Browsing by Author "Ceran, Mehmet Ufuk"

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Can complete blood count inflammatory parameters in epithelial ovarian cancer contribute to prognosis? - a survival analysis
(2019) Ceran, Mehmet Ufuk; Tasdemir, Umit; Colak, Eser; Gungor, Tayfun; 0000-0003-1923-2373; 0000-0002-8184-7531; 30744662
SubjectiveThe aim of the present study was to investigate the prognostic significance of preoperative complete blood count inflammatory markers in women operated for invasive Epithelial Ovarian Cancer (EOC).MethodTwo hundred forty four patients that underwent operation with the diagnosis of invasive EOC between 2006 and 2014 were included in the study. The date of operation, date of recurrence and final mortality evaluations were performed for survival analysis. The sensitivity, specificity, PPV and NPV were separately calculated with ROC analysis. Survival analysis was carried out with Kaplan Meier-Log Rank Method.ResultsFive-years overall survival rate was 56, 9% and 5-year disease-free survival (DFS) rate was 45,5%. Advanced disease stage, moderate-poor tumor differentiation, and the presence of recurrence were determined to have significant inverse relation at mean survival and 5-year survival rates. Neutrophil/lymphocyte ratio (NLR) and Platelet lymphocyte ratio (PLR) had prognostic effect on both DFS and overall survival based upon the cut-off values determined in the study (PLR=231, s36, NLR=3,83). Histopathological subtypes were not found to have any prognostic value. In correlation analysis, PLR and NLR had positive correlation with each other and negative correlation with overall survival.ConclusionsInflammatory markers such as NLR and PLR have independent prognostic value for women who undergo surgery for invasive EOC.
Does endometrioma surgery affect assisted reproductive technologies cycle outcome in patients with decreased ovarian reserve diagnosed by Bologna criteria?
(2021) Kahyaoglu, Inci; Gulerman, Cavidan; Yilmaz, Nafiye; Ceran, Mehmet Ufuk; Ozgu Erdinc, Ayse Seval; Kahyaoglu, Serkan; Bardakci, Yesim; Engin Ustun, Yaprak; 0000-0003-1923-2373; AAZ-4863-2021
Objectives: Data regarding whether the assisted reproductive technologies (ART) outcome of patients with decreased ovarian reserve (DOR) secondary to an endometrioma surgery differs from that of patients with DOR secondary to other etiologies is limited. The aim of this study was to compare the ART outcomes of DOR patients diagnosed by Bologna criteria secondary to a previous endometrioma surgery with DOR patients without a history of an endometrioma surgery. Methods: This retrospective cohort study was conducted in the assisted reproduction unit of a tertiary research and education hospital. Medical records of the patients with DOR were reviewed retrospectively. Group I included 23 cycles of DOR patients secondary to a previous endometrioma surgery and Group II consisted of 260 cycles of DOR patients without a history of endometrioma surgery. Results: No significant difference was demonstrated between groups regarding demographic features except for the age (32 (24-41) in Group I vs 35 (23-47) in Group II, p = 0.031). The data comparing the controlled ovarian stimulation parameters and ART outcomes showed similar results in both groups. No statistically significant difference was found between groups regarding pregnancy rates per transfer (23% vs 22.2 %) and per cycle (13% vs 15.4%) (p > 0.05). Conclusion: Cycle outcomes of DOR patients secondary to an endometrioma surgery did not differ from that of DOR without an endometrioma surgery history.
Evaluation of the tear parameters of ovulation induction patients in a short time period with anterior segment optical coherence tomography
(2020) Colak, Eser; Ulusoy, Mahmut Oguz; Ceran, Mehmet Ufuk; Tasdemir, Umit; Kal, Ali; Ozcimen, Emel Ebru; 33470279
Purpose: The effects of sex steroid hormones on tearparameters are known. Theaim of this studywas to examine the effects on tear parameters during exposure to high-dose sex steroids in a short period of time. Methods: Forty patients who were admitted to the infertility clinic of our hospital and planned to undergo ovulation induction with exogenous gonadotropins were included in our study. Prior tothe initiation of ovulation induction, the basal levels of estradiol were measured on day 3 of the menstrual cycle and ophthalmologic examinations were performed by the ophthalmology department of our hospital. The estradiol levels were-measured on the day ofovulation induction usinghuman chorionic gonadotropin and compared with basal estradiol; eye examinations were also repeated. Result: Forty women with reproductive period and average age of 33.3 +/- 4.2 years were included in this study. Basal levels of estradiol were significantly (p<0.001) higher after ovulation induction than before induction. The scores in the break-up timeand after induction were 6.2 +/- 2.8 sn and 8.4 +/- 1.4 sn, respectively. The values of Schirmer's test were 14.3 +/- 7.1 mm and 20.6 +/- 6.2 mm before and after induction, respectively. Both values were significantly higher after ovulation induction (p<0.001; p=0.001, respectively). Conclusion: We observed improvemet in tear function tests following the use of estradiol even for a limited time .The use of estradiol during menopause may improve dry eye symptoms in patients.
GnRH agonist versus HCG triggering in different IVF/ICSI cycles of same patients: a retrospective study
(2019) Yilmaz, Nafiye; Ceran, Mehmet Ufuk; Ugurlu, Evin Nil; Gulerman, Hacer Cavidan; Engin Ustun, Yaprak; 0000-0003-1923-2373; 31791167
The aim of this study was to assess Gonadotropin Releasing Hormone agonist (GnRHa) trigger results of fresh in vitro fertilisation (IVF), Intracytoplasmic Sperm Injection (ICSI) cycles in high-responder patients. Thirty-six high-responder patients, undergoing GnRH antagonist protocol combined with GnRHa trigger for final oocyte maturation, were included. All cycles were autologous fresh transfer cycles. Fifteen of 36 patients had previous IVF/ICSI cycles triggered with human chorionic gonadotropin (hCG) and both cycles of these patients were compared. The mean fertilisation rate, blastocyst development and clinical pregnancy rates were 67%, 44.4% and 44.4%, respectively. The hCG and GnRHa trigger cycles of the same patients were compared as two groups (n: 15). 2PN oocyte counts were significantly higher in agonist trigger cycles (p .048). There were no differences in terms of M2 oocyte count and fertilisation rate. The blastocyst formation and clinical pregnancy rates for hCG and GnRHa trigger cycles were 33.3-66.7% and 13.3-46.7%, respectively. These results were found to be 2-fold and 3.5-fold higher, but not statistically significant. GnRHa trigger in combination with LPS is a good option for final oocyte maturation due to its good pregnancy outcomes and virtually eliminating OHSS risks.IMPACT STATEMENT What is already known on this subject? Gonadotrophin releasing hormone agonist (GnRHa) trigger is effective in the induction of oocyte maturation and prevention of Ovarian Hyperstimulation Syndrome (OHSS) on IVF cycles using antagonist protocol. What do the results of this study add? The main strength of this study is the comparison of different triggers in different cycles of the same patients. GnRHa trigger in combination with Luteal Phase Support (LPS) is a good option for final oocyte maturation due to its good pregnancy outcomes and virtually eliminating OHSS risks.
Impact of endometrioma and bilaterality on IVF / ICSI cycles in patients with endometriosis
(2021) Yilmaz, Nafiye; Ceran, Mehmet Ufuk; Ugurlu, Evin Nil; Gulerman, Hacer Cavidan; Ustun, Yaprak Engin; 0000-0003-1923-2373; 32619727; AAZ-4863-2021
Aim: Endometriosis, one of the most common gynecological disorder, is a challenging disease observed in 20 %-40 % of subfertile women. Endometriomas affect 17-44 % of women with endometriosis. Because endometrioma has detrimental effects on fertility, many of these women need Assisted Reproductive Technology (ART) to conceive. In this study, we aimed to investigate the effects of endometrioma presence and impact of bilaterality over In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI) outcomes. Method: The study was designed retrospectively. A total of 159 women enrolled in IVF / ICSI cycles were included. Patients were divided into two groups as Endometrioma group (n: 73) and control group (n:86). In Endometrioma group, subgroup analysis was performed according to whether endometrioma was unilateral or bilateral. Demographic characters, clinical and laboratory parameters were recorded. SPSS was used for analysis. Results: In endometrioma group, although basal FSH levels was higher than control group, it was within normal limits, while estradiol levels was lower (p < 0.001, p 0.042, respectively). Antral follicle count (AFC), dominant follicle number, total oocyte count, MII oocyte numbers were found to be significantly lower, whereas numbers of embryos achieved, clinical pregnancy rates (PR) and live birth rates (LBR) were found to be similar.There were no statistically significant differences in terms of Antimullerian Hormon (AMH) levels, oocyte and embryo quality, the numbers of embryos achieved, PR and LBR between unilateral and bilateral endometrioma groups. Conclusion: This study shows that presence of endometrioma negatively effects fertility parameters albeit no significant effect over embryo quality, PR and LBR whereas bilaterality doesn't have any influence over any fertility parameters and PR. (c) 2020 Elsevier Masson SAS. All rights reserved.
Incidence of unexpected leiomyosarcoma in a Turkish province: a retrospective multi-centre study in a low income setting
(2022) Tasdemir, Umit; Ceran, Mehmet Ufuk; Dirican, Aylin Onder; Akar, Serra; Celik, Cetin; Energin, Hasan; Gorkemli, Huseyin; Mammadova, Narmin; Colak, Eser; Ayhan, Ali; 0000-0003-1923-2373; 0000-0002-8184-7531; 35253591
The aim of the current study was to estimate the incidence of unexpected leiomyosarcoma (LMS) in patients who underwent surgery due to leiomyomas in Konya province, and to contribute to the literature discussing comparisons with similar studies. The digital archives of eight high-volume hospitals were studied for surgeries performed due to leiomyomas between January 2012 and January 2019, and leiomyosarcoma incidence was calculated based on the data obtained. Twenty-one patients in 3703 cases were found to have unexpected leiomyosarcoma, which means we can expect one leiomyosarcoma in 176 (0.56%) surgeries. Six more malignant tumours were detected among the remaining cases. Thus, our study estimated the incidence of unexpected leiomyosarcoma as 1/176 (0.56%), which is higher than most of the studies in the literature justifying the debate started by the FDA in 2014. As the tumour biology is not yet clear, and the incidence of unexpected leiomyosarcoma tends to be so high, the key focus must be to try to detect uterine leiomyosarcomas preoperatively for robust patient care.IMPACT STATEMENT What is already known on this subject? The incidence of unexpected leiomyosarcoma varies widely from 1/498 to 1/8300 depending on the study method and the type of procedure, and there is still controversy, even after the FDA statement that led to a major restriction in laparoscopic surgeries due to concerns about inadvertent morcellation of leiomyosarcomas. What do the results of this study add? To the best of our knowledge, the current study found the highest incidence of unexpected leiomyosarcoma, and consequently a serious evaluation of all patients undergoing surgery due to leiomyomas preoperatively considering a leiomyosarcoma candidate is recommended. What are the implications of these findings for clinical practice and/or further research? Studies on tumour biology and novel markers must be supported for accurate preoperative diagnosis of leiomyosarcoma.
May myo-inositol andd-chiro-inositol (40:1) treatment be a good option on normal-weighted polycystic ovary syndrome patients without insulin resistance?
(2020) Colak, Eser; Ozcimen, Emel Ebru; Tohma, Yusuf Aytac; Ceran, Mehmet Ufuk; 0000-0002-8184-7531; 32989863
Aim To investigate the effectiveness of myo-inositol andd-chiro-inositol (MI:DCI) (40:1) treatment in normal-weight polycystic ovary syndrome (PCOS) patients without insulin resistance. Methods This retrospective case-control study included PCOS patients without insulin resistance who were diagnosed in the gynecology and obstetrics clinic of Baskent University Konya Practice and Research Hospital between January 2016 and October 2019 and received at least 6 months of MI:DCI (40:1) treatment. The patients were divided into two groups according to body mass index (BMI). Twenty-nine anovulatory patients without insulin resistance with a BMI of 18-25 were included in group 1 (normal-weight group), whereas 17 patients without insulin resistance with BMI > 25 were included in group 2 (obese/overweight group). Ovulation status of both groups was compared after MI:DCI treatment. Results Ovulation was detected in 23 of 29 patients in the normal-weight group, whereas it was detected only in 5 of 17 patients in the obese/overweight group; this difference was statistically significant (P < 0.001) (Table 2, Figure 1). Post-treatment progesterone levels of both groups were compared and in the normal-weight PCOS group was significantly higher than the obese/overweight group (P < 0.001) (Table 2, Figure 2). In addition, spontaneous pregnancy following treatment was observed in six of the seven (85.7%) patients in the normal-weight group who wanted to conceive, whereas it was observed in only two of the six (33.3%) patients in the obese/overweight group who wanted to conceive. Conclusion Our results showed that MI:DCI (40:1) treatment may be a first-line treatment in normal-weight PCOS patients without insulin resistance.
The role of FSH to AMH ratio in poor prognosis patients undergoing ICSI cycle
(2022) Gozukara, Ilay; Yilmaz, Nafiye; Ceran, Mehmet Ufuk; Atalay, Ece; Kahyaoglu, Inci; Gulerman, Hacer Cavidan; Engin-Ustun, Yaprak; https://orcid.org/0000-0003-1923-2373; 35263958
Objective: The objective of this study was to estimate the number of oocyte retrieval and cycle cancellation using follicle stimulating hormone (FSH) to anti-Mullerian hormone (AMH) ratio in poor prognosis patients undergoing intracytoplasmic sperm injection treatment.Material and Methods: This retrospective study including fresh cycles was conducted in Zekai Tahir Burak Women's Health Training and Research Hospital, between January 2015 and October 2018. Women aged between 24 and 44 years were recruited and the baseline serum hormone levels, FSH/AMH ratio, and the antral follicle count were recorded. Number of retrieved oocytes, metaphase-II oocytes, fertilised oocytes, and the number and grade of the embryos were also recorded.Results: A total of 108 cycles, corresponding to 92 women with poor prognosis were eligible for analysis. The use of FSH/AMH ratio performed well in predicting retrieved oocyte count <5 with an area under the curve (AUC) of 0.82 [95% confidence interval (CI): 0.71-0.92]. A FSH/AMH ratio cut-off of 11.36 was set for the retrieval of <5 oocyte at oocyte pick-up (OPU) with 80% sensitivity and 87% specificity. The FSH/AMH cut-off value was 14.22 to differentiate cycle cancellation and no oocyte retrieval at OPU, with a sensitivity of 91% and a specificity of 44% (AUC of 0.71; 95% CI: 0.59-0.83). There was no correlation between FSH/AMH ratio and clinical pregnancy. Conclusion: The assessment of this simple ratio at the beginning of the cycle may help clinicians better anticipate gonadotropin stimulation treatment and better counsel patients about cycle cancellation and the expected oocyte yield. (J Turk Ger Gynecol Assoc 2022; 23: 184-9)
Role of mean platelet volume in pregnancy to predict gestational diabetes mellitus in the first trimester
(2020) Colak, Eser; Ozcimen, Emel Ebru; Ceran, Mehmet Ufuk; Tohma, Yusuf Aytac; Kulaksizoglu, Sevsen; 0000-0001-9418-4733; 0000-0002-7613-2240; 0000-0003-1923-2373; 0000-0002-8184-7531; 30947572; AAE-6482-2021; AAI-8932-2021
Objectives:Gestational diabetes mellitus (GDM) is defined as glucose intolerance detected for the first time in pregnancy or identified during pregnancy. Mean platelet volume (MPV) is a marker of activation and function of platelet. Several studies investigated the relation between MPV and GDM. The purpose of the present study is to predict GDM in the first trimester by using MPV value. Materials and methods:Two hundred pregnant women with GDM and 200 normal pregnant women were enrolled in the study. The first trimester MPV values of GDM and control groups were compared to predict GDM in the first trimester. Results:Women with GDM had higher MPV value compared with the control group (p < .001). The area under the receiver-operator curve was 0.70 for MPV. The cutoff value of MPV was 7.38 fl with 70% sensitivity and 60% specificity. According to the ages, MPV value was higher in GDM group in the individuals who were above 28-year-old (p < .001). Conclusion:MPV can be used to predict GDM in the first trimester.
Serum and placental periostin levels in women with early pregnancy loss
(2020) Eroglu, Semra; Colak, Eser; Erinanc, Ozgur Hilal; Ozdemir, Duygu; Ceran, Mehmet Ufuk; Tasdemir, Umit; Kulaksizoglu, Sevsen; Ozcimen, Emel Ebru; 0000-0003-1401-6356; 0000-0002-7613-2240; 0000-0002-9959-9433; 32460058; AAL-1268-2021; AAI-8932-2021
Objectives: Periostin is secreted from the placenta in the embryonic period and it is emphasized that it may be involved in endometrial implantation. In this study, we aimed to investigate periostin serum levels and placental tissue expression in first trimester pregnancy losses. Study design: In this prospective case-control study, 30 patients who underwent dilatation and curettage with first trimester spontaneous abortion (< 10 weeks of gestation) were included in the study group and 30 patients who had voluntary pregnancy termination (< 10 gestational weeks) were included in the control group. Serum samples collected from the study and control groups were analyzed usingenzyme-linkedimmunosorbent assay (ELISA), and trophoblastic and decidual tissues were examined using immunohistochemical staining with streptavidin-biotin-peroxidase techniques. Results: There were no significant differences between the groups in terms of age, gravida status, parity number, gestational week, and number of previous abortions. In the spontaneous abortion group, the serum level of periostin was significantly lower than in the voluntary termination group (6.56 +/- 4.16 pg/mLvs. 9.51 +/- 4.52 pg/mL, p = 0.03). There was no significant difference between the two groups in terms of periostin expression in decidual and trophoblastic tissue (p = 0.617, p = 0.274, p = 0.497). Conclusion: Periostin serum levels were significantly reduced in patients with spontaneous pregnancy loss. Periostin can be used as a predictive marker for the success of endometrial implantation.
Serum endocan levels in fresh IVF/ICSI cycles in women with endometriosis: a comparative prospective study
(2022) Ceran, Mehmet Ufuk; Yilmaz, Nafiye; Colak, Eser; Bayraktar, Nilufer; Tohma, Yusuf Aytac; Zeyneloglu, Hulusi Bulent
Background: The current study tested the level of endocan, which is thought to have an effective role in both endothelial dysfunction and inflammation, in infertile women with endometriosis treated with in vitro fertilizationlintracytoplasmic sperm injection (IVF/ICSI). It is based on the hypothesis of chronic inflammation in the pathophysiology of endometriosis. Methods: This prospective case control study included a total of 64 women who were in the IVF/ICSI program. The women were divided into two groups: endometriosis (n = 32) and non-endometriosis (n = 32). Their baseline characteristics, stimulation parameters, and IVF/ICSI outcomes (clinical pregnancy and live birth rates) were recorded. Blood samples collected at the beginning of the IVE cycle for endocan levels were analyzed with a sandwich enzyme immunoassay and the results were documented. Results: The endocan levels in the endometriosis group were significantly higher than those in the non-endometriosis group, i.e., 5010 pg/mL and 2738 pg/mL, respectively (p < 0.05). A significant weakly positive correlation was found between endocan levels and the presence of endometriosis (p < 0.05, r: 0.284). The cut-off value for endometriosis was determined as 4693 pg/mL with a sensitivity of 53.13% and a specificity of 78.12%. Clinical pregnancy was insignificantly higher in the non-endometriosis group (p = 0.079). However, live birth rates were significantly higher in the non-endometriosis group (p < 0.05). No correlation was found between clinical pregnancy and live birth rate and endocan levels (p > 0.05). Conclusion: High endocan levels were detected in women who underwent IVF/ICSI treatment for endometriosis and infertility and there was a positive correlation between them. However, there was no relationship between endocan levels and IVF/ICSI outcomes.
Vaginal Micronized Progesterone in Treating Endometrial Hyperplasia Without Atypia
(2023) Dirican, Aylin Onder; Ceran, Mehmet Ufuk; HLH-2781-2023
Aim: In this study, we aimed to evaluate the efficacy of vaginal micronized progesterone (VMP) therapy in the treatment of endometrial hyperplasia without atypia by comparing it with levonorgestrel intrauterine device (LNG-IUD) therapy. Material and Methods: This retrospective study included 133 premenopausal females with endometrial hyperplasia without atypia. The patients were divided into two groups according to VMP (n = 68, 200 mg once a day, 10 days/cycle) and LNG-IUD (n = 65) treatments. The groups were compared in terms of endometrial thickness measurements, endometrial sampling results, and hemoglobin (Hb) and hematocrit (Hct) values before and after treatment. Results: Regression rates (90.8% with LNG-IUS vs. 88.2% with VMP; p = 0.601) and endometrial thickness values (4.5 mm with LNG-IUS, 5 mm with VMP, p = 0.382) were similar between the groups. A significant increase was observed in the VMP group in terms of blood parameters (Hb, Hct) after treatment (p < 0.05). Discussion: VMP is as effective as LNG-IUD in treating hyperplasia without atypia.