Hale Bayram

Background: Infertility is increasingly recognized as a significant global public health concern. A thorough understanding of the diverse causes of infertility and their influence on treatment outcomes is essential for optimizing therapeutic strategies and improving success rates. Methods: In this study, we analyzed data from 9132 couples who underwent IVF treatment at a fertility center in Istanbul, Turkey, between 2010 and 2020. Results: Female factor infertility was the most prevalent among all participants (35.4%), followed by male infertility (26.4%), combined infertility (22.3%), and unexplained infertility (15.8%). Diminished ovarian reserve was found to be the most common indication in the female and combined infertility groups. Embryo transfer (ET) was performed in 7485 cases. Within this cohort, the antral follicle count was higher in the combined and unexplained infertility groups compared with the female and male infertility groups. The highest number of MII oocytes was found in the unexplained infertility group. Pregnancy rates varied significantly across groups, being higher in the male infertility and unexplained infertility groups than in the female infertility and combined infertility groups. Live birth rates also varied significantly across groups. The highest rate was observed in the unexplained infertility group. Conclusions: The distribution of infertility etiologies and their association with ICSI outcomes underscore the necessity to enhance the efficacy of ART protocols and to adopt evidence-based approaches to treatment strategies. Female factor infertility remains a significant clinical challenge, whereas unexplained infertility presents relatively favorable outcomes.

Day 5 vs. Day 6 Embryo Transfer: A Comparative Analysis of Pregnancy Outcomes - Turkish Journal of Reproductive Medicine and Surgery

The male reproductive system exhibits a high degree of vulnerability to oxidative stress, a condition characterized by an imbalance between the production of reactive oxygen species (ROS) and the b...

The chemotherapeutic combination of bleomycin, etoposide, and cisplatin (BEP) is well-documented to exert gonadotoxic effects, ultimately leading to impaired fertility. This experimental rat study investigated the potential protective role of repeated medical ozone therapy in mitigating the deleterious effects of BEP treatment in male rats. Thirty-two adult male Sprague Dawley rats were randomly assigned to four groups: (i) a healthy control group, (ii) a group receiving injections of the BEP regimen over nine weeks, (iii) a group receiving the same BEP regimen plus medical ozone (1 mg/kg IP) twice weekly, and (iv) a group receiving only ozone therapy. BEP treatment significantly reduced sperm concentration and increased morphological abnormalities, both of which were partially restored by ozone co-administration. Ozone therapy also elevated testosterone and thyroid-stimulating hormone (TSH) levels when co-administered with BEP compared to BEP treatment alone. Oxidative stress analysis demonstrated that total oxidative status (TOS) and total antioxidant status (TAS) levels were significantly improved in the BEP + ozone group. Histopathological analysis revealed that ozone treatment ameliorated BEP-induced testicular damage, as evidenced by improved Johnsen scores and increased thickness of the seminiferous tubule epithelium. In conclusion, repeated medical ozone therapy appears to mitigate BEP-induced reproductive toxicity by preserving sperm quality, endocrine function, and redox homeostasis.

Background The relative merits of fresh or frozen testicular sperm in ICSI remain a matter of contention. This study aims to compare the reproductive outcomes of non-obstructive azoospermia patients undergoing ICSI using fresh and frozen-thawed microdissection testicular sperm extraction (micro-TESE) sperm. Methods A total of 223 men with non-obstructive azoospermia underwent micro-TESE to collect testicular spermatozoa. ICSI cycles were performed using fresh and frozen-thawed spermatozoa. The cleavage states and grading of embryos, fertilization, and pregnancy outcomes were compared between the groups to assess the impact of cryopreservation of testicular spermatozoa on embryo quality and ICSI outcomes. Results A total of 223 cases were evaluated, with fertilization observed in 208 cases and no fertilization observed in 15 cases. The number of day 3 total embryos and the number of cleavage embryos differed between the fresh and frozen micro-TESE groups, whereas the number of two-pronuclei oocytes, grading of embryos, fertilization, pregnancy, and live birth rates were found to be similar between the two groups. Conclusion The cryopreservation of spermatozoa obtained by micro-TESE does not affect the fertilization rate or pregnancy outcome in cases of non-obstructive azoospermia. The present findings, when considered in conjunction with the extant evidence, may serve to alleviate concerns regarding the utilization of frozen-thawed micro-TESE sperm in patients with non-obstructive azoospermia.

Amaç: Progesteron, adrenal bezler ve yumurtalıklar tarafından sentezlenen, yapısal olarak birçok farklı hormonun da öncüsü olan bir sinyal molekülüdür. D vitamini ise diğer vitaminlerden farklı olarak ekzojen alımın yanında endojen olarak da sentezlenebilen ancak eksiklik durumu güncel tıp dünyasında büyük tartışmalara neden olan steroid yapıda bir hormondur. Bu çalışmada amaç, progesteronun HepG2 hücre proliferasyonu ve karaciğer enzim aktivitelerine etkisini belirlemek, ayrıca D vitamininin progesteronun oluşturduğu sitotoksik etkileri engellemedeki rolünü incelemektir. Gereç ve Yöntem: HepG2 hepatoselüler kanser hücre kültürü ortamına uygulanacak progesteron ve D vitamini dozlarının belirlenmesi için öncelikle her iki hormon için ayrı sitotoksisite çalışmaları yapılmıştır. Ardından progesteron ve D vitamini, deney ve kontrol gruplarına tek başlarına veya birlikte belirli dozlarda uygulanmıştır. HepG2 hücre canlılığı, morfolojik özellikleri ve karaciğer enzim aktiviteleri gruplar arasında karşılaştırmalı olarak değerlendirilmiştir. Bulgular: Hücrelere uygulanan 1 mM ve 2 mM progesteron dozlarında kontrol grubuna kıyasla hücre canlılığında azalma olduğu saptandı. Ek olarak, 1 mM ve 2 mM progesteron uygulananlarda AST ve LDH aktivite değerlerinde de anlamlı olarak düşüklük bulundu. D vitamininin 0,008 μM ve 166,667 μM dozları aralığında HepG2 hücrelerinde sitotoksik bir etkiye sahip olmadığı belirlendi ve 2,5 μM dozda uygulandı. Yalnızca D vitamini uygulanan hücrelerde ALT, AST ve LDH enzim aktivite değerlerinde anlamlı bir farklılık görülmedi. Yalnızca progesteron uygulanan hücrelerle, progesteron+D vitamininin birlikte uygulandığı hücreler arasında hücre canlılığı ve karaciğer enzim düzeyleri benzerlik gösterdi. Sonuç: Kullanılan doz ve inkübasyon sürelerinde D vitamininin progesteronun sebep olduğu sitotoksik etkileri engellemede etkili olmadığı düşünülmektedir.

Chemotherapeutic agents used in the treatment of testicular cancer cause damage to healthy tissues, including the testis. We investigated the effects of glutathione on sperm DNA integrity and testicular histomorphology in bleomycin etoposide cisplatin (BEP) treated rats. Twelve-week-old male rats of reproductive age (n = 24) were randomly divided into three groups, the (i) control group, (ii) BEP group, and (iii) BEP+ glutathione group. Weight gain increase and testes indices of the control group were found to be higher than that of the BEP group and BEP+ glutathione group. While the BEP treatment increased sperm DNA fragmentation and morphological abnormalities when compared to the control group, GSH treatment resulted in a marked decrease for both parameters. Moreover, BEP treatment significantly decreased serum testosterone levels and sperm counts in comparison to the control group, yet this reduction was recovered in the BEP+ glutathione treated group. Similarly, seminiferous tubule epithelial thicknesses and Johnsen scores in testicles were higher in the control and BEP+ glutathione groups than in the BEP-treated group. In conclusion, exogenous glutathione might prevent the deterioration of male reproductive functions by alleviating the detrimental effects of BEP treatment on sperm quality and testicular histomorphology.