Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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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 Atorvastatin for Ovarian Torsion: Effects on Follicle Counts, AMH, and VEGF Expression(2014) Parlakgumus, H. Ayse; Bolat, Filiz Aka; Kilicdag, Esra Bulgan; Simsek, Erhan; Parlakgumus, Alper; https://orcid.org/0000-0003-2031-7374; https://orcid.org/0000-0002-0942-9108; 24507756; HJZ-1654-2023; AAK-8872-2021Objective(s): To determine if atorvastatin protects ovarian follicles against ischemia reperfusion (I/R) injury and to determine how anti-Mullerian hormone (AMH) and vascular endothelial growth factor-A (VEGF-A) expression is altered. Study design: This experimental study was conducted at the Baskent University Animal Research Laboratory. Forty-four rats were arbitrarily assigned into four groups of 11 rats each. The control group underwent a laparotomy. The atorvastatin group received atorvastatin (10 mg/kg/day), by oral gavage 7 days before and 7 days after the sham operation. The torsion group had bilateral torsion and detorsion of the ovaries. The atorvastatin + torsion group received atorvastatin (10 mg/kg/day) 7 days before and 7 days after the torsion/detorsion operation. At day 7, the animals were euthanized and their ovaries were removed. Ovarian follicles were counted, and AMH and VEGF-A expression was determined. The Kruskal-Wallis, chi(2), or Fisher's exact test were used when appropriate. Results: Primordial follicles (p = 0.001), VEGF-A expression (p = 0.018) and vascularization (p = 0.02) were significantly higher in the atorvastatin group compared to controls. Primordial (p = 0.002), primary (p = 0.001), and secondary follicles (p = 0.001), AMH expression (p = 0.001), and vascularization (p = 0.001) were lower in the torsion group compared with the control group. Primordial follicles (p = 0.001), AMH (p = 0.001) and VEGFA expression (p = 0.001), and vascularization (p = 0.001) were significantly higher in the atorvastatin + torsion group compared to the torsion group. Conclusion(s): Atorvastatin increased the primordial follicle pool and vascularization and protected primordial follicles and vascular structures against I/R injury. (C) 2014 Elsevier Ireland Ltd. All rights reserved.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 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.Item Reappraisal of the relationship between 24-hour proteinuria and preeclampsia in terms of the maternal and perinatal outcomes(2020) Yilmaz Baran, Safak; Alemdaroglu, Songul; Durdag, Gulsen Dogan; Yetkinel, Selcuk; Yuksel Simsek, Seda; Kalayci, Hakan; Simsek, Erhan; 0000-0003-4335-6659; 0000-0002-5064-5267; 0000-0002-2165-9168; 32037908; AAK-7016-2021; AAK-7016-2021; AAK-7016-2021; AAK-7016-2021; AAK-7016-2021Objective: This study evaluated the association between proteinuria levels and maternal, and perinatal outcomes of preeclampsia patients and determined the cutoff values for predicting severe complications. Methods: We retrospectively evaluated the records of 412 patients with proteinuric preeclampsia. Results: Median proteinuria levels were significantly higher in patients with severe maternal and adverse perinatal outcomes than in those without such outcomes, except in cases of placental abruption and late preterm delivery. Conclusion: Proteinuria levels may aid in diagnosing preeclampsia and indicating early intervention. The revised guidelines do not suggest that proteinuria encountered during pregnancy is clinically insignificant.Item An analysis of 635 consequetive laparoscopic hysterectomy patients in a tertiary referral hospital(2020) Yuksel, Seda; Serbetcioglu, Gonca Coban; Alemdaroglu, Songul; Yetkinel, Selcuk; Durdag, Gulsen Dogan; Simsek, Erhan; Celik, Husnu; 0000-0002-5064-5267; 0000-0002-3285-5519; 0000-0003-4335-6659; 0000-0002-2165-9168; 31610294; AAK-7016-2021; AAI-9594-2021; AAI-9974-2021; AAI-8400-2021; AAL-1530-2021Objective: The objective of this retrospective observational study is to analyse the properties of laparoscopic hysterectomy cases that are performed for benign indications and also endometrial cancer indications. Operation time, postoperative complicaton rate, blood transfusion need, and hospitalization time are compared according to benign and malign indications and also body mass index of the patients. Material and methods: Patients who were operated between September 2012 and December 2017 are included in this study. Patients' age, body mass index, medical histories, operation indications, operation time, pathology reports, pre and postoperative hemoglobine values and postoperative complications are obtained from medical records.Body mass index is classified as underweight for <19 ; normal for 19-25 ; overweight for 25-30 and obese for >= 30. Results: Operation and hospitalization times were significantly higher for high BMI and malign gynecologic indication groups than lower BMI and benign gynecologic indication groups (p:0.0001). Complication rates and transfusion needs were similar in between malign and benign gynecologic disease groups (p :0.443; P:0.670 respectively) and also in between high and lower BMI groups (P:0.813 ; P:0.468 respectively). Conclusion: Laparoscopic approach for hysterectomy operations in high BMI patients and endometrial cancer patients seem to be safe in terms of postoperative complication and bleeding that necessitate transfusion. (C) 2019 Elsevier Masson SAS. All rights reserved.Item Intrahepatic cholestasis of pregnancy: are in vitro fertilization pregnancies at risk?(2020) Alemdaroglu, Songul; Yilmaz Baran, Safak; Durdag, Gulsen Dogan; Yuksel Simsek, Seda; Yetkinel, Selcuk; Alkas Yaginc, Didem; Kalayci, Hakan; Simsek, Erhan; 0000-0002-5064-5267; 0000-0002-2165-9168; 0000-0003-4335-6659; 32419565; AAI-9594-2021; AAL-1530-2021; ABF-6439-2020; AAI-8400-2021; AAK-7016-2021Aim: Single pregnancy patients with intrahepatic cholestasis of pregnancy (ICP) were divided into two groups according to the conception method, as spontaneous and in vitro fertilization (IVF). We aim to compare the maternal, laboratory and perinatal characteristics of both groups. Materials and method: The records of 10,929 patients who gave birth in the center between October 2011 and July 2019 were analyzed retrospectively from the data processing system records. Maternal, laboratory and perinatal characteristics of 109 single pregnancies (spontaneous n: 91; IVF n: 18) diagnosed with ICP were compared. Findings: The maternal demographic data of both groups were similar (p: .05). In both groups, gestational week, gestational age at birth, birth weight, neonatal intensive care admission rate, meconium-stained amniotic fluid, umbilical cord pH, the 5-minute APGAR score, and the presence of pregnancy complications were similar (p > .05). Result: Although ICP is reported with a higher incidence in IVF pregnancies, ICP findings and prognosis are similar to those of spontaneous pregnancies.