Murat Seval | Ankara University (original) (raw)

Papers by Murat Seval

Research paper thumbnail of Cell free fetal DNA in the plasma of pregnant women with preeclampsia

Clinical and Experimental Obstetrics & Gynecology, 2015

OBJECTIVE Insufficient cytotrophoblast invasion to the myometrium is associated with preeclampsia... more OBJECTIVE Insufficient cytotrophoblast invasion to the myometrium is associated with preeclampsia, especially with the early-onset preeclampsia (before 34 gestational weeks). Several investigations have marked changes in the concentration of cell free fetal DNA in the maternal circulation of women with preeclampsia. However, these studies were not performed for early or late preeclampsia subgroups individually. The present authors planned to determine the levels of the cell free both fetal and maternal DNA in the maternal circulation in early preeclampsia subgroup and compare it with normotensive control cohort. MATERIALS AND METHODS A total of 16 women; eight of these with preeclampsia and eight normotensive control cohorts with singleton male pregnancy between 28 and 32 gestational weeks were included in the study. Real-time PCR analysis was performed for determining the circulating cell free DNA levels. RESULTS Cell free fetal DNA concentrations were higher in early preeclamptic women than control subjects. The authors found no statistically significant difference in each levels of maternal and total DNA between hypertensive and normotensive groups. CONCLUSIONS The present findings suggest that the levels of cell free fetal DNA in maternal circulation were higher in pregnancies which are complicated with early preeclampsia than normotensive controls.

Research paper thumbnail of Extrapelvic Endometriosis: Two Case Reports

Gorm, 2016

Endometriosis is the growth of endometrial cells outside the uterine cavity. Most common localiza... more Endometriosis is the growth of endometrial cells outside the uterine cavity. Most common localizations are pelvic organs and peritoneum. Endometriosis mostly affects women in their reproductive years. After surgery it can be seen on the abdominal wall. This article includes two patients, one has abdominal wall endometriosis and the other has inguinal endometriosis. Both of them had surgical excision without recieving any medical treatment.

Research paper thumbnail of İlk Trimester TSH Düzeyinin Obstetrik ve Perinatal Sonuçlara Etkisi

Aim: To investigate the association of first trimester TSH levels in pregnant woman with the feta... more Aim: To investigate the association of first trimester TSH levels in pregnant woman with the fetal birth weights. Material and Methods : The study was a retrospective study at Ankara University Ostetrics and Gynecology in January 2014 to January 2015 . 397 singleton pregnancies, the first trimester were included in the study. Thyroid disease history, diabetes mellitus, preeclampsia, heart disease, cigarettes and alcohol use, birth before 37 weeks of gestation were excluded from study. Patients were divided into two groups according to TSH levels. TSH levels in the first group of 0.5-2.5 mU / L (Group 1:202 patients ) and the second group TSH level 2.5-5 mU / L ( Group 2:195 patients ), respectively. Groups were compared with gestational age, birth weight, gravity, parity, Apgar scores, 50 g oral glucose tolerance test (OGTT) results, method of delivery, premature rupture of membranes, intrauterine growth retardation ( IUGR), pregnancy -induced hypertension (PIH ), placental abruptio...

Research paper thumbnail of Serum and follicular fluid concentration of stem cell factor in PCOS

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018

Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in reproduct... more Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in reproductive-aged women, which affects 5 to 20% of women in the reproductive age worldwide. This study aimed to compare the levels of SCF in serum and follicular fluid of PCOS patients with those of non-PCOS group and to investigate the relationship of SCF levels with ICSI success.Methods: This is an observational case control study that included the patients who underwent ICSI in the Infertility-IVF center at Ankara University Faculty of Medicine and in a private IVF center between March 2016 and February 2017. The study group consisted of 57 PCOS patients diagnosed according to the Rotterdam criteria and the control group consisted of 75 patients with normofollicular and regular menstrual cycles. Serum and follicular fluid samples were taken on day of oocyte retrieval. Serum and follicular fluid SCF levels were determined by ELISA using the SCF ELISA kit..Results: Serum and follicular fluid SCF...

Research paper thumbnail of AB0839 Fibromyalgia Syndrome in Pregnant Women; The Effects on Physical Functioning and Psychological Status

Annals of the Rheumatic Diseases, 2016

miR-320b and the score of depression scale.ROC curves for each miRNAs displayed a AUC greater tha... more miR-320b and the score of depression scale.ROC curves for each miRNAs displayed a AUC greater than ∼0.7 and the best generalized linear model that can be employed to discriminate FM patients from healthy controls was obtained by taking into account only 5 miRNAs: miR-23a-3p, miR-1, miR-133a, miR-346 and miR-320b (AUC=0.954, sensitivity=100%, specificity=83.3%). Conclusions: Our preliminary work outlines the importance of using circulating miRNAs in liquid biopsies as a powerful diagnostic signature for the diagnosis of FM.Although the expression and the modulation of miRNAs seem to be site specific, we suggested a panel of serum miRNAs that can be used in the future as potential predictors of FM.A wider cohort of patients will be necessary to integrate the results that we obtained in this work and to suggest a more robust predictive model to exploit as an additional diagnostic tool for FM patients.

Research paper thumbnail of The reproductive outcome after hysteroscopic metroplasty in patients with deep uterine septum and T-shaped uterus

Fertility and Sterility, 2016

Research paper thumbnail of True Management of Herlyn-Werner-Wunderlich Syndrome (OHVIRA Syndrome)

Journal of Minimally Invasive Gynecology, 2016

Research paper thumbnail of Association of first trimester serum uric acid levels gestational diabetes mellitus development

Journal of Turkish Society of Obstetric and Gynecology, 2016

Amaç: Düşük riskli gebelerde ilk trimester ürik asit seviyelerinin gestasyonel diabetes mellitus ... more Amaç: Düşük riskli gebelerde ilk trimester ürik asit seviyelerinin gestasyonel diabetes mellitus (GDM) gelişimiyle ilişkisinin saptanması. Gereç ve Yöntemler: Bu retrospektif veri analizinde birinci trimester biyokimya testi ile iki basamaklı gestasyonel diyabet taramasını tamamlamış gebe kadınların sonuçları; yaş, vücut kitle indeksi ve gestasyonel hafta açısından eşleştirilmiş kontrol grubu karşılaştırıldı. 100-g oral glukoz tolerans testine göre gebeler GDM ve bozulmuş glukoz toleransı (BGT) gruplarına ayrıldı. Gruplar arasında ürik asit seviyeleri karşılaştırıldı ve ürik asit seviyelerinin, GDM ve BGT için tanısal gücü sinyal algılama teorisinde, alıcı işletim karakteristiği eğrisi ile test edildi. Bulgular: GDM grubundaki 66 kadın ve BGT grubundaki 358 kadın, 202 sağlıklı kadınla karşılaştırıldı. Yaş, parite, gebelik öncesi vücut kitle indeksi ve gestasyonel yaş açısından istatistiksel anlamlı farklılıklar içermeyen grupların birinci trimester serum örnekleri toplandı. Ortalama serum ürik asit seviyesi GDM ve bozulmuş glukoz toleransı gruplarında (sırasıyla, 5,95 mg/dL (±0,97) ve 4,76 mg/dL (±1,51) kontrol grubu ile karşılaştırıldığında (3,76 mg/ dL±1,07) (p<0,001) daha yüksek olduğu görüldü. GDM tanısında ürik asit seviyeleri için ROC eğrisi altında kalan alan 0,92 idi (%95 güven aralığı 0,88-0,95). 3,95 mg/dL eşik değer olarak alındığında ürik asit seviyeleri GDM gelişme durumunu %60 spesifisite ve %100 sensitivite ile göstermektedir. Sonuç: İlk trimester ürik asit seviyeleri ile GDM ve BGT gelişimi arasında lineer bir ilişki vardır.

Research paper thumbnail of Fetal Kromozomal Hastalıklar: Fetal Tanısal İnvaziv Girişimler

Turkiye Klinikleri Journal of Gynecology and Obstetrics Special Topics, 2011

Research paper thumbnail of Heavy metal and trace element concentrations in blood and follicular fluid affect ART outcome

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2016

To assess the effects of heavy metal and trace element concentrations in blood and follicular flu... more To assess the effects of heavy metal and trace element concentrations in blood and follicular fluid on assisted reproductive technology cycle outcome. A prospective study was conducted between January 2012 and July 2012 in a university hospital infertility clinic. One hundred and one patients with unexplained infertility who underwent intracytoplasmic sperm injection using GnRH-antagonist protocol were recruited. Concentrations of four toxic metals (Cd, Pb, Hg, As) and three trace elements (Cu, Zn, Fe) were measured both in blood and follicular fluid specimens. Patients were evaluated in two groups; the study group consisted of patients with ongoing pregnancy (n=20) and the reference group consisted of patients experienced assisted reproductive technology failure, miscarriage or biochemical pregnancy (n=81). Demographics and cycle parameters were comparable between the groups except for median number of day 3 Grade A embryos. Statistically significant negative correlations were found between blood Pb levels and number of MII oocytes, implantation, clinical pregnancy and ongoing pregnancy rates. Results of the log binomial regression revealed 2.2% lower risk for ongoing pregnancy for each 1μg/dL higher blood Pb concentration while holding the other variables in the model constant (RR 0.978; 95% CI 0.956-0.998; P=.041). Also, the results revealed 71.9% lower risk for ongoing pregnancy for each 1μg/dL higher follicular fluid Cu concentration while holding the other variables in the model constant (RR 0.288; 95% CI 0.085-0.92; P=.039). Blood concentrations of Pb and follicular fluid concentrations of Cu seem to have significant impacts on assisted reproductive technology cycle outcome.

Research paper thumbnail of Laparoscopic Management of Juvenile Cystic Adenomyoma

Journal of Minimally Invasive Gynecology, 2015

Research paper thumbnail of Hızlı Gerileme Gösteren Tek Taraflı Fetal Plevral Efüzyon

Cukurova Medical Journal, 2015

Intrauterine pleural effusion of fetal lungs rarely regresses without intervention. In our case w... more Intrauterine pleural effusion of fetal lungs rarely regresses without intervention. In our case we treated a women at 32th weeks of gestation. Her pregnancy was complicated with fetal pleural effusion and polyhydramniosis. A therapeutic thoracocentesis was planned and she received two courses of betamethasone prior to procedure. On the day of planned procedure, a substantial regression of pleural effusion was observed and procedure was postponed. During her antenatal follow-up a complete regression of pleural effusion was observed. After delivery pleural effusion did not relapse. These findings hint there may be a role of antenatal steroids in treatment of fetal pleural effusion, which is known to be resistant to treatment modalities both during antenatal and postnatal period.

Research paper thumbnail of Problems with the Diagnosis of Endometriosis

Research paper thumbnail of Rapidly Regressive Unilateral Fetal Pleural Effusion

Intrauterine pleural effusion of fetal lungs rarely regresses without intervention. In our case w... more Intrauterine pleural effusion of fetal lungs rarely regresses without intervention. In our case we treated a women at 32th weeks of gestation. Her pregnancy was complicated with fetal pleural effusion and polyhydramniosis. A therapeutic thoracocentesis was planned and she received two courses of betamethasone prior to procedure. On the day of planned procedure, a substantial regression of pleural effusion was observed and procedure was postponed. During her antenatal follow-up a complete regression of pleural effusion was observed. After delivery pleural effusion did not relapse. These findings hint there may be a role of antenatal steroids in treatment of fetal pleural effusion, which is known to be resistant to treatment modalities both during antenatal and postnatal period.

Research paper thumbnail of Is omitting the 3rd hour measurement in the 100 g oral glucose tolerance test feasible?

Journal of perinatal medicine, Jan 30, 2015

To evaluate the diagnostic value of the 3rd hour plasma glucose level in the 100 g oral glucose t... more To evaluate the diagnostic value of the 3rd hour plasma glucose level in the 100 g oral glucose tolerance test (OGTT). Records of all pregnant patients with abnormal 50 g glucose challenge test (GCT) between January 2005 and December 2013 were reviewed (n=1963). The 100 g OGTT results were analyzed separately for both Carpenter & Couston (CC) and National Diabetes Data Group (NDDG) criteria. The number of patients diagnosed with gestational diabetes mellitus (GDM) was 297 (15.1%) according to CC criteria and 166 (8.4%) according to NDDG criteria. The 1st hour plasma glucose level showed the highest correlation with GDM diagnosis (ρ=0.595 for CC and ρ=0.567 for NDDG). However, the 3rd hour plasma glucose level showed the weakest correlation with GDM diagnosis (ρ=0.216 for CC and ρ=0.213 for NDDG). The 3rd hour value of 100 g OGTT was one of the two elevated measurements in 10.8% of patients when CC criteria are used and in 13.8% of patients when NDDG criteria are used. Omitting 3rd h...

Research paper thumbnail of Effect of the timing of delivery on perinatal outcomes at gestational hypertension

Interventional Medicine and Applied Science, 2015

Objective: We aimed to evaluate the perinatal outcomes of women diagnosed with gestational hypert... more Objective: We aimed to evaluate the perinatal outcomes of women diagnosed with gestational hypertension and no proteinuria according to the gestational weeks. Methods: We included women diagnosed with gestational hypertension between 2010 and 2014 at our institution and excluded the patients with preeclampsia and chronic hypertension. Women with gestational hypertension were grouped according to the gestational weeks. One group consisted of the pregnancies between 37 and 38*6, whereas the other group included pregnancies between 39 and 41 weeks. Then the outcomes of these pregnancies were compared with healthy women who had delivery between the same weeks (37-38*6 weeks and 39-41 weeks). We analyzed the mode of delivery, birth weight, and neonatal outcomes of these pregnancies. Results: First and fi fth minute Apgar scores were signifi cantly decreased in women with gestational hypertension who had delivery between 39 and 41 weeks compared to healthy subjects (respectively, p = 0.005 and p = 0.033). Perinatal outcomes were adversely aff ected if the time of delivery was beyond 39 weeks in pregnancies complicated with gestational hypertension. Conclusion: We concluded that perinatal outcomes were adversely aff ected if the time of delivery was beyond 39 weeks in pregnancies complicated with gestational hypertension, and outcomes of such pregnancies can be improved if time for delivery is <39 weeks.

Research paper thumbnail of Effect of reproductive history, lactation, first pregnancy age and dietary habits on bone mineral density in natural postmenopausal women

Aging Clinical and Experimental Research, 2015

Aim The aim of this study was to investigate the possible risk factors related with osteoporosis ... more Aim The aim of this study was to investigate the possible risk factors related with osteoporosis in women with spontaneous menopause. Methods Five hundred and one postmenopausal women were divided into three groups as normal, osteopenic and osteoporotic according to their bone mineral density (BMD). By face-to-face interview, parity, age at menarche, age at menopause, duration of fertility, duration of menopause, first pregnancy age, total lactation period, exercise, smoking were assessed. Women with menopause age before 40 years, surgical menopause, who had any anti-osteoporosis treatment, hormone replacement therapy at the time of BMD measurement and corticosteroid use longer than 6 months were excluded from the study. Results Among 501 postmenopausal women, 107 women were classified as normal, 170 as osteopenic and 224 as osteoporotic. Among demographic features of patients, there was statistically significant difference between the groups in age, BMI and parity (p \ 0.001, p \ 0.0001 and p = 0.002, respectively). There were statistically significant differences between the groups in case of age at menopause, duration of fertility and duration of menopause (p = 0.013, p = 0.013 and p \ 0.0001, respectively). In the multivariate logistic regression analysis, BMI over 32 and fertility duration over 33 years had a statistically significant protective effect against osteoporosis (OR 0.42, CI 95 % 0.27-0.66; OR 0.36, CI 95 % 0.24-0.56, respectively), but age was positively correlated with osteoporosis (OR 1.13, CI 95 % 1.01-1.17) Conclusions Duration of fertility (years of menstruation) longer than 33 years and body mass index higher than 32 seem to protect against postmenopausal osteoporosis. Age is also an independent risk factor for postmenopausal osteoporosis. Keywords Postmenopausal osteoporosis Á Risk factors Á Lactation Á First pregnancy age Á Duration of fertility Á Body mass index This study has been accepted as poster presentation in 23th EBCOG European Congress of Obstetrics and Gynaecology in Glasgow, Scotland (UK), on May 7th-10th 2014.

Research paper thumbnail of Follicular fluid levels of norepinephrine and dopamine are higher in polycystic ovarian syndrome (PCOS) after controlled ovarian stimulation (COS)

Fertility and Sterility, 2014

Research paper thumbnail of Agenesis of Ductus Venosus Presenting with Dilated Inferior Vena Cava with Favorable Outcome

International Journal of Women's Health and Reproduction Sciences, 2014

The ductus venosus regulates the distribution of oxygen and placental nutrients by restricting th... more The ductus venosus regulates the distribution of oxygen and placental nutrients by restricting the centralization of blood flow in fetal circulation. The ductus venosus is a small vein transmitting oxygen-rich blood from the umbilical vein to the fetal heart.. Increasing numbers of case reports are being published about ductus venosus agenesis with cardiac structural abnormalities, other malformations, chromosomal abnormalities, and stillbirth. Heart failure, hydrops and unexplained polyhydramnios could also be associated with ductus venosus agenesis. In the follow-up of fetuses with ductus venosus agenesis, care must be taken to examine for hydrops and heart failure. The agenesis of ductus venosus is often only found in fetuses by coincidentally. Herein we discuss the prenatal diagnosis of isolated agenesis of the ductus venosus presenting with a dilated inferior vena cava and without any disturbance of fetal hemodynamics and any other malformation. In conclusion a dilated inferior vena cava can be a sign of ductus venosus agenesia.

Research paper thumbnail of Hope and reality: dhea supplementation in poor responder regarding bologna criteria

Fertility and Sterility, 2014

OBJECTIVE: 10,000 IU hCG (10K) has been routinely used for the induction of oocyte maturation dur... more OBJECTIVE: 10,000 IU hCG (10K) has been routinely used for the induction of oocyte maturation during IVF cycle, but 5,000 IU (5K) may be a safer dose in high responding patients. We compared embryo development, implantation rate, and ongoing pregnancy rate/live birth rate in high responding patients who received hCG 5K vs hCG 10K in donor and non-donor IVF cycles. DESIGN: Retrospective cohort study. MATERIALS AND METHODS: All high responders defined as patients with peak serum estradiol > 4,000 pg/ml during IVF stimulation and < age 40 who underwent IVF from September of 2006 to March of 2014 were included in the study. Patients who received 5K hCG (n¼101) were compared with those who received 10K hCG (n¼104). Patient age, number of oocytes retrieved, percentage of matured oocytes, fertilization rate, number of embryos transferred, percentage of embryos reaching blastocyst stage, implantation rate and percentage of ongoing pregnancy/live birth were compared between the two groups. RESULTS: There were no significantly different in terms of patient's age, number of oocytes retrieved, percentage of matured oocytes, fertilization rate and number of embryos transferred between the two groups (P > 0.05). 42.7% of embryos in the hCG 5K group reached blastocyst stage, compared with 36.1% in the hCG 10K group (P < 0.05). Implantation rate in the hCG 5K was 38.1%, vs 25.2% in the hCG 10K group (P < 0.01). The ongoing pregnacy/live birth rate in the hCG 5K group was 57.4%, vs 39.4% in the hCG 10K group (P < 0.05). When the non-donor cycles were separated from the donor cycles, the implantation and blastocyst rates in the non-donor cycles were 35.6% and 39.7% in the hCG 5K group (n¼86), vs 23.3% (P<0.01) and 32.1% (P<0.05) in the hCG 10K group (n¼71). In IVF cycles with donor eggs, the implantation and blastocyst rates in the hCG 5K group (n¼15) were 56.7% and 59.9%, significantly higher than 30.3% and 44.4% in the hCG 10K group (n¼34, P<0.05). CONCLUSION: In high responders, the trigger of final oocyte maturation with hCG 5K resulted in more embryos developing to blastocyst, higher implantation rate, and higher ongoing pregnancy/live birth rate than did trigger with hCG 10K. Given that higher blastocyst development and implantation rates were seen in both donor and non-donor cycles, oocyte/embryo quality may play a greater role in our observations than endometrial receptivity.

Research paper thumbnail of Cell free fetal DNA in the plasma of pregnant women with preeclampsia

Clinical and Experimental Obstetrics & Gynecology, 2015

OBJECTIVE Insufficient cytotrophoblast invasion to the myometrium is associated with preeclampsia... more OBJECTIVE Insufficient cytotrophoblast invasion to the myometrium is associated with preeclampsia, especially with the early-onset preeclampsia (before 34 gestational weeks). Several investigations have marked changes in the concentration of cell free fetal DNA in the maternal circulation of women with preeclampsia. However, these studies were not performed for early or late preeclampsia subgroups individually. The present authors planned to determine the levels of the cell free both fetal and maternal DNA in the maternal circulation in early preeclampsia subgroup and compare it with normotensive control cohort. MATERIALS AND METHODS A total of 16 women; eight of these with preeclampsia and eight normotensive control cohorts with singleton male pregnancy between 28 and 32 gestational weeks were included in the study. Real-time PCR analysis was performed for determining the circulating cell free DNA levels. RESULTS Cell free fetal DNA concentrations were higher in early preeclamptic women than control subjects. The authors found no statistically significant difference in each levels of maternal and total DNA between hypertensive and normotensive groups. CONCLUSIONS The present findings suggest that the levels of cell free fetal DNA in maternal circulation were higher in pregnancies which are complicated with early preeclampsia than normotensive controls.

Research paper thumbnail of Extrapelvic Endometriosis: Two Case Reports

Gorm, 2016

Endometriosis is the growth of endometrial cells outside the uterine cavity. Most common localiza... more Endometriosis is the growth of endometrial cells outside the uterine cavity. Most common localizations are pelvic organs and peritoneum. Endometriosis mostly affects women in their reproductive years. After surgery it can be seen on the abdominal wall. This article includes two patients, one has abdominal wall endometriosis and the other has inguinal endometriosis. Both of them had surgical excision without recieving any medical treatment.

Research paper thumbnail of İlk Trimester TSH Düzeyinin Obstetrik ve Perinatal Sonuçlara Etkisi

Aim: To investigate the association of first trimester TSH levels in pregnant woman with the feta... more Aim: To investigate the association of first trimester TSH levels in pregnant woman with the fetal birth weights. Material and Methods : The study was a retrospective study at Ankara University Ostetrics and Gynecology in January 2014 to January 2015 . 397 singleton pregnancies, the first trimester were included in the study. Thyroid disease history, diabetes mellitus, preeclampsia, heart disease, cigarettes and alcohol use, birth before 37 weeks of gestation were excluded from study. Patients were divided into two groups according to TSH levels. TSH levels in the first group of 0.5-2.5 mU / L (Group 1:202 patients ) and the second group TSH level 2.5-5 mU / L ( Group 2:195 patients ), respectively. Groups were compared with gestational age, birth weight, gravity, parity, Apgar scores, 50 g oral glucose tolerance test (OGTT) results, method of delivery, premature rupture of membranes, intrauterine growth retardation ( IUGR), pregnancy -induced hypertension (PIH ), placental abruptio...

Research paper thumbnail of Serum and follicular fluid concentration of stem cell factor in PCOS

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018

Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in reproduct... more Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in reproductive-aged women, which affects 5 to 20% of women in the reproductive age worldwide. This study aimed to compare the levels of SCF in serum and follicular fluid of PCOS patients with those of non-PCOS group and to investigate the relationship of SCF levels with ICSI success.Methods: This is an observational case control study that included the patients who underwent ICSI in the Infertility-IVF center at Ankara University Faculty of Medicine and in a private IVF center between March 2016 and February 2017. The study group consisted of 57 PCOS patients diagnosed according to the Rotterdam criteria and the control group consisted of 75 patients with normofollicular and regular menstrual cycles. Serum and follicular fluid samples were taken on day of oocyte retrieval. Serum and follicular fluid SCF levels were determined by ELISA using the SCF ELISA kit..Results: Serum and follicular fluid SCF...

Research paper thumbnail of AB0839 Fibromyalgia Syndrome in Pregnant Women; The Effects on Physical Functioning and Psychological Status

Annals of the Rheumatic Diseases, 2016

miR-320b and the score of depression scale.ROC curves for each miRNAs displayed a AUC greater tha... more miR-320b and the score of depression scale.ROC curves for each miRNAs displayed a AUC greater than ∼0.7 and the best generalized linear model that can be employed to discriminate FM patients from healthy controls was obtained by taking into account only 5 miRNAs: miR-23a-3p, miR-1, miR-133a, miR-346 and miR-320b (AUC=0.954, sensitivity=100%, specificity=83.3%). Conclusions: Our preliminary work outlines the importance of using circulating miRNAs in liquid biopsies as a powerful diagnostic signature for the diagnosis of FM.Although the expression and the modulation of miRNAs seem to be site specific, we suggested a panel of serum miRNAs that can be used in the future as potential predictors of FM.A wider cohort of patients will be necessary to integrate the results that we obtained in this work and to suggest a more robust predictive model to exploit as an additional diagnostic tool for FM patients.

Research paper thumbnail of The reproductive outcome after hysteroscopic metroplasty in patients with deep uterine septum and T-shaped uterus

Fertility and Sterility, 2016

Research paper thumbnail of True Management of Herlyn-Werner-Wunderlich Syndrome (OHVIRA Syndrome)

Journal of Minimally Invasive Gynecology, 2016

Research paper thumbnail of Association of first trimester serum uric acid levels gestational diabetes mellitus development

Journal of Turkish Society of Obstetric and Gynecology, 2016

Amaç: Düşük riskli gebelerde ilk trimester ürik asit seviyelerinin gestasyonel diabetes mellitus ... more Amaç: Düşük riskli gebelerde ilk trimester ürik asit seviyelerinin gestasyonel diabetes mellitus (GDM) gelişimiyle ilişkisinin saptanması. Gereç ve Yöntemler: Bu retrospektif veri analizinde birinci trimester biyokimya testi ile iki basamaklı gestasyonel diyabet taramasını tamamlamış gebe kadınların sonuçları; yaş, vücut kitle indeksi ve gestasyonel hafta açısından eşleştirilmiş kontrol grubu karşılaştırıldı. 100-g oral glukoz tolerans testine göre gebeler GDM ve bozulmuş glukoz toleransı (BGT) gruplarına ayrıldı. Gruplar arasında ürik asit seviyeleri karşılaştırıldı ve ürik asit seviyelerinin, GDM ve BGT için tanısal gücü sinyal algılama teorisinde, alıcı işletim karakteristiği eğrisi ile test edildi. Bulgular: GDM grubundaki 66 kadın ve BGT grubundaki 358 kadın, 202 sağlıklı kadınla karşılaştırıldı. Yaş, parite, gebelik öncesi vücut kitle indeksi ve gestasyonel yaş açısından istatistiksel anlamlı farklılıklar içermeyen grupların birinci trimester serum örnekleri toplandı. Ortalama serum ürik asit seviyesi GDM ve bozulmuş glukoz toleransı gruplarında (sırasıyla, 5,95 mg/dL (±0,97) ve 4,76 mg/dL (±1,51) kontrol grubu ile karşılaştırıldığında (3,76 mg/ dL±1,07) (p<0,001) daha yüksek olduğu görüldü. GDM tanısında ürik asit seviyeleri için ROC eğrisi altında kalan alan 0,92 idi (%95 güven aralığı 0,88-0,95). 3,95 mg/dL eşik değer olarak alındığında ürik asit seviyeleri GDM gelişme durumunu %60 spesifisite ve %100 sensitivite ile göstermektedir. Sonuç: İlk trimester ürik asit seviyeleri ile GDM ve BGT gelişimi arasında lineer bir ilişki vardır.

Research paper thumbnail of Fetal Kromozomal Hastalıklar: Fetal Tanısal İnvaziv Girişimler

Turkiye Klinikleri Journal of Gynecology and Obstetrics Special Topics, 2011

Research paper thumbnail of Heavy metal and trace element concentrations in blood and follicular fluid affect ART outcome

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2016

To assess the effects of heavy metal and trace element concentrations in blood and follicular flu... more To assess the effects of heavy metal and trace element concentrations in blood and follicular fluid on assisted reproductive technology cycle outcome. A prospective study was conducted between January 2012 and July 2012 in a university hospital infertility clinic. One hundred and one patients with unexplained infertility who underwent intracytoplasmic sperm injection using GnRH-antagonist protocol were recruited. Concentrations of four toxic metals (Cd, Pb, Hg, As) and three trace elements (Cu, Zn, Fe) were measured both in blood and follicular fluid specimens. Patients were evaluated in two groups; the study group consisted of patients with ongoing pregnancy (n=20) and the reference group consisted of patients experienced assisted reproductive technology failure, miscarriage or biochemical pregnancy (n=81). Demographics and cycle parameters were comparable between the groups except for median number of day 3 Grade A embryos. Statistically significant negative correlations were found between blood Pb levels and number of MII oocytes, implantation, clinical pregnancy and ongoing pregnancy rates. Results of the log binomial regression revealed 2.2% lower risk for ongoing pregnancy for each 1μg/dL higher blood Pb concentration while holding the other variables in the model constant (RR 0.978; 95% CI 0.956-0.998; P=.041). Also, the results revealed 71.9% lower risk for ongoing pregnancy for each 1μg/dL higher follicular fluid Cu concentration while holding the other variables in the model constant (RR 0.288; 95% CI 0.085-0.92; P=.039). Blood concentrations of Pb and follicular fluid concentrations of Cu seem to have significant impacts on assisted reproductive technology cycle outcome.

Research paper thumbnail of Laparoscopic Management of Juvenile Cystic Adenomyoma

Journal of Minimally Invasive Gynecology, 2015

Research paper thumbnail of Hızlı Gerileme Gösteren Tek Taraflı Fetal Plevral Efüzyon

Cukurova Medical Journal, 2015

Intrauterine pleural effusion of fetal lungs rarely regresses without intervention. In our case w... more Intrauterine pleural effusion of fetal lungs rarely regresses without intervention. In our case we treated a women at 32th weeks of gestation. Her pregnancy was complicated with fetal pleural effusion and polyhydramniosis. A therapeutic thoracocentesis was planned and she received two courses of betamethasone prior to procedure. On the day of planned procedure, a substantial regression of pleural effusion was observed and procedure was postponed. During her antenatal follow-up a complete regression of pleural effusion was observed. After delivery pleural effusion did not relapse. These findings hint there may be a role of antenatal steroids in treatment of fetal pleural effusion, which is known to be resistant to treatment modalities both during antenatal and postnatal period.

Research paper thumbnail of Problems with the Diagnosis of Endometriosis

Research paper thumbnail of Rapidly Regressive Unilateral Fetal Pleural Effusion

Intrauterine pleural effusion of fetal lungs rarely regresses without intervention. In our case w... more Intrauterine pleural effusion of fetal lungs rarely regresses without intervention. In our case we treated a women at 32th weeks of gestation. Her pregnancy was complicated with fetal pleural effusion and polyhydramniosis. A therapeutic thoracocentesis was planned and she received two courses of betamethasone prior to procedure. On the day of planned procedure, a substantial regression of pleural effusion was observed and procedure was postponed. During her antenatal follow-up a complete regression of pleural effusion was observed. After delivery pleural effusion did not relapse. These findings hint there may be a role of antenatal steroids in treatment of fetal pleural effusion, which is known to be resistant to treatment modalities both during antenatal and postnatal period.

Research paper thumbnail of Is omitting the 3rd hour measurement in the 100 g oral glucose tolerance test feasible?

Journal of perinatal medicine, Jan 30, 2015

To evaluate the diagnostic value of the 3rd hour plasma glucose level in the 100 g oral glucose t... more To evaluate the diagnostic value of the 3rd hour plasma glucose level in the 100 g oral glucose tolerance test (OGTT). Records of all pregnant patients with abnormal 50 g glucose challenge test (GCT) between January 2005 and December 2013 were reviewed (n=1963). The 100 g OGTT results were analyzed separately for both Carpenter & Couston (CC) and National Diabetes Data Group (NDDG) criteria. The number of patients diagnosed with gestational diabetes mellitus (GDM) was 297 (15.1%) according to CC criteria and 166 (8.4%) according to NDDG criteria. The 1st hour plasma glucose level showed the highest correlation with GDM diagnosis (ρ=0.595 for CC and ρ=0.567 for NDDG). However, the 3rd hour plasma glucose level showed the weakest correlation with GDM diagnosis (ρ=0.216 for CC and ρ=0.213 for NDDG). The 3rd hour value of 100 g OGTT was one of the two elevated measurements in 10.8% of patients when CC criteria are used and in 13.8% of patients when NDDG criteria are used. Omitting 3rd h...

Research paper thumbnail of Effect of the timing of delivery on perinatal outcomes at gestational hypertension

Interventional Medicine and Applied Science, 2015

Objective: We aimed to evaluate the perinatal outcomes of women diagnosed with gestational hypert... more Objective: We aimed to evaluate the perinatal outcomes of women diagnosed with gestational hypertension and no proteinuria according to the gestational weeks. Methods: We included women diagnosed with gestational hypertension between 2010 and 2014 at our institution and excluded the patients with preeclampsia and chronic hypertension. Women with gestational hypertension were grouped according to the gestational weeks. One group consisted of the pregnancies between 37 and 38*6, whereas the other group included pregnancies between 39 and 41 weeks. Then the outcomes of these pregnancies were compared with healthy women who had delivery between the same weeks (37-38*6 weeks and 39-41 weeks). We analyzed the mode of delivery, birth weight, and neonatal outcomes of these pregnancies. Results: First and fi fth minute Apgar scores were signifi cantly decreased in women with gestational hypertension who had delivery between 39 and 41 weeks compared to healthy subjects (respectively, p = 0.005 and p = 0.033). Perinatal outcomes were adversely aff ected if the time of delivery was beyond 39 weeks in pregnancies complicated with gestational hypertension. Conclusion: We concluded that perinatal outcomes were adversely aff ected if the time of delivery was beyond 39 weeks in pregnancies complicated with gestational hypertension, and outcomes of such pregnancies can be improved if time for delivery is <39 weeks.

Research paper thumbnail of Effect of reproductive history, lactation, first pregnancy age and dietary habits on bone mineral density in natural postmenopausal women

Aging Clinical and Experimental Research, 2015

Aim The aim of this study was to investigate the possible risk factors related with osteoporosis ... more Aim The aim of this study was to investigate the possible risk factors related with osteoporosis in women with spontaneous menopause. Methods Five hundred and one postmenopausal women were divided into three groups as normal, osteopenic and osteoporotic according to their bone mineral density (BMD). By face-to-face interview, parity, age at menarche, age at menopause, duration of fertility, duration of menopause, first pregnancy age, total lactation period, exercise, smoking were assessed. Women with menopause age before 40 years, surgical menopause, who had any anti-osteoporosis treatment, hormone replacement therapy at the time of BMD measurement and corticosteroid use longer than 6 months were excluded from the study. Results Among 501 postmenopausal women, 107 women were classified as normal, 170 as osteopenic and 224 as osteoporotic. Among demographic features of patients, there was statistically significant difference between the groups in age, BMI and parity (p \ 0.001, p \ 0.0001 and p = 0.002, respectively). There were statistically significant differences between the groups in case of age at menopause, duration of fertility and duration of menopause (p = 0.013, p = 0.013 and p \ 0.0001, respectively). In the multivariate logistic regression analysis, BMI over 32 and fertility duration over 33 years had a statistically significant protective effect against osteoporosis (OR 0.42, CI 95 % 0.27-0.66; OR 0.36, CI 95 % 0.24-0.56, respectively), but age was positively correlated with osteoporosis (OR 1.13, CI 95 % 1.01-1.17) Conclusions Duration of fertility (years of menstruation) longer than 33 years and body mass index higher than 32 seem to protect against postmenopausal osteoporosis. Age is also an independent risk factor for postmenopausal osteoporosis. Keywords Postmenopausal osteoporosis Á Risk factors Á Lactation Á First pregnancy age Á Duration of fertility Á Body mass index This study has been accepted as poster presentation in 23th EBCOG European Congress of Obstetrics and Gynaecology in Glasgow, Scotland (UK), on May 7th-10th 2014.

Research paper thumbnail of Follicular fluid levels of norepinephrine and dopamine are higher in polycystic ovarian syndrome (PCOS) after controlled ovarian stimulation (COS)

Fertility and Sterility, 2014

Research paper thumbnail of Agenesis of Ductus Venosus Presenting with Dilated Inferior Vena Cava with Favorable Outcome

International Journal of Women's Health and Reproduction Sciences, 2014

The ductus venosus regulates the distribution of oxygen and placental nutrients by restricting th... more The ductus venosus regulates the distribution of oxygen and placental nutrients by restricting the centralization of blood flow in fetal circulation. The ductus venosus is a small vein transmitting oxygen-rich blood from the umbilical vein to the fetal heart.. Increasing numbers of case reports are being published about ductus venosus agenesis with cardiac structural abnormalities, other malformations, chromosomal abnormalities, and stillbirth. Heart failure, hydrops and unexplained polyhydramnios could also be associated with ductus venosus agenesis. In the follow-up of fetuses with ductus venosus agenesis, care must be taken to examine for hydrops and heart failure. The agenesis of ductus venosus is often only found in fetuses by coincidentally. Herein we discuss the prenatal diagnosis of isolated agenesis of the ductus venosus presenting with a dilated inferior vena cava and without any disturbance of fetal hemodynamics and any other malformation. In conclusion a dilated inferior vena cava can be a sign of ductus venosus agenesia.

Research paper thumbnail of Hope and reality: dhea supplementation in poor responder regarding bologna criteria

Fertility and Sterility, 2014

OBJECTIVE: 10,000 IU hCG (10K) has been routinely used for the induction of oocyte maturation dur... more OBJECTIVE: 10,000 IU hCG (10K) has been routinely used for the induction of oocyte maturation during IVF cycle, but 5,000 IU (5K) may be a safer dose in high responding patients. We compared embryo development, implantation rate, and ongoing pregnancy rate/live birth rate in high responding patients who received hCG 5K vs hCG 10K in donor and non-donor IVF cycles. DESIGN: Retrospective cohort study. MATERIALS AND METHODS: All high responders defined as patients with peak serum estradiol > 4,000 pg/ml during IVF stimulation and < age 40 who underwent IVF from September of 2006 to March of 2014 were included in the study. Patients who received 5K hCG (n¼101) were compared with those who received 10K hCG (n¼104). Patient age, number of oocytes retrieved, percentage of matured oocytes, fertilization rate, number of embryos transferred, percentage of embryos reaching blastocyst stage, implantation rate and percentage of ongoing pregnancy/live birth were compared between the two groups. RESULTS: There were no significantly different in terms of patient's age, number of oocytes retrieved, percentage of matured oocytes, fertilization rate and number of embryos transferred between the two groups (P > 0.05). 42.7% of embryos in the hCG 5K group reached blastocyst stage, compared with 36.1% in the hCG 10K group (P < 0.05). Implantation rate in the hCG 5K was 38.1%, vs 25.2% in the hCG 10K group (P < 0.01). The ongoing pregnacy/live birth rate in the hCG 5K group was 57.4%, vs 39.4% in the hCG 10K group (P < 0.05). When the non-donor cycles were separated from the donor cycles, the implantation and blastocyst rates in the non-donor cycles were 35.6% and 39.7% in the hCG 5K group (n¼86), vs 23.3% (P<0.01) and 32.1% (P<0.05) in the hCG 10K group (n¼71). In IVF cycles with donor eggs, the implantation and blastocyst rates in the hCG 5K group (n¼15) were 56.7% and 59.9%, significantly higher than 30.3% and 44.4% in the hCG 10K group (n¼34, P<0.05). CONCLUSION: In high responders, the trigger of final oocyte maturation with hCG 5K resulted in more embryos developing to blastocyst, higher implantation rate, and higher ongoing pregnancy/live birth rate than did trigger with hCG 10K. Given that higher blastocyst development and implantation rates were seen in both donor and non-donor cycles, oocyte/embryo quality may play a greater role in our observations than endometrial receptivity.