Dilek Benk Silfeler

Objective: We aimed to demonstrate any possible relationship between endometrial thickness on the day of hCG trigger and live birth rates (LBRs) among women with unexplained infertility who underwent IVF/ICSI-ET cycles. Materials and Methods: We retrospectively collected data from Zeynep Kamil Women's and Children's Disease Training and Research Hospital, IVF Center archive. Cases between 2005 and 2013 were collected. Women aged between 23-39 years with a BMI <30 kg/m2 with fresh embryo transfers were included. Patients were divided into two groups based on their livebirth status (live birth: group 1, no live birth: group 2). Demographic characteristics, treatment regimens, and endometrial thickness on the day of hCG trigger were compared between the two groups. In addition, patients were divided into subgroups according to the endometrial thickness on the day of hCG trigger (≤7 mm, 8 mm, 9 mm, 10 mm, 11 mm, 12 mm, 13 mm, and ≥14 mm, respectively). LBRs were compared between these subgroups. Results: Three hundred fifty-nine cycles (group 1: n=104, group 2: n=255) were included for statistical analysis. Other than estradiol level (pg/mL) on the day of hCG trigger (2517.2±1106.0, 2210.8±991.7, respectively; p=0.011), there were no statistically significant differences between the two groups. Among the subgroups based on endometrial thickness, the highest LBR was detected in the 13 mm subgroup (36.8%) and lowest LBR was detected in 12 mm subgroup (23.9%). However, LBRs were not statistically significant between the subgroups. Conclusion: LBRs do not seem to be affected by endometrial thickness on the day of hCG trigger among couples with unexplained infertility.

The aim of the study was to determine whether anhydramnios affected the duration of medical abortion in cases with various indications as compared to cases with normal amniotic fluid volume. Patients who were admitted to our clinic because of medical abortion between January 2010-December 2013 were included in this retrospective study. A total of 32 pregnant women with anhydramnios (study group) and 67 pregnant women with normal amniotic fluid volume but with fetal abnormality (control group) were included in the study. Patient age, gravidity, parity, gestational age, previous delivery route, and duration of the abortion were recorded. Mean duration of the abortion in the study group was 71.93 ± 47.51 h as compared to 79.08 ± 52.62 h in the control group. There were no statistically significant differences between the two groups in terms of duration of the abortion (p = 0.516). Also, we found no statistically significant differences in duration of the abortion with regard to previous delivery route (p = 0.220). There were no statistically significant differences between the study group and controls in terms of duration of the abortion. In addition, neither parity nor previous delivery route affected the duration of the abortion.

The aim of this study was to compare platelet parameters between abortus groups with gestational trophoblastic disease (GTD) (molar pregnancy, invasive mole, choriocarcinoma, etc) and without disease according to pathological result. The study population consisted of patients with GTD (n = 53) and aborted patients without disease as a control group (n = 53) who were seen in our clinic between January 2010 and December 2013. In this retrospective study, age, gravidity, levels of haemoglobin, white blood cell count, platelets, platelet parameters (mean platelet volume (MPV), platelet distrubition width (PDW), platelet crit (PCT), which shows platelet functions were recorded. The pathological diagnosis of GTD was recorded. The mean platelet count, MPV, PDW and PCT levels were similar between the groups. There is no statistically significiant difference between types of GTN in these parameters according to pathological diagnosis. According to our study results, platelet count and levels of MPV, PDW ve PCT in GTD patients were similar to aborted patients without disease.

Introduction: Â"CoastingÂ" is a method used in prevention of Ovarian Hyperstimulation Syndrome (OHSS) during In Vitro Fertilization (IVF) cycles. Coasting refers to witholding exogenous gonodotropine usage and delaying the administration of hCG in high risk cycles until serum estradiol levels falls into an acceptable range. The aim of our study is to evaluate coasting effect on IVF oucomes in patients with E2 levels of 4000-5000 pikogram. Metod: This study was a single centered, retrospective and a case-control study. Study population were selected from women applied Zeynep Kamil Research Hospital IVF department between January 2003 and December 2013(n≤ 7850). Patients taking GnRH aganist or antagonist protocol, having BMI between 23-28 kg/m2, having E2 levels between 4000-5000 pikogram and age ≤43 were included in the study. Patients were divided in 2 groups as conrol group (Group 1, n≤48) and coasted group (Group 2, n≤34) according to whether or not coasting performed. Peak E2 levels before coasting, follicle count before oocyte pick up, collected M2 oocyte count, fertilized oocyte count, OHSS incidince and pregnancy incidence were compared between groups.Statistical analysis was performed using StudentÂ's t test for continuous variables and chi-square test for categorical variables. Results: While most of patients in group 2 needed less than 2 days of coasting, only two patient needed 4 days of coasting. E2 levels on the day of hCG in group 2 were significiantly lower than group 1 (4332.6±256.6 and 3180.8±702.9; p<0.0001, respectively). There were no statistically significiant difference in follicle count before oocyte pick up, collected M2 oocyte count, fertilized oocyte count, pregnancy rate and OHSS incidence in between groups. Conclusion: Coasting is an effective method in high risk women to lower OHSS incidence. It can be appilied safely especially in patients having optimal follicular size and estradiol levels of 4000-5000.

Background: Trichomoniasis is a sexually transmitted vaginal infection caused by a protozoan called Trichomonas vaginalis. Its prevalence ranges between 3–40% among randomly tested women. Objectives: To investigate the presence of T. vaginalis in infertile women presenting to a Turkish gynecology outpatient clinic using parasitological methods. Methods: The study population comprised 51 patient participants who attended the gynecology clinic of Mustafa Kemal University Hospital between March and August 2013. The women were divided into those presenting with infertility (n = 22) and a patient control group (n = 29). Women in the control group had complaints other than infertility. Microscopic examination, Giemsa staining, and cysteine-peptone-liver-maltose culture were performed on samples taken from posterior fornix tested for T. vaginalis. Results: T. vaginalis was observed in 18% (n = 4) of infertile patients and in none of the control group (P = 0.03). Conclusions: Asymptomatic infertile women should be examined for T. vaginalis infection, which may play a role as a cause or contributing factor in infertility.

In this study, we aimed to investigate frequency of Demodex (D.) folliculorum infestation in Polycystic Ovary Syndrome patients. The study population consisted of 30 PCOS patients and 30 matched healthy control subjects admitted to the Hospital of Mustafa Kemal University, Gynecology and Obstetrics Clinic between March 2013 and January 2014. The demographic characteristics of the patients were recorded. Samples from the face region of the subjects were taken by standard method of superficial skin biopsy and evaluated by microscopy. Presence of five or more D. species in a cm2 was considered as positive. There were no significant differences in age, body mass index, diabetes mellitus incidence between PCOS patients and the control group. However, D. folliculorum infestation was found to increased in PCOS patients (n = 9; 30%) when compared to the control group (n = 2; 6, 7%) (p: 0.04). Our study results revealed that Demodex folliculorum appearance increased in PCOS patients.

The aim of our study was to investigate the ductus venosus doppler between 11-13+6 (week-day) in pregnant women with hemoglobinopaties and its relation with fetal outcomes. A total of 100 pregnant women with hemoglobinopathies and 100 healthy pregnant women were included in our study. Ultrasonography (USG) was performed to all pregnant women and the ductus venosus doppler (DVD) flows were evaluated. The results were statistically analyzed. The mean hemoglobin level was significantly lower in hemoglobinopathy group (9.7 ± 0.7) than control group (10.67 ± 0.82) (P<0.001). There was a significant relationship between Vmax, Vmin, S/D and reverse 'a' wave in fetuses with hemoglobinopathies. Vmax, Vmin and S/D parameters were higher in the group of hemoglobinopathies (respectively mean value, 31.3 ± 1.66, 8.90 ± 0.81, 2.97 ± 0.49). Reverse 'a' wave was detected especially in all fetuses with sickle cell anemia. There was no significantly relationship between the groups in terms of PI, RI and HR. In a logistic regression analyses, fetal hemoglobinopathy was independently associated with Vmin (β = 1.07, P = 0.001), S/D (β = 2.61, P = 0.001) and reverse 'a' wave (β = 2.46, P = 0.004). Pregnant women with hemoglobinopathies had changed ductus venosus doppler values in compared to normal pregnant women. Maternal anemia may cause this doppler changes. Furthermore all fetuses with sickle cell anemia (n = 5) had abnormal ductus venosus doppler findings. Further studies are needed to investigate the relationship between abnormal ductus venosus doppler findings and fetuses diagnosed with sickle cell anemia.

Endometriosis is an estrogen-dependent chronic inflammatory disease observed in reproductive period. The aim of the present study is to assess the efficacy of colchicine, widely used to treat many inflammatory diseases, in an experimental rat endometriosis model. Experimental endometriosis was constituted with implantation of autogenous endometrial tissue. Rats were divided randomly into 2 groups as colchicine group (n = 8) and control group (n =8). Although oral 0.1 mg/kg colchicine was administered 4 weeks to the colchicine group, the same amount of saline solution was administered to the control group. Before and after 30 days of treatment period, peritoneal and tissue tumor necrosis factor α (TNF-α), the volumes and histopathological properties of the implants were evaluated. Although the implant volume decreased significantly in the colchicine group (89.2 ± 13.4 mm³ to 35.2 ± 4.5 mm³, P < .05), the implant volume increased in the control group (85.1 ± 14.2 mm3 to 110.3 ± 10.5 mm³, P < .05). When compared to the control group, the colchicine group had significantly lower histopathologic sores (1.4 ± 0.2 vs 2.6 ± 0.4, P < .001). Although peritoneal fluid TNF-α levels were significantly decreased in the colchicine group (45.2 ± 5.3 pg/mL vs 12.1 ± 5.2 pg/mL, P < .001), the peritoneal fluid TNF-α levels were significantly increased in the control group after the treatment (44.2 ± 3.5 pg/mL vs 61.3 ± 12.2 pg/mL; P < .001). Tissue TNF-α levels were significantly lower in the colchicine group when compared to the control group (45.4 ± 8.6 pg/mL vs 71.3 ± 11.2 pg/mL; P < .001). Colchicine resulted in regression of endometrial implant volumes in experimental rat endometriosis model and decreased peritoneal and tissue TNF-α levels.