İsMet Gun

Objectives: To compare the effects of leukocyte- and platelet-rich plasma (L-PRP) and pure platelet-rich plasma (P-PRP), both among themselves and with the control group, in preventing intra-abdominal adhesions in an experimental rat model study. Materials and Methods: 34 Sprague-Dawley rats were randomized and divided into the control group (n=8), L-PRP (n=8), and P-PRP (n=8) treatment groups. The fourth group was used only for PRP preparation (5 rats for L-PRP and 5 rats for P-PRP) and was not included in the outcome analysis. All of the rats were operated on by the same two surgeons under general anesthesia for the uterine horn adhesion modeling. Apart from the control group, 1 mL of L-PRP and P-PRP solutions prepared for the other two treatment groups were applied to the lesion. Postoperative adhesion evaluation was performed on the 14th postoperative day. Adhesions were evaluated both macroscopically (presence, severity, and degree of adhesion) and histopathologically (levels of inflammation and fibrosis), and the evaluation was blinded by two similar surgeons. Results: One rat was lost during the study in each treatment group. There was a statistically significant difference in terms of the extent of adhesions among the groups (P = 0.025), the tenacity of the adhesions (P = 0.045), and total adhesion scores (7.13±2.7, 3.86±1.5, and 6.71±2.1; control, L-PRP, and P-PRP, respectively, P = 0.028). This difference was due to Group 2 during binary comparisons. However, the statistical difference between the groups after Bonferroni correction disappeared, apart from the tenacity of adhesions category. In the tenacity of adhesion category, the difference was only between the control group and L-PRP (12.5% in the gentle traction separation control group vs. 85.7% in L-PRP; P = 0.005). On histopathological examination, there was no difference between the groups in inflammation or fibrosis. Conclusions: In the experimental rat uterine horn adhesion modeling, neither L-PRP nor P-PRP was effective in preventing postoperative adhesion formation. However, the adhesion formed in the L-PRP group was more readily separated by gentle traction than in both the control and P-PRP groups.

Objectives: Varicocele is a major cause of male infertility, primarily driven by oxidative stress, inflammation, and apoptosis within testicular tissue. Chrysin, a natural flavonoid with potent antioxidant and anti-inflammatory properties, has shown potential benefits in reproductive disorders. This study aimed to evaluate the protective effects of chrysin in an experimental rat model of varicocele. Materials and Methods: Thirty-two adults male Wistar rats were randomly allocated into four groups: Sham, Chrysin (50 mg/ kg/d), Varicocele, and Varicocele + Chrysin. Varicocele was induced by partial ligation of the left renal vein. After eight weeks of treatment, sperm parameters, testicular histopathology, serum oxidative stress markers (MDA, SOD, GPx, TAC), and testicular expression of TNF α, IL 1β, Bax, and Bcl 2 (RT qPCR) were assessed. Statistical analyses included Analysis of Variance (ANOVA) or Kruskal–Wallis tests with appropriate post hoc comparisons. Results: Induction of varicocele markedly decreased testicular mass and compromised sperm parameters—including concentration, motility, and morphology—while also producing pronounced structural damage within the seminiferous tubules and lowering Johnsen scores. Oxidative stress was markedly elevated, as indicated by increased MDA and reduced SOD, GPx, and TAC levels. Additionally, varicocele upregulated TNF α, IL 1β, and Bax while downregulating Bcl 2, resulting in an increased Bax/Bcl 2 ratio. Chrysin treatment significantly ameliorated these changes by improving sperm parameters, preserving testicular architecture, reducing lipid peroxidation, restoring antioxidant capacity, and modulating inflammatory and apoptotic gene expression. Conclusions: Chrysin exerts strong protective effects against varicocele induced testicular dysfunction through antioxidant, anti inflammatory, and anti apoptotic mechanisms. These findings support its potential as a natural therapeutic candidate for managing varicocele-associated male infertility.

The purpose of the study was to compare the ovarian stromal blood flow and stromal thickness (ST) of polycystic ovary syndrome (PCOS) patients, with healthy women with polycystic ovarian morphology (PCOM) and normal ovarian morphology (NOM). A total of 220 participants were recruited and the three study groups were determined by diagnostic criteria (PCOS n = 106, PCOM n = 68, NOM n = 46). Clinical, hormonal and ultrasonographic measurements of ovaries were assessed and compared. PCOS patients showed statistically higher androgen levels, insulin resistance, hirsutism score, ovarian ST and stromal blood flow compared to PCOM and NOM. The correlation between free androgen index (FAI) and ST was measured. FAI was significantly highly correlated with left ovarian ST (0.83; p < .001) and right ovarian ST (0.83; p < .001). According to the results of this study, the ovarian ST which can be considered as ultrasonographic indicator of FAI, can be used in PCOS diagnosis. Also, it can be suggested that there is no statistically significant difference in ovarian ST and doppler findings between healthy women with PCOM or NOM. ROC analysis was used to measure diagnostic utility of ST.

To determine the possible detrimental effects of multiple methotrexate doses has on the ovarian reserve and to determine the beneficial effects of dehydroepiandrosterone supplementation. The rats (n:24) divided into three groups; Group 1: control group, Group 2: dehydroepiandrosterone and methotrexate group (6mg/kg dehydroepiandrosterone dissolved in 0.1 ml sesame seed oil subcutaneously for ten days and 1mg/kg intramuscular methotrexate at the 1st, 3rd, 5th and 7th days) and Group 3: methotrexate group (1mg/kg intramuscular methotrexate at the 1st, 3rd, 5th and 7th day). The groups compared in regards to their histopathological ovarian damage scores and AMH values. It established that multiple methotrexate applications had a considerable effect on reducing vascular congestion in the ovarian tissue. Both in groups 2 and 3 AMH values found to be significantly lower. When this decline in the ovarian reserve examined comparatively; while both the group 2 and 3 reported having a considerable and continuous reduction in the AMH levels correlative to the control group; the primordial, primary and total follicle counts shown to stay statistically the same in the group 2 (p

To determine the possible detrimental effects of multiple methotrexate doses has on the ovarian reserve and to determine the beneficial effects of dehydroepiandrosterone supplementation. The rats (n:24) divided into three groups; Group 1: control group, Group 2: dehydroepiandrosterone and methotrexate group (6mg/kg dehydroepiandrosterone dissolved in 0.1 ml sesame seed oil subcutaneously for ten days and 1mg/kg intramuscular methotrexate at the 1st, 3rd, 5th and 7th days) and Group 3: methotrexate group (1mg/kg intramuscular methotrexate at the 1st, 3rd, 5th and 7th day). The groups compared in regards to their histopathological ovarian damage scores and AMH values. It established that multiple methotrexate applications had a considerable effect on reducing vascular congestion in the ovarian tissue. Both in groups 2 and 3 AMH values found to be significantly lower. When this decline in the ovarian reserve examined comparatively; while both the group 2 and 3 reported having a considerable and continuous reduction in the AMH levels correlative to the control group; the primordial, primary and total follicle counts shown to stay statistically the same in the group 2 (p<0.0167). The dehydroepiandrosterone supplementation, while did not have a significant effect on reducing ovarian damage induced by methotrexate, also was not shown to provide any considerable increase in AMH levels. However, prolonged usage of dehydroepiandrosterone by contributing to the antral follicle pool considered promising in increasing the AMH levels conceivably

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.

Laparoscopic splenectomy became the gold standard recently for the removal of spleen. One of its rare indication is wandering spleen (WS). WS is characterized by incomplete fixation of the spleen. Patients usually have an asymptomatic abdominal mass. When they are symptomatic, abdominal pain with a mobile mass is the major finding. Laboratory data are nonspecific, but the diagnosis can be confirmed by imaging studies; computed tomography, magnetic resonance imaging, and ultrasonography are preferred modalities. It can predispose one to life-threatening complications such as splenic infarction, portal hypertension, pancretitis, and hemorrhage, due to torsion of its vascular pedicle. Herein, we present a female patient, a 24-year-old, 18-week primigravida. She was admitted with an intra-abdominal mass and lower abdominal pain. Ultrasonography revealed a mass behind the uterus. Magnetic resonance imaging was planned, and the spleen was seen at this area. We performed laparoscopic splenectomy for the treatment of a WS, which would be dangerous for pregnancy. The patient was discharged without any postoperative complication on the third day postoperatively. A healthy baby was delivered at term. Minimally invasive procedures should also be the primary choice in the treatment of such pregnant women. This is the first case of laparoscopic splenectomy in a pregnant woman for WS in the English literature.