Depression, anxiety, and stress in infertile couples during the COVID-19 pandemic: the consequences we face.

OBJECTIVE: Postponing assisted reproductive technology treatment can cause pronounced mental health problems. The aim of this study was to examine the level of depression, anxiety, stress, and overall infertility-related distress experienced by infertile couples during the pandemic, as well as the differences between men and women in the examined variables and the correlations between them. METHODS: A total of 131 participants were included in the study, 65 men and 66 women. They were selected based on their responses in the Fertility Problems Inventory (FPI); the Depression, Anxiety, and Stress Scale-21 (DASS-21); and a general data questionnaire provided to them at the time of IVF. RESULTS: The levels of depression, anxiety, and stress in women and men resided within the normal range. Depression (p<0.05), anxiety (p<0.01), stress (p<0.01), and social concern (p<0.05) were more pronounced among women. Significant correlations were found between depression, anxiety, stress, and global stress and its three dimensions: social concern, sexual concern, and relationship concern. CONCLUSIONS: During the pandemic, women undergoing assisted reproductive technology treatment experienced significantly higher levels of depression, anxiety, stress, and overall infertility-related stress than men. Furthermore, depression, anxiety, and stress were apparently correlated with overall infertility-related stress.

Length and weight of newborns in Croatia from 1985 to 2009.

BACKGROUND: Constitutional characteristics of humans are changing. People are becoming taller and they weigh more. These changes influence birth weight and birth length as well. METHODS: A study was conducted on 2414 mothers and their newborns from 1985 to 2009 in Zagreb, Croatia, to establish a secular change in the weight and length of infants and the factors that are most related to these changes. RESULTS: Birth weight has increased significantly in the past 25 years, and it is higher in male newborns. Taller mothers, with higher weight and body mass index, deliver newborns with higher birth weight. Weight gain in pregnancy has positive impact on birth weight. Multiparas and older and more educated women deliver newborns with higher weight. Birth weight does not depend on father's education. The number of newborns with birth weight more than 4000 g is increasing, but not significantly. Birth length was not significantly higher. Birth length is higher in male newborns, in newborns with higher birth weight and newborns of older and more educated mothers. CONCLUSION: Better life conditions and better health care improves population constitutional characteristics that have implications in higher birth weight and birth length. This could be an important change that influences delivery modalities.

Secular Changes in Education, Urban-rural Living, Menarche and Abortion Rates in Perinatal Population.

Over a 25-year period we examined the anthropological characteristics of mothers and their partners, such as the place of living: urban vs. rural, the degree of education, parity, the time of menarche, and the frequency of intentional abortions. We examined 2 414 mothers and their partners in four periods of time extending from 1985 to 2009 in order to establish changes in the said anthropological characteristics over a period of 25 years. The degree of education of mothers and their partners is on the rise. In the period from 1985 to 1994, the percentage of mothers from the country was on the rise. Women with less education have on average more children, and those with better education the least children. Women from rural areas have on average more children than women from urban areas. The time of menarche dropped by 9 months over the period of 25 years. Girls from urban areas have their first menstrual cycle earlier. Women with higher professional qualifications had their first period earlier. The number of intentional abortions over the 25-year period dropped.

Limited role of body satisfaction and body image self-consciousness in sexual frequency and satisfaction in pregnant women.

This cross-sectional study examined the role of maternal body image and body image self-consciousness in sexual satisfaction and intercourse frequency during pregnancy when controlling for satisfaction with partnership. Pregnant women in their third trimester of pregnancy (N = 150) participated in the study. Body image was measured by the Body Areas Satisfaction Scale (BASS) and Body Image Self-Consciousness Scale (BISC), while relationship satisfaction was measured by different subscales of the Perceived Quality of Marital Relationship (PQMR) Scale. Sexual satisfaction was also measured by one of the subscales of the PQMR (Intimate Relationship). The sexual behavior questionnaire comprised questions about frequency of sexual intercourse, desire, and other aspects of sexual functioning as well as the reasons that might prevent women from having intercourse during pregnancy. Findings suggested that satisfaction with body image and body image self-consciousness were related to sexual satisfaction. Nevertheless, other aspects of partnership, such as communication, appeared to be much more important predictors of sexual satisfaction than body image variables. The best predictor of sexual frequency was fear that intercourse might harm the fetus. Implications for education about sexuality issues in pregnancy are discussed.

Two cases of successful pregnancies after hysteroscopic removal of endometrioid adenocarcinoma grade I, stage IA, in young women with Lynch syndrome.

We present two cases of endometrioid adenocarcinoma grade I, FIGO IA (staging according to the International Federation of Gynecology and Obstetrics) in young women, diagnosed within endometrial polyps. Both patients underwent repeated hysteroscopies and multiple biopsies after initial treatment to medroxyprogesterone one 400 mg daily or the insertion of IUD-LND (intrauterine device-levonorgestrel) for three months. In both of them, all histological samples were negative. Both of them decided that they would try to conceive. The first patient conceived spontaneously and the second patient after IVF (in vitro fertilisation) treatment. They both gave birth to full-term infants. Hysterectomy was recommended to both of our patients, and was carried out. Both of the patients fulfilled both Amsterdam II and revised Bethesda criteria for hereditary non-polyposis colorectal cancer (HNPCC).

Secular trends in parental age in Croatia from 1985-2009.

BACKGROUND: In developed countries general living conditions and living standard have grown, leading to reproductive and other secular changes. During the past decade in Croatia living conditions and living standard have improved. OBJECTIVE: The aim of this study was to determine changes in reproductive secular trend in our country similar to trends in developed countries considering different and improved living conditions in Croatia. METHODS: 2414 parents and their newborns during 25 years were examined. The study was conducted in University Hospital Center "Sisters of mercy", Zagreb, Croatia. The study was randomized and included only healthy singleton pregnancies. The information was taken from medical data. Anthropological parameters of pregnant women regarding the place of residence, educational level, marital status and parity were examined. The results were statistically analyzed using nonparametric tests, parametric tests, and if necessary additional post hoc tests. RESULTS: The age of mothers during the study period significantly increased especially in primiparas and secundiparas. The percentage of highly educated mothers and fathers increased. The age of the fathers also increased. Women living in the cities deliver later. Older women deliver heavier and longer children. The share of under-aged mothers during the 25 year period did not change significantly. In the group of older fathers somewhat more common are boys. The proportion of babies with a specified mass is significantly different regarding the maternal age. The proportion of babies of certain length is significantly different with respect to the maternal age only when all periods are considered. CONCLUSION: Our data show a secular trend in reproductive health similar to developed countries.

Detection of ovarian cancer by determination of CA 125 in different patohistologycal types of tumor according to age.

During the eighteen-year period in "Sestre milosrdnice" University Hospital Center, Zagreb, 271 women with ovarian tumor was studied. 229 women with ovarian cancer and 42 with borderline tumor. The pathohistological types of tumors were different. The age of the patients ranged from 20-83 years. In all patients the value of biochemical marker CA125 was determined. The aim of this study was to determine the usefulness of CA125 measurement in different age groups and in different patohistologycal forms of tumor. CA125 has proven to be positive in 89.1% of women with ovarian cancer and in 62% with neoplasm of low malignant potential. The higher values of CA125 were detected in younger women with low malignant tumor potential. Serous and metastatic tumor types were also associated with higher values of CA125.

Secular changes in growth and obesity in perinatal population.

The survey was conducted during the last 25 years and included 2414 healthy women who delivered in "Sestre milosrdnice" University Hospital Center in Zagreb, Croatia and their newborns. The aim was to establish the secular trend of some anthropological factors through two generations. Anthropological features such as pre-pregnancy weight, body mass index before pregnancy, height, age, place of residence, educational level, parity and the newborn weight were registered. The study was randomized. The mothers from the city of Zagreb and the surrounding villages, rural areas are examined. The women age was different and also different levels of education and socioeconomic status. The study included women who had not given birth yet, who had delivered once, twice, and three or more times. Maternal height in 25 years increased by 3.1cm. and increases with education. The pre-pregnancy weight increased 2.8 kg and increases with age, parity and rural life. The body mass index (BMI) which the women had before pregnancy was calculated, and according to its value the participants were divided in three groups: with normal weight, overweight and fat. Among the studied periods BMI does not differ significantly, but does differ significantly with respect to the ordinal number of births, parity, age and living environment. Higher BMI was associated with deliveries to heavier children.

Platelet serotonin concentration at term pregnancy and after birth: physiologic values for Croatian population.

The aim of this study was to determine physiological value of platelet serotonin (5-HT) and its variations in the group of women in term pregnancy and after birth. Obtained results were compared to the platelet 5-HT level in nonpregnant women group. Determination of normal level of 5-HT in pregnancy and after could help in its further measurement and evaluation of different psychologic and psychiatric disorders related to pregnant and postpartal period, including better understanding of mood changes after the birth. A total of 137 healthy Croatian women were enrolled in the study--82 of them were pregnant and 55 were not. Their blood was sampled and the platelet serotonin concentration was determined. In pregnant women the blood was sampled twice: at term pregnancy, and soon after birth. The mean value of 5-HT in pregnant women was 1.209 nmol/mg protein, after the delivery 1.045 nmol/mg protein, and in non pregnant 1.088 nmol/ mg protein. The concentrations were significantly different in those three groups. We did not find differences in 5-HT levels in groups divided by age.

Prediction of ovarian tumor malignancy.

Ovarian cancer is the leading cause of mortality among gynecological cancers. The aim of the study was to form the decision rules for distinguishing benign from malignant ovary lesions. The research was conducted on 201 women with ovary tumor. Commonly used specific markers for ovarian cancer (biochemical marker Ca 125, ultrasound and vascular markers) were used. The significant difference in the presence of an ultrasound and vascular markers between benign and malignant ovary changes along with the significantly different level of Ca 125 is confirmed. To a specific marker certain score number was appointed and the scoring system was formed. The incidence of benign/malignant ovary changes was observed in the researched group regarding anthropometric parameters (age, marital and menopausal status and number of deliveries). There is also significant difference in the incidence of benign/malignant ovary tumor regarding these parameters. Based on combination of the scoring system and anthropometric parameters the decision rules for distinguishing benign from malignant ovary tumors were formed. The logistic regression method was used. We proved that this method has higher accuracy in prediction of malignancy in women with ovary tumors than using morphological, Doppler or anthropometric parameters separately.

Antropologic factors in prediction of ovary cancer.

The aim of the study was to determine a combination of anthropometric variables that would enable better differentiation between benign and malignant ovarian masses. Prospective study has been performed in a two year period in which 208 women with ovarian lesions were analyzed and correlated with histopathologic surgical findings. We examined the relation between self-reported anthropometric and other variables (height, weight, body mass index--BMI, parity, marital status, education, age, rural versus urban residence, menopausal status) and incidence of ovarian cancer. Age, parity, marital status and menopausal status individually showed statistical significance.