Vehbi Yavuz Tokgöz

Aim: To study the effect of infertility support education on treatment outcomes in women with unexplained infertility. Materials & methods: This quasi-experimental study with a pretest–posttest comparison group was conducted on women aged 19–45 years who were admitted to EO University Health, Practice and Research Hospital Department of Reproductive Endocrinology and Private D Health Hospital IVF Clinic with the diagnosis of unexplained infertility and decided to undergo in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) and were included in the treatment plan. A study group and a control group were formed by randomization method with at least 25 infertile women for each group. Data were collected using the Introductory questionnaire, Fertility Readiness Scale for women receiving fertility support, Healthy Lifestyle Behaviors Scale II and post-IVF/ICSI success evaluation form. The pretest scales were administered to the education and control groups at the first interview. Infertility support training was given to the education group in three sessions at 15-day intervals. Post-test data were obtained at the interview on the day of ovum pickup. Embryo transfer was performed in 25 infertile women in both groups, and human chorionic gonadotropic hormone evaluation was performed on day 12. Approximately 4 weeks later the presence of a fetal heartbeat was analyzed by reviewing the medical records, and the post-IVF/ICSI success evaluation form was completed. Results: Fetal heartbeat was detected in 15 women in the training group and only in 10 women in the control group, although the pregnancy rate increased after training and this difference was not statistically significant. Conclusion: Infertility support education has been found to have positive effects on fertility as well as general health.

Bu çalışmanın amacı, Bologna kriterlerine göre düşük over yanıtı tanısına uyan kadınlarda bazal yaş, FSH, AMH ve AFC değerlerinin toplanan oosit sayısı bağlantılı tedavi sonuçlarını öngörme gücünü değerlendirmektir. Eskişehir Osmangazi Üniversitesi Üreme Sağlığı Merkezi’ne Ocak 2017–Aralık 2024 tarihleri arasında başvuran, Bologna kriterlerine göre düşük over yanıt durumuna sahip 181 tüp bebek siklusu retrospektif olarak incelendi. Bazal parametreler (yaş, FSH, AMH, AFC) ile toplanan oosit sayıları arasındaki ilişki korelasyon ve lojistik regresyon analizleri ile; çok düşük over yanıtı (≤3 oosit) öngörüsü ROC analizi ile değerlendirildi. Gebelik sonuçları (biyokimyasal, klinik gebelik, canlı doğum) embriyo transferinden 12 gün sonraki β-hCG ve ultrasonografik bulgulara göre kaydedildi. Katılımcıların ortalama yaş 35.9±4.6 yıl, bazal FSH 9.9±4.1 IU/L, AMH 0.88±0.33 ng/mL, AFC 5.5±2.5 olarak tespit edildi. Ortalama toplam oosit sayısı 2.54±1.28, matür oosit sayısı 1.50±1.27 idi. AFC, toplam oosit sayısı ile anlamlı korelasyon (r=0.247, p<0.001) gösterirken; AMH (AUC=0.716, p=0.003) ve FSH (AUC=0.687, p=0.002) 3 ve altı oosit elde edilen döngüleri öngörmede AFC’ye göre daha yüksek öngörü potansiyeli sergiledi. Klinik gebelik oranı %28.9, canlı doğum oranı %18.1 olarak bulundu. Düşük over yanıtlı vakalarda AFC, toplam oosit sayısını öngörmede en güçlü belirteç iken; düşük yanıtlı döngülerin tanımlanmasında AMH ve FSH değerleri AFC’den daha iyi bir öngörü potansiyeli gösterdi. Bu veriler, IVF protokollerinin kişiselleştirilmesinde bazal over rezerv belirteçlerinin birlikte değerlendirilmesinin önemini vurgulamaktadır.

OBJECTIVE: This study aimed to evaluate whether there were differences in the first-trimester inflammatory markers: NLR (neutrophil-to-lymphocyte ratio), PLR (platelet-to-lymphocyte ratio), MPV (mean platelet volume), and MPVLR (MPV-to-lymphocyte ratio), between cases with and without gestational diabetes mellitus (GDM). STUDY DESIGN: The study was designed by examining the first-trimester hemogram parameters of cases who underwent GDM screening. The primary outcome was to determine the differences and effectiveness of NLR, PLR, MPV, and MPVLR values in the first trimester between study groups before the diagnosis of GDM. RESULTS: A total of 878 cases were analyzed in the study. Patients were divided into two groups based on the 75-gram oral glucose tolerance test (OGTT). The study groups consisted of cases with GDM (n=127) and without GDM (n=751). While leukocyte count was found to be marginally higher in the GDM group (8.6±2.2 x103/mm3 vs. 9.0±2.4 x103/mm3, p=0.047), NLR and PLR values did not differ between the groups. Although a minimal increase in MPV values was observed in the GDM group, it did not reach statistical significance (10.0±1.1 fL vs. 9.9±1.0 fL, p=0.785). Similarly, MPVLR values were comparable between the groups. However, the ROC analysis revealed MPVLR as the most effective marker for GDM detection (AUC: 0.537). CONCLUSION: Simple and cost-effective inflammatory markers examined in the first trimester may provide insights into predicting GDM. NLR, PLR, and MPV values stand out in this regard. Additionally, the newly examined MPVLR in GDM cases suggests its potential as a more effective predictor than these markers in our study.

Access to quality and reliable information sources during pregnancy, which is a special period, is important for both maternal and fetal health. The reliability and quality of the information obtained from video platforms such as YouTube are important. This study was designed to evaluate the quality and reliability of YouTube videos on thyroid disorders which are common during pregnancy. A total of 248 videos found on YouTube with the keywords 'thyroid disorders during pregnancy,' 'pregnancy and thyroid disorders' and 'pregnancy and thyroid gland' were recorded. After applying criteria, the remaining 68 videos were evaluated. General characteristics of the videos, modified DISCERN scoring and Global Quality Scale (GQS) scoring were performed. The videos were divided into two groups based on their sources: Obstetricians and Gynecologists, and Internal Medicine/Endocrinology physicians. A 10-parameter scoring system including necessary information about thyroid disease during pregnancy was used. As a result of the analysis of 68 videos evaluated in the study; it was observed that the information on diagnosis and treatment in the videos prepared by Internal Medicine/Endocrinology physicians regarding of thyroid diseases in pregnancy was better than the videos prepared by Obstetrics and Gynecology physicians (p<0.05). When videos were evaluated in terms of quality and reliability, both groups were found to have similar quality and reliability. When all videos were analyzed, 41% were classified of high quality, 41% were of medium quality, and 18% were of low quality. The quality and reliability of YouTube videos on thyroid diseases during pregnancy were found to be high. However, the video content needs to be more comprehensive.

Introduction: Infertile women may have difficulty coping with the stress caused by assisted reproductive methods. Aim: It was aimed to investigate the effect of chewing gum on stress levels in women with unexplained infertility. Method: Sixty - one women receiving in - vitro fertilization treatment in the tertiary care center were included in the study. A randomized controlled experimental design was established in the study. The group chewing gum for five minutes at least two times a day was called "Experimental Group - 1", the group chewing gum for 20 minutes at least two times a day was called "Experimental Group - 2", and the group not chewing gum was called "Control Group". Reproductive information and stress level data of infertile women were collected with the Descriptive Information Form and Fertility Problem Inventory. Results: No statistically significant difference was found in comparing Fertility Problem Inventory total scores between the groups (p > 0.005). However, a statistically signifiant difference was found between the mean values of the denial of life without children, which was a subscale of the Fertility Problem Inventory score according to time in the Experimental Group - 2 group (p <0.005). Conclusion: We believe that the positive effect of chewing gum on coping with stress may be an alternative intervention that may contribute positively to coping with the infertility treatment process and should be supported by other interventions.

Giriş: Kafein günümüzde tüm dünyada yaygın olarak kullanılan bir bileşendir, ancak gebelik sırasında kafein tüketiminin doğum ve çocukluk üzerindeki etkisi belirsiz bir konu olmuştur. Bu nedenle, bu çalışmada gebeliğin trimesterleri boyunca kafein alım alışkanlıklarını incelemeyi ve kafein düzeylerinin yenidoğan sağlığı üzerindeki etkilerini analiz etmeyi amaçladık. Yöntemler: Çalışmaya 42 kadın dahil edildi. Sosyo-demografik Özellikleri Değerlendirme Anketi ilk görüşmede dolduruldu ve aynı görüşme sırasında; Günlük Kafein Alım Düzeyleri Değerlendirme Formu belirlenen hafta ve günlerde güncellenmek üzere verildi. Doğum Bilgi Formu, doğum olduktan ve annelerin dosyaları incelendikten sonra doldurulmuştur. Bulgular: Günlük kafein alım düzeyleri gebelik öncesi ortalama 509,8±353,2 mg ve gebelik süresince ortalama 193,7±116,5 mg idi. Herhangi bir sosyo-demografik bulgu ile gebelik öncesi dönem de dahil olmak üzere gebelik döneminin herhangi bir dönemindeki ortalama kafein alımı arasında bir korelasyon bulunmamıştır. Ayrıca, gebeliğin trimesterlerinde kafein alımı arttıkça doğum ağırlığı, boyu ile 1. ve 5. dakika Apgar skorunun azaldığı bulunmuştur. Sonuç: Standart yöntemler kullanılarak yapılacak daha fazla çalışma ve bu çalışmaların meta-analizi, kafein ile gebelik sonuçları, yenidoğan ve çocuk sağlığı arasındaki ilişkinin keşfedilmesine yardımcı olabilir. Anahtar Kelimeler: Kafein, tüketim, gebelik, yenidoğan, hemşirelik

Introduction: The complete blood count parameters and its combinations, such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and mean platelet volume (MPV), are inflammatory markers. In this study, we aimed to demonstrate the possible role of complete blood count parameters (NLR, PLR, and MPV) in predicting preterm birth. Material and Methods: The complete blood count parameters in the first and third trimesters were recorded, as well as the corresponding NLR, PLR, and MPV. The study population was categorized as preterm (n = 94) and term births (n = 953). The preterm birth group was further divided into early preterm (n = 11) and late preterm birth (n = 83) groups. The inflammatory markers were compared between the study groups for the first and third trimesters separately. The alterations between the first and third trimester values were also compared. Results: The first trimester values were similar across the study groups. Moreover, the MPV difference between the first and third trimesters was significantly lower in the preterm group than in the term group (0.0  1.1 vs. 0.2  1.1, p = 0.038). Furthermore, NLR values were higher in the early preterm subgroup than in the late preterm and term groups for the first and third trimesters (first trimester; 4.0  1.2 vs. 3.1  2.0 and 3.1  1.3, p = 0.005; third trimester; 5.3  1.2 vs. 4.0  1.5 and 4.4  2.9, p = 0.013). Conclusion: NLR and MPV predict preterm births in the first trimester and before birth. This enables physicians to take some precautions in preventing preterm delivery.

AMAÇ: Bu çalışmada, smear sonucu düşük dereceli servikal intraepitelyal lezyon (LSIL), yüksek dereceli servikal intraepiteliyal lezyon (HSIL), önemi belirsiz tipik olmayan yassı hücreler (ASCUS) tespit edilen, servikal muayenede erzoyon saptanan hastalar ve yapılan human papilloma virüs (HPV) testi pozitif olan takiben kolposkopik biyopsi uygulanan hastalarımızda HPV, smear ve biyopsi sonuçları karşılaştırılması amaçlanmıştır.GEREÇ VE YÖNTEM: Toplamda çalışma grubu olarak 186 hasta dahil edildi. Hastalardan alınan servikal smearlar değerlendirildi. Servikal smear sonucu; ASCUS, LSIL ve HSIL, olan hastalar ile HPV pozitif hastalar kolposkopiye yönlendirildi. HPV tiplerinden 16, 18, 31 ve 33 olanları yüksek riskli, diğerlerini düşük riskli olarak gruplandırdık. Buna göre HPV, smear ve biyopsi sonuçları karşılaştırıldı.BULGULAR: Çalışmaya dahil edilen 186 hastanın 74’ü (%39,7) menopozdaydı. Kolposkopi yapılan hastaların 103’ünde (%55,3) HPV testi sonucu pozitif saptanması nedenli kolposkopi yapıldı. Bu hastaların 82’si yüksek riskli HPV grubundaydı. ASCUS nedenli 35 (%18,8) olguya, servikal erozyon nedenli 33 hastaya (%17,7), LSIL nedenli 12 hastaya (%6,5) HSIL nedenli 3 hastaya (%1,6) kolposkopi yapıldı. Kolposkopi yapılan hastaların alınan biyopsilerinin patoloji sonuçlarına bakacak olursak 134’ü (%72) benign olarak geldi. Smear sonucu malignite izlenmedi olarak gelen 121 hastanın kolposkopik biyopsi sonuçları değerlendirildiğinde 19 hastada CIN1 (%15,7), 6 hastada CIN2(%5), 2 hastada CIN3(%1,7) saptandı. Smear sonucuna göre LSIL gelen hastaların %25’inde ileri düzeyde epitelyal anomali (CIN 2 ve 3) gözlenirken, HSIL olan hastalarda bu oran %50 olarak tespit edilmiştir. HPV tipleri ile kolposkopik biyopsi sonuçları karşılaştırıldığında yüksek riskli HPV tipleri ile %37,8 oranında CIN 1, 2 ve 3 tespit edilirken, düşük riskli grupta bu oran %9,5 olarak bulunmuştur (p<0.016).SONUÇ: Smear tarama testi olarak kullanılmalıdır ve LSIL veya HSIL varlığında mutlaka kolposkopik biyopsi ile tanının doğrulanması gereklidir. Ayrıca özellikle yüksek riskli HPV tiplerinin pozitifliği tespit edilen olgularda smear sonucundan bağımsız olarak da kolposkopik biyopsinin önemi anlaşılmaktadır.