SİNEM ERTAŞ - Academia.edu (original) (raw)

Papers by SİNEM ERTAŞ

Reproductive BioMedicine Online, 2020

Research-question: Does anogenital distance (AGD) differ in newborn infants conceived through ass... more Research-question: Does anogenital distance (AGD) differ in newborn infants conceived through assisted reproduction technologies (ART) compared with those conceived naturally. Design: In this case-control study, anthropometric and anogenital measurements were performed in 247 male and 200 female newborns born after ART (n=121) or natural conception (n=326), within 24 hours of birth. Anogenital measurements included distance from anus to the a nterior clitoris (AGDAC) and to the posterior fourchette (AGDAF) in female infants, and distance from the center of the anus to the posterior base of the scrotum (AGDAS) and to anterior base of the penis (AGDAP) in male infants. Results: ART cohort was older, more likely to be nulliparous and delivered by cesarean section at an earlier gestational week. AGDAS of male infants was approximately twice as long as AGDAF of female infants (17.6±5.0 vs 9.1±3.6 mm, p<0.001). On average, female infants conceived by ART had shorter AGDAF (8.8±3.6 mm) than those conceived naturally (9.1±3.6 mm) but the difference was not significant (p >0.05). AGDAC were comparable for both groups (27.7 ± 7.1 vs 27.4 ± 6.3 mm, p>0.05). In male infants, no significant difference was seen between ART and natural conception groups in terms of AGDAS (17.4±4.6 vs 17.7±5.2 mm) and AGDAP (38.0 ± 6.7 vs 37.5 ± 6.6 mm, p >0.05 for both). When adjusted for gestational age, weight, length and head circumference, mode of conception was not associated with differences in any of the anogenital measurements. Conclusions: AGD measurements in infants conceived by ART are not different from those of infants conceived naturally.

Archives of Gynecology and Obstetrics

Background To date hysteroscopy is the gold standard technique for the evaluation and management ... more Background To date hysteroscopy is the gold standard technique for the evaluation and management of intrauterine pathologies. The cervical canal represents the access route to the uterine cavity. The presence of cervical stenosis often makes entry into the uterine cavity difficult and occasionally impossible. Cervical stenosis has a multifactorial etiology. It is the result of adhesion processes that can lead to the narrowing or total obliteration of the cervical canal. Purpose In this review, we summarize the scientific evidence about cervical stenosis, aiming to identify the best strategy to overcome this challenging condition. Methods The literature review followed the scale for the quality assessment of narrative review articles (SANRA). All articles describing the hysteroscopic management of cervical stenosis were considered eligible. Only original papers that reported data on the topic were included. Results Various strategies have been proposed to address cervical stenosis, i...

Reproductive BioMedicine Online, 2021

RESEARCH QUESTION What is the prevalence of T-shaped uteri among fertile women based on ESHRE/ESG... more RESEARCH QUESTION What is the prevalence of T-shaped uteri among fertile women based on ESHRE/ESGE and Congenital Uterine Malformation by Experts (CUME) criteria? DESIGN A prospective cohort study of 258 women of reproductive age with a history of at least one natural pregnancy resulting in live birth. Participants were recruited from the family planning clinic between January 2018 and March 2020. The ESHRE/ESGE classification of congenital anomalies of the female genital tract was used for describing abnormal findings. CUME criteria were also used for diagnosing T-shaped uterus. Uterine cavity volume was measured. RESULTS Mean age of participants was 35.4 ± 6.2 years. Participants were diagnosed with the following: congenital uterine abnormality (n = 9 [3.6%]); partial septate uterus (n = 5 [2.0%]) and hemiuterus (n = 2 [0.8%]). Two women (0.8%) were diagnosed with T-shaped uterus and borderline T-shaped uterus based on the ESHRE/ESGE criteria and CUME. Mean lateral indentation angle, lateral indentation depth and T-angle were 156.2° ± 9.53°, 2.85 ± 0.93 mm and 73.3° ± 9.85° in patients with normal uterine cavity. In patients with T-shaped and borderline T-shaped uteri, respective figures were 115° versus 121°, 10 mm versus 7.6 mm and 27.5° versus 70°. Median volume of the uterine cavity in patients with normal uterine cavity and T-shaped uterus was 3.71 ml (minimum 2.0 to maximum 9.03 ml, interquartile range 1.93) and 3.2 ml (2.9 and 3.62 ml), respectively. CONCLUSIONS The prevalence of T-shaped uteri in fertile women is low, which corresponds to previous reports of women with poor reproductive history.

Asian Pacific Journal of Cancer Prevention, 2016

Background: To evaluate the predictive role of a risk of malignancy index in discriminating betwe... more Background: To evaluate the predictive role of a risk of malignancy index in discriminating between benign and malignant adnexal masses preoperatively. Materials and Methods: A total of 408 patients with adnexal masses managed surgically between January 2010 and February 2014 were included. The risk of malignancy indices (RMI) 1, 2, 3 and 4 were calculated using findings for ultrasonography, menopausal status, and CA125 levels. Histopathologic results were the end point. ROC analysis was used for the sensitivity and the specificity of the models. Results: Some 37.6 % of the cases were malignant in the postmenopausal group while 7.9 % were malignant in the premenopausal group. Pelvic pain was the most common complaint, and the majority of the cases were diagnosed at stage 3. The RMI 1, 2, 3 and 4 yielded percentage sensitivities of 76.1, 79.1, 76.1 and 76.1 and specificities of 91.5, 89.1, 90.6, 88.6, respectively. RMI 1 was the most reliable test in the general population according to AUC levels and Kappa statistics. From ROC analysis results of post/ premenopausal women, the RMI 1 (cut off: 200) yielded sensitivities of 84.0/60.9 and specificities of 87.7/92.5. With RMI 2 they were 88.6/60.9 and 80.0/91.0, with RMI 3 84.0/ 60.9 and 87.7/91.8, and with RMI 4 (cut off:400) 81.8/47.8 and 83.6 /44.0. Although test performance of RMI methods were good in a general population and postmenopausal women, the RMI inter-agreement validity was only moderate or fair in premenopausal women. Conclusions: Our study confirms the effectiveness of RMI algorithms in postmenopausal women. However, more sensitive tests are needed for premenopausal women.

BMJ Open, 2017

BackgroundPatients undergoing in vitro fertilisation (IVF) receive various adjuvant therapies in ... more BackgroundPatients undergoing in vitro fertilisation (IVF) receive various adjuvant therapies in order to enhance success rates, but the true benefit is actively debated. Growth hormone (GH) supplementation was assessed in poor-prognosis women undergoing fresh IVF transfer cycles.MethodsData were retrospectively analysed from 400 IVF cycles, where 161 women received GH and 239 did not.ResultsClinical pregnancy, live birth rates and corresponding ORs and CIs were significantly greater with GH, despite patients being significantly older with lower ovarian reserve. Patient’s age, quality of transferred embryo and GH were the only significant independent predictors of clinical pregnancy (OR: 0.90, 5.00 and 2.49, p<0.002, respectively) and live birth chance (OR: 0.91, 3.90 and 4.75, p<0.014, respectively). GH increased clinical pregnancy chance by 3.42-fold (95% CI 1.82 to 6.44, p<0.0005) and live birth chance by 6.16-fold (95% CI 2.83 to 13.39, p<0.0005) after adjustment for...

Journal of Clinical and Experimental Investigations, 2013

Objective: Ovarian cancers, the relatively high frequency, poor prognosis and late diagnosis are ... more Objective: Ovarian cancers, the relatively high frequency, poor prognosis and late diagnosis are considerable clinical issues and additional diagnostic methods are needed. The aim of this study was to evaluate the predictive value of RMI as a diagnostic marker in ovarian cancers. Methods: Totally 80 patients with adnexal masses who were operated in Haydarpaşa Numune Training and Research Hospital Gynecology and Obstetrics Department between January 2012-June 2012, included in the study. This was a retrospective observational study. All patient' documents were reevaluated and calculated for RMI. The calculated results were compared with histopathologic findings. Results: The 30% (n=24) of women were in postmenopousal period. The major complains of patients during attendance were pelvic pain (65%) and 27.5% of the patients had no complaints and adnexal masses were detected during routine gynecological examination The 86.3% (n=69) of women had benign ovarian neoplasms, 11.3% (n=9) had malignant tumors and 2.5% (n=2) had borderline ovarian tumors. Most of the women with high RMI levels were in postmenopousal status (71.5%). The sensitivity and specificity of RMI were 81.8% and 92.6% respectively. The sensitivity and specificity of CA-125 levels were 90.9% and 36.4% respectively. Conclusion: Using RMI in diagnosis of malign ovarian tumors is easily appliable method with high sensitivity and specificity without financial burden.

Gynecological Endocrinology

Istanbul Medical Journal

Introduction: This study aimed to evaluate the prognosis of patients with low rates of oocyte mat... more Introduction: This study aimed to evaluate the prognosis of patients with low rates of oocyte maturity and compare those who are aforethought poor responders with respect to the Bologna criteria. Methods: All assisted reproductive technology (ART) cycles conducted from 2004 to 2018 in a tertiary center in İstanbul were analyzed retrospectively. Patients were grouped into three accordingly the count of total retrieved oocytes and metaphase-II [(M-II)-mature] oocytes after denudation (group 1: ≤3 oocytes and ≤3 M-II oocytes; group 2: >3 oocytes and ≤3 M-II oocytes; group 3: >3 oocytes and >3 M-II oocytes). A Low oocyte maturity rate was diagnosed when ≤50% of all harvested oocytes were in the M-II stage before the fertilization procedure. Results: During the study period 14,899 intracytoplasmic sperm injection cycles were evaluated. The study group's mean age was 32.6±5.3. The mean counts of total and mature oocytes were 9.8±5.9 and 7.3±4.5, respectively. A mean count of 2.38 embryos was transferred in 10118 cycles. The group 3 patients had a considerably higher live birth ratio compared to the group 1 and 2. Conclusion: We propose oocyte maturity rate and the count of M-II oocytes as two diagnostic criteria for the case definition of asynchronous follicle growth. Based on our findings, stimulation cycles ending with low oocyte maturity rate (≤50%) and ≤3 M-II oocytes would be considered asynchronous follicle development. Patients with low oocyte maturity rate and asynchronous follicle development should be counseled and informed regarding potential poor prognosis of the treatment.

Journal of the Turkish-German Gynecological Association, 2022

Journal of the Turkish German Gynecological Association, 2021

Objective The assessment of the optimal number of follicular flushing on retrieval rate and quali... more Objective The assessment of the optimal number of follicular flushing on retrieval rate and quality of oocytes in mono-follicular IVF cycles. Material and Methods This is a retrospective analysis of 246 oocyte pick-up procedures in mono-follicular IVF cycles of 226 poor responder women. The primary endpoint was oocyte retrieval rate in the initial aspirate versus subsequent flushing episodes. The secondary endpoints were oocyte maturity, fertilization rates and embryo cleavage. Results The procedure was successful in 187 cycles (76%), out of which 160 M-II oocytes were retrieved. Retrieval rates were similar for natural and modified natural cycles (p=0.595). The initial aspirate provided 54% of the total yield and the rest was obtained from up to four episodes of flushing. Follicular flushing increased oocyte recovery rate from 41.1% to 76%. None of the oocytes retrieved after three flushes fertilized. Oocyte maturity, fertilization and embryo cleavage rates were comparable for oocy...

The Journal of Maternal-Fetal & Neonatal Medicine, 2020

Introduction: This study aimed to evaluate the changes in ischaemia-modified albumin (IMA) levels... more Introduction: This study aimed to evaluate the changes in ischaemia-modified albumin (IMA) levels in different types of hypoxia-associated epileptic seizures. Methods: A total of 80 patients admitted to the Neurology Outpatient Clinic in Ankara Numune Training and Research Hospital and 103 controls were included in the study. The patients were divided into two groups in terms of the seizure type, including seizures with partial and secondary generalisation and primary generalised seizures. Additionally, patients were classified in terms of the duration between the initial diagnosis and admission. The levels of IMA, albumin and uric acid were analysed by spectrophotometry and comparisons between the groups were performed. Results: IMA levels and IMA/Albumin index values were higher in the patient group than in the control group (p<0.05; p<0.01, respectively). Regarding the evaluation of the seizure types, IMA and IMA/Albumin index levels were mainly higher in patients with primary generalised seizures (p<0.05). Moreover, these parameters were significantly increased in proportion to the duration of diagnosis. Conclusion: IMA and IMA/Albumin index may enable clinicians to differentiate the types of epilepsy.