This article is available in open access under Creative Common Attribution-Non-Commercial-No Deri... more This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
BackgroundThere are very few biomarkers available to diagnose cases with premature ovarian failur... more BackgroundThere are very few biomarkers available to diagnose cases with premature ovarian failure. Some complete blood count parameters have been introduced to be diagnostic biomarkers for several disorders associated with inflammatory process. Due to the evidence that indicated chronic inflammatory process to be underlying pathophysiology in premature ovarian insufficiency (POI), we aimed to assess the predictive value of complete blood count parameters for POI diagnosis.MethodA total of 96 women diagnosed to have premature ovarian failure were compared with 110 otherwise healthy women in terms of some basal hormone levels and complete blood count parameters.ResultsMean age was similar between groups. Neutrophil/lymphocyte and mean platelet volume/lymphocyte ratios were significantly higher in group with POI (P < .001, P < .003, respectively). In group with POI, there were significant correlations between anti‐Mullerian hormone and follicle stimulating hormone (r = −.30, P &...
OBJECTIVES The success of ovulation induction-intrauterine insemination (OI-IUI) procedures may b... more OBJECTIVES The success of ovulation induction-intrauterine insemination (OI-IUI) procedures may be limited by the absence of ovulation detection. The aim of this study was to evaluate the empirical use of ultrasonography and luteal phase progesterone (P4) as ovulation indicators and determine its effect on pregnancy outcome in OI-IUI cycles. MATERIAL AND METHODS This prospective observational study, which was performed in a university setting, included 107 women with unexplained infertility. Following OI, IUI was performed 36 hours after human chorionic gonadotropin (hCG). P4 was measured 72-96 hours after hCG. At the same time, the appearance of ovaries and signs indicative of ovulation, which are decreased follicle dimensions, irregularity of follicular walls, and the presence of free fluid in the Douglas pouch, were noted. RESULTS In 58 patients (54.2%), ovulation was detected at the P4 level of > 10 ng/mL. Eighty-nine patients had ultrasound images suggestive of ovulation. Ho...
OBJECTIVE: To investigate the effects of pre-pregnancy body mass index and weight gain during pre... more OBJECTIVE: To investigate the effects of pre-pregnancy body mass index and weight gain during pregnancy on perinatal outcomes and delivery mode. STUDY DESIGN: In this retrospective cohort study, 722 pregnant women giving birth between 2018-2019 were screened from our hospital database. First, they were divided into four groups according to their pre-pregnancy body mass index (low-weight/normal-weight/overweight/obese), and then they were redivided into three groups according to pregnancy weight gain (≤7/8-15/≥16 kg). Prenatal body mass index and pregnancy weight gain were compared concerning maternal-neonatal results and mode of delivery. RESULTS: According to pre-pregnancy body mass index, among the obese pregnant group, gestational diabetes mellitus (p<0.001), preeclampsia (p=0.029), preterm delivery (p=0.011) and cesarean delivery (p=0.061) rates were more common. As the body mass index increases, neonatal intensive care requirement (p=0.0020) and low 1st minute APGAR scores (...
Journal of Turkish Society of Obstetric and Gynecology, 2021
Myometrial thickness and gestational age of scar pregnancy were significantly associated with ist... more Myometrial thickness and gestational age of scar pregnancy were significantly associated with isthmocele formation 3 months later after treatment. Sezaryen skar gebeliği üzerindeki miyometriyal kalınlık, postoperatif dönemin üçüncü ayında istmosel oluşumu ile anlamlı ilişkilidir
Gynecology Obstetrics and Reproductive Medicine, 2011
OBJECTIVE: The aim of this study was to determine the possible predictors of total gonadotropin d... more OBJECTIVE: The aim of this study was to determine the possible predictors of total gonadotropin dose (TGD) required to achieve ovulation in patients with unexplained infertility or male subfertility. STUDY DESIGN: A prospective study on 230 patients (n:178 unexplained infertility, n:52 male subfertility) scheduled for controlled ovarian stimulation (COH) and intrauterine insemination (IUI) was designed to determine the association between basal follicle stimulating hormone (FSH), luteinizing hormone (LH), estrodiol (E2) levels, antral follicle count (AFC), age and body mass index (BMI) and total gonadotropin doses needed to achieve follicular growth. RESULT: Regression analysis revealed an association between basal FSH level, BMI and AFC with total gonadotropin dose (P=0.001, P=0.002, P=0.045). BMI was positively correlated with TGD (r:0.400, P=0.001). Mean BMI of patients who required a total dosage of >1500 IUs of gonadotropin was 29.7±4.8kg/ m2 where as it was 24.9±3.2kg/ m2 f...
Aim: The aim of this study was to figure out the differences in the cycle characteristics differe... more Aim: The aim of this study was to figure out the differences in the cycle characteristics differences between poor responder women with and without oocyte retrieval with transvaginal follicle aspiration. Material and Method: Some cycle characteristics of sixty-eight women with no oocyte retrieval were compared with sixty women with at least one oocyte retrieval following transvaginal follicle aspiration. All women had poor ovarian reserve determined by basal FSH, estradiol, AMH levels and antral follicle count. Diminished ovarian reserve was defined according to the basal FSH value >10 IU/L, antral follicle count 14 mm and peak estradiol on the trigger day (397 versus 1301 pg/ml). In multivariate regression analysis, duration of infertility and peak estradiol level were significantly associated with no oocyte retrieval following oocyte pick up procedure. Peak estradiol (AUC=0.888, P < 0.001) and duration of infertility (AUC=0.776, P < 0.001) were significant predictors for ...
Amniotic fluid has an essential role in fetal health. It has bacteriostatic, anti-inflammatory an... more Amniotic fluid has an essential role in fetal health. It has bacteriostatic, anti-inflammatory and thermoregulatory effects. Stable and adequate fluid amounts lead to proper growth of the fetal lung and musculoskeletal system. Oligohydramnios is a risk factor for uteroplacental insufficiency and hypoxemia.1 The stability of the fetal circulation ensures an uninterrupted exchange from maternal blood and enables the fetus to tolerate labor. The failure on this delicate circulation leads oxidative distress. Umbilical cord pH value is a sensitive marker for fetal asphyxia.2 Gamma Glutamyl Transferase (GGT) is a sensitive marker for oxidative stress and an early indicator for fetal distress.3 Obstetric Doppler ultrasonography (US) is a noninvasive assessment method in predicting of fetal condition in active labor. Doppler velocimetry of umbilical artery (UmA), uterine artery (UtA) and middle cerebral artery (MCA) is a useful technique to detect the alterations of circulation in fetal dis...
Gynecology Obstetrics and Reproductive Medicine, 2010
OBJECTIVE: To evaluate the clinical, endocrine and cardiovascular disease risk profile difference... more OBJECTIVE: To evaluate the clinical, endocrine and cardiovascular disease risk profile differences in polycystic ovary syndrome (PCOS) patients who complain of hirsutism or oligo-amenorrhea. STUDY DESIGN: A total of 129 consecutive women underwent the screening investigation at Dr. Sami Ulus Women’s Health Teaching and Research Hospital between December 2009 and June 2010. There were 48 PCOS patients with hirsutism while 49 PCOS patients with oligo-amenorrhea and 32 healthy women included in the study. Body mass index (BMI), Waist/hip ratio (WHR) serum follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone, free testosterone, glucose, low density lipoprotein (LDL), total cholesterol, high density lipoprotein (HDL), triglceride (TG), high sensitive C reactive protein (hs-CRP), insulin, insulin sensitivity and carotid intima thickness (CIMT) were compared in PCOS patients who complain of hirsutism or oligo-amenorrhea and control group. RESULTS: Mean ages were simil...
OBJECTIVE: This study aimed to compare cycle outcomes among women with endometrioma or non-functi... more OBJECTIVE: This study aimed to compare cycle outcomes among women with endometrioma or non-functional cysts versus control. STUDY DESIGN: Women under 35 years of age with unexplained infertility underwent in vitro fertilization cycle. Two hundred and ninety-nine women were included in this study. Study groups consist of women with endometrioma (n=82) or non-functional ovarian cysts (n=100) and control group (n=117). Women in each group were selected consecutively. Groups were matched for age and ovarian reserve and compared in terms of in vitro fertilization cycle outcome. RESULTS: There were no significant differences among groups in terms of mean age, early follicular phase Follicle-Stimulating Hormone, and anti-müllerian hormone levels (p>0.05). Baseline total antral follicle counts were similar among groups (p>0.05). There were significant differences among groups in terms of mean starting and total gonadotropin dose, peak estradiol level, total oocyte number, and mature o...
International Journal Of Medical Science And Clinical Invention, 2018
Background: We aimed to compare perinatal outcomes of intracytoplasmicsperm injection (ICSI) vers... more Background: We aimed to compare perinatal outcomes of intracytoplasmicsperm injection (ICSI) versus naturally (spontaneously) concieved age and parity matched group of singleton pregnants. Methods: Two hundred and sixteen singleton pregnancies aged between 18-45 years old were included in this study. Among all study group, 106 cases were ICSI pregnancies (study group) and 110 cases were spontaneously concieved singleton pregnancies (control group). Pregnancy outcome parameters were: the incidence of chronic hypertension, preeclampsia, gestational hypertension, placenta previa, placental abruption, preterm birth, intrahepatic cholestasis of pregnancy, gestational diabetes, preterm premature rupture of membranes, caesarean delivery. Results: There were no differences in terms of maternal age, BMI, gravidity, parity, gestational weeks at birth and birth weight between ICSI and spontaneously concieved pregnancy groups. Placental abruption, gestational diabetes and cesarean section rat...
OBJECTIVE: To compare some cycle characteristics and outcomes using a protocol consisting of a Gn... more OBJECTIVE: To compare some cycle characteristics and outcomes using a protocol consisting of a GnRH agonist trigger or hCG trigger after cotreatment with GnRH antagonist.STUDY DESIGN: Thirty-three patients under 35 years of age with polycystic ovarian syndrome, polycystic ovarian morphology, or previous high response who underwent ovulation trigger by GnRH agonist trigger and 132 patients under 35 years of age with the polycystic ovarian syndrome, polycystic ovarian morphology, or previous high response who underwent ovulation trigger by hCG for IVF treatment. Patients were non-randomly assigned to an ovarian stimulation protocol consisting of either GnRH agonist trigger after cotreatment with GnRH antagonist (study group) or hCG trigger after antagonist protocol (control group).RESULTS: The positive pregnancy test was obtained in 70 women in the control group whereas in 13 cases in the study group (p=0.161). No case in the study group needed hospitalization whereas there were 15 ca...
Gynecology Obstetrics & Reproductive Medicine, 2018
Objectives: The aim of this study was to assess the predictive value of coagulation tests at trig... more Objectives: The aim of this study was to assess the predictive value of coagulation tests at trigger day in patients with isolated factor V Leiden mutation who underwent intracytoplasmic sperm injection cycle (ICSI).Study Design: Ninety women with isolated factor V Leiden mutation underwent ICSI cycles with an indication of unexplained infertility. In all participants antagonist protocol was used for ovarian hyperstimulation and coagulation tests including activated partial thromboplastin time (APTT), partial thromboplastin time (PT), international normalized ratio (INR), serum fibrinogen and D-dimer levels at trigger day were determined to predict successful implantation. All the clinical parameters specific for the treatment and some patient characteristics were recorded for each participants.Results: There was no significant difference between groups with and without succesfull implantation in terms of age, body mass index, basal hormone levels (follicle stimulating hormone, est...
OBJECTIVE: We aimed to assess the effect of serum albumin level adjusted progesterone levels on t... more OBJECTIVE: We aimed to assess the effect of serum albumin level adjusted progesterone levels on the trigger day on clinical pregnancy rate in intracytoplasmic sperm injection cycles. STUDY DESIGN: A total of 100 women undergoing intracytoplasmic sperm injection cycles due to poor ovarian reserve or tubal factor infertility were included in this study. Serum progesterone and albumin levels on the trigger day were utilized to predict clinical pregnancy among normal and poor responders. RESULTS: There were significant differences between groups with and without successful clinical pregnancy in terms of serum albumin (4.6 vs. 4.3 g/dL), progesterone levels (0.5 ng/mL vs. 0.7 ng/mL) on the trigger day and endometrial thickness (11.5 mm vs. 9.3 mm) (p<0.05, p<0.05 and p<0.05, respectively). In ROC analyses, progesterone level on the trigger day was found to be a significant predictor of clinical pregnancy (AUC=0.652, p=0.015). An optimal cutoff value of 0.55 ng/mL was obtained with 65% sensitivity and 57% specificity. However, after adjustment for progesterone and albumin levels, endometrial thickness was found to be significantly associated with successful clinical pregnancy (β=0.39, sig=0.038). CONCLUSION: Progesterone action may be altered by albumin concentration, therefore albumin concentration should be taken into account to determine a cut off for premature progesterone rise.
International Journal of Radiology and Radiation Oncology, 2015
Women have fixed ovarian follicles after birth and the number of the follicles declines with age.... more Women have fixed ovarian follicles after birth and the number of the follicles declines with age. The decrease can be regulated by genetic, hormonal and/or therapy procedures. Radiation exposure can lead to premature ovarian failure (POF). POF is defined as interruption of the ovarian function in an adolescent woman. Genetic disorders including translocations and damage on the ovarian tissue may result POF. The essential diagnostic criteria is an adolescent woman younger than 40 years of age. The diagnosis depends on at least 4 months of amenorrhea and increased FSH levels (≥40 mIU/ml) in 2 blood samples at an interval of 1 month. or chemotherapy, surgery may reduce the number of the follicles. Chromosomal abnormalities are also responsible. X chromosome is usually affected. XO Turner's syndrome, 47, XXX, X chromosome mosaics (45,XO/46,XX, 46 XX/47,XXX, 45,XO/46,XX/47,XXX), X chromosome deletions and inversions and X;autosome balanced translocations [5]. Patients with Robertsonian Translocation usually
Journal of Turkish Society of Obstetric and Gynecology, 2017
Zayıf cevaplı hastalarda birbirini takip eden başarılı ve başarısız intrasitoplazmik sperm enjeks... more Zayıf cevaplı hastalarda birbirini takip eden başarılı ve başarısız intrasitoplazmik sperm enjeksiyonu (ICSI) sikluslarında bazı majör özellik farklarının ortaya konmasıdır. Gereç ve Yöntemler: Bologna kriterlerine göre karar verilmiş 60 düşük yanıtlı hasta başarısız bir siklus sonrası ICSI tedavine alındı. Başarılı ve başarısız sikluslarda yaş, vücut kitle indeksi (VKİ), serum folikül stimülan hormon (FSH) ve estradiol düzeyleri, antral folikül sayısı, gonadotropin dozu, stimülasyon, antagonist başlama günü, antagonist uygulama süresi, tetikleme günü endometrial kalınlık, total ve fertilize oosit sayısı, embriyo transfer günü, embriyo hücre sayısı ve fertilizasyon oranlarını içeren değişkenler aynı hasta grubunda klinik gebeliği öngörmek üzere karşılaştırıldı.
Amaç: Farklı yaş gruplarına göre anti-Müllerian hormon (AMH) ve folikül stimülan hormon (FSH) ara... more Amaç: Farklı yaş gruplarına göre anti-Müllerian hormon (AMH) ve folikül stimülan hormon (FSH) arasındaki diskordans oranının Türk kadın kohortunda araştırılması. Gereç ve Yöntem: Bu retrospektif çalışma, Zeynep Kamil Eğitim Araştırma Hastanesi infertilite kliniğinde gerçekleştirildi. Hastalar; yaş gruplarına göre AMH ve FSH arasındaki diskordansı değerlendirmek amacıyla ≤30 yaş, 31-35 yaş, 36-39 yaş ve ≥ 40 yaş olmak üzere dört gruba ayrıldı. Diskordans oranı, AMH ve FSH median değerleri yaş gruplarına göre incelendi. Bulgular: Çalışmaya dahil edilme kriterlerini sağlayan 467 hasta çalışmaya dahil edildi. Hastaların %35.1'i (n=164) ≤ 30 yaş, %28.3'ü (n=132) 31-35 yaş arası, %22.7'si (n=106) 36-39 yaş arası ve %13.9'u (n=65) ≥40 yaş idi. Diskordans oranı normal AMH-anormal FSH değeri olan hastalar için ≤30, 31-35, 36-39, ≥40 yaş hasta grupları için sırasıyla %4.2, %6.7, %11.0, %17.9 olarak saptandı. Normal FSH-anormal AMH değeri olan hastalarda diskordans oranı ≤30, 31-35, 36-39, ≥40 yaş hasta grupları için sırasıyla %6.2, %8.5, %16.7, %17.9 olarak tespit edildi. Tartışma: Diskordans oranının normal AMH-anormal FSH değeri olan ve anormal AMH-normal FSH değeri olan Çalışmamızın sonuçları ve literatürdeki sonuçlara göre farklı etnik gruplarda AMH ve FSH arasındaki diskordans oranlarının ve yaşa göre AMH ve FSH düzeylerinin farklılık gösterebileceği düşünülmektedir.
Gynecology Obstetrics & Reproductive Medicine, 2017
Objective: Some hormonal alterations after ovarian diathermy have been proposed in previous studi... more Objective: Some hormonal alterations after ovarian diathermy have been proposed in previous studies. Based on this data, we aimed to analyze some hormone profile changes following oocyte pick-up in women with polycystic ovarian syndrome.Study Designs: A total of 50 women with polycystic ovarian syndrome underwent ovarian stimulation for IVF cycle with an indication of anovulatory infertility. Some hormone profiles with the insulin resistance were assessed before and after oocyte pick-up to (early in the morning before starting stimulation and repeated 1 month later from oocyte pick-up day) assess whether high number of needle entries into the ovarian cortex and stroma result in similar effect with the diathermy.Results: Comparison of some variables revealed significantly decreased HOMA-IR and serum total testosterone concentrations after intervention. Correlation analyses showed significant correlations between number of needle entries, change in HOMA-IR, baseline total testosterone...
This article is available in open access under Creative Common Attribution-Non-Commercial-No Deri... more This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
BackgroundThere are very few biomarkers available to diagnose cases with premature ovarian failur... more BackgroundThere are very few biomarkers available to diagnose cases with premature ovarian failure. Some complete blood count parameters have been introduced to be diagnostic biomarkers for several disorders associated with inflammatory process. Due to the evidence that indicated chronic inflammatory process to be underlying pathophysiology in premature ovarian insufficiency (POI), we aimed to assess the predictive value of complete blood count parameters for POI diagnosis.MethodA total of 96 women diagnosed to have premature ovarian failure were compared with 110 otherwise healthy women in terms of some basal hormone levels and complete blood count parameters.ResultsMean age was similar between groups. Neutrophil/lymphocyte and mean platelet volume/lymphocyte ratios were significantly higher in group with POI (P < .001, P < .003, respectively). In group with POI, there were significant correlations between anti‐Mullerian hormone and follicle stimulating hormone (r = −.30, P &...
OBJECTIVES The success of ovulation induction-intrauterine insemination (OI-IUI) procedures may b... more OBJECTIVES The success of ovulation induction-intrauterine insemination (OI-IUI) procedures may be limited by the absence of ovulation detection. The aim of this study was to evaluate the empirical use of ultrasonography and luteal phase progesterone (P4) as ovulation indicators and determine its effect on pregnancy outcome in OI-IUI cycles. MATERIAL AND METHODS This prospective observational study, which was performed in a university setting, included 107 women with unexplained infertility. Following OI, IUI was performed 36 hours after human chorionic gonadotropin (hCG). P4 was measured 72-96 hours after hCG. At the same time, the appearance of ovaries and signs indicative of ovulation, which are decreased follicle dimensions, irregularity of follicular walls, and the presence of free fluid in the Douglas pouch, were noted. RESULTS In 58 patients (54.2%), ovulation was detected at the P4 level of > 10 ng/mL. Eighty-nine patients had ultrasound images suggestive of ovulation. Ho...
OBJECTIVE: To investigate the effects of pre-pregnancy body mass index and weight gain during pre... more OBJECTIVE: To investigate the effects of pre-pregnancy body mass index and weight gain during pregnancy on perinatal outcomes and delivery mode. STUDY DESIGN: In this retrospective cohort study, 722 pregnant women giving birth between 2018-2019 were screened from our hospital database. First, they were divided into four groups according to their pre-pregnancy body mass index (low-weight/normal-weight/overweight/obese), and then they were redivided into three groups according to pregnancy weight gain (≤7/8-15/≥16 kg). Prenatal body mass index and pregnancy weight gain were compared concerning maternal-neonatal results and mode of delivery. RESULTS: According to pre-pregnancy body mass index, among the obese pregnant group, gestational diabetes mellitus (p<0.001), preeclampsia (p=0.029), preterm delivery (p=0.011) and cesarean delivery (p=0.061) rates were more common. As the body mass index increases, neonatal intensive care requirement (p=0.0020) and low 1st minute APGAR scores (...
Journal of Turkish Society of Obstetric and Gynecology, 2021
Myometrial thickness and gestational age of scar pregnancy were significantly associated with ist... more Myometrial thickness and gestational age of scar pregnancy were significantly associated with isthmocele formation 3 months later after treatment. Sezaryen skar gebeliği üzerindeki miyometriyal kalınlık, postoperatif dönemin üçüncü ayında istmosel oluşumu ile anlamlı ilişkilidir
Gynecology Obstetrics and Reproductive Medicine, 2011
OBJECTIVE: The aim of this study was to determine the possible predictors of total gonadotropin d... more OBJECTIVE: The aim of this study was to determine the possible predictors of total gonadotropin dose (TGD) required to achieve ovulation in patients with unexplained infertility or male subfertility. STUDY DESIGN: A prospective study on 230 patients (n:178 unexplained infertility, n:52 male subfertility) scheduled for controlled ovarian stimulation (COH) and intrauterine insemination (IUI) was designed to determine the association between basal follicle stimulating hormone (FSH), luteinizing hormone (LH), estrodiol (E2) levels, antral follicle count (AFC), age and body mass index (BMI) and total gonadotropin doses needed to achieve follicular growth. RESULT: Regression analysis revealed an association between basal FSH level, BMI and AFC with total gonadotropin dose (P=0.001, P=0.002, P=0.045). BMI was positively correlated with TGD (r:0.400, P=0.001). Mean BMI of patients who required a total dosage of >1500 IUs of gonadotropin was 29.7±4.8kg/ m2 where as it was 24.9±3.2kg/ m2 f...
Aim: The aim of this study was to figure out the differences in the cycle characteristics differe... more Aim: The aim of this study was to figure out the differences in the cycle characteristics differences between poor responder women with and without oocyte retrieval with transvaginal follicle aspiration. Material and Method: Some cycle characteristics of sixty-eight women with no oocyte retrieval were compared with sixty women with at least one oocyte retrieval following transvaginal follicle aspiration. All women had poor ovarian reserve determined by basal FSH, estradiol, AMH levels and antral follicle count. Diminished ovarian reserve was defined according to the basal FSH value >10 IU/L, antral follicle count 14 mm and peak estradiol on the trigger day (397 versus 1301 pg/ml). In multivariate regression analysis, duration of infertility and peak estradiol level were significantly associated with no oocyte retrieval following oocyte pick up procedure. Peak estradiol (AUC=0.888, P < 0.001) and duration of infertility (AUC=0.776, P < 0.001) were significant predictors for ...
Amniotic fluid has an essential role in fetal health. It has bacteriostatic, anti-inflammatory an... more Amniotic fluid has an essential role in fetal health. It has bacteriostatic, anti-inflammatory and thermoregulatory effects. Stable and adequate fluid amounts lead to proper growth of the fetal lung and musculoskeletal system. Oligohydramnios is a risk factor for uteroplacental insufficiency and hypoxemia.1 The stability of the fetal circulation ensures an uninterrupted exchange from maternal blood and enables the fetus to tolerate labor. The failure on this delicate circulation leads oxidative distress. Umbilical cord pH value is a sensitive marker for fetal asphyxia.2 Gamma Glutamyl Transferase (GGT) is a sensitive marker for oxidative stress and an early indicator for fetal distress.3 Obstetric Doppler ultrasonography (US) is a noninvasive assessment method in predicting of fetal condition in active labor. Doppler velocimetry of umbilical artery (UmA), uterine artery (UtA) and middle cerebral artery (MCA) is a useful technique to detect the alterations of circulation in fetal dis...
Gynecology Obstetrics and Reproductive Medicine, 2010
OBJECTIVE: To evaluate the clinical, endocrine and cardiovascular disease risk profile difference... more OBJECTIVE: To evaluate the clinical, endocrine and cardiovascular disease risk profile differences in polycystic ovary syndrome (PCOS) patients who complain of hirsutism or oligo-amenorrhea. STUDY DESIGN: A total of 129 consecutive women underwent the screening investigation at Dr. Sami Ulus Women’s Health Teaching and Research Hospital between December 2009 and June 2010. There were 48 PCOS patients with hirsutism while 49 PCOS patients with oligo-amenorrhea and 32 healthy women included in the study. Body mass index (BMI), Waist/hip ratio (WHR) serum follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone, free testosterone, glucose, low density lipoprotein (LDL), total cholesterol, high density lipoprotein (HDL), triglceride (TG), high sensitive C reactive protein (hs-CRP), insulin, insulin sensitivity and carotid intima thickness (CIMT) were compared in PCOS patients who complain of hirsutism or oligo-amenorrhea and control group. RESULTS: Mean ages were simil...
OBJECTIVE: This study aimed to compare cycle outcomes among women with endometrioma or non-functi... more OBJECTIVE: This study aimed to compare cycle outcomes among women with endometrioma or non-functional cysts versus control. STUDY DESIGN: Women under 35 years of age with unexplained infertility underwent in vitro fertilization cycle. Two hundred and ninety-nine women were included in this study. Study groups consist of women with endometrioma (n=82) or non-functional ovarian cysts (n=100) and control group (n=117). Women in each group were selected consecutively. Groups were matched for age and ovarian reserve and compared in terms of in vitro fertilization cycle outcome. RESULTS: There were no significant differences among groups in terms of mean age, early follicular phase Follicle-Stimulating Hormone, and anti-müllerian hormone levels (p>0.05). Baseline total antral follicle counts were similar among groups (p>0.05). There were significant differences among groups in terms of mean starting and total gonadotropin dose, peak estradiol level, total oocyte number, and mature o...
International Journal Of Medical Science And Clinical Invention, 2018
Background: We aimed to compare perinatal outcomes of intracytoplasmicsperm injection (ICSI) vers... more Background: We aimed to compare perinatal outcomes of intracytoplasmicsperm injection (ICSI) versus naturally (spontaneously) concieved age and parity matched group of singleton pregnants. Methods: Two hundred and sixteen singleton pregnancies aged between 18-45 years old were included in this study. Among all study group, 106 cases were ICSI pregnancies (study group) and 110 cases were spontaneously concieved singleton pregnancies (control group). Pregnancy outcome parameters were: the incidence of chronic hypertension, preeclampsia, gestational hypertension, placenta previa, placental abruption, preterm birth, intrahepatic cholestasis of pregnancy, gestational diabetes, preterm premature rupture of membranes, caesarean delivery. Results: There were no differences in terms of maternal age, BMI, gravidity, parity, gestational weeks at birth and birth weight between ICSI and spontaneously concieved pregnancy groups. Placental abruption, gestational diabetes and cesarean section rat...
OBJECTIVE: To compare some cycle characteristics and outcomes using a protocol consisting of a Gn... more OBJECTIVE: To compare some cycle characteristics and outcomes using a protocol consisting of a GnRH agonist trigger or hCG trigger after cotreatment with GnRH antagonist.STUDY DESIGN: Thirty-three patients under 35 years of age with polycystic ovarian syndrome, polycystic ovarian morphology, or previous high response who underwent ovulation trigger by GnRH agonist trigger and 132 patients under 35 years of age with the polycystic ovarian syndrome, polycystic ovarian morphology, or previous high response who underwent ovulation trigger by hCG for IVF treatment. Patients were non-randomly assigned to an ovarian stimulation protocol consisting of either GnRH agonist trigger after cotreatment with GnRH antagonist (study group) or hCG trigger after antagonist protocol (control group).RESULTS: The positive pregnancy test was obtained in 70 women in the control group whereas in 13 cases in the study group (p=0.161). No case in the study group needed hospitalization whereas there were 15 ca...
Gynecology Obstetrics & Reproductive Medicine, 2018
Objectives: The aim of this study was to assess the predictive value of coagulation tests at trig... more Objectives: The aim of this study was to assess the predictive value of coagulation tests at trigger day in patients with isolated factor V Leiden mutation who underwent intracytoplasmic sperm injection cycle (ICSI).Study Design: Ninety women with isolated factor V Leiden mutation underwent ICSI cycles with an indication of unexplained infertility. In all participants antagonist protocol was used for ovarian hyperstimulation and coagulation tests including activated partial thromboplastin time (APTT), partial thromboplastin time (PT), international normalized ratio (INR), serum fibrinogen and D-dimer levels at trigger day were determined to predict successful implantation. All the clinical parameters specific for the treatment and some patient characteristics were recorded for each participants.Results: There was no significant difference between groups with and without succesfull implantation in terms of age, body mass index, basal hormone levels (follicle stimulating hormone, est...
OBJECTIVE: We aimed to assess the effect of serum albumin level adjusted progesterone levels on t... more OBJECTIVE: We aimed to assess the effect of serum albumin level adjusted progesterone levels on the trigger day on clinical pregnancy rate in intracytoplasmic sperm injection cycles. STUDY DESIGN: A total of 100 women undergoing intracytoplasmic sperm injection cycles due to poor ovarian reserve or tubal factor infertility were included in this study. Serum progesterone and albumin levels on the trigger day were utilized to predict clinical pregnancy among normal and poor responders. RESULTS: There were significant differences between groups with and without successful clinical pregnancy in terms of serum albumin (4.6 vs. 4.3 g/dL), progesterone levels (0.5 ng/mL vs. 0.7 ng/mL) on the trigger day and endometrial thickness (11.5 mm vs. 9.3 mm) (p<0.05, p<0.05 and p<0.05, respectively). In ROC analyses, progesterone level on the trigger day was found to be a significant predictor of clinical pregnancy (AUC=0.652, p=0.015). An optimal cutoff value of 0.55 ng/mL was obtained with 65% sensitivity and 57% specificity. However, after adjustment for progesterone and albumin levels, endometrial thickness was found to be significantly associated with successful clinical pregnancy (β=0.39, sig=0.038). CONCLUSION: Progesterone action may be altered by albumin concentration, therefore albumin concentration should be taken into account to determine a cut off for premature progesterone rise.
International Journal of Radiology and Radiation Oncology, 2015
Women have fixed ovarian follicles after birth and the number of the follicles declines with age.... more Women have fixed ovarian follicles after birth and the number of the follicles declines with age. The decrease can be regulated by genetic, hormonal and/or therapy procedures. Radiation exposure can lead to premature ovarian failure (POF). POF is defined as interruption of the ovarian function in an adolescent woman. Genetic disorders including translocations and damage on the ovarian tissue may result POF. The essential diagnostic criteria is an adolescent woman younger than 40 years of age. The diagnosis depends on at least 4 months of amenorrhea and increased FSH levels (≥40 mIU/ml) in 2 blood samples at an interval of 1 month. or chemotherapy, surgery may reduce the number of the follicles. Chromosomal abnormalities are also responsible. X chromosome is usually affected. XO Turner's syndrome, 47, XXX, X chromosome mosaics (45,XO/46,XX, 46 XX/47,XXX, 45,XO/46,XX/47,XXX), X chromosome deletions and inversions and X;autosome balanced translocations [5]. Patients with Robertsonian Translocation usually
Journal of Turkish Society of Obstetric and Gynecology, 2017
Zayıf cevaplı hastalarda birbirini takip eden başarılı ve başarısız intrasitoplazmik sperm enjeks... more Zayıf cevaplı hastalarda birbirini takip eden başarılı ve başarısız intrasitoplazmik sperm enjeksiyonu (ICSI) sikluslarında bazı majör özellik farklarının ortaya konmasıdır. Gereç ve Yöntemler: Bologna kriterlerine göre karar verilmiş 60 düşük yanıtlı hasta başarısız bir siklus sonrası ICSI tedavine alındı. Başarılı ve başarısız sikluslarda yaş, vücut kitle indeksi (VKİ), serum folikül stimülan hormon (FSH) ve estradiol düzeyleri, antral folikül sayısı, gonadotropin dozu, stimülasyon, antagonist başlama günü, antagonist uygulama süresi, tetikleme günü endometrial kalınlık, total ve fertilize oosit sayısı, embriyo transfer günü, embriyo hücre sayısı ve fertilizasyon oranlarını içeren değişkenler aynı hasta grubunda klinik gebeliği öngörmek üzere karşılaştırıldı.
Amaç: Farklı yaş gruplarına göre anti-Müllerian hormon (AMH) ve folikül stimülan hormon (FSH) ara... more Amaç: Farklı yaş gruplarına göre anti-Müllerian hormon (AMH) ve folikül stimülan hormon (FSH) arasındaki diskordans oranının Türk kadın kohortunda araştırılması. Gereç ve Yöntem: Bu retrospektif çalışma, Zeynep Kamil Eğitim Araştırma Hastanesi infertilite kliniğinde gerçekleştirildi. Hastalar; yaş gruplarına göre AMH ve FSH arasındaki diskordansı değerlendirmek amacıyla ≤30 yaş, 31-35 yaş, 36-39 yaş ve ≥ 40 yaş olmak üzere dört gruba ayrıldı. Diskordans oranı, AMH ve FSH median değerleri yaş gruplarına göre incelendi. Bulgular: Çalışmaya dahil edilme kriterlerini sağlayan 467 hasta çalışmaya dahil edildi. Hastaların %35.1'i (n=164) ≤ 30 yaş, %28.3'ü (n=132) 31-35 yaş arası, %22.7'si (n=106) 36-39 yaş arası ve %13.9'u (n=65) ≥40 yaş idi. Diskordans oranı normal AMH-anormal FSH değeri olan hastalar için ≤30, 31-35, 36-39, ≥40 yaş hasta grupları için sırasıyla %4.2, %6.7, %11.0, %17.9 olarak saptandı. Normal FSH-anormal AMH değeri olan hastalarda diskordans oranı ≤30, 31-35, 36-39, ≥40 yaş hasta grupları için sırasıyla %6.2, %8.5, %16.7, %17.9 olarak tespit edildi. Tartışma: Diskordans oranının normal AMH-anormal FSH değeri olan ve anormal AMH-normal FSH değeri olan Çalışmamızın sonuçları ve literatürdeki sonuçlara göre farklı etnik gruplarda AMH ve FSH arasındaki diskordans oranlarının ve yaşa göre AMH ve FSH düzeylerinin farklılık gösterebileceği düşünülmektedir.
Gynecology Obstetrics & Reproductive Medicine, 2017
Objective: Some hormonal alterations after ovarian diathermy have been proposed in previous studi... more Objective: Some hormonal alterations after ovarian diathermy have been proposed in previous studies. Based on this data, we aimed to analyze some hormone profile changes following oocyte pick-up in women with polycystic ovarian syndrome.Study Designs: A total of 50 women with polycystic ovarian syndrome underwent ovarian stimulation for IVF cycle with an indication of anovulatory infertility. Some hormone profiles with the insulin resistance were assessed before and after oocyte pick-up to (early in the morning before starting stimulation and repeated 1 month later from oocyte pick-up day) assess whether high number of needle entries into the ovarian cortex and stroma result in similar effect with the diathermy.Results: Comparison of some variables revealed significantly decreased HOMA-IR and serum total testosterone concentrations after intervention. Correlation analyses showed significant correlations between number of needle entries, change in HOMA-IR, baseline total testosterone...
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