[Internet as a source of information about infertility among infertile patients]. / Internet jako zródlo informacji o nieplodnosci wsród nieplodnych pacjentek.

OBJECTIVES: Around one million couples in Poland suffer from infertility People in reproductive age are most active Internet users. The aim of the study was to assess Internet habits of infertile patients. We checked to what extent infertile patients seek information about infertility on-line and what is their approach to the information found. MATERIALS AND METHODS: 85 female patients treated for infertility for at least one year were surveyed. The anonymous questionnaire was designed by the authors of the publication. It consisted of questions related to medical history of the patients and sources of information about infertility they used. It also checked Internet activity of the patients and contained Beck's Depression Inventory (BDI). Chi-square test and Spearman's correlation test were used to evaluate the results. RESULTS: The majority of patients used Internet to find information about infertility (93%); 46% of the respondent declared Internet forums to be their main source of information about it. Patients used on-line sources of information more often than stricte medical sources. Internet influenced their relation with the physician. 64% of patients verified on-line information and treatment proposed by their doctor before using them. One third of the surveyed women claimed their knowledge about infertility comes more from the Internet than the specialist who treated them. There was a positive correlation between patients who checked diagnostic or therapeutic methods proposed by their physician with depression in BDI. CONCLUSIONS: Considering the great impact of Internet forums and web pages on patient approach to diagnostics and treatment of infertility there seems to be a need to create a professional Polish website and forum to provide the patients with reliable information about the disease.

[External quality assessment of semen analysis in Poland]. / Zewnetrzna ocena jakosci badania seminologicznego w Polsce.

INTRODUCTION: Semen analysis is an important part of male infertility diagnosis and should be performed according to international recommendations. The reliability of the results depends mainly on the qualifications of the laboratory analysts. External Quality Assessment Programmes (EQAP) are performed in laboratories worldwide in order to standardize the results. The aim of this study was to perform the first in Poland comparison of the results of sperm analysis from different laboratories. MATERIALS AND METHODS: Forty two Polish laboratories were invited to participate in the EQAP and eight laboratories agreed to take part in the analysis. They were sent uniform semen samples, prepared in accordance with the WHO standards: one sample for the assessment of concentration, two for motility (on DVD) and two for the morphology of the sperm (Papanicolau staining). The reference group was comprised of three employees of the Andrologic Laboratory of Poznan University of Medical Sciences, who regularly take part in EQAP organized by ESHRE. The reference group analyzed the samples from the participating laboratories. Statistic features such as mean, median, standard deviation, minimal and maximal value, first and third quartile were assessed for every examined parameter Z-score index was used to compare the differences between assessed laboratories and the reference laboratory. The acceptable Z-score range was +/-1. RESULTS: Average concentration in the reference group was 43 mln/ml, while in the assessed laboratories (L) it was between 31 (L4) and 72.5 mln/ml (L1). Z-score for concentration analysis in three laboratories exceeded +/- 1 (2.51 for L1, 1.42 for L2 and -1.02 for L4). In the analysis of the first sample for progressive motility the reference group received 59%, while the values of participating laboratories varied from 42,5% (L1) to 80% (L4). Most of the centers achieved Z-score within the normal range, except for L1 and L4 (-1.48 and 1.88 respectively). The reference value for the second sample for motility was 33%. The received results ranged between 22% (L6) and 48% (L7). Z-score was -1.27 for L6 and 1.73 for L7, while the results of other laboratories were close to the reference group. Reference morphology for the first sample was 3%. The results sent by the participating laboratories varied from 2% (L2 and L3) to 72.7% (L8). Assessment of the first sample of sperm morphology resulted in significant differences in 4 laboratories: Z-score of 12.41 for L8, 2.54 for L5, 2.19 for L4 and 1.12 for L1. The reference morphology for the second sample was 1%, while the sent results ranged from 0% (L3) to 45.8% (L8). Z-score for the second sample was 5.69 for L8, and 3.07 for L4 and 1.18 for L5. CONCLUSIONS: 1) Significant differences between the laboratories in the obtained results of the analysis of sperm parameters, especially the morphology were found during the external quality assessment of the semen analysis. 2) Taking part in EQAP provides laboratories with information which procedures and stages ought to be improved in order to increase the reliability of semen results.

[Laparoscopic gonadectomy for androgen insensitivity syndrome--case report]. / Laparoskopowa gonadektomia u pacjentki z kompletnym zespolem niewrazliwosci na androgeny--opis przypadku.

UNLABELLED: Androgen insensitivity syndrome (AIS, Morris syndrome) is an X-linked recessive disorder of sexual development caused by the mutation of the androgen receptor coding gene (locus Xq11-q12). We present a case of a 17-year-old girl diagnosed because of primary amenorrhea. Her cytogenetic analysis revealed the kariotype of 46, XY. Clinical examinations, based on the Quigley's scale, showed features of complete AIS. Hormonal tests brought the following results: FSH - 2.81 mIU/ml, LH - 13.88 mIU/ml. Testosterone value met the norm for a male individual in reproductive age (7.97 ng/ml). Family anamnesis revealed no episodes of genetic diseases. Due to the risk of neoplasia, the diagnosis was an indication for surgical gonads removal, which was performed laparoscopically. Histopathologic examination showed tubular adenoma with immature seminiferous tubules without spermatogenesis, and serous cysts. Patient was discharged on the next day after the operation in good general condition, and estrogen therapy was prescribed. CONCLUSION: Laparoscopy is an effective method in AIS treatment.