Albert Lila - Academia.edu (original) (raw)
Papers by Albert Lila
International journal of gynaecology and obstetrics, Oct 1, 2012
Acta Clinica Croatica, 2020
Materia Socio Medica, 2015
![Research paper thumbnail of Impact of obesity on ovarian reserve [Utjecaj debljine na ovarijalnu rezervu]](https://attachments.academia-assets.com/120757096/thumbnails/1.jpg)
](Obesity is the most frequent chronic disease. In the Western world and in these areas the inciden... more Obesity is the most frequent chronic disease. In the Western world and in these areas the incidence of overweight and obesity is 50–60%. In parallel with an increase in obesity over the past 30 years, there is also an increase in infertility incidence. Obesity is often associated with PCOS and the combined pathophysiology can cause a variety of metabolic and reproductive disorders. Obesity is also associated with subfertility and infertility in men and women. ----- Aim of the study: The aim of this study was to identify the effects of obesity and central obesity on ovarian reserve. We also tried to identify the correlation of obesity with changes in reproductive hormones, which could be a cause of subfertility. We separately investigated the effects of obesity and PCOS on reproductive capacity. Ovarian reserve markers (AMH, AFC and ovarian volume) were investigated according to the body mass index of participating patients. ----- Methodology and methods: In this prospective cross-se...
Acta Clinica Croatica, 2018
-Th e aim of the review is to establish sexual and reproductive functions in men with spinal cord... more -Th e aim of the review is to establish sexual and reproductive functions in men with spinal cord lesion (SCL). Many sexual and reproductive dysfunctions may be found in these patients including individual's low self-esteem, delay of orgasm, erectile or ejaculatory disorder and abnormalities of semen, which are characterized by lower sperm motility or viability. Owing to improvements in physical medicine and rehabilitation, the focus has been shifted from keeping patients alive towards ensuring the quality of life and improvements of sexual dysfunctions and later reproduction. Erectile dysfunction can be treated by using phosphodiesterase-5 inhibitors, intracavernosal injections, vacuum devices and penile prostheses. Semen can be retrieved from anejaculatory patients by medically assisted methods utilizing penile vibratory stimulation, electroejaculation, prostate massage, or surgically. Although there is low chance for pregnancy in natural way in most of SCL patients, fatherhood is possible through the introduction of assisted medical management. By use of various medical, technical and surgical procedures for sperm retrieval combined with assisted reproductive methods, high pregnancy rates have been reported comparable to those in able-bodied subfertile patients. Nevertheless, future studies are needed to improve semen quality and methods of assisted ejaculation in patients with SCL.
Gynecological Endocrinology, Apr 10, 2017
Kisspeptin as a promising oocyte maturation trigger for in vitro fertilisation in humans. Gynecol... more Kisspeptin as a promising oocyte maturation trigger for in vitro fertilisation in humans. Gynecological Endocrinology, 33 (8). pp. 583-7.
International journal of gynaecology and obstetrics, Oct 1, 2009
To investigate whether endometriosis may be treatable by histone deacetylase inhibitors (HDACIs).... more To investigate whether endometriosis may be treatable by histone deacetylase inhibitors (HDACIs). Methods: Female, 8 week-old C57BL/6 mice were used and endometriosis was surgically induced. Then the ENDO group were divided into two groups: Group A (treatment) that received subcutaneous injections of trichostatin A (TSA) for 4 weeks, and Group B (control) that only received DMSO alone. The SHAM group became Group C, which received the same treatment as Group B. We measured hot-plate latency and serum levels of TNF-a and did immunohistochemistry analysis before surgery, and two weeks after surgery and six weeks after surgery. Results: We demonstrate in an established mouse model of endometriosis that surgically induced endometriosis results in increased serum TNFa levels and thermal sensitivity. The treatment with trichostatin A (TSA), an HDACI, results in significantly reduced average lesion size as compared with untreated mice, and also results in significantly improved response to noxious thermal stimulus and faster reduction in serum TNFa levels. In addition, mice treated with TSA have significantly lower immunoreactivity to Trpv1 in eutopic endometrium, to PKCe in ectopic endometrium, and to PGP9.5 in vagina. Conclusion(s): These results suggest that endometriosis induces uniformly increased central sensitivity to noxious stimuli, and that treatment with HDACIs reduces inflammation and may relieve pain symptoms in women with endometriosis. Thus, HDACIs may be a promising therapeutics for endometriosis.
International journal of gynaecology and obstetrics, Oct 1, 2012
Acta Clinica Croatica, 2018
-Th e aim of the review is to establish sexual and reproductive functions in men with spinal cord... more -Th e aim of the review is to establish sexual and reproductive functions in men with spinal cord lesion (SCL). Many sexual and reproductive dysfunctions may be found in these patients including individual's low self-esteem, delay of orgasm, erectile or ejaculatory disorder and abnormalities of semen, which are characterized by lower sperm motility or viability. Owing to improvements in physical medicine and rehabilitation, the focus has been shifted from keeping patients alive towards ensuring the quality of life and improvements of sexual dysfunctions and later reproduction. Erectile dysfunction can be treated by using phosphodiesterase-5 inhibitors, intracavernosal injections, vacuum devices and penile prostheses. Semen can be retrieved from anejaculatory patients by medically assisted methods utilizing penile vibratory stimulation, electroejaculation, prostate massage, or surgically. Although there is low chance for pregnancy in natural way in most of SCL patients, fatherhood is possible through the introduction of assisted medical management. By use of various medical, technical and surgical procedures for sperm retrieval combined with assisted reproductive methods, high pregnancy rates have been reported comparable to those in able-bodied subfertile patients. Nevertheless, future studies are needed to improve semen quality and methods of assisted ejaculation in patients with SCL.
Taiwanese Journal of Obstetrics and Gynecology, 2017
The role of macroprolactinemia in women with hyperprolactinemia is currently controversial and ca... more The role of macroprolactinemia in women with hyperprolactinemia is currently controversial and can lead to clinical dilemmas, depending upon the origin of macroprolactin, the presence of hyperprolactinemic symptoms and monomeric prolactin (PRL) levels. Macroprolactinemia is mostly considered an extrapituitary phenomenon of mild and asymptomatic hyperprolactinemia associated with normal concentrations of monomeric PRL and a predominance of macroprolactin confined to the vascular system, which is biologically inactive. Patients can therefore be reassured that macroprolactinemia should be considered a benign clinical condition, resistant to antiprolactinemic drugs, and that no diagnostic investigations or prolonged follow-up should be necessary. However, a significant proportion of macroprolactinemic patients appears to suffer from hyperprolactinemia-related symptoms and radiological pituitary findings commonly associated with true hyperprolactinemia. The symptoms of hyperprolactinemia are correlated to the levels of monomeric PRL excess, which may be explained as coincidental, by dissociation of macroprolactin, or by physiological, pharmacological and pathological causes. The excess of monomeric PRL levels in such cases is of primarily importance and the diagnosis of macroprolactinemia is misleading or inadequate. However, macroprolactinemia of pituitary origin associated with radiological findings of pituitary adenomas may rarely occur with similar hyperprolactinemic manifestations, exclusively due to bioactivity of macroprolactin. Therefore, in such cases with hyperprolactinemic signs and pituitary findings, macroprolactinemia should be considered a pathological biochemical condition of hyperprolactinemia. Accordingly, individualized diagnostic investigations with the introduction of dopamine agonists, or other treatment with prolonged follow-up, should be mandatory. The review analyses the laboratory and clinical significance of macroprolactinemia in hyperprolactinemic women suggesting clinically useful diagnostic and treatment strategies.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2019
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2019
Gynecological Endocrinology, 2017
Abstract The aim of this review is to analyze the role of obesity on fertility outcome in women u... more Abstract The aim of this review is to analyze the role of obesity on fertility outcome in women undergoing in vitro fertilization (IVF) with respect to clinical or live birth rates and pregnancy loss rates. Despite findings from several earlier and newer studies that obesity does not adversely affect pregnancy outcome in women attempting conception, numerous reports from mostly recent studies suggest that obesity undoubtedly impairs IVF outcomes. Obesity impairs ovarian responsiveness to gonadotrophin stimulation, requiring higher doses of medication, increased risk of cycle cancelation, pre-term delivery, low birth weight or miscarriage, and decreases implantation, clinical pregnancy or live birth rates compared to women of normal weight. The mechanisms underlying the adverse effects of female obesity on IVF outcome may be primarily explained by functional alterations to the hypothalamic-pituitary-ovarian axis. Additionally, obesity appears to affect deleteriously the number and quality of oocytes or embryos, and impairs endometrial decidualization which is necessary for uterine receptivity. Nevertheless, attaining normal body weight by the use of lifestyle modifications, including a healthy diet and exercise over time of several months before and during an IVF treatment, may be successful in achievement of gradual and sustainable weight loss with improvement of IVF outcome.
ACTA CLINICA CROATICA, 2017
-Th e purpose of this review is to analyze current medical strategies in the prevention of ovaria... more -Th e purpose of this review is to analyze current medical strategies in the prevention of ovarian hyperstimulation syndrome (OHSS) during ovarian stimulation for in vitro fertilization. Owing to contemporary preventive measures of OHSS, the incidence of moderate and severe forms of the syndrome varies between 0.18% and 1.40%. Although none of medical strategies is completely eff ective, there is high-quality evidence that replacing human chorionic gonadotropin (hCG) by gonadotropin-releasing hormone (GnRH) agonists after GnRH antagonists and moderate-quality evidence that GnRH antagonist protocols, dopamine agonists and mild protocols reduce the occurrence of OHSS. Among various GnRH agonists, buserelin 0.5 mg, triptorelin 0.2 mg and leuprolide acetate (0.5-4 mg) have been mostly utilized. Although GnRH trigger is currently regarded as the best tool for OHSS prevention, intensive luteal support with exogenous administration of estradiol and progesterone or low-dose hCG on the day of oocyte retrieval or on the day of GnRH agonist trigger are required to achieve optimal conception rates due to early luteolysis. Among currently available dopamine agonists, cabergoline, quinagolide and bromocriptine are the most common drugs that should be used for prevention of both early and late OHSS. Mild stimulation protocols off er attractive option in OHSS prevention with satisfactory pregnancy rates.
Gynecological Endocrinology, 2017
Kisspeptin as a promising oocyte maturation trigger for in vitro fertilisation in humans. Gynecol... more Kisspeptin as a promising oocyte maturation trigger for in vitro fertilisation in humans. Gynecological Endocrinology, 33 (8). pp. 583-7.
Journal of Perinatal Medicine, 2020
Objectives To evaluate the strength of association between maternal and pregnancy characteristics... more Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate par...
International journal of gynaecology and obstetrics, Oct 1, 2012
Acta Clinica Croatica, 2020
Materia Socio Medica, 2015
Obesity is the most frequent chronic disease. In the Western world and in these areas the inciden... more Obesity is the most frequent chronic disease. In the Western world and in these areas the incidence of overweight and obesity is 50–60%. In parallel with an increase in obesity over the past 30 years, there is also an increase in infertility incidence. Obesity is often associated with PCOS and the combined pathophysiology can cause a variety of metabolic and reproductive disorders. Obesity is also associated with subfertility and infertility in men and women. ----- Aim of the study: The aim of this study was to identify the effects of obesity and central obesity on ovarian reserve. We also tried to identify the correlation of obesity with changes in reproductive hormones, which could be a cause of subfertility. We separately investigated the effects of obesity and PCOS on reproductive capacity. Ovarian reserve markers (AMH, AFC and ovarian volume) were investigated according to the body mass index of participating patients. ----- Methodology and methods: In this prospective cross-se...
Acta Clinica Croatica, 2018
-Th e aim of the review is to establish sexual and reproductive functions in men with spinal cord... more -Th e aim of the review is to establish sexual and reproductive functions in men with spinal cord lesion (SCL). Many sexual and reproductive dysfunctions may be found in these patients including individual's low self-esteem, delay of orgasm, erectile or ejaculatory disorder and abnormalities of semen, which are characterized by lower sperm motility or viability. Owing to improvements in physical medicine and rehabilitation, the focus has been shifted from keeping patients alive towards ensuring the quality of life and improvements of sexual dysfunctions and later reproduction. Erectile dysfunction can be treated by using phosphodiesterase-5 inhibitors, intracavernosal injections, vacuum devices and penile prostheses. Semen can be retrieved from anejaculatory patients by medically assisted methods utilizing penile vibratory stimulation, electroejaculation, prostate massage, or surgically. Although there is low chance for pregnancy in natural way in most of SCL patients, fatherhood is possible through the introduction of assisted medical management. By use of various medical, technical and surgical procedures for sperm retrieval combined with assisted reproductive methods, high pregnancy rates have been reported comparable to those in able-bodied subfertile patients. Nevertheless, future studies are needed to improve semen quality and methods of assisted ejaculation in patients with SCL.
Gynecological Endocrinology, Apr 10, 2017
Kisspeptin as a promising oocyte maturation trigger for in vitro fertilisation in humans. Gynecol... more Kisspeptin as a promising oocyte maturation trigger for in vitro fertilisation in humans. Gynecological Endocrinology, 33 (8). pp. 583-7.
International journal of gynaecology and obstetrics, Oct 1, 2009
To investigate whether endometriosis may be treatable by histone deacetylase inhibitors (HDACIs).... more To investigate whether endometriosis may be treatable by histone deacetylase inhibitors (HDACIs). Methods: Female, 8 week-old C57BL/6 mice were used and endometriosis was surgically induced. Then the ENDO group were divided into two groups: Group A (treatment) that received subcutaneous injections of trichostatin A (TSA) for 4 weeks, and Group B (control) that only received DMSO alone. The SHAM group became Group C, which received the same treatment as Group B. We measured hot-plate latency and serum levels of TNF-a and did immunohistochemistry analysis before surgery, and two weeks after surgery and six weeks after surgery. Results: We demonstrate in an established mouse model of endometriosis that surgically induced endometriosis results in increased serum TNFa levels and thermal sensitivity. The treatment with trichostatin A (TSA), an HDACI, results in significantly reduced average lesion size as compared with untreated mice, and also results in significantly improved response to noxious thermal stimulus and faster reduction in serum TNFa levels. In addition, mice treated with TSA have significantly lower immunoreactivity to Trpv1 in eutopic endometrium, to PKCe in ectopic endometrium, and to PGP9.5 in vagina. Conclusion(s): These results suggest that endometriosis induces uniformly increased central sensitivity to noxious stimuli, and that treatment with HDACIs reduces inflammation and may relieve pain symptoms in women with endometriosis. Thus, HDACIs may be a promising therapeutics for endometriosis.
International journal of gynaecology and obstetrics, Oct 1, 2012
Acta Clinica Croatica, 2018
-Th e aim of the review is to establish sexual and reproductive functions in men with spinal cord... more -Th e aim of the review is to establish sexual and reproductive functions in men with spinal cord lesion (SCL). Many sexual and reproductive dysfunctions may be found in these patients including individual's low self-esteem, delay of orgasm, erectile or ejaculatory disorder and abnormalities of semen, which are characterized by lower sperm motility or viability. Owing to improvements in physical medicine and rehabilitation, the focus has been shifted from keeping patients alive towards ensuring the quality of life and improvements of sexual dysfunctions and later reproduction. Erectile dysfunction can be treated by using phosphodiesterase-5 inhibitors, intracavernosal injections, vacuum devices and penile prostheses. Semen can be retrieved from anejaculatory patients by medically assisted methods utilizing penile vibratory stimulation, electroejaculation, prostate massage, or surgically. Although there is low chance for pregnancy in natural way in most of SCL patients, fatherhood is possible through the introduction of assisted medical management. By use of various medical, technical and surgical procedures for sperm retrieval combined with assisted reproductive methods, high pregnancy rates have been reported comparable to those in able-bodied subfertile patients. Nevertheless, future studies are needed to improve semen quality and methods of assisted ejaculation in patients with SCL.
Taiwanese Journal of Obstetrics and Gynecology, 2017
The role of macroprolactinemia in women with hyperprolactinemia is currently controversial and ca... more The role of macroprolactinemia in women with hyperprolactinemia is currently controversial and can lead to clinical dilemmas, depending upon the origin of macroprolactin, the presence of hyperprolactinemic symptoms and monomeric prolactin (PRL) levels. Macroprolactinemia is mostly considered an extrapituitary phenomenon of mild and asymptomatic hyperprolactinemia associated with normal concentrations of monomeric PRL and a predominance of macroprolactin confined to the vascular system, which is biologically inactive. Patients can therefore be reassured that macroprolactinemia should be considered a benign clinical condition, resistant to antiprolactinemic drugs, and that no diagnostic investigations or prolonged follow-up should be necessary. However, a significant proportion of macroprolactinemic patients appears to suffer from hyperprolactinemia-related symptoms and radiological pituitary findings commonly associated with true hyperprolactinemia. The symptoms of hyperprolactinemia are correlated to the levels of monomeric PRL excess, which may be explained as coincidental, by dissociation of macroprolactin, or by physiological, pharmacological and pathological causes. The excess of monomeric PRL levels in such cases is of primarily importance and the diagnosis of macroprolactinemia is misleading or inadequate. However, macroprolactinemia of pituitary origin associated with radiological findings of pituitary adenomas may rarely occur with similar hyperprolactinemic manifestations, exclusively due to bioactivity of macroprolactin. Therefore, in such cases with hyperprolactinemic signs and pituitary findings, macroprolactinemia should be considered a pathological biochemical condition of hyperprolactinemia. Accordingly, individualized diagnostic investigations with the introduction of dopamine agonists, or other treatment with prolonged follow-up, should be mandatory. The review analyses the laboratory and clinical significance of macroprolactinemia in hyperprolactinemic women suggesting clinically useful diagnostic and treatment strategies.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2019
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2019
Gynecological Endocrinology, 2017
Abstract The aim of this review is to analyze the role of obesity on fertility outcome in women u... more Abstract The aim of this review is to analyze the role of obesity on fertility outcome in women undergoing in vitro fertilization (IVF) with respect to clinical or live birth rates and pregnancy loss rates. Despite findings from several earlier and newer studies that obesity does not adversely affect pregnancy outcome in women attempting conception, numerous reports from mostly recent studies suggest that obesity undoubtedly impairs IVF outcomes. Obesity impairs ovarian responsiveness to gonadotrophin stimulation, requiring higher doses of medication, increased risk of cycle cancelation, pre-term delivery, low birth weight or miscarriage, and decreases implantation, clinical pregnancy or live birth rates compared to women of normal weight. The mechanisms underlying the adverse effects of female obesity on IVF outcome may be primarily explained by functional alterations to the hypothalamic-pituitary-ovarian axis. Additionally, obesity appears to affect deleteriously the number and quality of oocytes or embryos, and impairs endometrial decidualization which is necessary for uterine receptivity. Nevertheless, attaining normal body weight by the use of lifestyle modifications, including a healthy diet and exercise over time of several months before and during an IVF treatment, may be successful in achievement of gradual and sustainable weight loss with improvement of IVF outcome.
ACTA CLINICA CROATICA, 2017
-Th e purpose of this review is to analyze current medical strategies in the prevention of ovaria... more -Th e purpose of this review is to analyze current medical strategies in the prevention of ovarian hyperstimulation syndrome (OHSS) during ovarian stimulation for in vitro fertilization. Owing to contemporary preventive measures of OHSS, the incidence of moderate and severe forms of the syndrome varies between 0.18% and 1.40%. Although none of medical strategies is completely eff ective, there is high-quality evidence that replacing human chorionic gonadotropin (hCG) by gonadotropin-releasing hormone (GnRH) agonists after GnRH antagonists and moderate-quality evidence that GnRH antagonist protocols, dopamine agonists and mild protocols reduce the occurrence of OHSS. Among various GnRH agonists, buserelin 0.5 mg, triptorelin 0.2 mg and leuprolide acetate (0.5-4 mg) have been mostly utilized. Although GnRH trigger is currently regarded as the best tool for OHSS prevention, intensive luteal support with exogenous administration of estradiol and progesterone or low-dose hCG on the day of oocyte retrieval or on the day of GnRH agonist trigger are required to achieve optimal conception rates due to early luteolysis. Among currently available dopamine agonists, cabergoline, quinagolide and bromocriptine are the most common drugs that should be used for prevention of both early and late OHSS. Mild stimulation protocols off er attractive option in OHSS prevention with satisfactory pregnancy rates.
Gynecological Endocrinology, 2017
Kisspeptin as a promising oocyte maturation trigger for in vitro fertilisation in humans. Gynecol... more Kisspeptin as a promising oocyte maturation trigger for in vitro fertilisation in humans. Gynecological Endocrinology, 33 (8). pp. 583-7.
Journal of Perinatal Medicine, 2020
Objectives To evaluate the strength of association between maternal and pregnancy characteristics... more Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate par...