series of comorbidities such as obesity, diabetes, and hypertension that could negatively affect pregnancy course and outcomes. This study aims to investigate the impact of maternal age and pre-pregnancy body mass index (BMI) on pregnancy outcomes of women with diabetes mellitus (DM). Material and methods: The study included 323 diabetic pregnant women. All complications throughout pregnancy and the early neonatal period were noted. The women were divided into groups according to age decade and BMI. Results: 84.8% of women reported pregnancy complications, with a higher prevalence in obese women (p = 0.003). However, most children had a good outcome with few early neonatal complications (36.85%). Old and obese women with DM often showed complications, and their newborns had higher birth weight (p = 0.003) and more neonatal complications (p = 0.041). Maternal BMI (p = 0.016; OR = 1.064), but not age (p = 0.801), was found to be a significant predictor of pregnancy complications. Conclusions: Pregnant women with DM should be considered as high-risk patients. Advanced age and increased BMI prior to pregnancy are risk factors for pregnancy complications. Maternal obesity is the most important predictor of pregnancy complications in women with DM. Pregnancy outcome can be good for both mothers and children with a timely and adequate approach. © 2022 Termedia Publishing House Ltd.. All rights reserved.