Aleksandra Zygula

Background: Cervical cancer is one of the most common cancers in women worldwide, with the leading risk factor being high-risk human papillomavirus (HR-HPV); persistent HR-HPV infection leads to cervical dysplasia. With early screening and, if indicated, therapeutic strategies such as a loop electrosurgical excision procedure (LEEP) and large loop excision of the transformation zone (LLETZ), morbidity and mortality in this population are decreasing. However, it is suspected that these procedures may have an impact on sexual dysfunction. Methods: In this single-center prospective longitudinal study, we recruited patients with a high-grade squamous intraepithelial lesion (HSIL) and HR-HPV-positive result and evaluated the impact of LEEP/LLETZ on their sexual life and psychological well-being. All participants received two questionnaires—the Female Sexual Function Index (FSFI) and the Brief Index of Sexual Function-Women (BISF-W)—after diagnosis, before treatment, and three months after the procedure. Results: A total of 40 women aged 28 to 55 years were enrolled. This study showed no significant changes in both the FSFI (F(1,39) = 0.774; p = 0.38) and BISF-W total scores (F(1,39). This study revealed that 32/40 (80%) of participants based on the FSFI either exhibited no change or improved sexual function. Only 3/40 (7.5%) mentioned sexual dysfunction after procedures. This study also found that the mean score for sexual function based on the FSFI was 2.80; p = 0.102. Conclusions: These findings suggest that patients who qualified for LEEP/LLETZ can be reassured that the anxiety they experience prior to treatment is not necessarily justified. This provides evidence of the safety of loop excision procedures in terms of sexual functioning after the procedure. Nevertheless, further studies are needed to analyze the potential risk factors that may contribute to adverse sexual outcomes and to achieve a better understanding of this complex problem.

Background/Objectives: Cervical cancer is one of the most common cancers in women worldwide, with the leading risk factor being high-risk human papillomavirus (HR-HPV); persistent HR-HPV infection leads to cervical dysplasia [1,2,3,4]. With early screening and, if indicated, therapeutic strategies such as loop electrosurgical excision procedure (LEEP) and large loop excision of transformation zone (LLETZ), morbidity and mortality in this population is decreasing. However, it is suspected that these procedures may have an impact on sexual dysfunction. Methods: In this single-centre prospective longitudinal study, we recruited patients with high-grade squamous intraepithelial lesion (HSIL) and HR-HPV positive result and evaluated the impact of LEEP/LLETZ on their sexual life and psychological well-being. All participants received two questionnaires - the Female Sexual Function Index (FSFI) and the Brief Index of Sexual Function-Women (BISF-W) – after diagnosis, before treatment and three months after the procedure. Results: A total of 40 women aged 28 to 55 years were enrolled. The study showed no significant changes in both FSFI (F(1,39) = 0.774; p = 0.38) and BISF-W total scores (F(1,39) The study revealed that 32/40 (80%) of participants based on FSFI either exhibited no change or improved sexual function. Only 3/40 (7.5%) mentioned sexual dysfunction after procedures. The study also found that the mean score for sexual function based on the FSFI was 2.80; p = 0.102. Conclusions: The findings suggest that patients qualified for LEEP/LLETZ can be reassured that the anxiety they experience prior to treatment is not necessarily justified. This provides evidence on the safety of loop excision procedures in terms of sexual functioning after the procedure. Nevertheless, further studies are needed to analyse potential risk factors that may contribute to adverse sexual outcomes and to achieve a better understanding of this complex problem.

This study aimed to evaluate the concentration of osteopontin in peritoneal fluid and plasma as potential biomarkers for diagnosing endometriosis. Osteopontin levels were measured using surface plasmon resonance imaging (SPRI) biosensors in patients suspected of having endometriosis. Plasma samples were collected from 120 patients, and peritoneal fluid was collected from 86 patients. Based on the detection of endometriosis lesions during laparoscopy, participants were divided into a study group (patients with endometriosis) and a control group (patients without endometriosis). The results showed no significant differences in plasma osteopontin levels between women with endometriosis and the control group (19.86 ± 6.72 ng/mL vs. 18.39 ± 4.46 ng/mL, p = 0.15). Similarly, peritoneal fluid osteopontin concentrations did not differ significantly between patients with and without endometriosis (19.04 ± 5.37 ng/mL vs. 17.87 ± 5.13 ng/mL, p = 0.29). Furthermore, osteopontin levels in both plasma and peritoneal fluid were not significantly associated with the stage of endometriosis, the presence of endometrioma, or the menstrual cycle phase. The findings of this study do not support osteopontin concentration as a reliable biomarker for endometriosis. However, further research is necessary to explore osteopontin’s potential role in the disease.

Objectives: To assess the experience and knowledge of Polish women up to 50 years of age about fertility and its disorders. Material and methods: A self-composed questionnaire consisting of 44 questions, divided into six sections, was available in social media from January until February 2020. The answers to 13 single-choice questions were analyzed to assess the level of knowledge. Statistical analysis was performed with the use of Statistica 13.0, with p value < 0.05 considered significant. Results: A total of 3,321 correctly filled out questionnaires were obtained. The average result was 8.88 out of 13 single-choice questions regarding the basics of the menstrual cycle and infertility (median 9, standard deviation [SD] 2.21). As many as 65.2% of respondents did not know which days in the cycle were fertile days. The women who had been and/or were pregnant at the time of survey, more often answered better than those, who had never given birth. They had a better mean score of 13 single-choice questions compared to those who had never been pregnant (9.02 vs 8.61, p < 0.001). Respondents who obtained information about infertility from doctors in 86.97% knew that regular intercourse meant 2–3 times per week in comparison to 79.7% of those who were not educated by medical practitioners (p < 0.0001). 69.8% respondents from the first group knew that the test of ovarian reserve existed in comparison to 55.63% of women from the second group (p < 0.0001). Conclusions: The research has shown that the knowledge about fertility and its disorders is not satisfying among Polish women. Objectives: To assess the experience and knowledge of Polish women up to 50 years of age about fertility and its disorders. Material and methods: A self-composed questionnaire consisting of 44 questions, divided into six sections, was available in social media from January until February 2020. The answers to 13 single-choice questions were analyzed to assess the level of knowledge. Statistical analysis was performed with the use of Statistica 13.0, with p value < 0.05 considered significant. Results: A total of 3,321 correctly filled out questionnaires were obtained. The average result was 8.88 out of 13 single-choice questions regarding the basics of the menstrual cycle and infertility (median 9, standard deviation [SD] 2.21). As many as 65.2% of respondents did not know which days in the cycle were fertile days. The women who had been and/or were pregnant at the time of survey, more often answered better than those, who had never given birth. They had a better mean score of 13 single-choice questions compared to those who had never been pregnant (9.02 vs 8.61, p < 0.001). Respondents who obtained information about infertility from doctors in 86.97% knew that regular intercourse meant 2–3 times per week in comparison to 79.7% of those who were not educated by medical practitioners (p < 0.0001). 69.8% respondents from the first group knew that the test of ovarian reserve existed in comparison to 55.63% of women from the second group (p < 0.0001). Conclusions: The research has shown that the knowledge about fertility and its disorders is not satisfying among Polish women.

The impact of HPV diagnosis and subsequent treatment with the electrosurgical excision procedure (LEEP) on anxiety, depression, psychosocial quality of life, and sexual functioning has not been thoroughly investigated. The aim of this review was to systematically summarize the available knowledge on this topic, according to PRISMA guidelines. Data from observational and intervention studies were analyzed. A total of 60 records were included, of which 50 papers addressed the impact of HPV diagnosis on patients’ psychosocial status, while 10 studies addressed the impact of the implemented LEEP procedure on patients’ mental health and sexual functioning. The results indicated a negative impact of HPV diagnosis on the occurrence of depressive and anxiety symptoms, poorer quality of life, as well as on the sexual functioning of the affected women. The results of the studies to date have not confirmed the negative impact of the LEEP procedure on mental health and sexual life, although more research is needed in this area. It is necessary to implement additional procedures to minimize anxiety and distress in patients receiving a diagnosis of HPV or abnormal cytology and to improve awareness of sexually transmitted pathogens.

Objectives: We report the case of a twin pregnancy with a partial hydatidiform mole and a coexistent live fetus diagnosed in a 28-year-old primipara at 15 weeks of gestation and discuss the problems associated with the ultrasound diagnosis, histopathological examination of molar tissue samples and treatment. Material and methods: A systematic research of the literature was conducted in PubMed database and Cochrane Library, including case reports and case series. A new case was also discussed. We collected data regarding the patient’s serum human chorionic gonadotropin (hCG) level, initial symptoms, diagnosis and treatment. Results: Most of the cases reported in the literature are those of a multiple pregnancy with complete hydatidiform mole (CHM) and a coexistent live fetus. The coexistence of a twin pregnancy with partial hydatidiform mole (PHM) and a live fetus in two separate amniotic sacs is extremely rare as a partial mole usually causes miscarriage of early pregnancy. Ultrasound is an important diagnostic tool, but the correct diagnosis is made only in 68% of cases. With further histological assessment of molar specimens and biochemical assays, the rates of correct early diagnoses should increase contributing to early therapeutic decisions and fewer adverse events. Conclusions: The diagnosis, management, and monitoring of this condition will remain challenging because of its rarity. Because of that, all cases of a suspected multiple pregnancy with a hydatidiform mole and a coexistent live fetus should be referred to and managed at a tertiary center which specializes in the diagnosis and treatment of gestational trophoblastic disease. Objectives: We report the case of a twin pregnancy with a partial hydatidiform mole and a coexistent live fetus diagnosed in a 28-year-old primipara at 15 weeks of gestation and discuss the problems associated with the ultrasound diagnosis, histopathological examination of molar tissue samples and treatment. Material and methods: A systematic research of the literature was conducted in PubMed database and Cochrane Library, including case reports and case series. A new case was also discussed. We collected data regarding the patient’s serum human chorionic gonadotropin (hCG) level, initial symptoms, diagnosis and treatment. Results: Most of the cases reported in the literature are those of a multiple pregnancy with complete hydatidiform mole (CHM) and a coexistent live fetus. The coexistence of a twin pregnancy with partial hydatidiform mole (PHM) and a live fetus in two separate amniotic sacs is extremely rare as a partial mole usually causes miscarriage of early pregnancy. Ultrasound is an important diagnostic tool, but the correct diagnosis is made only in 68% of cases. With further histological assessment of molar specimens and biochemical assays, the rates of correct early diagnoses should increase contributing to early therapeutic decisions and fewer adverse events. Conclusions: The diagnosis, management, and monitoring of this condition will remain challenging because of its rarity. Because of that, all cases of a suspected multiple pregnancy with a hydatidiform mole and a coexistent live fetus should be referred to and managed at a tertiary center which specializes in the diagnosis and treatment of gestational trophoblastic disease.

As medical technology evolves, clinicians are increasingly choosing relatively painless non-invasive methods of patient diagnosis and treatment. There are two principles behind this: greater patient comfort and lower cost. Tears, hair, saliva, urine, and faeces can replace blood for diagnosis. The varied constituents in these biological materials can serve as biomarkers for the detection of both local and systemic diseases. In this paper, we review a range of diagnostic techniques — all using biological material obtained via non-invasive procedure — for detecting medical conditions in pregnant women. PubMed, Medline, Embase, and the Cochrane Library were searched from January 1996 until December 2018. Forty seven studies were included: thirty-five original articles, nine reviews and three meta-analysis. Analysis showed that saliva, hair, tears, and other biological material — obtained via non-invasive methods — may serve as clinically informative biomarkers. These biomarkers may be used for: toxicology, psychological studies, disease detection, biomonitoring, and drug abuse. The analysis of tears, hair, saliva, urine, and faeces is a safe, noninvasive and useful diagnostic tool within groups of pregnant women, but further investigation is necessary to fully realize the promise of these novel diagnostic tools. As medical technology evolves, clinicians are increasingly choosing relatively painless non-invasive methods of patient diagnosis and treatment. There are two principles behind this: greater patient comfort and lower cost. Tears, hair, saliva, urine, and faeces can replace blood for diagnosis. The varied constituents in these biological materials can serve as biomarkers for the detection of both local and systemic diseases. In this paper, we review a range of diagnostic techniques — all using biological material obtained via non-invasive procedure — for detecting medical conditions in pregnant women. PubMed, Medline, Embase, and the Cochrane Library were searched from January 1996 until December 2018. Forty seven studies were included: thirty-five original articles, nine reviews and three meta-analysis. Analysis showed that saliva, hair, tears, and other biological material — obtained via non-invasive methods — may serve as clinically informative biomarkers. These biomarkers may be used for: toxicology, psychological studies, disease detection, biomonitoring, and drug abuse. The analysis of tears, hair, saliva, urine, and faeces is a safe, noninvasive and useful diagnostic tool within groups of pregnant women, but further investigation is necessary to fully realize the promise of these novel diagnostic tools.

Adverse perinatal outcomes in singleton IVF pregnancies have been most often explained by parental underlying diseases and so far laboratory conditions during embryo culture are still not explored well. The following review discusses the current state of knowledge on the influence of IVF laboratory procedures on the possible perinatal outcome. The role of improved media for human embryo culture is unquestionable. Addition of certain components to culture media and their effect on embryo survival and implantation rates have been taken into consideration recently and studied on animal model. Impact of media on perinatal outcome in IVF offspring has also been studied. It has been discovered that epigenetic changes and neonatal birth weight are probably associated with the use of specific culture media, as is the relation between placental size and its influence on perinatal outcome. There are still questions in the discussion about duration of embryo culture (cleavage stage versus blastocyst transfer). Some of the IVF methods, such as in vitro maturation of oocytes and freezing/thawing procedures, also require well-powered randomized controlled trials in order to define their exact impact on perinatal outcome. Constant further research is needed to assess the impact of laboratory environment on fetal and postnatal development. Adverse perinatal outcomes in singleton IVF pregnancies have been most often explained by parental underlying diseases and so far laboratory conditions during embryo culture are still not explored well. The following review discusses the current state of knowledge on the influence of IVF laboratory procedures on the possible perinatal outcome. The role of improved media for human embryo culture is unquestionable. Addition of certain components to culture media and their effect on embryo survival and implantation rates have been taken into consideration recently and studied on animal model. Impact of media on perinatal outcome in IVF offspring has also been studied. It has been discovered that epigenetic changes and neonatal birth weight are probably associated with the use of specific culture media, as is the relation between placental size and its influence on perinatal outcome. There are still questions in the discussion about duration of embryo culture (cleavage stage versus blastocyst transfer). Some of the IVF methods, such as in vitro maturation of oocytes and freezing/thawing procedures, also require well-powered randomized controlled trials in order to define their exact impact on perinatal outcome. Constant further research is needed to assess the impact of laboratory environment on fetal and postnatal development.