Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item 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-9594-2021Objectives: 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.Item 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-9940-2020AimThree 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.Item 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-1643-2020Cesarean 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.Item 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-1643-2020Objective: 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.Item 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-5686-2020Objective: 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.Item 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-5686-2020Corpus 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.Item 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-9974-2021AimWe 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.Item Septate Uterus. Resect or not? That is Not the Only Question(2022) Cok, Tayfun; 0000-0003-1244-7419; 36037812Item 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; 35760360Item 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-0014-2022The 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.