Browsing by Author "Cok, Tayfun"

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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.
Comment on: A comparison of the effects of two suture materials on isthmocele formation: A cohort study
(2021) Cok, Tayfun; 34175472
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.
Is Primiparity A Risk Factor for Advanced Maternal Age Pregnancies?
(2017) Kalayci, Hakan; Ozdemir, Halis; Alkas, Didem; Cok, Tayfun; Tarim, Ebru; 0000-0003-1244-7419; 0000-0002-9194-8504; 27406982; AAH-5686-2020; AAF-1643-2020
Objective: Currently, more women are delaying childbearing until their 40s. This study compared the pregnancy and maternal features, pregnancy and foetal outcomes between multiparous and primiparous patients. We compared the same factors between assisted reproductive technology (ART) and non-ART primiparous patients because of the high proportion of ART used in the primiparous patients. Methods: The study retrospectively examined 1680 patients, 35 years of age and older, between March 2008 and February 2015. Results: Comparing the features of these two groups, there was an increased incidence of employment and the use of ART in primiparous patients, while birth weight tended to be higher in the multiparous group. There were no significant differences in pregnancy complications other than hypertension disorders, such as pre-eclampsia and HELLP syndrome, which were significantly more frequent in primiparous patients. The rates of foetal growth retardation and perinatal death were significantly higher in primiparous women. Comparison of the data between ART and non-ART primiparous patients indicated that the ART group had a higher initial body mass index and a lower smoking rate. No significant differences in pregnancy complications or foetal outcome were observed between these two groups. Conclusion: Primiparity is associated with increased pregnancy and foetal complications in advanced age pregnancies. However, the use of ART in this age group does not seem to be an additional risk factor.
Is the Presence of Corpus Callosum Predictable in the First Trimester?
(2018) Kalayci, Hakan; Tarim, Ebru; Ozdemir, Halis; Cok, Tayfun; Parlakgumus, Ayse; https://orcid.org/0000-0002-9194-8504; https://orcid.org/0000-0003-1244-7419; 29017365; AAF-1643-2020; AAH-5686-2020
Corpus callosum agenesis (CCA) is a clinical condition accompanied by various aneuploidy and genetic syndromes. We identified the development of the corpus callosum (CC) in 278 patients before 18weeks of gestational age by visualising the pericallosal artery (PCA) in the callosal sulcus and changes in the lengths and ratios of the midbrain (MB) and falx (F), which suggested elevation of the third ventricle and thalamus due to CCA in the first trimester. We succeeded in visualising the path of the PCA in 273 patients. As expected, we observed an increase in the lengths of the MB and F throughout the pregnancies. The MB:F ratio was 0.5-0.6, and it was independent of gestational age. In all 278 patients, the MB:F ratio was <0.6 (95th percentile=0.79). We observed the presence of the CC during anatomical screening at gestational weeks 18-24. Visualisation of the PCA path (98% sensitivity) and calculation of the MB:F ratio<95th percentile (0.79-100% sensitivity) had very high sensitivity that indirectly confirmed the presence of the CC in the first trimester of pregnancy.Impact statementWhat is already known on this subject: After reading the articles for detecting the absence of corpus callosum (CC) at first trimester with midbrain (MB) and falx (F) measurement by Lachmann etal. (2013) and visualising pericallosal artery (PCA) as an indirect sign of CC agenesis by Pati etal. (2012), we aimed to have a look for our records visualising PCA in callosal sulcus and measure MB-F, as well as their ratios for an indirect sign of presence' of CC at first trimester.What the results of this study add: In recent literature, it is not possible to find many articles suggesting the presence of CC between 11 and 13 weeks of gestation. Diaz-Guerrero etal. (2013) and Pati etal. (2012) has researched visualising PCA path. Lachmann etal. (2013) reported an article for MB and F measurements in early suspicion of CC agenesis. Our study will be the first article in visualising PCA path and measuring MB-F lengths as well as their ratios for presence' of CC with high sensitivity rates (98% and 100%).What are the implications of these findings for clinical practice and/or further research: This study encourages clinicians visualising PCA path and measure MB-F lengths when they will try to visualise repetitive times and see how it is an easy procedure when you get used to it.
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.
The Nomogram of Prenasal Thickness and Nasal Bone Ratio and Its Relationship with Nuchal Fold in Second-Trimester Fetal Ultrasound
(2018) Ozdemir, Halis; Kalayci, Hakan; Yetkinel, Selcuk; Cok, Tayfun; Coban, Gonca; Tarim, Ebru; 0000-0002-9194-8504; 0000-0002-2165-9168; 0000-0003-1244-7419; 0000-0002-3285-5519; 29570920; I-5479-2017; AAL-1530-2021; AAI-9974-2021
AimWe aimed to define the normal values of second-trimester fetal prenasal thickness and nasal bone length ratio (PNT/NBL) in a low-risk Turkish population and investigate the relationship between the increased PNT and nuchal fold (NF). MethodWe retrospectively reviewed the data of 650 cases considered to be euploid fetuses who presented to our clinic between December 2013 and September 2014 for a second-line ultrasound between 17 and 24 weeks. Their PNT, NBL, NF and biometric (BPD, HC, AC, FL and HL) measurements were recorded. ResultsA total of 650 cases considered to be euploid fetuses were included in this study. There was a linear increase in PNT with the gestational weeks (mean value 3.01 at weeks 17-18 and 3.76 at weeks 23-24). The PNT/NB ratio showed a slight decrease in advancing gestational weeks (mean value 0.57 at weeks 17-18 and 0.50 at weeks 23-24). The 95th percentile value of the PNT/NB ratio, independent of the gestational week, was 0.76. The values of both PNT and NF increased with advancing gestational weeks, but there was no statistically linear increase between PNT and NF (R-2: 0.115). ConclusionIn this study, we provided a nomogram of the PNT/NB ratio. Both NF thickness and PNT should be dealt with as two separate markers. Although the formation mechanisms are thought to be the same in both of them, a strong linear relationship does not exist between them.
Outcomes of Cesarean Scar Pregnancy Treatment: Do We Have Options?
(2021) Simsek, Seda Yuksel; Simsek, Erhan; Yaginc, Didem Alkas; Baran, Safak Yilmaz; Cok, Tayfun; Kilicdas, Esra Bulgan; 34082520
Objective: To investigate the success and complications of medical and surgical modalities used in the treatment of cesarean scar pregnancies. Materials and Methods: Medical and surgical approaches that have been used to treat cesarean scar pregnancies were evaluated retrospectively, Local, systemic, and combined methotrexate treatments were grouped as the medical approach, and dilatation and evacuation, hysteroscopic resection, laparoscopic and laparotomic approaches were grouped as the surgical approach. Fifty-three patients were diagnosed as having cesarean scar pregnancy during the study period, 48 of whom were included in the final analysis. Eighteen patients were treated with medical interventions and 30 patients were treated surgically. Results: The success rate of surgical modalities was 96.6% and the medical treatment success was 33% (p<0.001). The complication rate was higher with medical approaches compared with surgical methods (66% vs 3.3%, respectively; p<0.001). Conclusion: Surgical intervention seems safer and more successful than medical treatment.
Prospective randomized controlled study of a microfluidic chip technology for sperm selection in male infertility patients
(2022) Aydin, Sirin; Bulgan Kilicdag, Esra; Caglar Aytac, Pinar; Cok, Tayfun; Simsek, Erhan; Haydardedeoglu, Bulent; https://orcid.org/0000-0001-6176-925X; 35263457; ADR-0014-2022
The purpose of this study is to evaluate the impact of a microfluidic approach for spermatozoon selection in male infertility patients undergoing intracytoplasmic sperm injection (ICSI). This research enrolled 128 individuals who had ICSI for male-factor infertility. The patients were separated into two groups according to the method used to pick the spermatozoa: group I (n = 64), which used traditional swim-up procedures, and group II (n = 64), which used the Fertile Chip for spermatozoon selection during ICSI therapy. Fertilization rates and embryo quality were the major outcomes. The rates of pregnancy, clinical pregnancy and live birth were used as secondary outcomes. As a result, there was no statistically significant difference between the two groups in terms of fertilization rate, total grade 1 and 2 embryos. Implantation rate was significantly higher in the Fertile Chip group than in the control group (50% vs. 31%, p = 0.02). The Fertile Chip group had considerably greater pregnancy rates, clinical pregnancy rates (CPR) and live birth rates than the control group (62.5% vs. 45.3%, p = 0.038; 59.4% vs. 35.9%, p = 0.006 and 46.8% vs. 25%, p = 0.009). Fertile Chip had no effect on fertilization rates or embryo quality in male-factor infertility couples. However, the Fertile Chip group had a statistically higher pregnancy rate, CPR and live birth rate.
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.
Rescue Vaginal Cerclage to Stop Funneling Following Laparoscopic Cerclage
(2021) Cok, Tayfun; 0000-0003-1244-7419; 34784638
Septate Uterus. Resect or not? That is Not the Only Question
(2022) Cok, Tayfun; 0000-0003-1244-7419; 36037812
Single- or double-layer uterine closure techniques following cesarean: A randomized trial
(2020) Yilmaz Baran, Safak; Kalayci, Hakan; Dogan Durdag, Gulsen; Yetkinel, Selcuk; Alemdaroglu, Songul; Cok, Tayfun; Bulgan Kilicdag, Esra; 0000-0002-5064-5267; 0000-0002-2165-9168; 0000-0003-4335-6659; 0000-0002-0942-9108; 0000-0002-7854-2921; 0000-0001-5874-7324; 33029804; AAI-9594-2021; AAL-1530-2021; AAI-8400-2021; AAK-8872-2021; A-8208-2008; ABF-6439-2020
Introduction Cesarean deliveries are commonly performed throughout the world. Although the uterine closure technique following this procedure may influence how the uterine scar heals, there is insufficient evidence for choosing the appropriate technique and so preventing long-term negative consequences. This prospective, randomized study examined the effects of single- and double-layer uterine closure techniques on uterine scar healing following cesarean delivery. Material and methods This study assessed a total of 282 women aged 18-45 years who were in gestational weeks 24-41 of singleton pregnancies. None had previously undergone uterine surgeries. These participants completed their first cesarean deliveries at the time of study and were randomized into the following two treatment groups: single-layer closure with locking and double-layer closure with locking in the first layer, but not in the second layer (NCT03629028). However, the decidua was not included for treatment in either group. Participants were evaluated at 6-9 months after cesarean section by saline infusion sonohysterography to assess cesarean delivery scar defects. These procedures were conducted by experienced sonographers who were not aware of the uterine closure technique. Results Of the 225 final participants, 109 received the single-layer closure technique, whereas 116 received the double-layer technique. The niche rates were 37% (n = 40) for the single-layer group and 45.7% (n = 53) for the double-layer group (P = .22, relative risk 1.4, 95% CI = 0.8-4.4). Conclusions The single- and double-layer closure techniques did not produce different impacts on uterine scar niche development.
Transvaginal Ultrasound-Guided Local Methotrexate Administration as the First-Line Treatment for Cesarean Scar Pregnancy: Follow-Up of 18 Cases
(2015) Cok, Tayfun; Kalayci, Hakan; Ozdemir, Halis; Haydardedeoglu, Bulent; Parlakgumus, Ayse H.; Tarim, Ebru; 0000-0002-9194-8504; 0000-0002-9194-8504; 0000-0003-1244-7419; 25491022; I-5479-2017; AAH-5686-2020; AAF-1643-2020
Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy, which occurs in previous cesarean section scar tissue, with an incidence of 1 in 1800-3000 pregnancies. Transvaginal ultrasound-guided local methotrexate (MTX) administration presents as a non-systemic option with possible better penetration to the pregnancy site. We present the management of 18 patients with CSP solely by transvaginal ultrasound-guided local MTX administration. All patients were treated with local MTX with a dose of 50mg/m(2). Eleven (61.1%) of the patients did not need any further intervention. Four patients (22.2%) were treated with additional single-dose systemic MTX due to inadequate alteration in blood -human chorionic gonadotrophin levels. Three patients (16.7%) required hysteroscopy and/or laparotomy. We suggest that transvaginal ultrasound-guided local MTX treatment may be considered as a first-line treatment for CSP.
What if all the Follicles were already Ruptured at the Time of Oocyte Pick-up in an IVF/ICSI Cycle?
(2022) Cok, Tayfun; 0000-0003-1244-7419; 35760360