Recent prospective studies of male reproductive health have shown differences between several European countries. Our objective was to evaluate the current situation in the two Baltic States Estonia and Lithuania. In 1997–99 we investigated semen parameters, levels of reproductive hormones and general health factors of 196 men from the general population in Lithuania; from Estonia, 79 men from the general population and 118 soldiers were investigated. Adjusted for interlaboratory differences and abstinence period, sperm concentration of Lithuanian and Estonian men from the general populations were shown to be 55 and 67 million/mL, respectively. The Estonian soldiers had the highest sperm concentration, 82 million/mL. The frequencies of morphologically normal spermatozoa were 6.2, 7.7 and 9.6%, respectively. In contrast to the semen qualities, highest Inhibin B levels were detected in the Lithuanians (233 pg/mL) followed by Estonian men from the general population (220 pg/mL) and Estonian soldiers (185 pg/mL). The soldiers had also the lowest level of testosterone and oestradiol. The sperm counts of the Estonian and Lithuanian men investigated here are higher than recently shown for Norwegian, Danish, Estonian and Finnish men. Comparisons should be cautiously drawn as the groups are not completely comparable. Still, even within the Baltic region, geographically close and sharing common recent social history, differences in semen quality and levels of reproductive hormones are apparent.

Objectives: The study investigated the effects on female sexual function of a progestogen-containing combined oral contraceptives (COCs) with an antiandrogenic profile taken in a continuous regimen. Methods: In this prospective randomised single-institution study, 80 healthy women with a monogamous partner and an active sexual life were randomised into two groups for a period of 3 months. Women in the exposed group (n = 40) took a COCs containing 30 μg ethinylestradiol (EE) and 3 mg drospirenone (DRSP) in a 21/7 regimen. Women in the control group (n = 40) used either a barrier contraceptive method (BCM) or a natural family planning method (NFPM). Participants were asked to complete a set of validated questionnaires to assess sociodemographic variables and measure Female Sexual Function Index (FSFI). Results: The total FSFI score (p < 0.0001), as well as the desire (p = 0.04) and arousal (p = 0.03) scores, were significantly lower in the COCs group after 3 months of hormonal contraceptive use compared with baseline. Women using BCM or NFPM showed an improvement in total FSFI score (p = 0.02). Hormonal contraception with DRSP increased the likelihood of worse sexual function in the desire (odds ratio [OR] 2.47; 95% confidence interval [CI] 1.22, 4.98; p = 0.01) and arousal domains (OR 2.85; 95%CI 1.34, 5.93; p = 0.005) and in total FSFI score (OR 2.01; 95%CI 1.45, 2.79; p < 0.001). The results remained statistically significant even after adjustment for smoking status. Conclusions: The study found evidence that women taking a combined EE/DRSP COCs for 3 months may have a worsening of sexual function as measured by FSFI.

Objectives. To evaluate if the quality of services provided by family physicians and obstetricians/gynecologists at primary personal health care institutions of Kaunas city and access to it meet the needs and expectations of pregnant women.
Material and methods. Pregnant women visiting the selected health care institutions at their third trimester of pregnancy were asked to fill in the anonymous questionnaire. The study was conducted at two randomly selected maternity centers of Kaunas city and two family practices of Kaunas city where antenatal care was provided by family physicians. The questionnaires were given to 106 patients visiting family physicians (response rate was 88.7%) and to 202 patients visiting obstetricians/ gynecologists (response rate was 81.7%).
Results. Health services provided by family physicians and obstetricians/gynecologists met the expectations of pregnant women in respect of providing with information and communication. The patients of obstetricians/gynecologists significantly more often stated that they were very satisfied with patient-physician communication (P<0.05), they significantly more often understood explanations given by the physician (P<0.001) and claimed having sufficient knowledge about pregnancy (P<0.05), while the patients of family physicians significantly more often asserted that the physician helped them in preparation for childbirth (P<0.05). The patients of obstetricians/gynecologists significantly more often did not face any problems with access to services as compared to the patients of family physicians (z=3.0). Most of pregnant women stated that they were satisfied or very satisfied with the quality of health care at the health care facility providing them with antenatal care irrespective of the physician’s specialty.
Conclusions. The quality of antenatal health care provided by both family physicians and obstetricians/gynecologists and access to it satisfied the needs and expectations of the surveyed women. Correction of the limitations noticed, e.g., closer communication, more understandable explanations, more attention to preparation for childbirth, better work planning, could improve the quality of antenatal care provided by the family physicians.

Waiting time to pregnancy is an important characteristic of human reproductive health, which has not been investigated in Lithuania until now. Data on waiting time to pregnancy have been collected from medical records of 111 women admitted to the Department of Obstetrics, Klaipėda Hospital. Seven women in whom pregnancy was the result of infertility treatment were excluded from the analysis, and the rest 104 cases were analyzed. We evaluated waiting time to pregnancy in respect to the age of couples, contraceptive use, cigarette smoking of both partners, and some other features of obstetric history. The mean waiting time to pregnancy in the cohort was 5.21±7.03 months. If both partners smoked, the mean waiting time to pregnancy was significantly longer than in nonsmoking couples (7.68±9.41 vs. 4.30±5.73, P<0.05). Risk to have waiting time to pregnancy longer than 6 months was significantly higher if both partners smoked as compared to nonsmoking couples (OR 3.32, 95% CI 1.07–10.30, P=0.03), while paternal smoking and smoking of any partner did not increase this risk significantly. The other possible factors – age, living place (rural or city), previous contraceptive use, regularity of menstrual cycle, and frequency of intercourse – did not influence waiting time to pregnancy significantly. Results obtained from this pilot study enable us to plan and implement a larger-scale study of waiting time to pregnancy in Lithuanian population.

Introduction: Even though the importance of nutrition in diabetes development is well known, little has been done to explore whether nutrition affects reproductive health and escalates the risk for further consequences of deterioration of metabolic parameters in young men. The goal of our study was to evaluate a possible relationship between eating patterns, metabolic parameters and androgenisation levels in healthy young men. Methods: A total of 199 men aged 18-26 participated in this sub-study. Anthropometric measurement included height, weight, hip circumference, waist circumference, and calculation of body mass index. Investigation of reproductive function consisted of clinical evaluation, including orchidometry and measurement of serum testosterone, sex hormone binding globulin (SHBG), estradiol and inhibin B levels. Body composition analysis was performed by bioelectrical impedance analysis. Nutrition questions included usage of milk and dairy products, eggs, different types of meat and fish, pulses, fruit and vegetables. Results: A weak inverse correlation between beer consumption and SHBG has been observed (r=−0.180, P=0.013). Amount of wine consumed was related to estradiol levels (r=0.211, P=0.007). SHBG levels had inverse correlation with fat mass (r=−0.258, P<0.001), hip circumference (r=−0.249, P=0.001) and waist circumference (r=−0.200, P=0.008). Comparison of distributions among groups showed that milk non-users had lower testosterone (P=0.032) and estradiol (P=0.033) levels and higher waist circumference (P=0.047). More frequent usage of beef or veal was borderline associated with higher waist circumference (P=0.043). Conclusions: Our data demonstrate that nutrition can be related to reproductive health and metabolic parameters in healthy young men. Consumption of milk is related to higher sex hormone levels. Beer consumption inversely correlated with SHBG levels, while wine consumption showed positive correlation with estradiol concentration.