Browsing by Author "Haydardedeoglu, Bulent"

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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.
The combination of dehydroepiandrosterone, transdermal testosterone, and growth hormone as an adjuvant therapy in assisted reproductive technology cycles in patients aged below 40 years with diminished ovarian reserve
(2015) Haydardedeoglu, Bulent; Isik, Ahmet Zeki; Kilicdag, Esra Bulgan; 28913044
Objective: To evaluate to the efficacy of testosterone, dehydroepiandrosterone (DHEA) and growth hormone (GH) supplementations in patients with diminished ovarian reserve (DOR) in assisted reproductive technology (ART) cycles. Materials and Methods: A retrospective cohort including 33 women with 81 ART cycles were aged and ovarian reserve matched 52 women with 102 conventional in vitro fertilization (IVF)/intra-cytoplasmic sperm injection (ICSI) protocol. Administration of DHEA for 12 weeks and transdermal testosterone for 4 weeks as pretreatment adjuvant and luteal start GH in DOR patient treatment arm compared to conventional IVF/ICSI cycles. Results: The number of follicles > 14 mm, number of oocytes, number of metaphase 2 oocytes and fertilisation rate were significantly higher in ISIK protocol (IP). The clinical pregnancy rate (CPR) per embryo transfer of the IP was 38.2% (13/34). The cancellation rate of cycles decreased significantly from 54.5 % (24/44) to 8.1% (3/37) with the IP, while the OPR was 35.3% (12/34). Conclusions: Our study has shown that even the poorest responders could achieve clinical pregnancy after inducing ovarian folliculogenesis with a combination of transdermal testosterone, DHEA.
Direct aspiration versus follicular flushing in poor responders undergoing intracytoplasmic sperm injection: a randomised controlled trial
(2017) Haydardedeoglu, Bulent; Gjemalaj, F.; Aytac, P.C.; Kilicdag, E.B.; 0000-0002-0942-9108; 28276148; AAC-9940-2020; AAK-8872-2021
Objective To compare follicle flushing three times with direct follicular aspiration in poor responders. Our hypothesis was that follicle flushing three times in poor responders would result in similar oocyte yield compared with direct aspiration in poor responders. Design A randomised controlled trial performed between January 2015 and June 2015. Setting University hospital. Population or sample Eighty eligible poor responders, who were defined as having five or fewer follicles >= 13 mm in average diameter with at least two follicles having maximum diameters >17 mm on the day of human chorionic gonadotrophin administration. Monofollicular cycles, including natural cycles, were excluded from the current trial. Methods In the double-lumen needle group, oocyte retrieval was performed by flushing three times with 2 ml in each follicle and in the single-lumen group direct follicle aspiration was performed. Main outcome measure Number of metaphase II oocytes retrieved. Results The mean number of metaphase II oocytes was similar in both groups (1.9 +/- 0.1 versus 2.1 +/- 0.1, respectively). The clinical pregnancy and live birth rates were similar in both groups (32.5% versus 25% and 25% versus 22.5%, respectively). The only significant difference between the two groups was the duration of oocyte retrieval (178.4 +/- 13.4 versus 236.3 +/- 24.1seconds, respectively, P = 0.01). Conclusion Follicular flushing is time consuming and has similar results compared with direct follicle aspiration in poor responders.
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.
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.
GNRH Agonists and Antagonists in Rescue for Cyclophosphamide-Induced Ovarian Damage: Friend or Foe?
(2015) Parlakgumus, Huriye A.; Kilicdag, Esra B.; Bolat, Filiz A.; Haydardedeoglu, Bulent; Parlakgumus, Alper; 0000-0002-0942-9108; 0000-0003-2031-7374; 25472738; AAK-8872-2021; HJZ-1654-2023
To find out if GnRH agonist (GnRHa) and GnRH antagonist (GnRHant) offer ovarian protection from cyclophosphamide (Cyc) and if AMH expression is affected. This experimental study was conducted in Baskent University Animal research laboratory and 66 virgin Wistar albino rats were assigned to six groups. The control group received intraperitoneal saline injection. The GnRHa group had a single dose of leuprolide acetate (1 mg/kg) 28 days prior to saline injection. The GnRHant group had a single dose of cetrorelix acetate (0.1 mg/kg) 1 h prior to saline injection. The Cyc group had a single intraperitoneal dose of Cyc (75 mg/kg). The GnRHa+Cyc group had a single dose of leuprolide acetate (1 mg/kg) 28 days prior to Cyc (75 mg/kg). The GnRHant+Cyc group had single dose of cetrorelix acetate (0.1 mg/kg) 1 h prior to Cyc (75 mg/kg). At day 35, the animals were euthanized, and their ovaries were removed. Primordial follicles were counted and AMH expression was determined. The Kruskal-Wallis, chi (2), or Fisher's exact test was used where appropriate. p < 0.05 was considered statistically significant. PMF count was reduced in GnRHant (p < 0.01) and Cyc (p < 0.01) groups. Cyc, GnRHa+Cyc and GnRHant+Cyc groups had similar numbers of PMF. AMH expression was reduced in Cyc, GnRHa+Cyc and GnRHant+Cyc groups (p < 0.01). Neither GnRHa nor GnRHant can offer protection against Cyc-induced damage. GnRHant itself reduces the number of primordial follicles.
The impact of endometriosis on fertility
(2015) Haydardedeoglu, Bulent; Zeyneloglu, Hulusi Bulent; 26448139
Although the prevalence of endometriosis in infertile women seemed to be nearly 50%, all women with endometriosis are not infertile...
The impact of sweeping the membranes on cervical length and labor: a randomize clinical trial
(2014) Parlakgumus, Huriye A.; Yalcinkaya, Cem; Haydardedeoglu, Bulent; Tarim, Ebru; 25322540
Objectives: The aim of the study was to investigate to what extent sweeping of the membranes contributes to cervical shortening and if cervical shortening is related to the time to onset of labor and duration of the active phase of labor. Methods: This prospective randomized clinical trial was performed at Baskent University between February and March 2011. Women were randomly assigned to receive membrane sweeping (Sweeping Group) (n=69) or no membrane sweeping (Control Group) (n=71). Cervical length was measured (cervix 1) in both groups by examiner 1 and the Bishap Score was determined in the control group and sweeping was performed in the sweeping group by examiner 2. Two days later the patients had another cervical length measurement (cervix 2) by examiner 1, blinded to the group and results of the examiner 2. t test, Mann-Whitney U test and Chi-square test were used for statistical analyses. Results: Cervix 1 was 27.4 +/- 8.4 mm and 29.6 +/- 8.9 mm (p = 0.14), cervix 2 was 23.3 +/- 8.8 mm and 23.8 +/- 8.5mm (p = 0.28) and cervical shortening was 5 +/- 4 mm and 5 +/- 4mm (p = 0.446), time to onset of labor was 6.3 +/- 4.6 and 5.7 +/- 4.1 (p = 0.38) and duration of labor was 5.8 +/- 2.89 and 5.7 +/- 2.4 (p = 0.82) for the sweeping and the control groups, respectively. Conclusions: Sweeping of the membranes does not reduce cervical length and does not shorten time to onset of labor and duration of the active phase of labor.
The Importance of CD56 and CD98 Levels in Patients with Recurrent Implantation Failure
(2017) Bildaci, Tevfik Berk; Haydardedeoglu, Bulent; Karakaya, Burcu Kisa; Bolat, Filiz Aka; Zeyneloglu, Hulusi Bulent; 0000-0002-0289-2642; B-6487-2009
Aim: Despite major advances in assisted reproductive techniques, clinical pregnancy rates remain around 31% with fresh embryo transfer and around 41% with oocyte donations. We also know that the implantation process itself and the window period defined as the "implantation phase'' are significantly important for successful in-vitro fertilization (IVF) cycles. With this study we have tried to determine any differences in immunohistochemical staining for CD56 and CD98 within the implantation phase endometrium of patients with recurrent implantation failure and of a control group that eventually had a successful IVF cycle. Material and Method: This study was retrospectively performed on a total of 36 patients selected out of a database of 6260 patients who received their IVF cycles from 2004 to 2010. Patients were defined as implantation failure if they did not have a positive result for b-HCG testing following at least 3 IVF cycles with a total of at least 8 embryo transfers. The control group was formed with patients who had success (positive b-HCG testing) on their first IVF treatment. Results: Comparison of means for CD 56 staining percentages, CD 98 staining percentages, CD 98 staining power, and CD 98 staining score showed significant difference between the control group and the study group (p<.001). The endometrium of patients without recurrent implantation failure is significantly more stainable by CD 98 than that of patients with recurrent implantation failure. Discussion: We suggest that CD 56 and CD 98 staining for endometrium tissue can be a part of diagnostic testing for patients who are candidates for IVF treatments. We need further studies to determine the correlation between the overall chance for pregnancy and these types of immunohistochemical staining for patients receiving IVF treatment.
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.
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.
A novel approach using a minimal number of injections during the IVF/ICSI cycle: Luteal half-dose depot GnRH agonist following corifollitropin alfa versus the corifollitropin alfa with a GnRH-antagonist cycle
(2016) Haydardedeoglu, Bulent; Kilicdag, Esra Bulgan; 0000-0002-0942-9108; 27651724; AAK-8872-2021
Objective: Corifollitropin alfa is a good choice for assisted reproductive technology (ART) cycles because fewer injections are needed than with other agents. In this retrospective cohort, we analyzed luteal injected half-dose depot gonadotropin hormone-releasing hormone (GnRH) agonist cycles in women who received corifollitropin alfa and those who underwent a conventional corifollitropin alfa cycle with a GnRH antagonist. Material and Methods: In this retrospective cohort, we analyzed luteal injected half-dose depot GnRH agonist cycles in women who received corifollitropin alfa and those who underwent a conventional corifollitropin alfa cycle with a GnRH antagonist at the Division of Reproductive Endocrinology and IVF Unit, Obstetrics and Gynecology Department, Baskent University School of Medicine, Adana, Turkey, from March 2014 to August 2015. The patient's baseline characteristics were similar between the two groups. Forty-five patients underwent the long protocol, in which a half-dose of depot GnRH agonist was administered on day 21 of the preceding cycle. Forty-nine patients underwent the GnRH-antagonist protocol. Corifollitropin alfa was administered on the menstrual cycle day 3. Results: The mean ages of the two groups were similar (32.77+/-5.55 vs. 34.2+/-4.51 years ["for the long-and antagonist-protocol groups, respectively"]). The total number of retrieved oocytes, the fertilization rate, and the number of transferred embryos were similar between the two groups. The only significant difference between the two protocols was the number of injections during the controlled ovarian stimulation (COH) cycle, which included the depot-agonist injection in the long-protocol group (4.46+/-1.64 vs. 5.71+/-2.51, p=0.006). The clinical pregnancy and implantation rates were similar in the two protocols (16/45 [35.6%] vs. 16/49 [32.7%] for the intention to treat and 32.5+/-6.82% vs. 36.25+/-8.58%, respectively). Conclusion: Our results show that ART cycles could be performed with fewer injections using corifollitropin alfa and a half-dose of depot GnRH agonist.
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.
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.
Serum Betatrophin Levels Are Reduced in Patients with Full-Blown Polycystic Ovary Syndrome
(2019) Haydardedeoglu, Filiz Eksi; Bagir, Gulay Simsek; Haydardedeoglu, Bulent; Bozkirli, Emre; Bakiner, Okan; Metin, Kerem; Ertorer, Melek Eda; https://orcid.org/0000-0002-0179-9673; https://orcid.org/0000-0002-1644-6790; https://orcid.org/0000-0001-9629-7002; https://orcid.org/0000-0001-7357-8709; 30241452; AAK-5003-2021; E-9887-2014; AAK-5525-2021; AAJ-8545-2021; ABI-3705-2020
Betatrophin is defined as a new marker in glucose homeostasis and lipid metabolism. We aimed to investigate the role of serum betatrophin in full-blown polycystic ovary syndrome (PCOS) patients and 47-aged healthy women, 51 full-blown PCOS patients were included in this cross-sectional study. Betatrophin concentrations were significantly lower in PCOS group and displayed a positive correlation only with serum tryglyceride in control group (p < .05). A cutoff level (464.5 ng/L) was determined for betatrophin according to Receiver Operating Characteristic curve. Using this value, 64.7% of PCOS patients were classified as below the cutoff and in this group betatrophin was found to correlate negatively with fasting glucose, fasting insulin, and homeostasis model assessment of insulin resistance (p = .038, p = .020, and p = .014, respectively), and positively with total testosterone (p = .041). In the rest of PCOS cases (35.3%) who had betatrophin higher than cutoff, positive correlation was found with low-density lipoprotein cholesterol (p = .009). In conclusion, betatrophin levels are reduced in full-blown PCOS patients who had worse metabolic phenotype.
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.