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Cilj ovog istraživanja bio je (1) ispitati razlikuje li se razina stresa povezana s neplodnosti i zadovoljstvo intimnim odnosima s obzirom na uzrok neplodnosti i tip tretmana kod žena i muškaraca te (2) ispitati koji specifični čimbenici stresa pridonose zadovoljstvu intimnim odnosima i objašnjava li partnerovo/partneričino zadovoljstvo intimnim odnosima dodatni dio varijance. U istraživanju je sudjelovalo 94 para žena i muškaraca s problemom neplodnosti koji su ispunili Inventar problema plodnosti koji mjeri opći stres te pet dimenzija: socijalna zabrinutost, seksualna zabrinutost, teškoće odnosa, odbacivanje životnog stila bez djeteta i potreba za roditeljstvom ; Novu skalu seksualnog zadovoljstva koja mjeri usmjerenost na sebe i usmjerenost na partnera/partnericu te upitnik općih podataka i podataka o neplodnosti, poput trajanja neplodnosti, vrste uzroka (ženski čimbenici, muški čimbenici, oboje, nepoznat uzrok) te tip tretmana. Rezultati jednosmjernih analiza varijance pokazali su da se razina stresa ne razlikuje s obzirom na tip tretmana ni kod žena ni kod muškaraca. Međutim, razina stresa se razlikuje s obzirom na uzrok neplodnosti, ali samo kod muškaraca. Točnije, razina općeg stresa, seksualne zabrinutosti i teškoća odnosa viša je kod onih muškaraca koji su izvijestili da su „muški čimbenici“ uzrok neplodnosti nego kod onih muškaraca koji su izvijestili da su „ženski čimbenici“ uzrok. Hijerarhijske regresijske analize su pokazale slične rezultate kod žena i muškaraca u predikciji zadovoljstva intimnim odnosima. Nakon kontroliranja učestalosti intimnih odnosa koji objašnjavaju značajan dio varijance (oko 35%), specifični aspekti stresa povezani s neplodnosti značajno objašnjavaju dodatni dio varijance (oko 30%) pri čemu su seksualna zabrinutost i teškoće odnosa značajni negativni prediktori zadovoljstva intimnim odnosima. U trećem koraku, varijable partnerovog/partneričinog zadovoljstva značajno objašnjavaju dodatni dio varijance (od 3% kod muškaraca do 11% kod žena), pri čemu je usmjerenost partnera/partnerice na sebe značajan pozitivan prediktor vlastitog zadovoljstva intimnim odnosima. Zaključno, stresu povezanom s neplodnosti posebno su izloženi muškarci kod kojih su muški čimbenici uzrok neplodnosti. I kod žena i kod muškaraca intimnim odnosima većim dijelom pridonose aspekti neplodnosti koji se tiču partnerskih odnosa, dok partnerovo/partneričino zadovoljstvo tek manjim dijelom pridonosi osobnom zadovoljstvu intimnim odnosima.

The in vitro fertilization (IVF) legislation can directly affect the success of IVF treatment. The illustration and support for these statements can be found in the Italian restrictive law (Law 40/2004) and the effect of its implementation. The aim of this study was to compare data on assisted reproduction treatment and outcome before and after the introduction of this new legislation and give answer to a question on the possible negative effects of restrictive IVF regulation using data from Croatia. Data were analysed retrospectively: the first group consisted of data from patients which underwent IVF/ICSI procedure during period of restrictions (group I) and the second one of data from patients which underwent IVF/ICSI procedure after the new law was enforced (group II).In both groups there were more antagonist cycles (71.9%) than agonist cycles (28.1%) ; but after the new law was enforced there were more antagonist cycles (81.4% for group II compared to 59.5% for group I). Regarding ICSI and IVF procedure ; for ICSI 68.7% in group I vs. 67.4% in group II, and for IVF cycles 31.3% in group I vs. 32.6% in group II. Ratio of ICSI and IVF was similar (χ²=0.598, df=1, p >.01) although we expected more ICSI cycles in group I. During restrictions (in group I, 49.2%) usually three embryos were implemented but after the enforcement of the new law (group II, 63.4%) mostly two embryos were implemented (χ²=77.70, df=2, p < .01). In both groups embryo transfer was usually done on the third day but after the enforcement of the new law much more transfers were done on the fifth day (group II, 23.1%) compared to previous period (group I, 7.1%). During restrictive IVF law there were 28% of twin pregnancies (group I) compared to 12.5% under the new IVF regulation (group II) ; in addition multiple pregnancies (triplets) were 2.81% in group I and 0.96% in group II. In group I there were 9.58% biochemical pregnancies compared to 6.73% in group II ; and there were 4.22% of miscarriages (spontaneous abortions) in group I compared to 12.5% of miscarriages in group II. The percentage of pregnancies did not differ between groups (χ²=0.70, df=1, p>.01) leaving us with a conclusion that the pregnancy rate around 30% was achieved during enforcement of both laws. These results show that IVF regulation affects the treatment and outcomes in ART, and that for some issues in ART restrictive regulations has negative effects. Our findings represent clinical contribution for countries still debating the enforcement of restrictions in ART legislation.

INTRODUCTION Resting metabolic rate (RMR) are indicators of the amount of calories a person needs during one day at rest. They provide information on the amount of calories burnt on basic body functions and also the amount of calories burned by food intake and physical activity. The purpose of this study was to determine possible daily variations in measured values of resting metabolic rate (RMR). METH- ODS Twenty male students of kinesiology (A: 24.3±3. 3 years, H: 180.83±19.50 cm, W: 80.36±35.10 kg) were tested for RMR via COSMED QUARK CPET during one day, in the morning (8 am) in the midday (1 pm) and in the evening (5 pm). All measurements were conducted at the Sports Diagnostic center at the Faculty of Kinesiology, University of Zagreb. During the test the subject is lying without movement for 16 minutes and the RMR values are based on the last 10 minutes of the test. Statistical analysis was done using repeated measures ANOVA (Statistica for Windows 12.0), and statistical significance was set at p

The aim of the present study was to analyze retrospectively the safety and success rates of single- and two-dose methotrexate (MTX) protocols for the treatment of hemodynamically stable cases of ectopic pregnancy at University Department of Gynecology and Obstetrics, Zagreb University Hospital Center, during a five-year period. The study evaluated MTX treatment efficacy in 35 women with ectopic pregnancies in relation to the initial levels of human chorionic gonadotropin (hCG) and progesterone. Successful treatment was recorded in 32/35 women, 24/25 on single dose MTX and 8/10 on double dose MTX, whereas 3/35 patients underwent laparoscopy. The mean initial hCG level in all 35 patients on day 0 was 657.54 +/- 592.4 IU/L ; 572.99 +/- 488.10 IU/L in those successfully treated with MTX and 1560.30 +/- 890.70 IU/L in those requiring additional laparoscopy (p < 0.005). The mean initial hCG level was 393.10 +/- 305.9 IU/L in patients successfully treated with a single dose of MTX and 973.5 +/- 722.40 IU/L in those with an additional dose of MTX (p < 0.002). The mean initial progesterone level was 16.36 +/-10.70 nmol/L in 35 MTX-treated ectopic pregnancy patients, 13.64 +/- 8.89 nmol/L in those with treatment success and 28.45 +/- 11.32 nmol/L in cases of treatment failure (p < 0.05). The mean level of progesterone on day 0 was 12.74 +/- 830 nmol/L in patients successfully treated with a single dose of MTX and 26.10 +/- 18.80 nmol/L in patients treated with double-dose MTX (p < 0.006). It is concluded that pretreatment values of hCG and progesterone are inversely related to medicamentous treatment success in selected cases ofhemodynamically stable patients, thus they may be used as an important predictor in the management of ectopic pregnancy treated with MTX.

This study was designed to investigate the influence of seasonal variations on the number of retrieved ova, fertilization rate, embryo quality rates and pregnancy rate in IVF cycles. Prospective cohort study was conducted on a total number of 2140 cycles in infertile patients undergoing their first IVF cycle between 2000 and 2007 in IVF policlinic. Chi2-test, Pearson's correlation coefficient and one-way analysis of variance were used for statistical analyses. Overall fertilization rate was 77.96% and pregnancy rate 29.15 +/- 2.72% per cycle. Seasonal prevalence of pregnancy rate was highest during fall 33.8 +/- 4.5% and lowest during summer 23.4 +/- 6.2%, but these differences did not reach statistical significance. The study did not show any statistically significant differences in the number of retrieved oocyte, fertilization, and embryo quality according to season. Therefore seasonal changes should not be taken into account in everyday IVF practice.

Purpose To compare the delivery and neonatal outcome of IVF singleton pregnancies with those conceived spontaneously in primiparous women ≥35 years of age. Methods Data were collected by the hospital’s obstetrics and pediatric staff at the time of examination, hospitalization, delivery and discharge. A total of 283 women with IVF singleton deliveries were matched according to ethnicity, age, gravidity, smoking habits, body mass index, weight gain in pregnancy, site and time of delivery with consecutive 283 women conceived spontaneously. Outcome measures were mode of delivery, birth weight, preterm birth, chromosomal and/or congenital abnormalities and perinatal mortality. Results Caesarean deliveries rates were significantly higher among IVF singletons, as well as preterm birth rate. No difference was found in the chromosomal and/or congenital abnormalities, perinatal mortality or the birth weight records (SGA, VLBW, LBW and LGA). However, average gestational birth weight was lower among infants conceived after IVF. Conclusions Singleton IVF pregnancies in women aged 35 and above have increased risk associated with preterm births, and infants of lower average birth weight. However, delivery complications, number of infants with low or very low birth weight, small or large birth weight for appropriate gestation and overall rate of congenital abnormalities did not differ from those of the spontaneous conceptions.

Anti-Müllerov hormon (AMH) sintetizira se u u granuloza stanicama jajnika u žena. Dosadašnje studije dokazale su važnost određivanja anti-Müllerovog hormona kao novog biljega u procjeni ovarijske rezerve. Također, ranije objavljeni rezultati pokazali su neznačajnu promjenjivost koncentracija AMH u serumu, tijekom menstruacijskog ciklusa. Rezultati naših istraživanja, iako na ograničenom broju ispitanica, podupiru dijagnostičku važnost AMH kao osjetljivog biljega u procjeni ovarijske rezerve.

Na temelju današnjih dijagnostičkih kriterija procjenjuje se kako PCOS zahvaća 5-10% žena. Hiperandrogenizam i menstrualni poremećaji najčešće su poteškoće u mladih PCOS pacijentica, dok su povišena razina androgena, oligomenoreja ili amenoreja, a posebice neplodnost najčešći problemi PCOS žena reproduktivne dobi. Dosadašanji radovi su pokazali kako je više od 50% ovih žena povećane tjelesne težine ili pretilo. Istraživanja najsnažnijeg znaka seksualnog dimorfizma – rasporeda subkutane i visceralne masti pokazuju da žene s PCOS-om imaju veću masu masnog tkiva u području trbuha, struka i gornjeg dijela ruku za razliku zdravih žena. Rane promjene morfoloških i tjelesnih značajki PCOS-a mogle bi pomoći u predviđanju metaboličkih karakteristika, razvoju sindroma, te njegovom ishodu.

Fizička aktivnost i vježbanje u trudnoći sigurni su i preporučljivi svim trudnicama s urednim tijekom trudnoće. Pozitivni učinci vježbanja očituju se u smanjenom nastanku komplikacija u trudnoći (preeklampsija, hipertenzija, gestacijski dijabetes), boljoj kontroli tjelesne težine i glikemije, smanjenju „svakodnevnih nelagoda trudnoće” (zatvora, smetnji mokrenja, jutarnjih mučnina, varikoznih vena), olakšanim porodom, a s psihološkog gledišta višim samopoštovanjem i smanjenjem depresije i neuroze. Do sada nisu zabilježeni negativni učinci vježbanja na ishod trudnoće niti razvoj novorođenčeta. Programe vježbanja u trudnoći potrebno je planirati pod nadzorom perinatologa-ginekologa i iskusnog kineziologa s individualnim pristupom prije svega u planiranju trajanja i intenziteta vježbi poželjnih za svaku zdravu trudnicu.

The development of cervical cancer occurs in about 90% of cases over precancerous lesion, in about 10% without any sign (spray - cancer). Microinvasive squamous cell carcinoma of the cervix is well-known entity that is defined as carcinoma with invasion of less than 5mm, which invade the stroma and rarely metastasizes. Microinvasive squamous cervical carcinoma with superficial spread along the entire length of the endometrium of the uterus is extremely rare phenomenon that has been described in literature less than 20 times. It is even rarer case of microinvasive squamous cervical carcinoma with superficial spread to the endometrium of the uterus and early infiltrating growth, which so has so far only once been described previously. We report the case of 67-year-old patient, who was admitted for surgery, total hysterectomy with bilateral salpingoovariectomy due to PAPA proved cervical squamous cell carcinoma. The conisation was previously done in 2005 for carcinoma in situ of the cervix, with the free edges in PHD findings. In the 2009 we made planned surgical procedure and PHD finding confirmed the CIS squamous cell carcinoma of the cervix, which per continuitatem spread to the entire lining of the uterus, replaced the endometrium and invaded the uterine body to less than ½ of its thickness. Given that a total of 27 described secondary squamous cell carcinoma of the endometrium and 35 primary carcinoma, the studies are limited to case reports. Prognosis given the small number of reported cases is not yet possible, but considering the usual cancer prognostic factors (number of mitoses, degree of differentiation, lymph nodes, etc.) can be assumed that the after surgery was fairly good. This is a unique case of continuous expansion and invasion of cervical squamous cell carcinoma in situ that until today has not been described. Prognosis is not known, but the treatment approach should be to perform total hysterectomy with bilateral salpingoovariectomy.

Prosječno 4 - 6 tjedana nakon poroda preporuča se započeti s rekreacijskim vježbanjem uz odobrenje liječnika – ginekologa i individualiziran program pod stručnim nadzorom kineziologa. Žene treba ohrabriti spoznajama da umjereno, pa i intenzivno vježbanje uz pravilnu prehranu u postpartalnom periodu, sigurno dovode do gubitka kilograma, nemaju negativnih posljedica na dojenje, a djeluju zaštitno na mineralnu gustoću kosti. Preporučljiv je gubitak 0, 5-1 kg tjedno. Nakon prva tri postpartalna mjeseca, ne postoji više ograničenje intenziteta i trajanja vježbi, ali ni tada kalorijski unos ne bi trebao biti niži od 65% baznog potrebnog unosa hrane, kako se ne bi kompromitirala laktacija.

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Oral contraception is safe and widespread method of contraception with many health benefits beyond pregnancy prevention. The oral contraceptives are highly efficient in preventing premenstrual pain, diminishing of menstrual flux and lowering the frequency and severity of dysmenorrhe along with imprroving cycle regularity. Combind hormone contraceptio has positive noncontraceptive effects not only on menstrual cycle but also on hyperandrogenism, functional ovarian cysts, endometriosis, benign berast disease and possibly rheumathoid arthritis. Definitive evidence exists for protection against ovarian and endometrial cancers, pelvic inflammatory disease, ectopic pregnancy and iron-deficiency anemia. Oral contraceptives may also provide a benefit on bone minera density, uterine fibroids and colorectal cancer. The probability of a patient experiencing a cardiovascular event whilee taking a low-dose OC is paltry. However, smoking, hypertension, obesity and diabetes are risk factors that must be taken into account and carefully studied before OC colud be intoduced. With the respect of the basic rules and contraindications, the benefits of combined oral contraception prescription are higher than its risks.

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U pozvanom predavanju prikazani su rezultati relevantnih IVF centara u Europi s usporedbom na rezultate IVF Poliklinike. Uspoređujući protokole indukcije ovulacije najuspješniji u ovoj dobnoj skupini bio je Menopur i Gonal F. Stopa trudnoća po ciklusu bile je 18, 1%, a stopa živorođenih 13, 8%. Za životnu dob trudnica starijih od 40g. ti su rezultati u samom vrhu rezultata Europskih Klinika.