Kamila Wójtowicz

Background/Objectives: Infertility is an important public health problem. It is the source of considerable psychological load, negatively affecting the quality of life, social relations, and psychological health. Stress in infertility plays the role of both a risk factor and a consequence of reproductive disorders, exerting an effect through hormonal, inflammatory and oxidative mechanisms, which may reduce the effectiveness of treatment. The aim of the study is assessment of the frequency of occurrence of depression, anxiety, and stress in infertile women. Methods: The study included 300 women treated due to infertility, and 50 women in the control group. The evaluation was carried out using an author-constructed socio-demographic questionnaire and the Depression Anxiety Stress Scales-42 (DASS-42) for the measurement of depression, anxiety, and stress. In addition, selected hormones were determined in blood serum. Results: Hormonal analysis showed significantly higher levels of prolactin (PRL) in women treated due to infertility, especially in the group without the use of assisted reproductive technology (non-ART), whereas higher levels of the follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were noted in the control group. The level of anti-mullerian hormone (AMH) was lower in the therapeutic group, with no differences observed between the methods of treatment, and the levels of thyroid-stimulating hormone (TSH) did not differ between groups. Psychological evaluation according to the DASS-42 showed a significantly higher intensity of depression, anxiety, and stress in patients treated due to infertility, this intensity being the highest in the in vitro fertilization (IVF) group. Weak, but significant, correlations were found between PRL, FSH and LH, and the intensity of the symptoms of depression, anxiety, and stress, and the overall result according to the DASS-42. Conclusions: Infertile women experienced higher levels of depression, anxiety, and stress, compared to fertile women. The study suggests a relationship between the level of psychological stress in persons treated for infertility, and their hormonal status. The study demonstrates that integration of psychological support and infertility treatment may bring about important benefits for psychological health and the quality of life of patients.

Background/Objectives: Infertile people experience a lot of psychological stress due to the inability to conceive and achieve pregnancy. Studies on the quality of life (QoL) of people undergoing infertility treatment typically show a lower QoL for couples struggling with reproductive problems. In recent years, a new factor that may have had a stressful impact on people treated for infertility is the COVID-19 pandemic. The aim of this study is to assess the impact of the COVID-19 pandemic on the QoL of Polish women treated for infertility and on the secretion of selected sex hormones. Methods: The study sample consisted of 600 women undergoing treatment due to infertility and 100 healthy women in a control group. The World Health Organization Quality of Life-BREF (WHOQOL-BREF) and the Polish version of the questionnaire Fertility Quality of Life (FertiQoL) were used for data collection. The levels of selected hormones were measured from blood samples. Results: The effects of the pandemic were visible primarily in the reduced QoL of patients. The QoL in terms of physical health, psychological health, social relationships, and environmental sphere was drastically reduced by COVID-19, especially among women treated with IVF (in vitro fertilization) and IUI (intrauterine insemination). The hormonal status of women treated for infertility during the pandemic significantly changed due to a decrease in FSH (follicle-stimulating hormone) and LH (luteinizing hormone) secretion and an increase in PRL (prolactin). Conclusions: The pandemic resulted in a decline in the QoL of women with reproductive problems. The quality of life was influenced by the type of therapy used during infertility treatment. The study also suggests a relationship between a decrease in the quality of life of persons treated for infertility during the pandemic and their hormonal status.

Objectives: The Polish criteria for “intrauterine death” include fetal demise after 22 weeks of gestation, weighing > 500 g and body length at least 25 cm, when the gestational age is unknown. The rate of fetal death in Poland in 2015 is 3:10,000. In 2020, 1,231 stillbirths were registered. Material and methods: An analysis using 142,662 births in the period between 2015–2020 in 11 living in Poland. The first subgroup was admitted as patients > 22 to the beginning of the 30^th week of pregnancy (n = 229), and the second from the 30th week of pregnancy inclusively (n = 179). In the case of women from both subgroups, there was a risk of preterm delivery close to hospitalization. Results: It was found that stillbirth in 41% of women in the first pregnancy. For the patient, stillbirth was also the first in his life. The average stillbirth weight was 1487 g, the average body length was 40 cm. Among fetuses up to 30 weeks, male fetuses are born more often, in subgroup II, the sex of the child was usually female. Most fetal deaths occur in mothers < 15 and > 45 years of age. Conclusions: According to the Polish results of the origin of full-term fetuses > 30 weeks of gestation for death in the concomitant antenatal, such as placental-umbilical and fetal hypoxia, acute intrapartum effects rarely, and moreover < 30 Hbd fetal growth restriction (FGR), occurring placental-umbilical, acute intrapartum often. Objectives: The Polish criteria for “intrauterine death” include fetal demise after 22 weeks of gestation, weighing > 500 g and body length at least 25 cm, when the gestational age is unknown. The rate of fetal death in Poland in 2015 is 3:10,000. In 2020, 1,231 stillbirths were registered. Material and methods: An analysis using 142,662 births in the period between 2015–2020 in 11 living in Poland. The first subgroup was admitted as patients > 22 to the beginning of the 30^th week of pregnancy (n = 229), and the second from the 30th week of pregnancy inclusively (n = 179). In the case of women from both subgroups, there was a risk of preterm delivery close to hospitalization. Results: It was found that stillbirth in 41% of women in the first pregnancy. For the patient, stillbirth was also the first in his life. The average stillbirth weight was 1487 g, the average body length was 40 cm. Among fetuses up to 30 weeks, male fetuses are born more often, in subgroup II, the sex of the child was usually female. Most fetal deaths occur in mothers < 15 and > 45 years of age. Conclusions: According to the Polish results of the origin of full-term fetuses > 30 weeks of gestation for death in the concomitant antenatal, such as placental-umbilical and fetal hypoxia, acute intrapartum effects rarely, and moreover < 30 Hbd fetal growth restriction (FGR), occurring placental-umbilical, acute intrapartum often.

Introduction and objective: Many scientific reports confirm a systematic decline in male semen parameters over the last decades. This phenomenon has been observed in all parts of the world, and its occurrence is associated, among others, with the hazardous effects of some environmental factors. The environmental factors for which the adverse effect on male fertility has been proven include water, air, and soil pollution, as well as electromagnetic fields and ionizing radiation. The aim of this article was the evaluation of the effect of selected environmental factors on male reproductive capacity based on an analysis of the current scientific reports. Review methods: A systematic literature review was carried out using three databases: PubMed, EMBASE, and Scopus. The search was limited to the period from 2015 until the end of December 2023. Brief description of the state of knowledge: Environmental factors, such as heavy metals, tobacco smoke, pesticides, dioxins, furans, phthalates, and bisphenols, are well-tested substances that exert an adverse effect on male fertility. A harmful effect of electromagnetic fields and water and air pollution on reproductive functions may be expected; however, this has not been fully proven. Summary: Results obtained by many researchers published to date should evoke great concern regarding the quality of the environment in which we live, as well as fears about the effect of environmental factors not only on male fertility, but also on all aspects of human health. The majority of environmental pollutants affect the male body by causing oxidative stress and through their effect on the endocrine system.

Coronavirus disease—COVID-19 (coronavirus disease 2019) has become the cause of the global pandemic in the last three years. Its etiological factor is SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus type 2). Patients with diabetes (DM—diabetes mellitus), in contrast to healthy people not suffering from chronic diseases, are characterised by higher morbidity and mortality due to COVID-19. Patients who test positive for SARCoV-2 are at higher risk of developing hyperglycaemia. In this paper, we present, analyse and summarize the data on possible mechanisms underlying the increased susceptibility and mortality of patients with diabetes mellitus in the case of SARS-CoV-2 infection. However, further research is required to determine the optimal therapeutic management of patients with diabetes and COVID-19.

Uterine tumors are a challenge encountered by every gynecologist in clinical practice. In the era of increasing incidence of endometrial cancer in the general population of women at reproductive age, compared to other genital malignancies, we should not forget about other tumors originating from the mucous and muscular layer of the uterus. Clear ultrasonographic differentiation of uterine tumors into benign (myomas) and malignant (sarcomas) lesions may sometimes prove impossible. Myomas, the most common uterine tumors, are characterized by discrete vascularization on color Doppler and high blood flow velocity as well as the lack of early diastolic notch on Doppler ultrasound. Sarcomas, on the other hand, show characteristic rich vascularization. Rapid tumor growth should also be noted when making the diagnosis. There are multiple known causes of uterine tumors. So far, no clear Doppler flow markers have been identified to characterize benign and malignant lesions.