Pervin Karli - Academia.edu (original) (raw)

Papers by Pervin Karli

Research paper thumbnail of Serum kisspeptin levels in deep-infiltrating, ovarian, and superficial endometriosis: A prospective observational study

Research paper thumbnail of Does Type of Menopause Affect the Sex Lives of Women?

Medical Science Monitor, 2020

The aim of this study was to investigate factors affecting the sex lives of middle-aged women, an... more The aim of this study was to investigate factors affecting the sex lives of middle-aged women, and whether surgical menopause affects sexual function differently from natural menopause, by comparing effects on sexual performance of women with similar demographic features. Material/Methods: The study included 151 women with surgical menopause (SM), 357 women with natural menopause (NM), and 186 perimenopausal women (PM). The women were asked to complete a 6-question survey of sexual performance parameters. The relationship between the demographic and clinical features and hormone levels of the groups and sexual function parameters were evaluated. We also compared these parameters between the 3 study groups, and paired comparisons were made between the SM group and the NM group. Results: Demographic features, serum DHEA-S, total testosterone, and FSH levels were found to have statistically significant effects on sexual performance of women (p<0.05). The sexual function scores for the frequency of sexual desire, coitus, and orgasm were significantly higher in the PM group, whereas vaginal lubrication scores were lower compared to the NM and SM group (p<0.05). In paired comparison of NM and SM, the scores for the frequency of coitus, orgasm, and vaginal lubrication were significantly higher in the SM group, while sexual desire frequency scores were higher in the NM group (p<0.05). Conclusions: Our study approached to this topic in an extended manner and found significant relationships between several demographic-clinical and hormonal factors. SM was found to not affect female sexual performance, except for sexual desire, more than NM.

Research paper thumbnail of Melatoninin kaynağı triptofanın IVF hastalarının sonuçlarına ve Doppler parametrelerine etkisi

Journal of Health Sciences and Medicine, 2020

Aims: Melatonin is the most powerful antioxidant and protects sperm, oocyte and embryo against ox... more Aims: Melatonin is the most powerful antioxidant and protects sperm, oocyte and embryo against oxidative stress. The effect of tryptophan, which is the building block of melatonin, on follicular melatonin levels and IVF outcomes is unknown. The objective of this study was to investigate the effect of tryptophan administration, a precursor for melatonin, on the levels of intrafollicular melatonin with the aim to reveal the correlation between tryptophan and the total number and quality of oocytes as well as clinical pregnancy rates. In addition, we aimed to examine the effect of melatonin increased by tryptophan on uterine and ovarian blood flow. Methods: Out of 103 patients who applied to Ondokuzmayis University IVF clinic for IVF treatment, 51 patients were administered a 100 mg dose of tryptophan orally (Group A) and 50 control patients who were randomly selected did not receive tryptophan (Group B). Firstly, follicular melatonin levels were compared between Group A receiving tryp...

Research paper thumbnail of Evaluations of pregnancy admitted to perinatology clinics that pregnants have fetal anomalies

Journal of Health Sciences and Medicine, 2020

Objective Our objective was to investigate the most common anomalies in our region with a retrosp... more Objective Our objective was to investigate the most common anomalies in our region with a retrospective evaluation of the congenital anomaly cases, who applied to the outpatient department of perinatology Materials and Methods: We was reviewed file of congenital anomaly cases, who applied to the outpatient department of perinatology in the Medical Faculty at Ondokuz Mayıs University between May 2014 and May 2019,and to determine the risk factors related to these anomalies. Seven hundred twenty-five pregnant women, whose infants were diagnosed with congenital anomalies in our center, were included in the present study. Parameters like the mother's age, consanguineous parents, history of previous habitual abortions, history of siblings with anomalies, number of parity and abortus history, gestational week at diagnosis, smoking, alcohol and drug consumption in the first trimester, periconceptional folic acid use, co-morbidities, ultrasonographic findings, presence of the karyotype ...

Research paper thumbnail of The two new surgical techniques for vaginal cuff prolapse and uterine prolapse

Journal of Surgery and Medicine, 2019

Pelvic organ prolapse and vaginal cuff prolapse are clinical conditions that affect women's quali... more Pelvic organ prolapse and vaginal cuff prolapse are clinical conditions that affect women's quality of life and require surgical treatment. In this study, we aimed to present apical vaginal prolapse and uterine descensus treatment with two new techniques. The classical sacrospinous ligament fixation technique fixes only one or two corners of the vaginal apex to the sacrospinous ligament, but it does not support the upper anterior and posterior vaginal fascia. Since it expands the upper part of the vagina with a suture put on the sides of the vaginal apex, it may not only expose the anterior and posterior vaginal walls to greater intraabdominal pressure and cause cystocele and enterocele development, but lead to sexual problems, as well. Apart from this, if sacrospinous colpopexy is performed to one side only, the vaginal apex is deviated towards the fixation, thus spoiling the vaginal anatomy. With our following methods, we imitate the physiological anatomy: Transapical circular Sacrospinous colpopexy (TACSAC) and Transcervical apical circular Sacrospinous uteropexy (TACSU). TACSAC: Bilateral side walls of the vaginal apex are marked with a color pencil 2 cm medially to the right and left ischial spine and 2 cm in length. Vaginal apex walls are bilaterally and vertically incised until the submucosa layer. Two submucosal tunnels are opened by using a right-angle clamp between the tips of two vertical incisions on the vaginal apex. The vaginal apex is fixed with a TOT mesh through these channels. In TACSU, the same procedure is followed for the cervix. These methods are more likely to mimic normal anatomy, easier to perform, and lower risk of complications.

Research paper thumbnail of Impact of serum adipokines on tumor mitotic and apoptotic activity in endometrial cancer

Journal of Surgery and Medicine, 2019

Aim: Endometrial cancer is the most common malignancy of female genital system. Obesity is one of... more Aim: Endometrial cancer is the most common malignancy of female genital system. Obesity is one of the most important risk factors in endometrial cancer. Adipose tissue functions just like an endocrine organ by secreting many bioactive substances and contribute to tumor development. The aim of this study was to investigate the correlation between serum adipokine levels and tumor mitotic and apoptotic activity levels in endometrial cancer. Methods: We designed a cross-sectional study. After obtaining the approval of Ethics Committee, 38 patients with endometrial cancer admitted between 2014 July-2014 December to Obstetrics and Gynecology outpatient clinic of Ondokuz Mayıs University, Faculty of Medicine were included in the study. Serum leptin and adiponectin levels were measured in 5 cc serum samples taken from the patients preoperatively. The pathology specimens of the patients were semi quantitatively evaluated with immunohistochemical study considering the percentage and intensity of staining for bcl-2 and the percentage of staining for Ki67. Moreover, preoperative estradiol levels, insulin resistance, body fat percentages and body mass index (BMI) values were determined. The Mann Whitney U test, Kruskal Wallis and Spearman's Correlation test were used statistically. The results were considered statistically significant for P<0.05. Results: The patients included in the study were between 36-82 years of age and the mean age was 62.5 (10.4) years. The mean BMI value of the patients was 31.1 (4.8) kg/m2 (range: 19-38 kg/m 2). According to the FIGO 2010 staging system, the distribution of the patients were as follows: 30 patients (78%) Stage 1, 1 patient (2.6%) Stage 2 and 7 patients (18.4%) Stage 3. Of the patients, 6 (15.8%) had grade 1, 20 (52.6%) had grade 2 and 12 (31.6%) had grade 3. Twenty-seven patients were classified as endometrioid type and 11 patients were classified as nonendometrioid type. There was no statistically significant correlation between serum leptin and adiponectin levels and percentage of Ki-67 immunohistochemical staining in tumoral tissue and bcl-2 score (P=0.05). In the immunohistochemical examination of tumoral tissue, it was found that tumor grade statistically significantly increased as the staining percentage for Ki67 increased (r=0.571, P<0.001). There was no statistically significant correlation between Bcl-2 score and tumor grade or stage (P=0.751). It was found that serum leptin levels significantly increased as BMI increased (r=0.341, P=0.036). As HOMA-IR increased, adiponectin level statistically significantly increased (r=0.393, P=0.015). There was also no statistically significant difference between the endometrioid and non-endometrioid groups in terms of leptin, adiponectin and leptin/adiponectin levels (P=0.554, P=0.652). There was no statistically significant difference between the endometrioid and non-endometrioid groups in terms of median BCL-2 score and Ki-67 percentage (P=0.05). Conclusion: There was no correlation between serum leptin and adiponectin levels and Ki-67 immunohistochemical staining percentage and bcl-2 score.

Research paper thumbnail of A Different Method in the Treatment of Placenta Previa: A Comparison of Lower Uterine Segment Transverse Suture Technique and Bakri Balloon Application

Open Journal of Obstetrics and Gynecology, 2019

Objective: The incidence of placenta previa (PP) has been increasing due to the rise in cesarean ... more Objective: The incidence of placenta previa (PP) has been increasing due to the rise in cesarean rates. The aim of this study is to determine the success of lower uterine segment compression suture and bakri balloon applications in patients diagnosed with placenta previa. Materials and Methods: 257 patients who underwent cesarean section due to placenta previa totalis (PPT) between the years of 2010-2018 in Ondokuz Mayıs University were screened retrospectively. The patients were evaluated in four groups according to their treatment method: medical treatment, bakri balloon application, compression suture and hysterectomy. Results: In the study, between the years 2010-2015, postpartum hysterectomy was performed in the cases of adherent placenta previa, and hysterectomy was performed in 33 patients. Between the years of 2015-2018, first, bakri balloon or compression suture was applied; and if bleeding control was not achieved despite these, then, hysterectomy was performed. Between 2015 and 2018, a total of 27 patients underwent compression suture and 1 patient had a hysterectomy after all. The success rate was 96.3% with compression suture and 91.7% for bakri balloon application. Totally, 24 patients were treated with bakri balloon and yet, two patients underwent hysterectomy. When all the cases were examined, complications caused by urinary bladder and ureteral injury were seen in 5.6% of patients, and all of these complications were also seen in hysterectomy patients. Conclusion: Lower uterine segment transverse suture technique and bakri balloon application should be considered as a good alternative to prevent hysterectomy in

Research paper thumbnail of Thyroid Diseases During Pregnancy

E-journal of New World Sciences Academy, 2019

Research paper thumbnail of Antioxidant Supplement Improves the Pregnancy Rate in Patients Undergoing <i>in Vitro</i> Fertilization for Unexplained Infertility

Open Journal of Obstetrics and Gynecology, 2019

Objective: This is a retrospective study to evaluate the effect of using the antioxidants contain... more Objective: This is a retrospective study to evaluate the effect of using the antioxidants containing coenzyme Q10 (CoQ10) and omega-3 in patients undergoing in vitro fertilization and intracytoplasmic sperm injection (IVF-ICSI) for unexplained infertility. Materials Methods: A total of 299 patients undergoing IVF-ICSI for unexplained infertility at the IVF center of Ondokuz Mayıs University were studied. The subject group consisted of 135 patients who used OMEPA Q10 (Co Q10 100 mg, omega-3 600 mg, eicosapentaenoic acid 300 mg, docosahexaenoic acid 230 mg) for two months before ovarian stimulation. A group of 164 patients who did not use the supplement were evaluated as the control group. Results: The pregnancy rate of patients using antioxidants was statistically higher than that of those who did not use the supplement (p < 0.05). The pregnancy rates of patients in the two groups were 32.9% and 49.6% respectively. The pregnancy rate of patients using antioxidants was statistically higher than that of those who did not use the supplement (p < 0.05) seemed not enough. Conclusion: We concluded that using antioxidants that contain Co Q10 and omega-3 in patients undergoing IVF-ICSI for unexplained infertility increased the clinical pregnancy rate. We recommend using antioxidants that contain Co Q10 and omega-3 in infertile patients.

Research paper thumbnail of Isthmocele, challenging but not a rare entity; Its expected incidence might be more than reported

Journal of Surgery and Medicine, 2018

Aim: Isthmocele, a long-term complication of Cesarean section (CS) surgery, has drawn increasing ... more Aim: Isthmocele, a long-term complication of Cesarean section (CS) surgery, has drawn increasing worldwide interest. However, not all women with this Cesarean scar defect (CSD) present with clinical symptoms. We studied a group of non-pregnant women with a CS history to determine the prevalence of isthmocele, the potential risk factors for its development, and the most common clinical complaints. Methods: This study included women who had a cesarean operation more than 6 months ago, who were not pregnant between April 2017 and April 2017 and applied to the gynecology clinic for any reason. The exclusion criteria were the patients in the menopause period. Data was collected on 115 participants, including age, body mass index, duration after CS, and the number of CS surgeries that had been performed. Standardized scar parameters (residual myometrial thickness (RMT) and the depth and width of the triangular hypoechoic niche) were measured using transvaginalultrasonography (TVS). Isthmocele symptoms were categorized as asymptomatic, postmenstrual spotting, menometrorrhagia, chronic pelvic pain, dysmenorrhea, and infertility. Associations between isthmocele and menstrual complications were investigated. The relationship between isthmocele development and the reasons for the CS surgery were evaluated. Results: TVS examination diagnosed 17 women (14.78%) with isthmocele. Women who had undergone recurrent CS surgeries tended to have more visible isthmocele than those with a single CS surgery. The average isthmocele depth was 6.006 ± 0.7970 mm. Among the women with isthmoceles, elective CS surgery had been performed in six (35.3%), while 11 (64.7%) had the surgery at parturition. The presence of an isthmocele was frequently symptomatic, predominantly as postmenstrual spotting. Women with an isthmocele had significantly lower RMT values (5.57 ± 0.60 mm versus 8.78 ± 0.22 mm) than those without an isthmocele. There was no correlation between age, body mass index, and the presence of an isthmocele (p > 0.05). Conclusions: The incidence and prevalence of CSD is greater than most gynecologists realize. Isthmoceles can develop after just one CS surgery, leading to long-term complications that morbidly effect women for the rest of their lives. A reduction in the number of CS surgeries is the most effective way to decrease the prevalence of isthmoceles.

Research paper thumbnail of Olgu sunumu: İki Yıl Sonra Diğer Overde Tekrar Eden Müsinoz Kistadekarsinom

Adıyaman Üniversitesi Sağlık Bilimleri Dergisi, 2018

Over kanserleri jinekolojik maligniteler içerisinde sıklıkla görülen malignitelerdendir. Semptoma... more Over kanserleri jinekolojik maligniteler içerisinde sıklıkla görülen malignitelerdendir. Semptomatik olarak prezentasyonu orjini ile bağlantılı olmak üzere, büyüklük ve yaş ile de bağlantılıdır. Tanı için en değerli yöntemlerden biri ultrasonografidir. Bilgisayarlı tomografi (BT) ve magnetik rezonans görüntüleme(MRI) yöntemleri de ayrıcı tanıda kullanılmalıdır. Olgu: 35 yaşında bir hastaya 2 yıl önce başka bir merkezde müsinöz kistadenokarsinoma nedeniyle cerrahi yapılmıştı. Hasta bize karında şişlik ve ağrı ile geldi. Ultrasonografi ve tetkiklerinin yapılmasından sonra cerrahi planlandı. Cerrahi sırasında; kitle spontan rüptüre olmuş ve yer yer nekrotik alan içeriyordu. Biz bu dev over malignitesini ve müsinöz materyali ile peritonite sebep olan olguyu paylaşmayı amaçladık.

Research paper thumbnail of Breast cancer and ovulation induction

Journal of Surgery and Medicine, 2019

Breast cancer is the most common malignancy of women at reproductive age. Nowadays, with increasi... more Breast cancer is the most common malignancy of women at reproductive age. Nowadays, with increasing early diagnosis, survival rate is higher, which is why the number of patients wanting to get pregnant are on the rise. Fertility preservation, ovulation induction, the safety of these interventions and pregnancy results are discussed in this review.

Research paper thumbnail of Evaluation of the clinical significance of serum pentraxin-3 levels in patients with polycystic ovary syndrome

Clinical and Experimental Obstetrics & Gynecology

Background: Polycystic ovary syndrome (PCOS) is commonly associated with insulin resistance (IR),... more Background: Polycystic ovary syndrome (PCOS) is commonly associated with insulin resistance (IR), hyperinsulinemia, and dyslipidemia, which play a role in the development of endothelial dysfunction and promote the early onset of cardiovascular diseases. The aim of this study was to evaluate the clinical importance of pentraxin-3 levels in PCOS patients. Methods: Forty-five female patients diagnosed with PCOS according to the 2003 Rotterdam criteria and 42 healthy women were included in the study. All women studied were tested within 3 and 5 days of their menstrual cycle. Ultrasonographic evaluation of each patient was first conducted using the suprapubic method. Serum PTX-3, endothelin 1 (ET-1), vascular cell adhesion molecule 1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), and nitric oxide levels were measured using the enzyme-linked immunosorbent assay method. Results: Pentraxine-3 (PTX-3) levels in the patient group were significantly lower than those in the control group (p < 0.05). PTX-3 levels in the group with hirsutism were significantly higher than those in the nonhirsutism group (p < 0.05). Homeostatic model assessment for IR (HOMA-IR) levels in the patient group were significantly higher than those in the control group (p < 0.01). A weak negative correlation was found between PTX-3 and HbA1c levels. The accuracy rate of the PTX-3 test in distinguishing patients and nonpatients was moderate with a 0.634 area-under-the-curve value. Conclusions: During the follow-up of patients with PCOS, a decrease in serum PTX-3 levels associated with hirsutism and IR may be observed.

Research paper thumbnail of COVID-19 pandemic and the quality of couples’ sexual relationships

Aim: COVI-19 pandemic causes stress between individuals, and this stress can affect the quality o... more Aim: COVI-19 pandemic causes stress between individuals, and this stress can affect the quality of couples’ sexual relationships. This study aimed to examine the quality of women’s sexual life during the COVID-19 pandemic. Material and Methods: This prospective cross-sectional study was conducted at May-June 2020. 235 sexually active women aged 18 to 51 years participated in this study. The Female Sexual Function Index (FSFI) was used to examine women’s sexuality from six different perspectives: desire, arousal, lubrication, orgasm, satisfaction, and pain. Due to quarantine restrictions, questionnaires were emailed to participants. Results: The participants’ age range was 18 to 51, with an average of 29.6 ± 6.08 years. The total FSFI score with a minimum of 1 and a maximum of 26.75 had an average of 18.12 ± 6.23. Since the cut-off value for female sexual dysfunction is 26.0, it can be concluded that, on average, participants had poor function and quality of sexual intercourse in the...

Research paper thumbnail of A benign disease characterized by vulvar itching: vulvar vestibular papillomatosis

Clinical and Experimental Obstetrics & Gynecology, 2019

Research paper thumbnail of Evaluation of Effectiveness of Laser Assisted Hatching Pregnancy Rates on Fresh IVF / ICSI Cycles

Gazi Medical Journal

Objectives: To investigate the effects of laser assisted hatching (LAHA) implantation rates, clin... more Objectives: To investigate the effects of laser assisted hatching (LAHA) implantation rates, clinical pregnancies, and live births of the patients enrolled in a fresh in vitro fertilization and intracytoplasmic sperm injection-embryo transfer (IVF/ICSE-ET) program. Material and Methods: A total of 315 patients who underwent at least two unsuccessful ETs or had a baseline follicle-stimulating hormone (FSH) level of ≥10 mIU/mL and who underwent IVF/ICSE-ET at IVF Center. The patients were divided into two groups: patient group (n=100) who underwent LAHA and control group (n=215) who did not. The beta human chorionic gonadotropin (βhCG) positivity, clinical pregnancies, and live births of both groups were compared. Results: There was no significant difference in the clinical pregnancy and implantation rates between the groups including those with an advanced maternal age or recurrent implantation failure. In the patients with elevated FSH levels (FSH ≥10 mIU/mL), these rates were significantly lower in the study group, compared to the control group. Conclusion: Our study results show that laser assisted hatching does not improve the biochemical, clinical, and take home baby rates in IVF / ICSI-ET patients.

Research paper thumbnail of Do midkine levels in serum and follicular fluid affect IVF-ICSI outcome?

Journal of Health Sciences and Medicine

This work is licensed under a Creative Commons Attribution 4.0 International License. Do midkine ... more This work is licensed under a Creative Commons Attribution 4.0 International License. Do midkine levels in serum and follicular fluid affect IVF-ICSI outcome? Serum ve foliküler sıvıdaki midkin düzeyleri IVF-ICSI sonuçlarını etkiler mi?

Research paper thumbnail of The effect of GnRH Agonist use in Frozen Cycles on pregnancy results

Annals of Medical Research

The aim of this study was to investigate the effect of GnRH agonist use on pregnancy and abortion... more The aim of this study was to investigate the effect of GnRH agonist use on pregnancy and abortion in the preparation of the endometrium in autologous frozen embryo transfers performed with hormone replacement therapy. Material and Methods: All autologous artificial Frozen-thawed embryo transfer (FET) between 1/2016 and 1/2018 were evaluated retrospectively in order to investigate the effect of GnRH agonist use on pregnancy and abortion rates in frozen embryo FET cycles. Results: 226 patients were included in the study. The mean age of the patients included in the study was 30.76 ± 4.72 years. Of the patients, 144 (63.7%) were diagnosed with unexplained infertility, 20 (8.8) with low ovarian reserve, and 62 (27.4) with male factor. No significant difference was found in terms of pregnancy result and abortion in patients using (N: 22) and not using GnRH agonist (p = 0.212, 1,000). Conclusion: No significant effect of GnRH agonist use on pregnancy rate or abortion was detected in autologous frozen embryo transfers performed with HRT. The prospective studies involving larger patient populations are needed to clarify this subject.

Research paper thumbnail of Does high estrogen level negatively affect pregnancy success in frozen embryo transfer?

Archives of Medical Science

IntroductionHigh estrogen levels could reduce pregnancy rates by disrupting the implantation of t... more IntroductionHigh estrogen levels could reduce pregnancy rates by disrupting the implantation of the embryo into the endometrium in patients treated with fresh cycles of in vitro fertilization. The aim of the present study was to investigate the effect of estrogen levels on the pregnancy and abortion rate in autologous frozen embryo transfer with hormone replacement therapy (HRT).Material and methodsA historical cohort study was conducted in an academic setting to investigate the effect of estrogen levels on the pregnancy and abortion rates for all autologous artificial frozen embryo transfer cycles performed from January 2016 to January 2018. Serum estradiol levels recorded on day 2 or 3 of the cycle were stated as e1, and levels recorded on the day of progesterone were indicated as e2. Human chorionic gonadotropin (β-hCG) positivity, which was examined 14 days after the transfer, was used to evaluate biochemical pregnancy. Abortion was defined as the termination of pregnancy before...

Research paper thumbnail of Higher adrenomedullin levels during implantation are associated with successful pregnancy

Future Science OA

Aim: To determine how the adrenomedullin (ADM) level in a woman’s serum on the day of embryo tran... more Aim: To determine how the adrenomedullin (ADM) level in a woman’s serum on the day of embryo transfer affects pregnancy results. Materials & Methods: Women who had undergone frozen embryo transfer between July 2018 and February 2019 were prospectively included in the study. The relation between the level of ADM and pregnancy result was examined after taking a sample of serum from each patients on the same day as the transfer. Results: The results revealed that the ADM levels in patients who became pregnant were higher, but not to a statistically significant level. Conclusion: Adrenomedullin is an important molecule for human embryo implantation.

Research paper thumbnail of Serum kisspeptin levels in deep-infiltrating, ovarian, and superficial endometriosis: A prospective observational study

Research paper thumbnail of Does Type of Menopause Affect the Sex Lives of Women?

Medical Science Monitor, 2020

The aim of this study was to investigate factors affecting the sex lives of middle-aged women, an... more The aim of this study was to investigate factors affecting the sex lives of middle-aged women, and whether surgical menopause affects sexual function differently from natural menopause, by comparing effects on sexual performance of women with similar demographic features. Material/Methods: The study included 151 women with surgical menopause (SM), 357 women with natural menopause (NM), and 186 perimenopausal women (PM). The women were asked to complete a 6-question survey of sexual performance parameters. The relationship between the demographic and clinical features and hormone levels of the groups and sexual function parameters were evaluated. We also compared these parameters between the 3 study groups, and paired comparisons were made between the SM group and the NM group. Results: Demographic features, serum DHEA-S, total testosterone, and FSH levels were found to have statistically significant effects on sexual performance of women (p<0.05). The sexual function scores for the frequency of sexual desire, coitus, and orgasm were significantly higher in the PM group, whereas vaginal lubrication scores were lower compared to the NM and SM group (p<0.05). In paired comparison of NM and SM, the scores for the frequency of coitus, orgasm, and vaginal lubrication were significantly higher in the SM group, while sexual desire frequency scores were higher in the NM group (p<0.05). Conclusions: Our study approached to this topic in an extended manner and found significant relationships between several demographic-clinical and hormonal factors. SM was found to not affect female sexual performance, except for sexual desire, more than NM.

Research paper thumbnail of Melatoninin kaynağı triptofanın IVF hastalarının sonuçlarına ve Doppler parametrelerine etkisi

Journal of Health Sciences and Medicine, 2020

Aims: Melatonin is the most powerful antioxidant and protects sperm, oocyte and embryo against ox... more Aims: Melatonin is the most powerful antioxidant and protects sperm, oocyte and embryo against oxidative stress. The effect of tryptophan, which is the building block of melatonin, on follicular melatonin levels and IVF outcomes is unknown. The objective of this study was to investigate the effect of tryptophan administration, a precursor for melatonin, on the levels of intrafollicular melatonin with the aim to reveal the correlation between tryptophan and the total number and quality of oocytes as well as clinical pregnancy rates. In addition, we aimed to examine the effect of melatonin increased by tryptophan on uterine and ovarian blood flow. Methods: Out of 103 patients who applied to Ondokuzmayis University IVF clinic for IVF treatment, 51 patients were administered a 100 mg dose of tryptophan orally (Group A) and 50 control patients who were randomly selected did not receive tryptophan (Group B). Firstly, follicular melatonin levels were compared between Group A receiving tryp...

Research paper thumbnail of Evaluations of pregnancy admitted to perinatology clinics that pregnants have fetal anomalies

Journal of Health Sciences and Medicine, 2020

Objective Our objective was to investigate the most common anomalies in our region with a retrosp... more Objective Our objective was to investigate the most common anomalies in our region with a retrospective evaluation of the congenital anomaly cases, who applied to the outpatient department of perinatology Materials and Methods: We was reviewed file of congenital anomaly cases, who applied to the outpatient department of perinatology in the Medical Faculty at Ondokuz Mayıs University between May 2014 and May 2019,and to determine the risk factors related to these anomalies. Seven hundred twenty-five pregnant women, whose infants were diagnosed with congenital anomalies in our center, were included in the present study. Parameters like the mother's age, consanguineous parents, history of previous habitual abortions, history of siblings with anomalies, number of parity and abortus history, gestational week at diagnosis, smoking, alcohol and drug consumption in the first trimester, periconceptional folic acid use, co-morbidities, ultrasonographic findings, presence of the karyotype ...

Research paper thumbnail of The two new surgical techniques for vaginal cuff prolapse and uterine prolapse

Journal of Surgery and Medicine, 2019

Pelvic organ prolapse and vaginal cuff prolapse are clinical conditions that affect women's quali... more Pelvic organ prolapse and vaginal cuff prolapse are clinical conditions that affect women's quality of life and require surgical treatment. In this study, we aimed to present apical vaginal prolapse and uterine descensus treatment with two new techniques. The classical sacrospinous ligament fixation technique fixes only one or two corners of the vaginal apex to the sacrospinous ligament, but it does not support the upper anterior and posterior vaginal fascia. Since it expands the upper part of the vagina with a suture put on the sides of the vaginal apex, it may not only expose the anterior and posterior vaginal walls to greater intraabdominal pressure and cause cystocele and enterocele development, but lead to sexual problems, as well. Apart from this, if sacrospinous colpopexy is performed to one side only, the vaginal apex is deviated towards the fixation, thus spoiling the vaginal anatomy. With our following methods, we imitate the physiological anatomy: Transapical circular Sacrospinous colpopexy (TACSAC) and Transcervical apical circular Sacrospinous uteropexy (TACSU). TACSAC: Bilateral side walls of the vaginal apex are marked with a color pencil 2 cm medially to the right and left ischial spine and 2 cm in length. Vaginal apex walls are bilaterally and vertically incised until the submucosa layer. Two submucosal tunnels are opened by using a right-angle clamp between the tips of two vertical incisions on the vaginal apex. The vaginal apex is fixed with a TOT mesh through these channels. In TACSU, the same procedure is followed for the cervix. These methods are more likely to mimic normal anatomy, easier to perform, and lower risk of complications.

Research paper thumbnail of Impact of serum adipokines on tumor mitotic and apoptotic activity in endometrial cancer

Journal of Surgery and Medicine, 2019

Aim: Endometrial cancer is the most common malignancy of female genital system. Obesity is one of... more Aim: Endometrial cancer is the most common malignancy of female genital system. Obesity is one of the most important risk factors in endometrial cancer. Adipose tissue functions just like an endocrine organ by secreting many bioactive substances and contribute to tumor development. The aim of this study was to investigate the correlation between serum adipokine levels and tumor mitotic and apoptotic activity levels in endometrial cancer. Methods: We designed a cross-sectional study. After obtaining the approval of Ethics Committee, 38 patients with endometrial cancer admitted between 2014 July-2014 December to Obstetrics and Gynecology outpatient clinic of Ondokuz Mayıs University, Faculty of Medicine were included in the study. Serum leptin and adiponectin levels were measured in 5 cc serum samples taken from the patients preoperatively. The pathology specimens of the patients were semi quantitatively evaluated with immunohistochemical study considering the percentage and intensity of staining for bcl-2 and the percentage of staining for Ki67. Moreover, preoperative estradiol levels, insulin resistance, body fat percentages and body mass index (BMI) values were determined. The Mann Whitney U test, Kruskal Wallis and Spearman's Correlation test were used statistically. The results were considered statistically significant for P<0.05. Results: The patients included in the study were between 36-82 years of age and the mean age was 62.5 (10.4) years. The mean BMI value of the patients was 31.1 (4.8) kg/m2 (range: 19-38 kg/m 2). According to the FIGO 2010 staging system, the distribution of the patients were as follows: 30 patients (78%) Stage 1, 1 patient (2.6%) Stage 2 and 7 patients (18.4%) Stage 3. Of the patients, 6 (15.8%) had grade 1, 20 (52.6%) had grade 2 and 12 (31.6%) had grade 3. Twenty-seven patients were classified as endometrioid type and 11 patients were classified as nonendometrioid type. There was no statistically significant correlation between serum leptin and adiponectin levels and percentage of Ki-67 immunohistochemical staining in tumoral tissue and bcl-2 score (P=0.05). In the immunohistochemical examination of tumoral tissue, it was found that tumor grade statistically significantly increased as the staining percentage for Ki67 increased (r=0.571, P<0.001). There was no statistically significant correlation between Bcl-2 score and tumor grade or stage (P=0.751). It was found that serum leptin levels significantly increased as BMI increased (r=0.341, P=0.036). As HOMA-IR increased, adiponectin level statistically significantly increased (r=0.393, P=0.015). There was also no statistically significant difference between the endometrioid and non-endometrioid groups in terms of leptin, adiponectin and leptin/adiponectin levels (P=0.554, P=0.652). There was no statistically significant difference between the endometrioid and non-endometrioid groups in terms of median BCL-2 score and Ki-67 percentage (P=0.05). Conclusion: There was no correlation between serum leptin and adiponectin levels and Ki-67 immunohistochemical staining percentage and bcl-2 score.

Research paper thumbnail of A Different Method in the Treatment of Placenta Previa: A Comparison of Lower Uterine Segment Transverse Suture Technique and Bakri Balloon Application

Open Journal of Obstetrics and Gynecology, 2019

Objective: The incidence of placenta previa (PP) has been increasing due to the rise in cesarean ... more Objective: The incidence of placenta previa (PP) has been increasing due to the rise in cesarean rates. The aim of this study is to determine the success of lower uterine segment compression suture and bakri balloon applications in patients diagnosed with placenta previa. Materials and Methods: 257 patients who underwent cesarean section due to placenta previa totalis (PPT) between the years of 2010-2018 in Ondokuz Mayıs University were screened retrospectively. The patients were evaluated in four groups according to their treatment method: medical treatment, bakri balloon application, compression suture and hysterectomy. Results: In the study, between the years 2010-2015, postpartum hysterectomy was performed in the cases of adherent placenta previa, and hysterectomy was performed in 33 patients. Between the years of 2015-2018, first, bakri balloon or compression suture was applied; and if bleeding control was not achieved despite these, then, hysterectomy was performed. Between 2015 and 2018, a total of 27 patients underwent compression suture and 1 patient had a hysterectomy after all. The success rate was 96.3% with compression suture and 91.7% for bakri balloon application. Totally, 24 patients were treated with bakri balloon and yet, two patients underwent hysterectomy. When all the cases were examined, complications caused by urinary bladder and ureteral injury were seen in 5.6% of patients, and all of these complications were also seen in hysterectomy patients. Conclusion: Lower uterine segment transverse suture technique and bakri balloon application should be considered as a good alternative to prevent hysterectomy in

Research paper thumbnail of Thyroid Diseases During Pregnancy

E-journal of New World Sciences Academy, 2019

Research paper thumbnail of Antioxidant Supplement Improves the Pregnancy Rate in Patients Undergoing <i>in Vitro</i> Fertilization for Unexplained Infertility

Open Journal of Obstetrics and Gynecology, 2019

Objective: This is a retrospective study to evaluate the effect of using the antioxidants contain... more Objective: This is a retrospective study to evaluate the effect of using the antioxidants containing coenzyme Q10 (CoQ10) and omega-3 in patients undergoing in vitro fertilization and intracytoplasmic sperm injection (IVF-ICSI) for unexplained infertility. Materials Methods: A total of 299 patients undergoing IVF-ICSI for unexplained infertility at the IVF center of Ondokuz Mayıs University were studied. The subject group consisted of 135 patients who used OMEPA Q10 (Co Q10 100 mg, omega-3 600 mg, eicosapentaenoic acid 300 mg, docosahexaenoic acid 230 mg) for two months before ovarian stimulation. A group of 164 patients who did not use the supplement were evaluated as the control group. Results: The pregnancy rate of patients using antioxidants was statistically higher than that of those who did not use the supplement (p < 0.05). The pregnancy rates of patients in the two groups were 32.9% and 49.6% respectively. The pregnancy rate of patients using antioxidants was statistically higher than that of those who did not use the supplement (p < 0.05) seemed not enough. Conclusion: We concluded that using antioxidants that contain Co Q10 and omega-3 in patients undergoing IVF-ICSI for unexplained infertility increased the clinical pregnancy rate. We recommend using antioxidants that contain Co Q10 and omega-3 in infertile patients.

Research paper thumbnail of Isthmocele, challenging but not a rare entity; Its expected incidence might be more than reported

Journal of Surgery and Medicine, 2018

Aim: Isthmocele, a long-term complication of Cesarean section (CS) surgery, has drawn increasing ... more Aim: Isthmocele, a long-term complication of Cesarean section (CS) surgery, has drawn increasing worldwide interest. However, not all women with this Cesarean scar defect (CSD) present with clinical symptoms. We studied a group of non-pregnant women with a CS history to determine the prevalence of isthmocele, the potential risk factors for its development, and the most common clinical complaints. Methods: This study included women who had a cesarean operation more than 6 months ago, who were not pregnant between April 2017 and April 2017 and applied to the gynecology clinic for any reason. The exclusion criteria were the patients in the menopause period. Data was collected on 115 participants, including age, body mass index, duration after CS, and the number of CS surgeries that had been performed. Standardized scar parameters (residual myometrial thickness (RMT) and the depth and width of the triangular hypoechoic niche) were measured using transvaginalultrasonography (TVS). Isthmocele symptoms were categorized as asymptomatic, postmenstrual spotting, menometrorrhagia, chronic pelvic pain, dysmenorrhea, and infertility. Associations between isthmocele and menstrual complications were investigated. The relationship between isthmocele development and the reasons for the CS surgery were evaluated. Results: TVS examination diagnosed 17 women (14.78%) with isthmocele. Women who had undergone recurrent CS surgeries tended to have more visible isthmocele than those with a single CS surgery. The average isthmocele depth was 6.006 ± 0.7970 mm. Among the women with isthmoceles, elective CS surgery had been performed in six (35.3%), while 11 (64.7%) had the surgery at parturition. The presence of an isthmocele was frequently symptomatic, predominantly as postmenstrual spotting. Women with an isthmocele had significantly lower RMT values (5.57 ± 0.60 mm versus 8.78 ± 0.22 mm) than those without an isthmocele. There was no correlation between age, body mass index, and the presence of an isthmocele (p > 0.05). Conclusions: The incidence and prevalence of CSD is greater than most gynecologists realize. Isthmoceles can develop after just one CS surgery, leading to long-term complications that morbidly effect women for the rest of their lives. A reduction in the number of CS surgeries is the most effective way to decrease the prevalence of isthmoceles.

Research paper thumbnail of Olgu sunumu: İki Yıl Sonra Diğer Overde Tekrar Eden Müsinoz Kistadekarsinom

Adıyaman Üniversitesi Sağlık Bilimleri Dergisi, 2018

Over kanserleri jinekolojik maligniteler içerisinde sıklıkla görülen malignitelerdendir. Semptoma... more Over kanserleri jinekolojik maligniteler içerisinde sıklıkla görülen malignitelerdendir. Semptomatik olarak prezentasyonu orjini ile bağlantılı olmak üzere, büyüklük ve yaş ile de bağlantılıdır. Tanı için en değerli yöntemlerden biri ultrasonografidir. Bilgisayarlı tomografi (BT) ve magnetik rezonans görüntüleme(MRI) yöntemleri de ayrıcı tanıda kullanılmalıdır. Olgu: 35 yaşında bir hastaya 2 yıl önce başka bir merkezde müsinöz kistadenokarsinoma nedeniyle cerrahi yapılmıştı. Hasta bize karında şişlik ve ağrı ile geldi. Ultrasonografi ve tetkiklerinin yapılmasından sonra cerrahi planlandı. Cerrahi sırasında; kitle spontan rüptüre olmuş ve yer yer nekrotik alan içeriyordu. Biz bu dev over malignitesini ve müsinöz materyali ile peritonite sebep olan olguyu paylaşmayı amaçladık.

Research paper thumbnail of Breast cancer and ovulation induction

Journal of Surgery and Medicine, 2019

Breast cancer is the most common malignancy of women at reproductive age. Nowadays, with increasi... more Breast cancer is the most common malignancy of women at reproductive age. Nowadays, with increasing early diagnosis, survival rate is higher, which is why the number of patients wanting to get pregnant are on the rise. Fertility preservation, ovulation induction, the safety of these interventions and pregnancy results are discussed in this review.

Research paper thumbnail of Evaluation of the clinical significance of serum pentraxin-3 levels in patients with polycystic ovary syndrome

Clinical and Experimental Obstetrics & Gynecology

Background: Polycystic ovary syndrome (PCOS) is commonly associated with insulin resistance (IR),... more Background: Polycystic ovary syndrome (PCOS) is commonly associated with insulin resistance (IR), hyperinsulinemia, and dyslipidemia, which play a role in the development of endothelial dysfunction and promote the early onset of cardiovascular diseases. The aim of this study was to evaluate the clinical importance of pentraxin-3 levels in PCOS patients. Methods: Forty-five female patients diagnosed with PCOS according to the 2003 Rotterdam criteria and 42 healthy women were included in the study. All women studied were tested within 3 and 5 days of their menstrual cycle. Ultrasonographic evaluation of each patient was first conducted using the suprapubic method. Serum PTX-3, endothelin 1 (ET-1), vascular cell adhesion molecule 1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), and nitric oxide levels were measured using the enzyme-linked immunosorbent assay method. Results: Pentraxine-3 (PTX-3) levels in the patient group were significantly lower than those in the control group (p < 0.05). PTX-3 levels in the group with hirsutism were significantly higher than those in the nonhirsutism group (p < 0.05). Homeostatic model assessment for IR (HOMA-IR) levels in the patient group were significantly higher than those in the control group (p < 0.01). A weak negative correlation was found between PTX-3 and HbA1c levels. The accuracy rate of the PTX-3 test in distinguishing patients and nonpatients was moderate with a 0.634 area-under-the-curve value. Conclusions: During the follow-up of patients with PCOS, a decrease in serum PTX-3 levels associated with hirsutism and IR may be observed.

Research paper thumbnail of COVID-19 pandemic and the quality of couples’ sexual relationships

Aim: COVI-19 pandemic causes stress between individuals, and this stress can affect the quality o... more Aim: COVI-19 pandemic causes stress between individuals, and this stress can affect the quality of couples’ sexual relationships. This study aimed to examine the quality of women’s sexual life during the COVID-19 pandemic. Material and Methods: This prospective cross-sectional study was conducted at May-June 2020. 235 sexually active women aged 18 to 51 years participated in this study. The Female Sexual Function Index (FSFI) was used to examine women’s sexuality from six different perspectives: desire, arousal, lubrication, orgasm, satisfaction, and pain. Due to quarantine restrictions, questionnaires were emailed to participants. Results: The participants’ age range was 18 to 51, with an average of 29.6 ± 6.08 years. The total FSFI score with a minimum of 1 and a maximum of 26.75 had an average of 18.12 ± 6.23. Since the cut-off value for female sexual dysfunction is 26.0, it can be concluded that, on average, participants had poor function and quality of sexual intercourse in the...

Research paper thumbnail of A benign disease characterized by vulvar itching: vulvar vestibular papillomatosis

Clinical and Experimental Obstetrics & Gynecology, 2019

Research paper thumbnail of Evaluation of Effectiveness of Laser Assisted Hatching Pregnancy Rates on Fresh IVF / ICSI Cycles

Gazi Medical Journal

Objectives: To investigate the effects of laser assisted hatching (LAHA) implantation rates, clin... more Objectives: To investigate the effects of laser assisted hatching (LAHA) implantation rates, clinical pregnancies, and live births of the patients enrolled in a fresh in vitro fertilization and intracytoplasmic sperm injection-embryo transfer (IVF/ICSE-ET) program. Material and Methods: A total of 315 patients who underwent at least two unsuccessful ETs or had a baseline follicle-stimulating hormone (FSH) level of ≥10 mIU/mL and who underwent IVF/ICSE-ET at IVF Center. The patients were divided into two groups: patient group (n=100) who underwent LAHA and control group (n=215) who did not. The beta human chorionic gonadotropin (βhCG) positivity, clinical pregnancies, and live births of both groups were compared. Results: There was no significant difference in the clinical pregnancy and implantation rates between the groups including those with an advanced maternal age or recurrent implantation failure. In the patients with elevated FSH levels (FSH ≥10 mIU/mL), these rates were significantly lower in the study group, compared to the control group. Conclusion: Our study results show that laser assisted hatching does not improve the biochemical, clinical, and take home baby rates in IVF / ICSI-ET patients.

Research paper thumbnail of Do midkine levels in serum and follicular fluid affect IVF-ICSI outcome?

Journal of Health Sciences and Medicine

This work is licensed under a Creative Commons Attribution 4.0 International License. Do midkine ... more This work is licensed under a Creative Commons Attribution 4.0 International License. Do midkine levels in serum and follicular fluid affect IVF-ICSI outcome? Serum ve foliküler sıvıdaki midkin düzeyleri IVF-ICSI sonuçlarını etkiler mi?

Research paper thumbnail of The effect of GnRH Agonist use in Frozen Cycles on pregnancy results

Annals of Medical Research

The aim of this study was to investigate the effect of GnRH agonist use on pregnancy and abortion... more The aim of this study was to investigate the effect of GnRH agonist use on pregnancy and abortion in the preparation of the endometrium in autologous frozen embryo transfers performed with hormone replacement therapy. Material and Methods: All autologous artificial Frozen-thawed embryo transfer (FET) between 1/2016 and 1/2018 were evaluated retrospectively in order to investigate the effect of GnRH agonist use on pregnancy and abortion rates in frozen embryo FET cycles. Results: 226 patients were included in the study. The mean age of the patients included in the study was 30.76 ± 4.72 years. Of the patients, 144 (63.7%) were diagnosed with unexplained infertility, 20 (8.8) with low ovarian reserve, and 62 (27.4) with male factor. No significant difference was found in terms of pregnancy result and abortion in patients using (N: 22) and not using GnRH agonist (p = 0.212, 1,000). Conclusion: No significant effect of GnRH agonist use on pregnancy rate or abortion was detected in autologous frozen embryo transfers performed with HRT. The prospective studies involving larger patient populations are needed to clarify this subject.

Research paper thumbnail of Does high estrogen level negatively affect pregnancy success in frozen embryo transfer?

Archives of Medical Science

IntroductionHigh estrogen levels could reduce pregnancy rates by disrupting the implantation of t... more IntroductionHigh estrogen levels could reduce pregnancy rates by disrupting the implantation of the embryo into the endometrium in patients treated with fresh cycles of in vitro fertilization. The aim of the present study was to investigate the effect of estrogen levels on the pregnancy and abortion rate in autologous frozen embryo transfer with hormone replacement therapy (HRT).Material and methodsA historical cohort study was conducted in an academic setting to investigate the effect of estrogen levels on the pregnancy and abortion rates for all autologous artificial frozen embryo transfer cycles performed from January 2016 to January 2018. Serum estradiol levels recorded on day 2 or 3 of the cycle were stated as e1, and levels recorded on the day of progesterone were indicated as e2. Human chorionic gonadotropin (β-hCG) positivity, which was examined 14 days after the transfer, was used to evaluate biochemical pregnancy. Abortion was defined as the termination of pregnancy before...

Research paper thumbnail of Higher adrenomedullin levels during implantation are associated with successful pregnancy

Future Science OA

Aim: To determine how the adrenomedullin (ADM) level in a woman’s serum on the day of embryo tran... more Aim: To determine how the adrenomedullin (ADM) level in a woman’s serum on the day of embryo transfer affects pregnancy results. Materials & Methods: Women who had undergone frozen embryo transfer between July 2018 and February 2019 were prospectively included in the study. The relation between the level of ADM and pregnancy result was examined after taking a sample of serum from each patients on the same day as the transfer. Results: The results revealed that the ADM levels in patients who became pregnant were higher, but not to a statistically significant level. Conclusion: Adrenomedullin is an important molecule for human embryo implantation.