Wos İndeksli Yayınlar Koleksiyonu
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Item Diet and pravastatin administration prior to in vitro fertilization treatment may improve pregnancy outcome in women with dyslipidemia(2022) Zeyneloglu, Hulusi Bulent; Tohma, Yusuf Aytac; Gunakan, Emre; Abasiyanik, Mehmet Ali; Sozen, Ceren; Onalan, Gogsen; 0000-0002-0289-2642; 0000-0001-9418-4733; 0000-0001-8854-8190; 0000-0002-5741-8489; 35257641; B-6487-2009; ABI-1707-2020In this study, we aimed to identify whether using statins may increase the chance of pregnancy in In Vitro Fertilisation / Intra-Cytoplasmic Sperm Injection (IVF/ICSI) patients with hyperlipidaemia. Therefore, in this retrospective cohort study, 70 patients constituted the study population and all patients were managed by lipid lowering diet. Ten mg pravastatin (pravachol DEVA, Istanbul, Turkey) was added to therapy in case of resistant hypercholesterolaemia after 15 days of the diet. Fifty-one patients were treated with diet only and the remaining nineteen patients were offered both diet and pravastatin. Clinical pregnancy rate was significantly better with the patients who used pravastatin (68.4% vs. 39.2%, p = .029). Ongoing pregnancy rates were 63.2% and 33.3% with pravastatin and diet only, respectively, which were statistically significant (p:.024). According to multivariate analysis, pravastatin use was found independently and statistically significant for clinical pregnancy and ongoing pregnancy rate after IVF/ICSI in patients with dyslipidemia (HR 3.79; 95% CI 1.31-10.97; p:.014 and HR 3.18; 95% CI 1.22-8.27; p:.018). When we analysed stratified data according to the AMH levels, we noticed that as AMH levels increased, the pregnancy rates increased; the most benefit from pravastatin was in the group with AMH levels >2 ng/mL.IMPACT STATEMENT What is already known on this subject? Dyslipidemia in In IVF/ICSI patients with polycystic ovary syndrome had negative impact on pregnancy rates What the results of this study add? The findings of the study support that pravastatin may help to improve pregnancy outcome, especially in normal and high responders, regardless of whether decreased serum LDL or total cholesterol level. What the implications are of these findings for clinical practice and/or further research? As a result of our data, we speculated that it should be routine to investigate the lipid profile in every IVF/ICSI patient and should be treated accordingly, if necessary.Item Comparison of placental alpha microglobulin-1 protein assay (Amnisure) with speculum examination for the diagnosis of premature preterm rupture of membranes (PPROM): a clinical evaluation(2021) Esin, Sertac; Tohma, Yusuf Aytac; Alay, Ismail; Guden, Mahmut; Colak, Eser; Demirel, Nihal; Bas, Ahmet Yagmur; Serdar Yalvac, Ethem; Kandemir, Omer; 0000-0001-9577-4946; 32835549; AAI-8810-2021In this study, we aimed to compare the clinical outcomes of Premature Preterm Rupture of Membranes (PPROM) cases diagnosed by classical speculum examination and by placental alpha microglobulin-1 protein (PAMG-1) assay. The medical records of all patients with singleton pregnancies that were diagnosed with PPROM were retrospectively reviewed. Singleton pregnancies with PPROM diagnosis that was confirmed either by direct visualisation of amniotic fluid leaking through the cervix or by placental alpha microglobulin-1 protein (PAMG-1) assay if no amniotic fluid leakage was documented were included in the study. Demographics, prenatal and postnatal characteristics were reviewed from the medical charts and were recorded. The study included 138 pregnancies with PPROM; 111 patients in clinical speculum examination group and 27 in PAMG-1 assay group. There were no significant differences in maternal and pregnancy characteristics between the clinical speculum examination and PAMG-1 assay groups. Foetal outcomes were comparable between clinical speculum examination and PAMG-1 assay groups. In the clinical speculum examination group, there were nine (8.1%) chorioamnionitis cases, however, there were no chorioamnionitis cases in the PAMG-1 assay group during the latency period (p = .21).Impact statement What is already known on this subject?Placental alpha microglobulin-1 protein assay uses immunochromatography method to detect trace amount of placental alpha microglobulin-1 protein in vaginal fluids and has high sensitivity and specificity for ROM diagnosis. However, to the best of our knowledge, the clinical outcome of ROM cases detected by classical speculum examination and by placental alpha microglobulin-1 protein assay has not been compared in the literature previously. What do the results of this study add?Although statistically insignificant, cases diagnosed by PAMG-1 assay had lower risk of chorioamnionitis during latency period. What are the implications of these findings for clinical practice and/or further research?Whether cases diagnosed by PAMG-1 assay represent a milder form of rupture of membranes than cases diagnosed by classical speculum examination group warrants further research.Item A Novel Technique for Prediction of Preterm Birth: Fetal Nasal Flow Doppler(2021) Esin, Sertac; Okuyan, Erhan; Gunakan, Emre; Zengin, Hatice Yagmur; Hayran, Mutlu; Tohma, Yusuf Aytac; 0000-0001-8854-8190; 0000-0002-9855-2449; 0000-0001-9418-4733; 33180051; ABI-1707-2020; ABA-3224-2021; AAE-6482-2021Objectives: Absence of fetal breathing movements (FBM) has been found to be a good predictor of preterm delivery in symptomatic patients. However, analysis of FBM patterns and Doppler measurement of them for preterm birth prediction have not been performed before. In this study, we aimed to investigate and analyze FBM patterns in symptomatic preterm labor patients by fetal ultrasonography and nasal Doppler. Methods: This was a multicenter, prospective cohort study. Singleton pregnant patients between 24 and 37 gestational weeks diagnosed with preterm labor were included in the study. Patients were evaluated in three groups: no FBM (Group 1), regular FBM (Group 2), irregular FBM (Group3). Results: Seventy-three patients were available for the final analysis after exclusion. Preterm delivery rate in 24 h in groups were 91.7, 32.7 and 100%, respectively. The absence of FBM (Group 1) was statistically significant for preterm delivery in for both 24 (91.7 vs. 42.6%, p=0.002) and 48 h (91.7 vs. 49.2%, p=0.006) when compared with fetal breathing positive Group 2 and 3. In fetal nasal Doppler analyses in Group 2, the inspiration/expiration number rate was significantly lower in the patients who delivered in 24 h (0 .98 +/- 0.2 vs. 1.25 +/- 0.57, p=0.015). By using fetal nasal Doppler, combination of absence of FBM or irregular FBM or regular FBM with inspiration number/expiration number (I/E) <1.25 detects 94.6% of patients who will eventually deliver in the first 24 h after admission. Conclusions: Examining FBM patterns and using nasal Doppler may help the clinician to differentiate those who will deliver preterm and may be an invaluable tool for managing preterm labor patients.Item Dydrogesterone primed luteal phase stimulation may be better than follicular phase stimulation in patients with diminished ovarian reserve(2021) Zeyneloglu, Hulusi Bulent; Tohma, Yusuf Aytac; Gunakan, Emre; 0000-0002-0289-2642; 0000-0001-9418-4733; 0000-0001-8854-8190; 33944650; B-6487-2009; AAE-6482-2021; ABI-1707-2020Objective In this study, we aimed to compare the efficacy of luteal phase stimulation (LPS) and follicular phase stimulation (FPS) in two separate menstrual cycles (2-5 months intervals) of the same patient, utilizing LPS with dydrogesteron only. Methods This retrospective case control study was conducted with patients with diminished ovarian reserve (DOR) (Group 1) and infertile patients with Anti-Mullerian hormone >1.2 ng/mL (Group 2) undergoing two ovarian stimulations (FPS and LPS with dydrogesteron only) and two oocyte retrievals in two separate menstrual cycles (2-5 months intervals) in the Division of Reproductive Endocrinology and Infertility of Baskent University, Ankara, between April 2019 and December 2019. Results In group 1, the number of frozen embryos was significantly higher in LPS when compared to FPS; 1.71 vs. 0.54, (p < .001), respectively. In group 2, the number of frozen embryos was higher in LPS when compared to FPS (0.8 vs. 0.4) however the difference did not reach a statistical significance (p: 0.157). Conclusion LPS may be beneficial especially in the patients with diminished ovarian reserve with follicular asynchronization in the menstrual onset. In addition, it should be kept in mind that dydrogesterone only may be used instead of gonadotropin-releasing hormone antagonist to prevent possible luteinizing hormone rise in LPS.Item Effects Of Subendometrial Autologous Platelet Rich Plasma Injection On Endometrium And Pregnancy Rates In Patients With Unresponsive Thın Endometrium Undergoing Frozen-Thawed Embryo Transfer.(2021) Cakiroglu, Yigit; Tohma, Yusuf Aytac; Yuceturk, Aysen; Karaosmanoglu, Ozge; Kopuk, Sule Yildirim; Korun, Zeynep Ece Utkan; Scott, Richard T., Jr.; Tiras, Bulent; Zeyneloglu, Hulusi Bulent; Seli, EmreItem Gut dysbiosis may be associated with hyperemesis gravidarum(2020) Balci, Serdar; Tohma, Yusuf Aytac; Esin, Sertac; Onalan, Gogsen; Tekindal, Mustafa Agah; Zeyneloglu, Hulusi Bulent; 0000-0001-9418-4733; 0000-0002-0289-2642; 0000-0002-1782-7325; 0000-0001-9577-4946; 32519907; AAE-6482-2021; B-6487-2009; AAJ-1097-2021; AAI-8810-2021Purpose:In this study, we aimed to determine the frequency of different intestinal microorganisms of patients with normal pregnancies and HG and to compare these frequencies between the two groups. Materials and methods:This case-control study was carried out in Baskent University Department of Obstetrics and Gynecology and included 20 patients; 10 of whom had normal pregnancies and 10 of whom had HG. A stool flora scan was routinely planned for all patients. Transient and continuous fecal bacteria and fungal flora were analyzed. All data were evaluated statistically and their relationships with clinical condition were discussed. Results:The study group consisted of 20 pregnant women with a mean age of 31.5 years. All patients were nonsmokers and free of chronic diseases and of any medications. Aerobic and anaerobic bacteria groups, fungal colonies, and parasites were examined and bowel pH values were measured separately for each patient. Bacterial and fungal species outside the reference ranges were recorded for each patient. There was a statistically significant increase inClostridiumspp. (p:.01) andCandidaspp. (p:.033) and a statistically significant decrease inBifidobacteriumspp.(p:.008) in patients with HG compared to women with normal pregnancies. There was a significant difference between the group with HG and the group with normal pregnancies in terms of flora dysbiosis (p:.001). Conclusion:Our results suggest that gut dysbiosis may be a factor in HG. The effect of the severity of gut dysbiosis on the disease may be the subject of future studies.Item Role of mean platelet volume in pregnancy to predict gestational diabetes mellitus in the first trimester(2020) Colak, Eser; Ozcimen, Emel Ebru; Ceran, Mehmet Ufuk; Tohma, Yusuf Aytac; Kulaksizoglu, Sevsen; 0000-0001-9418-4733; 0000-0002-7613-2240; 0000-0003-1923-2373; 0000-0002-8184-7531; 30947572; AAE-6482-2021; AAI-8932-2021Objectives:Gestational diabetes mellitus (GDM) is defined as glucose intolerance detected for the first time in pregnancy or identified during pregnancy. Mean platelet volume (MPV) is a marker of activation and function of platelet. Several studies investigated the relation between MPV and GDM. The purpose of the present study is to predict GDM in the first trimester by using MPV value. Materials and methods:Two hundred pregnant women with GDM and 200 normal pregnant women were enrolled in the study. The first trimester MPV values of GDM and control groups were compared to predict GDM in the first trimester. Results:Women with GDM had higher MPV value compared with the control group (p < .001). The area under the receiver-operator curve was 0.70 for MPV. The cutoff value of MPV was 7.38 fl with 70% sensitivity and 60% specificity. According to the ages, MPV value was higher in GDM group in the individuals who were above 28-year-old (p < .001). Conclusion:MPV can be used to predict GDM in the first trimester.Item May myo-inositol andd-chiro-inositol (40:1) treatment be a good option on normal-weighted polycystic ovary syndrome patients without insulin resistance?(2020) Colak, Eser; Ozcimen, Emel Ebru; Tohma, Yusuf Aytac; Ceran, Mehmet Ufuk; 0000-0002-8184-7531; 32989863Aim To investigate the effectiveness of myo-inositol andd-chiro-inositol (MI:DCI) (40:1) treatment in normal-weight polycystic ovary syndrome (PCOS) patients without insulin resistance. Methods This retrospective case-control study included PCOS patients without insulin resistance who were diagnosed in the gynecology and obstetrics clinic of Baskent University Konya Practice and Research Hospital between January 2016 and October 2019 and received at least 6 months of MI:DCI (40:1) treatment. The patients were divided into two groups according to body mass index (BMI). Twenty-nine anovulatory patients without insulin resistance with a BMI of 18-25 were included in group 1 (normal-weight group), whereas 17 patients without insulin resistance with BMI > 25 were included in group 2 (obese/overweight group). Ovulation status of both groups was compared after MI:DCI treatment. Results Ovulation was detected in 23 of 29 patients in the normal-weight group, whereas it was detected only in 5 of 17 patients in the obese/overweight group; this difference was statistically significant (P < 0.001) (Table 2, Figure 1). Post-treatment progesterone levels of both groups were compared and in the normal-weight PCOS group was significantly higher than the obese/overweight group (P < 0.001) (Table 2, Figure 2). In addition, spontaneous pregnancy following treatment was observed in six of the seven (85.7%) patients in the normal-weight group who wanted to conceive, whereas it was observed in only two of the six (33.3%) patients in the obese/overweight group who wanted to conceive. Conclusion Our results showed that MI:DCI (40:1) treatment may be a first-line treatment in normal-weight PCOS patients without insulin resistance.Item The Role of Analysis of NK Cell Subsets in Peripheral Blood and Uterine Lavage Samples in Evaluation of Patients with Recurrent Implantation Failure(2020) Tohma, Yusuf Aytac; Musabak, Ugur; Gunakan, Emre; Akilli, Huseyin; Onalan, Gogsen; Zeyneloglu, Hulusi Bulent; 0000-0003-1511-7634; 0000-0002-0289-2642; 0000-0001-8854-8190; 32413518; AAU-1810-2020; B-6487-2009; ABI-1707-2020; AAX-3230-2020Objective: In this study, we aimed to determine the role of analyses of NK cell subsets in peripheral blood and uterine lavage samples in evaluation of patients with unexplained RIF. Methods: This retrospective single-institution case-control study included two different cohorts between 2017-2019. First cohort included patients examined with peripheral blood samples for evaluation of possible immunologic problems in patients with unexplained recurrent implantation failure; in the study period, a total of 75 consecutive patients with RIF (study group; n: 42) or infertile patients without RIF (control group; n: 33) were included. Second cohort included those patients whose uterine samples were assessed for immunologic problems; RIF (study group ; n: 16) or infertile patients without RIF (control group; n: 25). Results: In the first cohort, the percentage of NK cells (CD3-CD16(+)56(+)) is statistically significantly lower (9.8 vs. 12.6, respectively, p: 0.038) in the study group than those of the controls whereas there was no statistical significance in the absolute number of NK cells (CD3-CD16(+)56(+)). In the second cohort, the only remarkable finding in uterine lavage samples was significantly increased uNKs cells (CD3-CD16(di)(m)56(bright)) percentages in controls (9.95 vs 12.7, respectively, p: 0.026) compared to those of study group. Conclusion: Our data shows that the analysis of NK cell subtypes in peripheral blood does not seem appropriate to investigate the patients with RIF and we suggest that uterine lavage samples instead of peripheral blood samples be implemented and evaluated. (C) 2020 Elsevier Masson SAS. All rights reserved.Item Oncological and obstetric outcomes after fertility-sparing radical abdominal trachelectomy for early stage cervical cancer: a tertiary centre's 10 years' experience(2019) Ayhan, Ali; Tohma, Yusuf Aytac; Sahin, Hanifi; Kocaman, Eda; Tunc, Mehmet; Haberal, Asuman Nihan; 0000-0001-9418-4733; 30371139; AAE-6482-2021The aim of this study is to present our clinical experience about fertility-sparing procedures in early stage cervical cancer and its obstetrical and oncological outcomes. Between the years 2006 and 2016, a total of 22 early stage cervical cancer patients who underwent a fertility-sparing radical abdominal trachelectomy in our clinic were retrospectively analysed. The median age was 33 (range: 28-39) years. The median follow-up was 47 (range: 22-125) months. Five patients (22.7%) had Stage IA1, three patients had (13.6%) Stage IA2, and 14 patients (63.6%) had Stage IB1 disease. Only one patient had a recurrence. A pregnancy was obtained in five patients (22.7%) and one of them (20%) had a live birth. A pregnancy was obtained spontaneously in two patients (40%), whereas assisted reproductive techniques were used in three of the patients (60%). A miscarriage occurred in two patients (40%), and one of them was within the first trimester and the other was within the second trimester.