Browsing by Author "Aytac, Pinar Caglar"

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Addition of gonadotropin releasing hormone agonist for luteal phase support in in-vitro fertilization: an analysis of 2739 cycles
(2015) Simsek, Erhan; Kilicdag, Esra Bulgan; Aytac, Pinar Caglar; Coban, Gonca; Simsek, Seda Yüksel; Cok, Tayfun; Haydardedeoglu, Bulent; 26097392
Objective: Luteal phase is defective in in vitro fertilization (IVF) cycles, and many regimens were tried for the very best luteal phase support (LPS). Gonadotropin releasing hormone (GnRH) agonist use, which was administered as an adjunct to the luteal phase support in IVF cycles, was suggested to improve pregnancy outcome measures in certain randomized studies. We analyzed the effects of addition of GnRH agonist to standard progesterone luteal support on pregnancy outcome measures, particularly the live birth rates. Material and Methods: This is a retrospective cohort study, including 2739 IVF cycles. Long GnRH agonist and antagonist stimulation IVF cycles with cleavage-stage embryo transfer were included. Cycles were divided into two groups: Group A included cycles with single-dose GnRH agonist plus progesterone LPS and Group B included progesterone only LPS. Live birth rates were the primary outcome measures of the analysis. Miscarriage rates and multiple pregnancy rates were the secondary outcome measures. Results: Live birth rates were not statistically different in GnRH agonist plus progesterone (Group A) and progesterone only (Group B) groups in both the long agonist and antagonist stimulation arms (40.8%/41.2% and 32.8%/34.4%, p<0.05 respectively). Moreover, pregnancy rates, implantation rates, and miscarriage rates were found to be similar between groups. Multiple pregnancy rates in antagonist cycles were significantly higher in Group A than those in Group B (12.0% and 6.9%, respectively). Conclusion: A beneficial effect of a single dose of GnRH agonist administration as a luteal phase supporting agent is yet to be determined because of the wide heterogeneity of data present in literature. Well-designed randomized clinical studies are required to clarify any effect of luteal GnRH agonist addition on pregnancy outcome measures with different doses, timing, and administration routes of GnRH agonists.
Effect of pigtail catheter application on obstetric outcomes in in vitro fertilization/intracytoplasmic sperm injection pregnancies following hyperstimulation syndrome
(2017) Aytac, Pinar Caglar; Kalayci, Hakan; Yetkinel, Selcuk; Alkas, Didem; Simsek, Seda Yuksel; Haydardedeoglu, Bulent; Kilicdag, Esra Bulgan; 28913144
Objective: To evaluate the effects of percutaneous pigtail catheter drainage on the outcomes of intracytoplasmic sperm injection (ICSI) pregnancies following moderate or severe ovarian hyperstimulation syndrome (OHSS). Materials and Methods: This retrospective study included 189 patients hospitalized for OHSS following ICSI treatment in a tertiary in vitro fertilization unit between 2006 and 2014. Pigtail catheters were applied in 63 patients; the other 126 patients did not need that treatment. The obstetric reports of 173 patients could be accessed and were examined to investigate the pregnancy outcomes of those with and without catheters. Results: No complications such as infection or vascular or intra-abdominal organ trauma were observed related to the pigtail application. There were no differences in abortus, preterm labor, gestational diabetes mellitus, and preeclampsia ratio between the pigtail and control groups (p>0.05). The rate of readmission to hospital for OHSS was lower in the pigtail group than in the control group although not statistically significant (p=0.08). Conclusion: Pigtail application is a safe and effective method for draining ascites in patients with OHSS after ICSI treatment. The use of pigtail catheters had no adverse effects on the perinatal outcomes of patients hospitalized with OHSS who became pregnant after ICSI treatment. In addition, the percutaneous drainage of ascites via a pigtail catheter helped prevent the readmission of patients with moderate or severe OHSS.
The effect of preserving prepared sperm samples at room temperature or at 37 C-circle before intrauterine insemination (IUI) on clinical pregnancy rate
(2015) Cok, Tayfun; Aytac, Pinar Caglar; Simsek, Erhan; Haydardedeoglu, Bulent; Kalayci, Hakan; Ozdemir, Halis; Kilicdag, Esra Bulgan; 28913033
Objective: The comparison of the effect of preserving prepared sperm samples at room temperature or at 37(circle)C before intrauterine insemination (IUI) on clinical pregnancy rate. Materials and Methods: Retrospective clinical research. University hospital, infertility clinic. Patients with one or two follicles, between the ages of 20 and 40, whose infertility period was less than 6 years and the injected total motile sperm count was more than 10 million. Preserving sperm samples prepared for IUI at 37(circle)C or at room temperature before IUI. The clinical pregnancy rate of IUI cycles between 1st of January 2004 and 1st of December 2011 in which prepared sperm samples were preserved at 37(circle)C and the clinical pregnancy rate of IUI cycles between 1st of December 2011 and 31st of May 2014 in which prepared sperm samples preserved at room temperature. Results: Clinical pregnancy rates were similar in IUI cycles in which prepared sperm samples were preserved at 37(circle)C and at room temperature (9.3% vs. 8.9%). Clinical pregnancy rates in IUI cycles with 2 follicles were higher than IUI cycles with 1 follicle (10.8% vs. 7.6%) (p=0.002). Further statistical analysis after splitting data according to the number of the follicles revealed that there was no statistical difference between clinical pregnancy rates after IUI cycles in which prepared sperm samples were preserved at 37(circle)C or at room temperature in both one follicle (7.6% vs. 7.6%), and two follicle cycles (11.5% vs. 10.1%). Conclusions: Preserving prepared sperm samples at room temperature had no negative effect on clinical pregnancy rates when compared with reserving prepared sperm samples at 37(circle)C during IUI cycles.
The Effect of Suture Materials with Different Absorption Times on Isthmocele: A Retrospective Study
(2023) Yetkinel, Selcuk; Aytac, Pinar Caglar; Kalayci, Hakan; Cok, Tayfun; Durdag, Gulsen Dogan; Yaginc, Didem Alkas; Baran, Safak Yilmaz; Alemdaroglu, Songul; Kilicdag, Esra Bulgan; 0000-0002-2165-9168; 0000-0002-5064-5267; 37306162; AAL-1530-2021; AAC-9940-2020; AAI-9594-2021
Objectives: With the increasing rate of cesarean operations, the formation of niches and related early and late complications have been observed more frequently. In this study, we examined the effects of using a suture material that can be absorbed faster than conventional sutures on the formation of niches.Material and methods:This study was designed as a retrospective study and completed with a total of 101 patients. During the cesarean operation, the uterus was closed with Rapide Vicryl center dot in 49 patients and Vicryl center dot in 52 patients. The uterine niche was measured with a sonohysterogram 6 months after the operation. The primary outcome of the study was determined as uterine niche formation and the secondary outcome was the post-menstrual spotting (PMS) rate.Results: Duration of surgery, intraoperative/postoperative blood loss, and hospitalization time were similar between the two groups. Niche formation was significantly lower in the Rapide Vicryl group (22.4%) when compared to the Vicryl group (42.3%) (p = 0.046). Also, PMS was observed significantly lower in the Rapide Vicryl group (16.2% and 52.8% in Rapide Vicryl and Vicryl groups, respectively; p = 0.002).Conclusions:The formation of niches and associated PMS rates were less with suture materials that were absorbed faster.
Fertility Outcomes of Patients with Early Stage Endometrial Carcinoma
(2014) Parlakgumus, Huriye Ayse; Kilicdag, Esra Bulgan; Simsek, Erhan; Haydardedeoglu, Bulent; Cok, Tayfun; Aytac, Pinar Caglar; Bagis, Tayfun; Erkanli, Serkan; https://orcid.org/0000-0002-0942-9108; https://orcid.org/0000-0003-1244-7419; 24033512; AAK-8872-2021; AAH-5686-2020; AAC-9940-2020
AimThree to five percent of endometrial carcinoma patients are younger than 40 years and may desire fertility. Conservative treatment can be employed in these cases. We aimed to review treatment outcomes of patients who were diagnosed with endometrial carcinoma and who wanted to preserve their fertility. Material and MethodsWe reviewed nine patients who were diagnosed with early stage endometrial carcinoma and wanted to spare their fertility. The patients were followed up at Baskent University Adana Research Center from January 2004 to December 2011. ResultsIn all patients the carcinoma presented as polyps, which were resected by hysteroscopy. After being informed about both surgical and medical therapies, four patients preferred surgery and five preferred medical treatment. The mean number of in vitro fertilization trials after conservative treatment was 3.25. One woman, who was on medroxyprogesterone acetate, delivered a healthy term baby from a fresh cycle. Another woman, who was on dydrogesterone, got pregnant from a thawing cycle, which later ended up in a missed abortus. Of all the patients who chose medical treatment, three had surgery at the end. One woman developed an ovarian tumor during the follow-up; one woman had a recurrence of endometrial carcinoma on dilatation and curettage for missed abortus and one woman tried in vitro fertilization several times and could not get pregnant, thus decided to have surgery. Two women had stage IA endometrial carcinoma and one had stage IIB ovarian carcinoma. ConclusionConservative treatment of endometrial carcinoma is safe in most cases. However, patients should be well-informed about the risks of conservative treatment because delaying definitive treatment sometimes worsens the prognosis.
First Trimester Maternal Lipid Levels and Serum Markers of Small-And Large-For-Gestational Age Infants
(2014) Parlakgumus, Huriye Ayse; Aytac, Pinar Caglar; Kalayc, Hakan; Tarim, Ebru; 23617575; AAC-9940-2020
Objective: To investigate if first trimester lipids, sonographic parameters and serum markers are related to small-and large-for-gestational age (SGA, LGA) infants. Methods: This study was conducted at Baskent University Adana Research Center between December 2009 and July 2011 and enrolled 433 women. Blood samples were drawn to measure fasting blood glucose, serum triglycerides, cholesterol, very low-density lipoprotein, low-density lipoprotein, high-density lipoprotein, f beta-hCG and pregnancy associated protein-A (PAPP-A) at the first trimester. Crown rump length and nuchal translucency were measured as suggested by the fetal medicine foundation. Results: LGA group was significantly taller (p = 0.016) and SGA group had significantly greater BMI (0.025). SGA fetuses were born at a significantly earlier gestational age (p = 0.001). Univariate analysis revealed that LGA group had significantly lower cholesterol (p = 0.038) and LDL levels (p = 0.041). PAPP-A was significantly lower in SGA Group compared with LGA Group (0.027). After controlling for age, parity, height, pre-pregnant BMI, weight gain during pregnancy and fasting blood sugar, none of the lipids, serum markers or sonographic parameters was related to LGA. PAPP-A was the only parameter significantly associated with SGA after multivariate analysis (p = 0.008). Conclusion: PAPP-A was significantly associated with SGA after controlling for confounders.
Luteal Phase Support After Mild Ovulation Induction with Intrauterine Insemination: An On-Going Debate
(2016) Aytac, Pinar Caglar; Bulgan Kilicdag, Esra; Haydardedeoglu, Bulent; Simsek, Erhan; Cok, Tayfun; Coban, Gonca; 0000-0002-3285-5519; 0000-0002-0942-9108; 0000-0003-1244-7419; 26850073; AAI-9974-2021; AAC-9940-2020; AAK-8872-2021; AAH-5686-2020
Objective: To evaluate the effect of luteal phase support (LPS) using progesterone vaginal gel on pregnancy rate (PR) and live birth rate (LBR) during cycles in which controlled ovarian stimulation (COH) was performed using gonadotropins with intrauterine insemination (IUI) cycles in patients with unexplained infertility and polycystic ovarian syndrome.Materials and methods: From 2010 to 2015, all IUI cycles in which COH was performed using gonadotropins were evaluated retrospectively. LPS was not used until July 2013, after which vaginal progesterone gel was applied in the luteal phase of IUI cycles. Both groups of patients were evaluated in terms of the effect of LPS on PR and LBR.Results: In total, 1578 IUI cycles were evaluated, of which 481 were LPS (+) and 1097 LPS (-). PR and LBR per cycle were 10.6% and 7.4%, respectively, in the LPS (+) group, and 11.6% and 7.7%, respectively, in the LPS (-) group (p=0.31 and p=0.25). PR and LBR per patient were 17% and 12%, respectively, in the LPS (+) group, and 17.4% and 12.3%, respectively, in the LPS (-) group (p=0.48 and p=0.82).Conclusions: We found no difference in PR and LBR per cycle and per patient according to the use of LPS in IUI cycles in which COH was performed using gonadotropins. Thus, routine use of LPS in gonadotropin-stimulated cycles requires further research involving larger numbers of patients.
Management of transient ejaculation failure due to erectile difficulties encountered on the oocyte retrieval day
(2020) Ozer, Cevahir; Goren, Mehmet Resit; Aytac, Pinar Caglar; 0000-0002-7850-6912; 0000-0002-2001-1386; 31350169; AAM-2222-2020; Y-6143-2019
Introduction: Transient ejaculation failure can be seen on the oocyte retrieval day which might cause the cancetation of oocyte retrieval procedure. The aim of this study was to evaluate the management of these patients and to assess the clinical outcome of intracytoptasmic sperm injection (ICSI) using spermatozoa obtained from them. Methods: The records of the oocyte pick-up (OPU) procedures between November 2014 and January 2017 were reviewed, the management and ICSI outcomes of 26 patients with transient ejaculation failure due to erectile difficulties on the oocyte retrieval day were evaluated. Results: Intracavemosat injection (ICI), percutaneous sperm aspiration (PESA) and microdissection testicular sperm extraction (micro-TESE) were performed to 15, 6 and 5 patients, respectively. The sperm retrieval rate (SRR) and live birth rate (LBR) of ICI, PESA and micro-TESE were 26%, 63.6% and 100% and 40%, 16.7%, 38.4% respectively. Conclusions: Although a limited number of cases were evaluated in this study, micro-TESE appears to be the preferable approach when assessed both in terms of sperm retrieval method success and ICSI results. (C) 2019 Asociacion Espanola de Andrologia, Medicina Sexual y Reproductiva. Published by Elsevier Espana, S.L.U. All rights reserved.
A novel approach for congenital absence of the uterine cervix: Office hysteroscopic versapoint canalization using real-time trans-abdominal sonography guidance
(2016) Haydardedeoglu, Bulent; Aytac, Pinar Caglar; 28913088
Herein, we report a novel technique for cervical agenesis via office hysteroscopy using Versapoint using real-time trans-abdominal sonography guidance. Fourteen days after the canalization procedure, a second hysteroscopy was performed to remove the silicone catheter and insert a Cupper T380a intrauterine device, which aimed to prevent a neocervical canal occlusion. This is the first case report of a patient with congenital cervical agenesis undergoing canalization with Versapoint in an office hysteroscopy; laparoscopy was not performed for assistance.
Outcome of intracytoplasmic sperm injection after preinstillation of a gonadotropin releasing hormone agonist in the uterine cavity just before embryo transfer
(2017) Aytac, Pinar Caglar; Haydardedeoglu, Bulent; Ozdemir, Halis; Kilicdag, Esra Bulgan; 0000-0002-9194-8504; 0000-0002-0942-9108; 28913141; AAC-9940-2020; AAF-1643-2020; AAK-8872-2021
Objective: To evaluate the effects of a gonadotropin releasing hormone agonist (GnRHa) injection prior to embryo transfer on implantation and pregnancy rate. Materials and Methods: We performed a retrospective analysis of patients undergoing in vitro fertilization (IVF) therapy with and without GnRHa preinstallation into the uterine cavity just before embryo transfer between January 2012 and March 2013 in a single IVF center of a university hospital. Patients were evaluated based upon implantation, pregnancy, live birth, and miscarriage rates. Results: GnRHa was injected into the uterine cavity of 108 patients prior to embryo transfer which were regarded as study group. One thousand forty-seven patients who were not injected GnRHa were regarded as the control group. Pregnancy rates were 44.4% and 41.7% in the GnRHa and control groups, respectively. Live birth rates were 27.8% and 26.1%, miscarriage rates were 15.7% and 15.7%, and implantation rates were 31% and 30%, respectively and there were no difference between groups statistically (p>0.05). Conclusion: No statistically significant differences in implantation, pregnancy, live birth, or miscarriage rates were observed in patients treated with GnRHa prior to embryo transfer, relative to the controls. Therefore, GnRHa injection into the uterine cavity prior to embryo transfer is not recommended as a means of increasing implantation or pregnancy rates in IVF. However, prospective randomized controlled studies are needed to clarify the effect of GnRHa instillation in the uterine cavity for embryo implantation in IVF.
Outcomes of nerve-sparing laparoscopic sacropexy on one hundred fifteen cases
(2020) Serbetcioglu, Gonca Coban; Simsek, Seda Yuksel; Alemdaroglu, Songul; Aytac, Pinar Caglar; Kalayci, Hakan; Celik, Husnu; 0000-0002-3285-5519; 0000-0003-4335-6659; 32474191; AAI-9974-2021; AAI-8400-2021; AAK-7016-2021
Study objective: To evaluate the postoperative anatomic and functional outcomes of patients who underwent laparoscopic nerve-sparing sacrocolpopexy or sacrocervicopexy for pelvic organ prolapse (POP) POP-Q stage III and IV apical prolapse, and to delineate the contributing factors for recurrence. Study Design and Classification: The file records of patients who underwent sacropexy in the last five years were reviewed retrospectively and compared in terms of preoperative and postoperative anatomic findings and symptoms. Patients: Patients who underwent laparoscopic nerve-sparing surgery for treatment of POP-Q Stage III and IV/prolapse of uterine or vaginal cuff were included. Interventions: Postoperative anatomic and functional outcomes were evaluated using POP-Q classification and urinary/anal function by questioning during visits. Results: The mean follow-up duration was 24.2 +/- 17.6 months. Anatomic recovery was achieved in 104 (90.4 %) cases. Advanced age (>= 70 years), longer duration of symptoms, and low body mass index were determined as parameters related to recurrence risk. (C) 2020 Elsevier Masson SAS. All rights reserved.
Reproductive outcomes of office hysteroscopic metroplasty in women with unexplained infertility with dysmorphic uterus
(2018) Haydedeoglu, Bulent; Durdag, Gulsen Dogan; Simsek, Seda; Aytac, Pinar Caglar; Cok, Tayfun; Kilicdag, Esra Bulgan; 30202621
Objective: The correlation between dysmorphic uterus and infertility still remains enigmatic. We evaluated the reproductive outcomes of metroplasty via office hysteroscopy in unexplained infertile women with dysmorphic uteri. Materials and Methods: In this retrospective cohort study, metroplasty via office hysteroscopy using a bipolar system was performed to 272 women with unexplained infertility with dysmorphic uteri from January 2013 to January 2016. Of all the patients, 162 had primary infertility, and 110 had secondary infertility. Results: In the primary infertility group, the clinical pregnancy rate was 45.68% (74/162) and the live birth rate was 38.9% (63/162), and in the secondary infertility group, the clinical pregnancy rate was 55.45% (61/110) and the live birth rate was 49% (54/110) after metroplasty. In the secondary infertility group, the miscarriage rate and especially the ectopic pregnancy rate declined dramatically [from 84.5% (93/110) to 9.8% (6/61) and from 15.5% (17/110) to 1.6% (1/61), respectively] (p<0.01). Conclusion: Reproductive outcome can be impaired by Mullerian anomalies, hence, infertile women with dysmorphic uteri should undergo hysteroscopy to improve reproductive outcomes. Our study demonstrated that office hysteroscopic metroplasty of a dysmorphic uterus might improve fertility, particularly in patients with unexplained infertility with dysmorphic uteri, which was an ignored factor previously. Office hysteroscopy is an alternative option in terms of non-invasive procedure.