Browsing by Author "Gurbuz, Ali Sami"

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    Absence of Luteal Phase Defect and Spontaneous Pregnancy in IVF Patients Despite Gnrh-Agonist Trigger and "Freeze All Policy'' without Luteal Phase Support: A Report Of Four Cases
    (2016) Gurbuz, Ali Sami; Deveer, Ruya; Ozcimen, Necati; Ozcimen, Emel Ebru; Lawrenz, Barbara; Banker, Manish; Antonio Garcia-Velasco, Juan; Fatemi, Human Mousavi; 26487486
    Human chorionic gonadotropin (hCG) is commonly used for final oocyte maturation in in vitro fertilization (IVF)-treatment cycles, however, the main important risk is development of severe ovarian hyperstimulation syndrome (OHSS). OHSS can almost be avoided by using gonadotrophin-releasing-hormone agonist for final oocyte maturation in an antagonist protocol. However, primarily this approach lead to a very poor reproductive outcome, despite the use of a standard luteal phase support. The reason seems to be severe luteolysis. Obviously, luteolysis post-gonadotropin-releasing-hormone-agonist (post-GnRH-a) trigger is individual specific, and not all patients will develop a complete luteolysis, as expected previously. Luteolysis can been reverted by the administration of hCG. Unprotected intercourse around the time of ovulation induction and oocyte retrieval can lead to a spontaneous conception in IVF treatment and, endogenous hCG, produced by the trophoblast, will rescue the corpora lutea. Therefore, one should not rely on complete luteolysis after GnRH-a triggering and, especially patients for egg donation and pre-implantation-genetic diagnosis for single gene disorder, have to be counselled to avoid unprotected intercourse.
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    GnRH agonist triggering affects the kinetics of embryo development: a comparative study
    (2016) Gurbuz, Ali Sami; Gode, Funda; Uzman, Mehmet Sukru; Ince, Betul; Kaya, Melek; Ozcimen, Necati; Ozcimen, Emel Ebru; Acar, Ali; 27059823
    Background: To evaluate the effects of an ovulation triggering agent, human chorionic gonadotropin (hCG), versus a gonadotropin-releasing hormone agonist (GnRHa) on early embryo development in vitro using a time-lapse system. Methods: Retrospective analysis of a prospectively collected database. A total of 739 embryos from 152 infertile couples undergoing intracytoplasmic sperm injection cycles. Interventions : Embryo culture in a time-lapse incubator (EmbryoScope, Vitrolife, Goteborg, Sweden). Main Outcome Measures: Embryo morphokinetic parameters. Results: In the 152 women, 252 embryos were derived from GnRHa-triggered cycles compared with 487 embryos derived from hCG-triggered cycles. Time-lapse analysis revealed that embryos from cycles triggered by a GnRHa cleaved faster than embryos derived from hCG-triggered cycles. Conclusion: Triggering with a GnRHa in in vitro fertilization cycles affects embryo kinetics.