PubMed İndeksli Açık & Kapalı Erişimli Yayınlar
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Item Incidence of unexpected leiomyosarcoma in a Turkish province: a retrospective multi-centre study in a low income setting(2022) Tasdemir, Umit; Ceran, Mehmet Ufuk; Dirican, Aylin Onder; Akar, Serra; Celik, Cetin; Energin, Hasan; Gorkemli, Huseyin; Mammadova, Narmin; Colak, Eser; Ayhan, Ali; 0000-0003-1923-2373; 0000-0002-8184-7531; 35253591The aim of the current study was to estimate the incidence of unexpected leiomyosarcoma (LMS) in patients who underwent surgery due to leiomyomas in Konya province, and to contribute to the literature discussing comparisons with similar studies. The digital archives of eight high-volume hospitals were studied for surgeries performed due to leiomyomas between January 2012 and January 2019, and leiomyosarcoma incidence was calculated based on the data obtained. Twenty-one patients in 3703 cases were found to have unexpected leiomyosarcoma, which means we can expect one leiomyosarcoma in 176 (0.56%) surgeries. Six more malignant tumours were detected among the remaining cases. Thus, our study estimated the incidence of unexpected leiomyosarcoma as 1/176 (0.56%), which is higher than most of the studies in the literature justifying the debate started by the FDA in 2014. As the tumour biology is not yet clear, and the incidence of unexpected leiomyosarcoma tends to be so high, the key focus must be to try to detect uterine leiomyosarcomas preoperatively for robust patient care.IMPACT STATEMENT What is already known on this subject? The incidence of unexpected leiomyosarcoma varies widely from 1/498 to 1/8300 depending on the study method and the type of procedure, and there is still controversy, even after the FDA statement that led to a major restriction in laparoscopic surgeries due to concerns about inadvertent morcellation of leiomyosarcomas. What do the results of this study add? To the best of our knowledge, the current study found the highest incidence of unexpected leiomyosarcoma, and consequently a serious evaluation of all patients undergoing surgery due to leiomyomas preoperatively considering a leiomyosarcoma candidate is recommended. What are the implications of these findings for clinical practice and/or further research? Studies on tumour biology and novel markers must be supported for accurate preoperative diagnosis of leiomyosarcoma.Item Impact of endometrioma and bilaterality on IVF / ICSI cycles in patients with endometriosis(2021) Yilmaz, Nafiye; Ceran, Mehmet Ufuk; Ugurlu, Evin Nil; Gulerman, Hacer Cavidan; Ustun, Yaprak Engin; 0000-0003-1923-2373; 32619727; AAZ-4863-2021Aim: Endometriosis, one of the most common gynecological disorder, is a challenging disease observed in 20 %-40 % of subfertile women. Endometriomas affect 17-44 % of women with endometriosis. Because endometrioma has detrimental effects on fertility, many of these women need Assisted Reproductive Technology (ART) to conceive. In this study, we aimed to investigate the effects of endometrioma presence and impact of bilaterality over In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI) outcomes. Method: The study was designed retrospectively. A total of 159 women enrolled in IVF / ICSI cycles were included. Patients were divided into two groups as Endometrioma group (n: 73) and control group (n:86). In Endometrioma group, subgroup analysis was performed according to whether endometrioma was unilateral or bilateral. Demographic characters, clinical and laboratory parameters were recorded. SPSS was used for analysis. Results: In endometrioma group, although basal FSH levels was higher than control group, it was within normal limits, while estradiol levels was lower (p < 0.001, p 0.042, respectively). Antral follicle count (AFC), dominant follicle number, total oocyte count, MII oocyte numbers were found to be significantly lower, whereas numbers of embryos achieved, clinical pregnancy rates (PR) and live birth rates (LBR) were found to be similar.There were no statistically significant differences in terms of Antimullerian Hormon (AMH) levels, oocyte and embryo quality, the numbers of embryos achieved, PR and LBR between unilateral and bilateral endometrioma groups. Conclusion: This study shows that presence of endometrioma negatively effects fertility parameters albeit no significant effect over embryo quality, PR and LBR whereas bilaterality doesn't have any influence over any fertility parameters and PR. (c) 2020 Elsevier Masson SAS. All rights reserved.Item Serum and placental periostin levels in women with early pregnancy loss(2020) Eroglu, Semra; Colak, Eser; Erinanc, Ozgur Hilal; Ozdemir, Duygu; Ceran, Mehmet Ufuk; Tasdemir, Umit; Kulaksizoglu, Sevsen; Ozcimen, Emel Ebru; 0000-0003-1401-6356; 0000-0002-7613-2240; 0000-0002-9959-9433; 32460058; AAL-1268-2021; AAI-8932-2021Objectives: Periostin is secreted from the placenta in the embryonic period and it is emphasized that it may be involved in endometrial implantation. In this study, we aimed to investigate periostin serum levels and placental tissue expression in first trimester pregnancy losses. Study design: In this prospective case-control study, 30 patients who underwent dilatation and curettage with first trimester spontaneous abortion (< 10 weeks of gestation) were included in the study group and 30 patients who had voluntary pregnancy termination (< 10 gestational weeks) were included in the control group. Serum samples collected from the study and control groups were analyzed usingenzyme-linkedimmunosorbent assay (ELISA), and trophoblastic and decidual tissues were examined using immunohistochemical staining with streptavidin-biotin-peroxidase techniques. Results: There were no significant differences between the groups in terms of age, gravida status, parity number, gestational week, and number of previous abortions. In the spontaneous abortion group, the serum level of periostin was significantly lower than in the voluntary termination group (6.56 +/- 4.16 pg/mLvs. 9.51 +/- 4.52 pg/mL, p = 0.03). There was no significant difference between the two groups in terms of periostin expression in decidual and trophoblastic tissue (p = 0.617, p = 0.274, p = 0.497). Conclusion: Periostin serum levels were significantly reduced in patients with spontaneous pregnancy loss. Periostin can be used as a predictive marker for the success of endometrial implantation.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 GnRH agonist versus HCG triggering in different IVF/ICSI cycles of same patients: a retrospective study(2019) Yilmaz, Nafiye; Ceran, Mehmet Ufuk; Ugurlu, Evin Nil; Gulerman, Hacer Cavidan; Engin Ustun, Yaprak; 0000-0003-1923-2373; 31791167The aim of this study was to assess Gonadotropin Releasing Hormone agonist (GnRHa) trigger results of fresh in vitro fertilisation (IVF), Intracytoplasmic Sperm Injection (ICSI) cycles in high-responder patients. Thirty-six high-responder patients, undergoing GnRH antagonist protocol combined with GnRHa trigger for final oocyte maturation, were included. All cycles were autologous fresh transfer cycles. Fifteen of 36 patients had previous IVF/ICSI cycles triggered with human chorionic gonadotropin (hCG) and both cycles of these patients were compared. The mean fertilisation rate, blastocyst development and clinical pregnancy rates were 67%, 44.4% and 44.4%, respectively. The hCG and GnRHa trigger cycles of the same patients were compared as two groups (n: 15). 2PN oocyte counts were significantly higher in agonist trigger cycles (p .048). There were no differences in terms of M2 oocyte count and fertilisation rate. The blastocyst formation and clinical pregnancy rates for hCG and GnRHa trigger cycles were 33.3-66.7% and 13.3-46.7%, respectively. These results were found to be 2-fold and 3.5-fold higher, but not statistically significant. GnRHa trigger in combination with LPS is a good option for final oocyte maturation due to its good pregnancy outcomes and virtually eliminating OHSS risks.IMPACT STATEMENT What is already known on this subject? Gonadotrophin releasing hormone agonist (GnRHa) trigger is effective in the induction of oocyte maturation and prevention of Ovarian Hyperstimulation Syndrome (OHSS) on IVF cycles using antagonist protocol. What do the results of this study add? The main strength of this study is the comparison of different triggers in different cycles of the same patients. GnRHa trigger in combination with Luteal Phase Support (LPS) is a good option for final oocyte maturation due to its good pregnancy outcomes and virtually eliminating OHSS risks.