Browsing by Author "Gulerman, Hacer Cavidan"

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Evaluation of bone mineral density and its associated factors in postpartum women
(2019) Eroglu, Semra; Karatas, Gulsah; Aziz, Vusale; Gursoy, Aybala Fatma; Ozel, Sule; Gulerman, Hacer Cavidan; 31759531; AAD-8353-2020
Objective: Although osteoporosis commonly appears among postmenopausal women, it is rarely diagnosed during the postpartum period as pregnancy-lactation associated osteoporosis (PAO). The aim of the study reported here was to investigate low bone mineral density and its associated risk factors in postpartum women. Materials and methods: The sample consisted of 93 females aged 18-40 years and in the first month of the postpartum period. All the women had low back pain. The bone mineral density (BMD) Z-score values of the lumbar vertebrae, femur (neck and total) were examined using dual energy x-ray absorbtiometry four weeks after birth. Patients body mass index (BMI), 25-hydroxyvitaminD (25-OHD) levels and complete blood counts were recorded. Participants were divided into two groups to their Z scores: the normal group (n = 71) and the low BMD group (n = 22). Results: The 25-OHD levels were significantly lower (p = .02) in the low BMD group [4.45 (4.0-12.4)] than in the control group [22 (12-48)], however, NLR and PLR values were similar between groups. BMI positively correlated with BMD scores for the lumbar, femoral neck and femoral overall (p = .011, p = .026 and p = .026, respectively). Conclusion: Vitamin D deficiency and BMI may play a critical role in PAO. Low back pain during postpartum period should be carefully evaluated. Adequate calcium and vitamin D supplementation may prevent possible bone loss. (C) 2019 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V.
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.
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)