Publications by authors named "Hurkan Akyol"

5 Publications

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Does bilateral uterine artery ligation have negative effects on ovarian reserve markers and ovarian artery blood flow in women with postpartum hemorrhage?

Clin Exp Reprod Med 2019 Mar 1;46(1):30-35. Epub 2019 Mar 1.

Department of Obstetrics and Gynecology, Suleymaniye Maternity, Research and Training Hospital, University of Health Sciences, Istanbul, Turkey.

Objective: Bilateral uterine artery ligation (UAL) is a fertility-preserving procedure used in women experiencing postpartum hemorrhage (PPH). However, the long-term effects of this procedure on ovarian function remain unclear. The aim of this study was to investigate whether bilateral UAL compromised ovarian reserve and ovarian blood supply.

Methods: This prospective study included 49 women aged between 21 and 36 years who had undergone a cesarean section for obstetric indications. Of these, 25 underwent uterine bilateral UAL to control intractable atonic PPH. The control group consisted of 24 women who had not undergone bilateral UAL. Standard clinical parameters, the results of color Doppler screening, and ovarian reserve markers were assessed in all participants at 6 months after surgery. The clinical parameters included age, parity, cycle history, body mass index, and previous medication and/or surgery. Color Doppler screening findings included the pulsatility index (PI) and resistance index (RI) for both the uterine and ovarian arteries. The ovarian reserve markers included day 3 follicle-stimulating hormone (FSH) levels, antral follicle count, and anti-Müllerian hormone (AMH) levels.

Results: There were no significant differences in the ovarian reserve markers of day 3 FSH levels, antral follicle count, and AMH levels between the study and control groups (p>0.05 for all). In addition, no significant differences were observed in the PI and RI indices of the uterine and ovarian arteries (p>0.05 for all).

Conclusion: In this study, we showed that bilateral UAL had no negative effects on ovarian reserve or ovarian blood supply, so this treatment should be used as a fertility preservation technique to avoid hysterectomy in patients experiencing PPH.
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http://dx.doi.org/10.5653/cerm.2019.46.1.30DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436468PMC
March 2019

Evaluation of Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Red Blood Cell Distribution Width-Platelet Ratio for Diagnosis of Premature Ovarian Insufficiency.

J Family Reprod Health 2016 Dec;10(4):211-216

Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Adnan Menderes University, Aydın, Turkey.

To evaluate whether systemic inflammatory markers (neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and red blood cell distribution width (RDW) to platelet ratio (RPR)) can be used as reliable markers for the diagnosis of premature ovarian insufficiency (POI) and to determine if there is a relationship between these markers and follicle stimulating hormone (FSH), Anti-Müllerian Hormone (AMH) levels. Written and electronic medical records were reviewed using searches for diagnoses with the terms of 'premature ovarian failure', 'premature ovarian insufficiency'. Patients younger than the age of 40 were diagnosed to have premature ovarian insufficiency based on their menstrual history and sonographic examination and they were compared with healthy females. Complete blood counts, day-3 hormone profiles, AMH levels of all subjects were analyzed. NLR was statistically higher in POI group compared with controls (p < 0.05). NLR had a positive correlation between FSH (r = 0.23, p = 0.045) and a negative association with AMH (r = - 0.27, p = 0.018). The area under ROC curve for NLR in POI was 0.66, with a threshold value 1.5 and sensitivity = 75.7 % and specificity = 46.0 %. NLR can be a marker for the diagnosis of POI. There is a close relationship between NLR and ovarian reserve markers such as FSH and AMH.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440821PMC
December 2016

Cardiovascular risk may be increased in women with unexplained infertility.

Clin Exp Reprod Med 2017 Mar 31;44(1):28-32. Epub 2017 Mar 31.

Department of Obstetrics and Gynecology, Suleymaniye Maternity, Research, and Training Hospital, Istanbul, Turkey.

Objective: Growing evidence suggests that increased cardiovascular disease (CVD) risk is associated with female infertility caused by conditions such as polycystic ovarian disease, obesity, thyroid dysfunction, and endometriosis. The aim of this study was to evaluate whether any relationship exists between CVD and unexplained infertility.

Methods: Sixty-five women with unexplained infertility and 65 fertile controls were enrolled in the study. CVD risk markers such as low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), triglycerides (TG), insulin resistance (defined by the homeostasis model assessment ratio), and high-sensitivity C-reactive protein (hs-CRP) were assessed.

Results: TG, TC, LDL, and hs-CRP levels were higher and HDL levels were lower in patients with unexplained infertility than in fertile controls (<0.05 for all). Positive associations were found between unexplained infertility and TG, TC, LDL, and hs-CRP levels, and a negative correlation was found for HDL (<0.05 for all). Multivariate logistic regression analysis showed that TG, HDL, and hs-CRP were independent variables associated with unexplained infertility.

Conclusion: Our study showed that women with unexplained infertility had an atherogenic lipid profile and elevated hs-CRP levels, suggesting a higher risk of developing CVD in the future. Further studies with larger groups are needed to investigate the nature of this link.
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http://dx.doi.org/10.5653/cerm.2017.44.1.28DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5395549PMC
March 2017

Premenstrual Syndrome Is Associated With a Higher Frequency of Female Sexual Difficulty and Sexual Distress.

J Sex Marital Ther 2017 Nov 13;43(8):811-821. Epub 2017 Mar 13.

a Department of Obstetrics and Gynecology , Süleymaniye Women and Children's Health Training and Research Hospital , İstanbul , Turkey.

Few prospective studies have evaluated the impact of premenstrual symptoms (PMS) on female sexual function and sexuality-related distress. The purpose of the present study was therefore to find out risk factors of PMS for  female sexual function and sexuality-related personal distress. This prospective cohort study was conducted at the Süleymaniye Women and Children's Health Training and Research Hospital in Istanbul, Turkey, between February 2014 and March 2016. The study group consisted of women admitted to the general gynecology outpatient clinic aged 18 to 40 years who met the inclusion criteria. The American College of Obstetricians and Gynecologists criteria were used for the initial diagnosis of PMS and the participants were allocated to PMS(+) and PMS(-) groups (healthy subjects). All participants completed the Beck Depression Inventory to exclude those at risk for depression. The patients with an initial diagnosis of PMS then completed the PMS Daily Record of Severity of Problems form prospectively for two consecutive menstrual cycles to confirm PMS diagnosis. Lastly, both sexual function and sexual distress of eligible PMS(+) (n = 143) and PMS(-) (n = 143) participants were assessed with both the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Revised (FSDS-R). According to the FSFI cutoff value, 77.6% of patients in the PMS(+) group and 27.3% of patients in the PMS(-) group had sexual concerns (p < 0.05). The sexuality-related personal distress rate was 51.7% in the PMS(+) group and 24.5% in the PMS(-) group (p < 0.05). Overall, 51.7% of the PMS(+) and 24.5% of the PMS(-) group were recognized as having sexual difficulties based on the presence of sexual distress and the low FSFI scores (p < 0.05). We concluded that women with PMS are likely to have sexual difficulties and a higher level of sexual distress, emphasizing the importance of the sexual aspects of PMS in clinical practice.
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http://dx.doi.org/10.1080/0092623X.2017.1305030DOI Listing
November 2017

Low antimullerian hormone levels may be associated with cardiovascular risk markers in women with diminished ovarian reserve.

Gynecol Endocrinol 2016 27;32(4):302-5. Epub 2015 Nov 27.

b Department of Obstetrics & Gynecology , Diyarbakir Gazi Yasargil Training and Research Hospital , Diyarbakir , Turkey.

There is growing evidence that diminished ovarian reserve (DOR) may be associated with cardiovascular disease (CVD). The aim of the study was to investigate whether there was any relationship between antimullerian hormone (AMH) and CVD risk markers in the study. Ninety women with DOR and 90 women with normal ovarian reserve (NOR) attending the infertility unit at XXXX, were enrolled in the study. CVD risk markers such as insulin resistance [defined by the homeostasis model assessment ratio (HOMA-IR)], C-reactive protein (CRP), low density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), and triglyceride (TG) were assessed. HOMA-IR, CRP, TG, LDL levels were higher and HDL and AMH were lower among patients with DOR compared with controls (p < 0.05, for all). There were positive associations between low AMH and HOMA-IR, CRP, TG, LDL levels and a negative correlation with HDL (p < 0.05, for all). However, multivariate logistic regression analysis showed that HOMA-IR, CRP, TG and HDL were independent variables that were associated with low AMH. There was a close relationship between low AMH and CVD risk markers in the study. Further studies with larger groups are needed to investigate the nature of this link in these patients.
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http://dx.doi.org/10.3109/09513590.2015.1116065DOI Listing
January 2017
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