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Papers by kiper aslan

Research paper thumbnail of The Impact of Coronavirus Disease-19 on Pregnancy Outcomes, A Case Series

Gynecology Obstetrics & Reproductive Medicine

OBJECTIVE: To investigate the impact of Corona Virus Disease 19 (COVID-19) infection on pregnancy... more OBJECTIVE: To investigate the impact of Corona Virus Disease 19 (COVID-19) infection on pregnancy outcomes. STUDY DESIGN: This retrospective study was conducted at a tertiary university hospital between the years of October 2020-October 2021. All the pregnant women with COVID-19 diagnoses were enrolled in the study during this period. Demographic parameters, a history of Favipiravir use, COVID-19 symptoms, treatment approaches, hospitalization, intensive care unit admission, and obstetric and neonatal outcomes were recorded. RESULTS: A total of 92 patients were enrolled in the study. The mean age was 30+5 years. Forty-seven of the patients were asymptomatic (51%). The most common symptoms were respectively; fatigue (37.8%), fever (27.6%), dyspnea (22%), cough (17.8%), headache (11%), anosmia (4.4%), hyperemesis (4.4%), diarrhea (2.2%). There were 20 patients (21.7%) who were hospitalized. Eight of these women (8.6%) required intensive care unit admission due to COVID pneumonia-relat...

Research paper thumbnail of How does the ERAS protocol work in patients who underwent cesarean section? ( HERMES study)

International Journal of Gynecology & Obstetrics

Research paper thumbnail of EROSS study: effect of ovarian reserve on sexual satisfaction

Journal of Obstetrics and Gynaecology

Research paper thumbnail of A huge vaginal stone in a spastic paraplegic woman

International Urogynecology Journal

Research paper thumbnail of Effect of Sequential Ejaculation with Short Abstinence Time on Sperm Chromatin Integrity and Antioxidant Activity

Uludağ Üniversitesi Tıp Fakültesi Dergisi

Üremeye yardımcı tedavi uygulamalarında tercih edilen tedavi yaklaşımına göre semen parametreleri... more Üremeye yardımcı tedavi uygulamalarında tercih edilen tedavi yaklaşımına göre semen parametrelerinin embriyoloji laboratuvarı sonuçlarına ve klinik başarıya etkisi değişmektedir. Semen parametreleri abstinens süresine ve androloji laboratuvarında uygulanan yıkama protokollerine göre değişmekte ve insemine edilecek sperm materyalinin kalitesini etkilemektedir. Bu çalışmada normozoospermik erkeklerde kısa abstinens süresinin rutin semen parametrelerine, sperm kromatin ve DNA bütünlüğüne, oksidatif strese karşı gelişen antioksidan kapasiteye etkisinin değerlendirilmesi amaçlandı. Aynı hastadan ardışık ejakülasyonla 2-5 günlük abstinens süresi sonrası (n=36) ve 1 saat abstinens süresi sonrası (n=36) alınan numuneler yıkama öncesi ve yıkama sonrası değerlendirildi. Yıkama öncesinde sperm volümünün ve total motil sperm sayısının kısa abstinens grubunda anlamlı olarak azaldığı bulundu. Yıkama sonrasında gruplar arasında motilitenin değişmediği, konsantrasyonun kısa abstinens grubunda anlam...

Research paper thumbnail of Prognostic factors of IVF&ICSI cycle cancellation in patients with endometriosis related infertility; A Retrospective Study

Research paper thumbnail of Clinical importance of placental membrane microscopic chorionic pseudocysts in preeclampsia

Clinical and Experimental Obstetrics & Gynecology, 2016

OBJECTIVE To determine the importance of placental membrane microscopic chorionic pseudocysts (MC... more OBJECTIVE To determine the importance of placental membrane microscopic chorionic pseudocysts (MCP) in preeclamptic and normal placentas and evaluate the association between MCP and neonatal complications in preeclamptic patients. MATERIALS AND METHODS In this prospective case-control study, microscopic examination of placentas was performed, including MCP count, in 33 preeclamptic and 35 normal control pregnant women from December 2008 to May 2009. The MCP were counted in placentas for each patient and modeled as a continuous variable to assess the difference between the two groups. RESULTS The mean MCP count was similar for preeclamptic (7 ± 2) and control patients (7 ± 2; not significant). A weak positive correlation was noted between placental weight and MCP (r = 0.253; p ≤ 0.04). In the preeclamptic patients, mean MCP count was significantly higher for neonates that did not have neonatal respiratory distress syndrome (NRDS) (p ≤ 0.05) and who did not admitted to neonatal intensive care unit (NICU) than admitted to NICU (P ≤ .03). The risk for developing NRDS was 20.3-fold greater in neonates of preeclamptic patients who did not have than had MCP (odds ratio, 20.3 95% confidence interval, 1.0 to 48; P ≤ .05). The MCP count cutoff value was ≤ 1 for developing NRDS (sensitivity 83%; specificity, 70%). CONCLUSION The absence of MCP was significantly associated with the development of NRDS in neonates. The MCP count was inversely associated with the risk of NRDS in newborns of high-risk pregnancies caused by preeclampsia.

Research paper thumbnail of Are all antral follicles the same? Size of antral follicles as a key predictor for response to controlled ovarian stimulation

Journal of Obstetrics and Gynaecology, 2021

The aim of this study was to evaluate whether antral follicle size has any value with respect to ... more The aim of this study was to evaluate whether antral follicle size has any value with respect to antral follicle count (AFC) in predicting ovarian response to controlled ovarian stimulation. Patients who were considered to be normal responders based on their ovarian reserve markers were consecutively recruited. Total AFC was the number of 2-10 mm follicles in both ovaries. Antral follicles were separated into two subgroups according to the size: 2-5 mm and 6-10 mm follicles. Patients were divided into two main groups according to ovarian response to COS. Group 1 (suboptimal response, 4-9 oocytes retrieved, n = 61) and Group 2 (normal responders, ≥10 oocytes retrieved, n = 65). Demographic parameters were comparable between the groups. The number of 2-5 mm follicles was significantly lower in the suboptimal response group (5 [4:7] and 8 [6:10], respectively, p < .001). The ratio of 2-5 mm follicles to total antral follicles was also significantly lower in Group 1 (44.4% and 75%, respectively, p < .001). The ratio of small antral follicles was positively correlated with ovarian response (r = 0.587, p < .001). In conclusion, the ratio of small (2-5 mm) antral follicles could be a more specific predictive marker than AFC for ovarian response.IMPACT STATEMENTWhat is already known on this subject? Prediction of the ovarian response during ovarian stimulation is commonly based on antral follicle count and anti-mullerian hormone. The ovarian response may be inadequate even in patients with normal antral follicle count and anti-mullerian hormone.What do the results of this study add? A high ratio of small-size (2-5 mm) basal antral follicles is a predictive factor for higher ovarian response to ovarian hyperstimulation.What are the implications of these findings for clinical practice and/or further research? To obtain optimal ovarian response, the antral follicles should be evaluated initially in a more detailed and systematic way by taking their sizes into consideration in addition to their counts. Small antral follicle count rather than whole antral follicle count may be beneficial for optimising the ovarian response. Future studies may determine the cut off values of small antral follicle count for high/poor ovarian response.

Research paper thumbnail of Incidence of congenital uterine abnormalities in polycystic ovarian syndrome (CONUTA Study)

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2022

OBJECTIVE To investigate whether the frequency of uterine cavity abnormalities in PCOS patients h... more OBJECTIVE To investigate whether the frequency of uterine cavity abnormalities in PCOS patients higher than the normo-ovulatory patients. STUDY DESIGN This retrospective cohort study was conducted at the ART center of a tertiary university hospital. A total of 103 patients; 51 PCOS, and 52 male factor infertility were enrolled in the study between the years 2011-2019. HSG images of all patients were numbered and evaluated by ten senior reproductive endocrinologists and surgeons whom were blinded to the research and choose the most appropriate figure for each patient's HSG image and marked the shape of cavity according to the ASRM and ESGE/ESHRE classification. Results and demographic parameters were compared between PCOS and male factor infertility groups. RESULTS The percentage of the normal uterine cavity was significantly lower in the PCOS group than control group as 51 % and 66.7 %, 77 % and 94.2 % according to the ASRM and ESHRE/ESGE classifications, respectively. The frequency of Partial Septate Uterus (ESHRE-ESGE U2a / ASRM Va, 21.6% vs 5.8 % p < 0.05), Complete Septate Uterus (ESHRE-ESGE U2b / ASRM Vb, 7.8% vs 0% p < 0.01) and Dysmorphic Uterus (ESHRE-ESGE U1c) / ASRM VII) 3.9 % vs 0p < 0.05) were significantly higher in PCOS patients than controls. The frequency of arcuate uterus classified as VI in ASRM and considered as normal in ESHRE/ESGE was 16 % and 17.3 % in PCOS and control groups, respectively, without statistically significant difference. CONCLUSIONS This study provides that, compared to the healthy population, the frequency of uterine cavity abnormality is clearly higher in PCOS patients.

Research paper thumbnail of Which is more predictive ovarian sensitivity marker if there is discordance between serum anti-Müllerian hormone levels and antral follicle count? A retrospective analysis

Journal of Obstetrics and Gynaecology, 2022

This retrospective study aims to determine the more predictive ovarian reserve marker when there ... more This retrospective study aims to determine the more predictive ovarian reserve marker when there is discordance between anti-Müllerian hormone (AMH) and antral follicle count (AFC) in patients with diminished ovarian reserve (DOR). Patients who underwent ICSI because of DOR were divided into three groups. Group 1: patients with low AMH (<1.1 ng/ml) and AFC (n < 7), group 2: patients with low AMH (<1.1 ng/ml) and normal AFC (n ≥ 7) and group 3: patients with normal AMH (≥1.1 ng/dl) and low AFC (n < 7). Demographic values, follicle output rate (FORT) score and follicle to oocyte index (FOI) score of the groups were compared. Totally, 662 cycles were enrolled in the study. There were 418 cycles in group 1, 167 cycles in group 2 and 77 cycles in group 3. As the primary result, FORT and FOI scores were higher in group 3 than the other two groups. Median FORT Score with quartiles: group 1: 100 (66-150), group 2: 71 (57-100), group 3: 136 (96-200), p<.01 - median FOI score with quartiles: group 1: 83 (50-140), group 2: 71 (40-100), group 3: 116 (66-216), p<.01. In conclusion, serum AMH level has more predictive value for stimulation success if there is discordance with AFC.Impact StatementWhat is already known on this subject? Female age, serum Anti-Müllerian Hormone (AMH) levels, and antral follicle count (AFC) are commonly used to assess ovarian reserve and predict response to ovarian stimulation. AMH and AFC are both positively correlated with ovarian reserve.What do the results of this study add? If there is discordance between AFC and AMH in patients with diminished ovarian reserve (DOR), the ovarian response is better in patients with high AMH and low AFC than the patients with low AMH and high AFC.What are the implications of these findings for clinical practice and/or further research? It is important to assess both AFC and AMH before controlled ovarian hyperstimulation, to predict ovarian response in DOR patients, rather than assessing AFC or AMH alone.

Research paper thumbnail of Semen Parametrelerinin ve İnseminasyon Öncesi Hazırlık Periyodunun İntrauterin İnseminasyon Başarısına Etkisi

Uludağ Üniversitesi Tıp Fakültesi Dergisi, 2021

Üremeye yardımcı tedavi (ÜYT) uygulamalarında ilk basamak olan intrauterin inseminasyonda (IUI) k... more Üremeye yardımcı tedavi (ÜYT) uygulamalarında ilk basamak olan intrauterin inseminasyonda (IUI) kadın yaşı, vücut kitle indeksi (VKİ), stimülasyon süresi, abstinens süresi ve semen parametreleri başarıyı etkileyen prognostik faktörler arasındadır. Her ÜYT merkezinin rutin tedavi yaklaşımları ve laboratuvar uygulamaları sonucunda elde ettiği klinik başarı dikkate alınarak kendi prognostik faktörleri oluşturulmalı ve tedavi sürecinin yönetimi bu perspektifte düzenlenmelidir. Bu retrospektif çalışmada Ocak 2019-Şubat 2020 tarihleri arasında ÜYT merkezimizde gerçekleştirilen 245 IUI siklusu değerlendirilmiştir. IUI tedavisi uygulanan hastaların etiyoloji, yaş, VKİ, ejakülatın yıkama öncesi ve yıkama sonrası sperm parametreleri, abstinens süresi ve ejakulat yıkama işlemi boyunca geçen zaman periyotları değerlendirilmiştir. Kadın ve erkek yaşı, kadın VKİ, etiyoloji, infertilite süresi, siklus sayısı ve abstinens süresi bakımından gruplar arası farklılık saptanmaz iken, erkek VKİ artışının gebelik başarısını azalttığı saptandı. Semen volümü, yıkama öncesi ve sonrası sperm konsantrasyonu ve total motil sperm sayısının gebelik başarısı açısından belirleyici etkisinin olmadığı, yıkama sonrası motil sperm ve immotil sperm yüzdesinin belirleyici olduğu görüldü. Numune verilmesi ve yıkama sonrasından IUI işlemine kadar geçen sürelerin klinik başarıyı etkilemediği, fakat yıkama öncesi uzun inkübasyon süresinin gebelik şansını azalttığı saptandı. Küçük örneklem grubuyla yapılan bu çalışmada IUI tedavisinde klinik başarıda yıkama öncesi semen parametrelerinin belirleyici bir etkisinin olmadığı, erkek obezitesi ve numune hazırlama süreçlerinin prognostik faktörler olarak göz önünde bulundurulması gerektiği sonucuna varıldı.

Research paper thumbnail of Evaluation of Endometrioma Pathophysiology and Related Ovarian Damage by Pten / Akt Apoptosis Signaling Pathway

Fertility and Sterility, 2020

Research paper thumbnail of The Effect of Embryo Transfer Process Duration on Implantation Success

Gynecology Obstetrics & Reproductive Medicine, 2021

OBJECTIVE: To evaluate the effect of the embryo transfer duration of standard and simple embryo t... more OBJECTIVE: To evaluate the effect of the embryo transfer duration of standard and simple embryo transfer method. STUDY DESIGN: This study was a retrospective cohort study conducted at a tertiary ART Centre, between June 2018- September 2018. Day 5 fresh embryo transferred patients aged between 18 - 40, BMI <35 kg/m2 without uterine pathology were enrolled in the study. Patients were divided into two groups. Group-1 consisted of patients who had successful implantation and Group-2 consisted of patients who did not have implantation. Groups were compared according to their embryo transfer durations. Ninety-two patients were enrolled in the study. Also, sub-steps of as; cleaning of the cervical mucus and placing the outer catheter in the cervix, loading the embryo to the catheter, the period between embryo loading and embryo transfer, and following that, time spent for retracting the outer catheter evaluated. RESULTS: Between Group-1 and Group-2, there was no significant difference ...

Research paper thumbnail of The Effect of Embryo Transfer Process Duration on Implantation Success

Gynecology Obstetrics & Reproductive Medicine, 2021

OBJECTIVE: To evaluate the effect of the embryo transfer duration of standard and simple embryo t... more OBJECTIVE: To evaluate the effect of the embryo transfer duration of standard and simple embryo transfer method. STUDY DESIGN: This study was a retrospective cohort study conducted at a tertiary ART Centre, between June 2018- September 2018. Day 5 fresh embryo transferred patients aged between 18 - 40, BMI <35 kg/m2 without uterine pathology were enrolled in the study. Patients were divided into two groups. Group-1 consisted of patients who had successful implantation and Group-2 consisted of patients who did not have implantation. Groups were compared according to their embryo transfer durations. Ninety-two patients were enrolled in the study. Also, sub-steps of as; cleaning of the cervical mucus and placing the outer catheter in the cervix, loading the embryo to the catheter, the period between embryo loading and embryo transfer, and following that, time spent for retracting the outer catheter evaluated. RESULTS: Between Group-1 and Group-2, there was no significant difference ...

Research paper thumbnail of Which is More Predictive Ovarian Reserve Marker When There is Discordance Between Anti - Mullerian Hormone and Antral Follicle Count in Patients with Diminished Ovarian Reserve, Amh or Afc?

Fertility and Sterility, 2020

Research paper thumbnail of Sexual Outcomes and Motherhood Plans of The Mayer Rokitansky Küster Hauser Syndrome Patients Operated with Uncu Modified Remnant-Supported Laparoscopic Double-Layer Peritoneal Pull-Down Vaginoplasty Technique

Objective: To determine the sexual outcomes and motherhood plans of the Mayer Rokitansky Küster H... more Objective: To determine the sexual outcomes and motherhood plans of the Mayer Rokitansky Küster Hauser (MRKH) Syndrome patients operated with Uncu Modified Remnant-Supported Laparoscopic Double-Layer Peritoneal Pull-Down Vaginoplasty operation Design: Cohort Study Setting: Tertiary University Hospital Patients: Women with MRKH syndrome Methods: This study involves the patients with MRKH syndrome who underwent Uncu Modified Remnant-Supported Laparoscopic Double-Layer Peritoneal Pull-Down Vaginoplasty Operation between the years 2008-2020. The first step of the study is about our surgical technique outcomes. The second step consists of long-term results for sexual functioning which was assessed by female sexual function index (FSFI) survey and motherhood plans by another survey. Main Outcome Measure: FSFI and Motherhood Survey Results Results Total 42 patients with MRKH syndrome underwent vaginoplasty operation. At least one year after surgery all patients was physically examined. The...

Research paper thumbnail of Supernumerary embryos, do they show the cycle success in a fresh embryo transfer? A retrospective analysis

Gynecological Endocrinology, 2021

Abstract Objective To determine the predictive value of cryopreserved embryos during single fresh... more Abstract Objective To determine the predictive value of cryopreserved embryos during single fresh blastocyst transfer Methods This retrospective cohort study was conducted at a tertiary university hospital ART center. Patients who underwent a single fresh blastocyst transfer were selected from the electronic database. Patients with diminished ovarian reserve, uterine pathology, advanced age (>40 years) were excluded from the study. Patients were divided into two groups. Group A consisted of patients with only one available embryo for the fresh transfer. Group B consisted of patients with cryopreserved embryos apart from the fresh transferred embryo. Demographic and embryology parameters, pregnancy results were compared. Results Demographic values, ovarian reserve parameters were comparable between groups. The number of the picked-up oocyte, metaphase-2 oocyte, and two-pronucleus embryo was lower in Group A. Positive pregnancy rates were two-fold higher in Group B (23.4% vs. 50.9% p < .01). Pregnancy results did not change depending on the number of cryopreserved embryos in Group B. Conclusion According to our results, the presence of cryopreserved embryos results in higher pregnancy rates in patients with fresh blastocyst embryo transfer independent from the woman’s age and ovarian reserve. Thus, these results may help us to predict the implantation rate before embryo transfer.

Research paper thumbnail of Amh Levels May Predict for Mullerian Anomalies and Pregnancy Outcomes Patients with Pcos

Fertility and Sterility, 2020

Research paper thumbnail of Prognostic Factors of IVF Cycle Cancellation in Patients with Endometriosis-Related Infertility

Gynecology Obstetrics & Reproductive Medicine, 2020

Objective: To elucidate the prognostic factors for intracytoplasmic sperm injection cycle cancell... more Objective: To elucidate the prognostic factors for intracytoplasmic sperm injection cycle cancellation in patients with endometriosis-related infertility. Study Design: This was a retrospective cohort study and conducted at the Assisted Reproductive Technology center of Uludag University School of Medicine, between the years 2011-2017. The electronic database was screened and infertile patients with endometriosis, without male factor infertility, systemic disease, or undefined adnexal mass, and aged <40 were selected. The endometriosis phenotype of all cycles was classified into three subgroups: superficial endometriosis, ovarian endometrioma and deep infiltrating endometriosis. Cycles were divided into two groups: Group I (Cycle Cancellation) vs. Group II (Embryo transferred). Results: Forty-four cycles were canceled and in 178 cycles, the embryo was able to be transferred. When the groups were compared age and day 3 FSH levels were statistically higher, and anti-Mullerian hormo...

Research paper thumbnail of Luteal Fazda Vajinal Laktobasil Desteğinin IVF/ICSI Sikluslarında Taze Embriyo Transferi Uygulanan Hastalarda İmplantasyon Oranlarına Etkisi

Uludağ Üniversitesi Tıp Fakültesi Dergisi, 2020

Bu prospektif çalışmanın amacı IVF/ICSI sikluslarında taze embriyo transferi uygulanan infertil h... more Bu prospektif çalışmanın amacı IVF/ICSI sikluslarında taze embriyo transferi uygulanan infertil hastalarda luteal fazda vajinal laktobasil desteğinin implantasyon oranlarına etkisini araştırmaktır. Vajinal mikrobiyota ve infertilite ilişkisi günümüzde oldukça popüler bir araştırma konusudur ve yapılan çalışmalarda bozulmuş vajinal mikrobiyotanın infertil hastalarda gebelik sonuçlarını olumsuz olarak etkilediği bilinmektedir. Biz de bu sebeple çalışmamızda 88 infertil hastaya kontrollü ovaryan hiperstimülasyon sonrası oosit toplandığı gün vajinal 1x4 tablet vajinal laktobasil desteği sağlayarak, gebelik sonuçlarını laktobasil desteği uygulanmayan 88 kontrol hastası ile karşılaştırdık. Sonuçlarda grupların demografik verileri birbirine benzerdi. Ve çalışmanın birincil sonucu olan implantasyon oranları çalışma grubunda %38,6 kontrol grubunda %32,9 olarak bulundu. Sonuçlar kontrol grubunda daha yüksek olmasına rağmen istatistiksel olarak benzerdi. Çalışmanın sonucu olarak taze embriyo transferi yapılan infertil hastalarda luteal fazda laktobasil desteği sağlanmasının gebelik sonuçlarına etkisi gözlenmedi.

Research paper thumbnail of The Impact of Coronavirus Disease-19 on Pregnancy Outcomes, A Case Series

Gynecology Obstetrics & Reproductive Medicine

OBJECTIVE: To investigate the impact of Corona Virus Disease 19 (COVID-19) infection on pregnancy... more OBJECTIVE: To investigate the impact of Corona Virus Disease 19 (COVID-19) infection on pregnancy outcomes. STUDY DESIGN: This retrospective study was conducted at a tertiary university hospital between the years of October 2020-October 2021. All the pregnant women with COVID-19 diagnoses were enrolled in the study during this period. Demographic parameters, a history of Favipiravir use, COVID-19 symptoms, treatment approaches, hospitalization, intensive care unit admission, and obstetric and neonatal outcomes were recorded. RESULTS: A total of 92 patients were enrolled in the study. The mean age was 30+5 years. Forty-seven of the patients were asymptomatic (51%). The most common symptoms were respectively; fatigue (37.8%), fever (27.6%), dyspnea (22%), cough (17.8%), headache (11%), anosmia (4.4%), hyperemesis (4.4%), diarrhea (2.2%). There were 20 patients (21.7%) who were hospitalized. Eight of these women (8.6%) required intensive care unit admission due to COVID pneumonia-relat...

Research paper thumbnail of How does the ERAS protocol work in patients who underwent cesarean section? ( HERMES study)

International Journal of Gynecology & Obstetrics

Research paper thumbnail of EROSS study: effect of ovarian reserve on sexual satisfaction

Journal of Obstetrics and Gynaecology

Research paper thumbnail of A huge vaginal stone in a spastic paraplegic woman

International Urogynecology Journal

Research paper thumbnail of Effect of Sequential Ejaculation with Short Abstinence Time on Sperm Chromatin Integrity and Antioxidant Activity

Uludağ Üniversitesi Tıp Fakültesi Dergisi

Üremeye yardımcı tedavi uygulamalarında tercih edilen tedavi yaklaşımına göre semen parametreleri... more Üremeye yardımcı tedavi uygulamalarında tercih edilen tedavi yaklaşımına göre semen parametrelerinin embriyoloji laboratuvarı sonuçlarına ve klinik başarıya etkisi değişmektedir. Semen parametreleri abstinens süresine ve androloji laboratuvarında uygulanan yıkama protokollerine göre değişmekte ve insemine edilecek sperm materyalinin kalitesini etkilemektedir. Bu çalışmada normozoospermik erkeklerde kısa abstinens süresinin rutin semen parametrelerine, sperm kromatin ve DNA bütünlüğüne, oksidatif strese karşı gelişen antioksidan kapasiteye etkisinin değerlendirilmesi amaçlandı. Aynı hastadan ardışık ejakülasyonla 2-5 günlük abstinens süresi sonrası (n=36) ve 1 saat abstinens süresi sonrası (n=36) alınan numuneler yıkama öncesi ve yıkama sonrası değerlendirildi. Yıkama öncesinde sperm volümünün ve total motil sperm sayısının kısa abstinens grubunda anlamlı olarak azaldığı bulundu. Yıkama sonrasında gruplar arasında motilitenin değişmediği, konsantrasyonun kısa abstinens grubunda anlam...

Research paper thumbnail of Prognostic factors of IVF&ICSI cycle cancellation in patients with endometriosis related infertility; A Retrospective Study

Research paper thumbnail of Clinical importance of placental membrane microscopic chorionic pseudocysts in preeclampsia

Clinical and Experimental Obstetrics & Gynecology, 2016

OBJECTIVE To determine the importance of placental membrane microscopic chorionic pseudocysts (MC... more OBJECTIVE To determine the importance of placental membrane microscopic chorionic pseudocysts (MCP) in preeclamptic and normal placentas and evaluate the association between MCP and neonatal complications in preeclamptic patients. MATERIALS AND METHODS In this prospective case-control study, microscopic examination of placentas was performed, including MCP count, in 33 preeclamptic and 35 normal control pregnant women from December 2008 to May 2009. The MCP were counted in placentas for each patient and modeled as a continuous variable to assess the difference between the two groups. RESULTS The mean MCP count was similar for preeclamptic (7 ± 2) and control patients (7 ± 2; not significant). A weak positive correlation was noted between placental weight and MCP (r = 0.253; p ≤ 0.04). In the preeclamptic patients, mean MCP count was significantly higher for neonates that did not have neonatal respiratory distress syndrome (NRDS) (p ≤ 0.05) and who did not admitted to neonatal intensive care unit (NICU) than admitted to NICU (P ≤ .03). The risk for developing NRDS was 20.3-fold greater in neonates of preeclamptic patients who did not have than had MCP (odds ratio, 20.3 95% confidence interval, 1.0 to 48; P ≤ .05). The MCP count cutoff value was ≤ 1 for developing NRDS (sensitivity 83%; specificity, 70%). CONCLUSION The absence of MCP was significantly associated with the development of NRDS in neonates. The MCP count was inversely associated with the risk of NRDS in newborns of high-risk pregnancies caused by preeclampsia.

Research paper thumbnail of Are all antral follicles the same? Size of antral follicles as a key predictor for response to controlled ovarian stimulation

Journal of Obstetrics and Gynaecology, 2021

The aim of this study was to evaluate whether antral follicle size has any value with respect to ... more The aim of this study was to evaluate whether antral follicle size has any value with respect to antral follicle count (AFC) in predicting ovarian response to controlled ovarian stimulation. Patients who were considered to be normal responders based on their ovarian reserve markers were consecutively recruited. Total AFC was the number of 2-10 mm follicles in both ovaries. Antral follicles were separated into two subgroups according to the size: 2-5 mm and 6-10 mm follicles. Patients were divided into two main groups according to ovarian response to COS. Group 1 (suboptimal response, 4-9 oocytes retrieved, n = 61) and Group 2 (normal responders, ≥10 oocytes retrieved, n = 65). Demographic parameters were comparable between the groups. The number of 2-5 mm follicles was significantly lower in the suboptimal response group (5 [4:7] and 8 [6:10], respectively, p < .001). The ratio of 2-5 mm follicles to total antral follicles was also significantly lower in Group 1 (44.4% and 75%, respectively, p < .001). The ratio of small antral follicles was positively correlated with ovarian response (r = 0.587, p < .001). In conclusion, the ratio of small (2-5 mm) antral follicles could be a more specific predictive marker than AFC for ovarian response.IMPACT STATEMENTWhat is already known on this subject? Prediction of the ovarian response during ovarian stimulation is commonly based on antral follicle count and anti-mullerian hormone. The ovarian response may be inadequate even in patients with normal antral follicle count and anti-mullerian hormone.What do the results of this study add? A high ratio of small-size (2-5 mm) basal antral follicles is a predictive factor for higher ovarian response to ovarian hyperstimulation.What are the implications of these findings for clinical practice and/or further research? To obtain optimal ovarian response, the antral follicles should be evaluated initially in a more detailed and systematic way by taking their sizes into consideration in addition to their counts. Small antral follicle count rather than whole antral follicle count may be beneficial for optimising the ovarian response. Future studies may determine the cut off values of small antral follicle count for high/poor ovarian response.

Research paper thumbnail of Incidence of congenital uterine abnormalities in polycystic ovarian syndrome (CONUTA Study)

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2022

OBJECTIVE To investigate whether the frequency of uterine cavity abnormalities in PCOS patients h... more OBJECTIVE To investigate whether the frequency of uterine cavity abnormalities in PCOS patients higher than the normo-ovulatory patients. STUDY DESIGN This retrospective cohort study was conducted at the ART center of a tertiary university hospital. A total of 103 patients; 51 PCOS, and 52 male factor infertility were enrolled in the study between the years 2011-2019. HSG images of all patients were numbered and evaluated by ten senior reproductive endocrinologists and surgeons whom were blinded to the research and choose the most appropriate figure for each patient's HSG image and marked the shape of cavity according to the ASRM and ESGE/ESHRE classification. Results and demographic parameters were compared between PCOS and male factor infertility groups. RESULTS The percentage of the normal uterine cavity was significantly lower in the PCOS group than control group as 51 % and 66.7 %, 77 % and 94.2 % according to the ASRM and ESHRE/ESGE classifications, respectively. The frequency of Partial Septate Uterus (ESHRE-ESGE U2a / ASRM Va, 21.6% vs 5.8 % p < 0.05), Complete Septate Uterus (ESHRE-ESGE U2b / ASRM Vb, 7.8% vs 0% p < 0.01) and Dysmorphic Uterus (ESHRE-ESGE U1c) / ASRM VII) 3.9 % vs 0p < 0.05) were significantly higher in PCOS patients than controls. The frequency of arcuate uterus classified as VI in ASRM and considered as normal in ESHRE/ESGE was 16 % and 17.3 % in PCOS and control groups, respectively, without statistically significant difference. CONCLUSIONS This study provides that, compared to the healthy population, the frequency of uterine cavity abnormality is clearly higher in PCOS patients.

Research paper thumbnail of Which is more predictive ovarian sensitivity marker if there is discordance between serum anti-Müllerian hormone levels and antral follicle count? A retrospective analysis

Journal of Obstetrics and Gynaecology, 2022

This retrospective study aims to determine the more predictive ovarian reserve marker when there ... more This retrospective study aims to determine the more predictive ovarian reserve marker when there is discordance between anti-Müllerian hormone (AMH) and antral follicle count (AFC) in patients with diminished ovarian reserve (DOR). Patients who underwent ICSI because of DOR were divided into three groups. Group 1: patients with low AMH (<1.1 ng/ml) and AFC (n < 7), group 2: patients with low AMH (<1.1 ng/ml) and normal AFC (n ≥ 7) and group 3: patients with normal AMH (≥1.1 ng/dl) and low AFC (n < 7). Demographic values, follicle output rate (FORT) score and follicle to oocyte index (FOI) score of the groups were compared. Totally, 662 cycles were enrolled in the study. There were 418 cycles in group 1, 167 cycles in group 2 and 77 cycles in group 3. As the primary result, FORT and FOI scores were higher in group 3 than the other two groups. Median FORT Score with quartiles: group 1: 100 (66-150), group 2: 71 (57-100), group 3: 136 (96-200), p<.01 - median FOI score with quartiles: group 1: 83 (50-140), group 2: 71 (40-100), group 3: 116 (66-216), p<.01. In conclusion, serum AMH level has more predictive value for stimulation success if there is discordance with AFC.Impact StatementWhat is already known on this subject? Female age, serum Anti-Müllerian Hormone (AMH) levels, and antral follicle count (AFC) are commonly used to assess ovarian reserve and predict response to ovarian stimulation. AMH and AFC are both positively correlated with ovarian reserve.What do the results of this study add? If there is discordance between AFC and AMH in patients with diminished ovarian reserve (DOR), the ovarian response is better in patients with high AMH and low AFC than the patients with low AMH and high AFC.What are the implications of these findings for clinical practice and/or further research? It is important to assess both AFC and AMH before controlled ovarian hyperstimulation, to predict ovarian response in DOR patients, rather than assessing AFC or AMH alone.

Research paper thumbnail of Semen Parametrelerinin ve İnseminasyon Öncesi Hazırlık Periyodunun İntrauterin İnseminasyon Başarısına Etkisi

Uludağ Üniversitesi Tıp Fakültesi Dergisi, 2021

Üremeye yardımcı tedavi (ÜYT) uygulamalarında ilk basamak olan intrauterin inseminasyonda (IUI) k... more Üremeye yardımcı tedavi (ÜYT) uygulamalarında ilk basamak olan intrauterin inseminasyonda (IUI) kadın yaşı, vücut kitle indeksi (VKİ), stimülasyon süresi, abstinens süresi ve semen parametreleri başarıyı etkileyen prognostik faktörler arasındadır. Her ÜYT merkezinin rutin tedavi yaklaşımları ve laboratuvar uygulamaları sonucunda elde ettiği klinik başarı dikkate alınarak kendi prognostik faktörleri oluşturulmalı ve tedavi sürecinin yönetimi bu perspektifte düzenlenmelidir. Bu retrospektif çalışmada Ocak 2019-Şubat 2020 tarihleri arasında ÜYT merkezimizde gerçekleştirilen 245 IUI siklusu değerlendirilmiştir. IUI tedavisi uygulanan hastaların etiyoloji, yaş, VKİ, ejakülatın yıkama öncesi ve yıkama sonrası sperm parametreleri, abstinens süresi ve ejakulat yıkama işlemi boyunca geçen zaman periyotları değerlendirilmiştir. Kadın ve erkek yaşı, kadın VKİ, etiyoloji, infertilite süresi, siklus sayısı ve abstinens süresi bakımından gruplar arası farklılık saptanmaz iken, erkek VKİ artışının gebelik başarısını azalttığı saptandı. Semen volümü, yıkama öncesi ve sonrası sperm konsantrasyonu ve total motil sperm sayısının gebelik başarısı açısından belirleyici etkisinin olmadığı, yıkama sonrası motil sperm ve immotil sperm yüzdesinin belirleyici olduğu görüldü. Numune verilmesi ve yıkama sonrasından IUI işlemine kadar geçen sürelerin klinik başarıyı etkilemediği, fakat yıkama öncesi uzun inkübasyon süresinin gebelik şansını azalttığı saptandı. Küçük örneklem grubuyla yapılan bu çalışmada IUI tedavisinde klinik başarıda yıkama öncesi semen parametrelerinin belirleyici bir etkisinin olmadığı, erkek obezitesi ve numune hazırlama süreçlerinin prognostik faktörler olarak göz önünde bulundurulması gerektiği sonucuna varıldı.

Research paper thumbnail of Evaluation of Endometrioma Pathophysiology and Related Ovarian Damage by Pten / Akt Apoptosis Signaling Pathway

Fertility and Sterility, 2020

Research paper thumbnail of The Effect of Embryo Transfer Process Duration on Implantation Success

Gynecology Obstetrics & Reproductive Medicine, 2021

OBJECTIVE: To evaluate the effect of the embryo transfer duration of standard and simple embryo t... more OBJECTIVE: To evaluate the effect of the embryo transfer duration of standard and simple embryo transfer method. STUDY DESIGN: This study was a retrospective cohort study conducted at a tertiary ART Centre, between June 2018- September 2018. Day 5 fresh embryo transferred patients aged between 18 - 40, BMI <35 kg/m2 without uterine pathology were enrolled in the study. Patients were divided into two groups. Group-1 consisted of patients who had successful implantation and Group-2 consisted of patients who did not have implantation. Groups were compared according to their embryo transfer durations. Ninety-two patients were enrolled in the study. Also, sub-steps of as; cleaning of the cervical mucus and placing the outer catheter in the cervix, loading the embryo to the catheter, the period between embryo loading and embryo transfer, and following that, time spent for retracting the outer catheter evaluated. RESULTS: Between Group-1 and Group-2, there was no significant difference ...

Research paper thumbnail of The Effect of Embryo Transfer Process Duration on Implantation Success

Gynecology Obstetrics & Reproductive Medicine, 2021

OBJECTIVE: To evaluate the effect of the embryo transfer duration of standard and simple embryo t... more OBJECTIVE: To evaluate the effect of the embryo transfer duration of standard and simple embryo transfer method. STUDY DESIGN: This study was a retrospective cohort study conducted at a tertiary ART Centre, between June 2018- September 2018. Day 5 fresh embryo transferred patients aged between 18 - 40, BMI <35 kg/m2 without uterine pathology were enrolled in the study. Patients were divided into two groups. Group-1 consisted of patients who had successful implantation and Group-2 consisted of patients who did not have implantation. Groups were compared according to their embryo transfer durations. Ninety-two patients were enrolled in the study. Also, sub-steps of as; cleaning of the cervical mucus and placing the outer catheter in the cervix, loading the embryo to the catheter, the period between embryo loading and embryo transfer, and following that, time spent for retracting the outer catheter evaluated. RESULTS: Between Group-1 and Group-2, there was no significant difference ...

Research paper thumbnail of Which is More Predictive Ovarian Reserve Marker When There is Discordance Between Anti - Mullerian Hormone and Antral Follicle Count in Patients with Diminished Ovarian Reserve, Amh or Afc?

Fertility and Sterility, 2020

Research paper thumbnail of Sexual Outcomes and Motherhood Plans of The Mayer Rokitansky Küster Hauser Syndrome Patients Operated with Uncu Modified Remnant-Supported Laparoscopic Double-Layer Peritoneal Pull-Down Vaginoplasty Technique

Objective: To determine the sexual outcomes and motherhood plans of the Mayer Rokitansky Küster H... more Objective: To determine the sexual outcomes and motherhood plans of the Mayer Rokitansky Küster Hauser (MRKH) Syndrome patients operated with Uncu Modified Remnant-Supported Laparoscopic Double-Layer Peritoneal Pull-Down Vaginoplasty operation Design: Cohort Study Setting: Tertiary University Hospital Patients: Women with MRKH syndrome Methods: This study involves the patients with MRKH syndrome who underwent Uncu Modified Remnant-Supported Laparoscopic Double-Layer Peritoneal Pull-Down Vaginoplasty Operation between the years 2008-2020. The first step of the study is about our surgical technique outcomes. The second step consists of long-term results for sexual functioning which was assessed by female sexual function index (FSFI) survey and motherhood plans by another survey. Main Outcome Measure: FSFI and Motherhood Survey Results Results Total 42 patients with MRKH syndrome underwent vaginoplasty operation. At least one year after surgery all patients was physically examined. The...

Research paper thumbnail of Supernumerary embryos, do they show the cycle success in a fresh embryo transfer? A retrospective analysis

Gynecological Endocrinology, 2021

Abstract Objective To determine the predictive value of cryopreserved embryos during single fresh... more Abstract Objective To determine the predictive value of cryopreserved embryos during single fresh blastocyst transfer Methods This retrospective cohort study was conducted at a tertiary university hospital ART center. Patients who underwent a single fresh blastocyst transfer were selected from the electronic database. Patients with diminished ovarian reserve, uterine pathology, advanced age (>40 years) were excluded from the study. Patients were divided into two groups. Group A consisted of patients with only one available embryo for the fresh transfer. Group B consisted of patients with cryopreserved embryos apart from the fresh transferred embryo. Demographic and embryology parameters, pregnancy results were compared. Results Demographic values, ovarian reserve parameters were comparable between groups. The number of the picked-up oocyte, metaphase-2 oocyte, and two-pronucleus embryo was lower in Group A. Positive pregnancy rates were two-fold higher in Group B (23.4% vs. 50.9% p < .01). Pregnancy results did not change depending on the number of cryopreserved embryos in Group B. Conclusion According to our results, the presence of cryopreserved embryos results in higher pregnancy rates in patients with fresh blastocyst embryo transfer independent from the woman’s age and ovarian reserve. Thus, these results may help us to predict the implantation rate before embryo transfer.

Research paper thumbnail of Amh Levels May Predict for Mullerian Anomalies and Pregnancy Outcomes Patients with Pcos

Fertility and Sterility, 2020

Research paper thumbnail of Prognostic Factors of IVF Cycle Cancellation in Patients with Endometriosis-Related Infertility

Gynecology Obstetrics & Reproductive Medicine, 2020

Objective: To elucidate the prognostic factors for intracytoplasmic sperm injection cycle cancell... more Objective: To elucidate the prognostic factors for intracytoplasmic sperm injection cycle cancellation in patients with endometriosis-related infertility. Study Design: This was a retrospective cohort study and conducted at the Assisted Reproductive Technology center of Uludag University School of Medicine, between the years 2011-2017. The electronic database was screened and infertile patients with endometriosis, without male factor infertility, systemic disease, or undefined adnexal mass, and aged <40 were selected. The endometriosis phenotype of all cycles was classified into three subgroups: superficial endometriosis, ovarian endometrioma and deep infiltrating endometriosis. Cycles were divided into two groups: Group I (Cycle Cancellation) vs. Group II (Embryo transferred). Results: Forty-four cycles were canceled and in 178 cycles, the embryo was able to be transferred. When the groups were compared age and day 3 FSH levels were statistically higher, and anti-Mullerian hormo...

Research paper thumbnail of Luteal Fazda Vajinal Laktobasil Desteğinin IVF/ICSI Sikluslarında Taze Embriyo Transferi Uygulanan Hastalarda İmplantasyon Oranlarına Etkisi

Uludağ Üniversitesi Tıp Fakültesi Dergisi, 2020

Bu prospektif çalışmanın amacı IVF/ICSI sikluslarında taze embriyo transferi uygulanan infertil h... more Bu prospektif çalışmanın amacı IVF/ICSI sikluslarında taze embriyo transferi uygulanan infertil hastalarda luteal fazda vajinal laktobasil desteğinin implantasyon oranlarına etkisini araştırmaktır. Vajinal mikrobiyota ve infertilite ilişkisi günümüzde oldukça popüler bir araştırma konusudur ve yapılan çalışmalarda bozulmuş vajinal mikrobiyotanın infertil hastalarda gebelik sonuçlarını olumsuz olarak etkilediği bilinmektedir. Biz de bu sebeple çalışmamızda 88 infertil hastaya kontrollü ovaryan hiperstimülasyon sonrası oosit toplandığı gün vajinal 1x4 tablet vajinal laktobasil desteği sağlayarak, gebelik sonuçlarını laktobasil desteği uygulanmayan 88 kontrol hastası ile karşılaştırdık. Sonuçlarda grupların demografik verileri birbirine benzerdi. Ve çalışmanın birincil sonucu olan implantasyon oranları çalışma grubunda %38,6 kontrol grubunda %32,9 olarak bulundu. Sonuçlar kontrol grubunda daha yüksek olmasına rağmen istatistiksel olarak benzerdi. Çalışmanın sonucu olarak taze embriyo transferi yapılan infertil hastalarda luteal fazda laktobasil desteği sağlanmasının gebelik sonuçlarına etkisi gözlenmedi.