Publications by authors named "Yesim Bayoglu Tekin"

26 Publications

  • Page 1 of 1

Evaluation of SCUBE-1 levels as a placental dysfunction marker at gestational diabetes mellitus.

Gynecol Endocrinol 2020 May 31;36(5):417-420. Epub 2019 Oct 31.

Department of Biochemistry, Recep Tayyip Erdogan University, School of Medicine, Rize, Turkey.

To evaluate the alteration of plasma levels of signal peptide-CUB-EGF domain-containing protein (SCUBE)-1 as a marker of endothelial dysfunction and vascular injury in gestational diabetes mellitus (GDM) in comparison to healthy pregnant controls. A prospective study conducted at an antenatal outpatient clinic of a University hospital. Fifty pregnancies with GDM and thirty healthy pregnancies as controls were enrolled in the study. There was no statistically significant difference between the groups in terms of age, gravidity, weight and BMI from pre-pregnancy until delivery, total weight gain, fetal weight and other hematological and biochemical parameters. SCUBE-1 levels were significantly higher in GDM patients ( = .007). Hyperglycemia predisposes to endothelial injury and vascular remodeling at GDM, and therefore, SCUBE-1 could be a predictor of vascular injury during pregnancy. Our study is the first to illustrate increased SCUBE-1 levels in GDM as a marker of placental endothelial dysfunction.
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http://dx.doi.org/10.1080/09513590.2019.1683537DOI Listing
May 2020

Alteration of maternal serum irisin levels in gestational diabetes mellitus.

Ginekol Pol 2016 ;87(5):395-8

Department of Gynecology and Obstetrics, Recep Tayyip Erdogan University Medical Faculty, Rize, Turkey.

Objectives: The aim of our study was to compare serum irisin concentrations in pregnant women with and without ges-tational diabetes mellitus (GDM).

Material And Methods: This study was performed at the Tertiary Care Center, Department of Obstetrics and Gynecol-ogy, between January 2014 and April 2014. A total of 45 pregnant women with GDM (diabetes group) and 41 BMI- and age-matched healthy pregnant women (control group) were recruited. Maternal serum irisin levels were measured by enzyme-linked immunosorbent assay kit at 24-28 weeks of gestation. An association between maternal serum irisin lev-els and metabolic parameters was analyzed. Body mass index, serum levels of glucose, insulin and irisin were tested and analyzed in the study group and controls.

Results: Pregnant women with GDM had significantly higher fasting plasma glucose (p = 0.001), first-hour OGTT glucose (p = 0.001), second-hour OGTT glucose (p = 0.001), and fasting insulin (p = 0.045) levels as compared to controls. Serum irisin levels were 1.04 ± 0.3 and 1.3 ± 0.2 in pregnant women with GDM and healthy pregnant controls, respectively (p = 0.001). Correlation analysis between irisin levels and anthropometric and biochemical parameters in patients with gestational diabetes revealed that none of the investigated parameters correlated with serum irisin level.

Conclusions: Our results suggest that serum irisin levels might be introduced as a novel marker for GDM, with decreased levels of irisin being indicative of GDM.
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http://dx.doi.org/10.5603/GP.2016.0013DOI Listing
July 2018

Nesfatin-1 and Vitamin D levels may be associated with systolic and diastolic blood pressure values and hearth rate in polycystic ovary syndrome.

Bosn J Basic Med Sci 2015 Jul 9;15(3):57-63. Epub 2015 Jul 9.

University of Recep Tayyip Erdoğan School of Medicine, Department of Obstetrics and Gynecology.

Obesity, insulin resistance (IR), inflammation, and hyperandrogenism may lead to polycystic ovary syndrome (PCOS) and hypertension. Nesfatin-1 (N1) may be related to IR, obesity, and hypertension. Furthermore, a vitamin D (VD) deficiency is associated with hypertension and PCOS. We aimed to investigate N1 and VD levels in PCOS that have an effect on systolic and diastolic blood pressure (BP) and heart rate (HR).This study included 54 patients with PCOS and 48 age-body mass index (BMI)-matched healthy controls. PCOS was diagnosed according to clinical practice guidelines. Ferriman-Gallwey scores (FGS) were calculated, while N1, VD, and other hormonal and biochemical parameters were measured for all subjects. Systolic and diastolic BP was measured as well. HR was calculated using an electrocardiogram.The levels of N1 (p < 0.001), high-sensitivity C-reactive protein (hs-CRP) (p = 0.036), homeostasis model assessment as an index of insulin resistance (HOMA-IR) (p < 0.001), systolic (p < 0.001) and diastolic (p < 0.001) BP and HR (p < 0.001) in the PCOS group were significantly higher than in the control group. However, the VD levels of the PCOS group were lower than the control group (p = 0.004). N1 had a strong positive correlation with BMI, HOMA-IR, hs-CRP, luteinizing hormone, systolic and diastolic BP, and HR. VD levels were negatively correlated with HOMA-IR and luteinizing hormone.Elevated N1 and decreased VD levels may be related to the presence of high-normal BP or hypertension in PCOS subjects.  N1 level may be associated with an increased BP due to its relation to inflammation and IR.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4594327PMC
http://dx.doi.org/10.17305/bjbms.2015.432DOI Listing
July 2015

Biochemical, Histopathological and Immunohistochemical Evaluation of the Protective and Therapeutic Effects of Thymoquinone against Ischemia and Ischemia/Reperfusion Injury in the Rat Ovary.

Gynecol Obstet Invest 2016 9;81(1):47-53. Epub 2015 Jul 9.

Department of Obstetrics and Gynecology, Recep Tayyip Erdox011F;an University School of Medicine, Rize, Turkey.

Aim: To evaluate the antioxidant effects of thymoquinone (TQ) and to investigate the biochemical, histopathological and immunohistochemical changes in experimental rat ovarian torsion.

Methods: A total of 48 female adult rats were used in this study and randomly divided into 7 groups: (1) sham operation; (2) bilateral 3-hour ovarian ischemia; (3) 3-hour ischemia and 3-hour reperfusion; (4) and (5) rats were administered 20 and 40 mg/kg of TQ, respectively, before 0.5 h of ischemia, and then 3 h of ovarian ischemia was applied; (6) and (7) 3-hour ovarian ischemia was applied; 2.5 h after the induction of ischemia, rats were administered the same doses of TQ; at the end of 3 h of ischemia, a 3-hour reperfusion was applied. Histologic changes under light microscopy, immunoreactivity for anticaspase-3 and serum levels of malondialdehyde, interleukin-6, catalase and glutathione peroxidase were noted and compared between the 7 groups.

Results: Ischemia and ischemia/reperfusion cause a deterioration of biochemical and histopathological parameters. Administration of TQ seems to reverse these alterations and alleviate the injury. Antioxidant defense mechanisms appear to be enhanced by the administration of TQ.

Conclusion: TQ at different doses attenuates ovarian ischemia and ischemia/reperfusion injury in rats.
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http://dx.doi.org/10.1159/000431220DOI Listing
December 2016

Primary fallopian tube carcinoma diagnosed preoperatively by cervical smear.

Ann Saudi Med 2014 Sep-Oct;34(5):444-6

Dr. Ulku Mete Ural, Department of Obstetrics and Gynecology, Recep Tayyip Erdogan University School of Medicine, Rize, Turkey 53100, T: +906-464-213-0492,

Primary fallopian tube carcinoma is a rare clinical entity that constitutes a diagnostic challenge in gynecological practice. Patients generally suffer from the three symptoms: vaginal bleeding, pelvic pain, and vaginal discharge; however, this is usually not sufficient for confirming the diagnosis preoperatively in most circumstances. In this case report, we present a 49-year-old woman whose cervical smear raised a suspicion for fallopian tube carcinoma. All preoperative examination measures such as ultrasonography, hysteroscopy, and endometrial aspiration were normal. Repeated cervical smears were consistent with adenocarcinoma presumably ensourcing from the fallopian tube. The patient underwent laparatomy,total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic para-aortic lymph node dissection. The primary serous papillary adenocarcinoma of the right fallopian tube was detected at the histopathological analysis, and the patient was referred for adjuvant chemotherapy. Cervical smear findings can be the only clue for the diagnosis of fallopian tube carcinoma.
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http://dx.doi.org/10.5144/0256-4947.2014.444DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6074562PMC
November 2015

Controlled reperfusion for different durations in the treatment of ischemia-reperfusion injury of the rat ovary: evaluation of biochemical features, molecular gene expression, and histopathology.

Can J Physiol Pharmacol 2015 Apr 16;93(4):269-74. Epub 2015 Jan 16.

Department of Obstetrics and Gynecology, Faculty of Medicine, Ataturk University, Erzurum 25250, Turkey.

High numbers of proinflammatory cells (PMNLs), which are carried by the blood to ischemic tissue during reperfusion, are considered responsible for inducing the inflammatory response that occurs in ischemia-reperfusion (I/R) injury. Our objective was to determine the controlled reperfusion (CR) interval duration (CRID) that would minimize the injury caused by the PMNLs that infiltrate ischemic tissue. Animal groups were divided into the following groups: Sham group, ovarian I/R group (OIR), and ovarian ischemia controlled-reperfusion groups OICR-1, OICR-2, OICR-3, OICR-4, OICR-5, OICR-6, which had their ovarian artery opened and then closed for 10, 8, 6, 4, 2, or 1 s, respectively. The results show that the COX-2 activity and the gene expression decreased while the COX-1 activity and the gene expression were found to be increased in parallel to the shortening of the period in CRID. From the histopathological examinations, the findings of hemorrhage, edema, congested vascular structures, degenerated cells, and migration and adhesion of PMNLs were scaled as follows: Sham group < OICR-6 < OICR-5 < OICR-4 < OICR-3 < OICR-2 < OICR-1. The results from the histopathological assessments were consistent with the molecular and biochemical findings. In conclusion, our findings suggest that increased COX-2 activity plays a role in I/R injury of the rat ovary, and that controlled reperfusion for 3, 2, or 1 s following 2 h of ischemia may attenuate the effects of I/R injury.
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http://dx.doi.org/10.1139/cjpp-2014-0359DOI Listing
April 2015

Evaluation of the effects of fasting associated dehydration on maternal NGAL levels and fetal renal artery Doppler parameters.

J Matern Fetal Neonatal Med 2016 24;29(4):629-32. Epub 2015 Feb 24.

a Department of Obstetrics and Gynecology .

Objective: The aim of this study was to evaluate maternal neutrophil gelatinase-asssociated lipocalin (NGAL) levels and fetal renal artery (fRA) Doppler flow indices in pregnant women fasting in Ramadan in respect of dehydration in long hot summer days as a marker of hypoperfusion and early renal injury.

Methods: A cross-sectional observational study was carried out at a University Hospital. Fasting pregnant women and non-fasting age, gravidity and gestational age-matched women were evaluated for hematologic, blood biochemistry and urine parameters in the first and fourth weeks of the Ramadan. Umbilical artery and fRA Doppler flows were studied in each evaluation.

Results: Blood urea nitrogen, potassium and hematocrit levels, blood and urine NGAL levels were significantly higher, and fRA Doppler indices increased in fasting women (p < 0.05) during the second visit in the last week of the Ramadan, while non-fasting women had no significant alterations in each evaluation (p > 0.05).

Conclusions: Adequate maternal vascular volume is essential for the maintenance of healthy pregnancy. Fasting during the long and hot summer days leads to fluid deprivation and dehydration which was found to be related to subclinical maternal renal dysfunction and increased fRA Doppler indices.
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http://dx.doi.org/10.3109/14767058.2015.1014789DOI Listing
September 2016

Tubal pregnancy associated with endometrial carcinoma after in vitro fertilization attempts.

Case Rep Obstet Gynecol 2014 28;2014:481380. Epub 2014 Dec 28.

Department of Gynecology and Obstetrics, School of Medicine, Black Sea Technical University, 61200 Trabzon, Turkey.

Endometrial carcinoma is rarely seen during reproductive ages and commonly related to infertility, polycystic ovarian syndrome (PCOS), and obesity. Pregnancy associated endometrial carcinoma is even rarer and this is the second case reported in the literature concerning tubal pregnancy associated endometrial carcinoma. We present a case of a 36-year-old woman with a history of PCOS, infertility, and several attempts of ovulation induction and in vitro fertilization, who was diagnosed with tubal pregnancy and a well differentiated endometrial carcinoma. We also review the literature about pregnancy associated endometrial carcinoma in the first trimester.
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http://dx.doi.org/10.1155/2014/481380DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295414PMC
January 2015

The role of hypoxia at primary dysmenorrhea, utilizing a novel hypoxia marker--SCUBE1.

J Pediatr Adolesc Gynecol 2015 Feb 20;28(1):63-65. Epub 2014 May 20.

Department of Gynecology and Obstetrics, Recep Tayyip Erdoğan University, Faculty of Medicine, Rize, Turkey.

Study Objective: To determine the SCUBE1 levels in adolescents with primary dysmenorrhea.

Design: A prospective cross-sectional study.

Setting: A university hospital outpatient clinic, Rize, Turkey.

Participants: A total of 40 adolescent girls, 15 on menses and 25 not on menses.

Interventions And Main Outcome Measures: Demographic features and menstrual history of the participants were assessed and blood samples were obtained for detecting the platelet volume, platelet counts, and SCUBE1 levels of the participants.

Results: No difference was detected between the 2 groups in mean platelet volume, platelet count, and SCUBE1 levels.

Conclusion: Future trials are required to investigate the relation between SCUBE1 levels and primary dysmenorrhea.
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http://dx.doi.org/10.1016/j.jpag.2014.05.001DOI Listing
February 2015

Is resveratrol a potential substitute for leuprolide acetate in experimental endometriosis?

Eur J Obstet Gynecol Reprod Biol 2015 Jan 11;184:1-6. Epub 2014 Nov 11.

Departments of Gynecology and Obstetrics, Recep Tayyip Erdogan University, School of Medicine, 53020 Rize, Turkey.

Objective: Resveratrol, a phytoalexin polyphenol, has anti-angiogenic, antioxidant, anti-inflammatory properties. We aimed to compare the anti-inflammatory and anti-angiogenic effects of resveratrol and leuprolide acetate (LA) in an experimental endometriosis model.

Study Design: A prospective experimental study was conducted in a University Surgical Research Center. Thirty-three non-pregnant female Sprague-Dawley rats, in which experimental model of endometriosis were surgically induced were randomly divided into four groups. Group 1 was administered 30 mg/kg resveratrol i.m. for 14 days, group 2 was given 1mg/kg s.c. single dose LA, group 3 was administered both resveratrol and LA, and group 4 had no medication. After two weeks medication rats were sacrificed and size, histopathology and immunreactivity to matrix metalloproteinase (mmp)2, mmp9, vascular endothelial growth factor (VEGF) of the endometriotic implants were evaluated. Plasma and peritoneal fluid levels of interleukin (IL)-6, IL-8, and tumor necrosis factor-α (TNF-α) were analyzed.

Results: The endometriotic implant volumes, histopathological grade and immunreactivity to mmp2, mmp9 and VEGF were significantly reduced (p<0.001), and plasma and peritoneal fluid levels of IL-6, IL-8 and TNF-α were significantly decreased in group 1 and group 2 in comparison to group 3 and group 4 (p < 0.001).

Conclusion: Resveratrol alone is a potential agent for the treatment of endometriosis and may be an alternative to LA. In contrast, the combination of LA and resveratrol decreased the anti-inflammatory and anti-angiogenic effects of each agent. Since resveratrol is widely used as an alternative therapy for a variety of conditions, it can undermine the effectiveness of LA. Therefore, caution should be exercised when used in combination with other agents.
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http://dx.doi.org/10.1016/j.ejogrb.2014.10.041DOI Listing
January 2015

What should be the protocol selection after failure of in-vitro fertilization at normoresponder patients: Agonist or antagonist?

Turk J Obstet Gynecol 2014 Dec 15;11(4):198-202. Epub 2014 Dec 15.

Gülhane Military Medical Academy, In-Vitro Fertilization Unite, Ankara, Turkey.

Objective: Evaluation of the impact of agonist or antagonist protocol selection on pregnancy outcomes after failure of in-vitro fertilization (IVF) treatment cycles which were down regulated with Gonadotropin Releasing Hormone (GnRH) agonist.

Materials And Methods: This was a retrospective study. Two hundred and sixty nine patients who were treated with GnRH agonist protocol between years 2002-2012 at an IVF unit and underwent a second attempt following one year period after failure of IVF enrolled in the study. Age, basal FSH levels, antral follicle counts, duration of induction, the number of yielded oocytes, the number of transferred embryos and the transfer days, clinical and ongoing pregnancy rates were evaluated for each treatment cycle.

Results: Normoresponder patients were separated into two groups according to the agonist or antagonist protocol selection at the second attempt and the results of two consequent IVF cycles were compared. There were no statistically significant difference between the groups for the dosage of administered gonadotropin, duration of induction, the count of yielded oocytes, the day and the number of transferred embryos (p>0.05). Furthermore the fertilization rate, clinical and ongoing pregnancy rates were similar in two groups.

Conclusion: The selection of antagonist treatment is effective as agonist protocols at normoresponder patients after failure of IVF.
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http://dx.doi.org/10.4274/tjod.03789DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5558360PMC
December 2014

Pemphigoid gestationis in a third trimester pregnancy.

Case Rep Obstet Gynecol 2014 9;2014:127628. Epub 2014 Nov 9.

Department of Obstetrics and Gynecology, Faculty of Medicine, Recep Tayyip Erdoğan University, Merkez, Islampasa Mahallesi, Sehitler Caddesi, No. 74, 53100 Rize, Turkey.

Pemphigoid gestationis (PG) is a rare vesiculobullous dermatosis of pregnancy. It is commonly seen in second or third trimester. The diagnosis is frequently made with direct immunofluorescence studies of perilesional skin. Prompt recognition and appropriate management may reduce morbidity of this disease. Herein we present a case of pemphigoid gestationis occurring in a 33-year-old primigravida woman with symptoms of generalized pruritus.
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http://dx.doi.org/10.1155/2014/127628DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4241730PMC
November 2014

Does low pentraxin-3 levels associate with polycystic ovary syndrome and obesity?

Int J Clin Exp Med 2014 15;7(10):3512-9. Epub 2014 Oct 15.

Department of Internal Medicine, University of Recep Tayyip Erdoğan School of Medicine Rize, Turkey.

Pentraxin-3 (PTX3) a cytokine-inducible molecule is released from various tissues. Its level increases as a response to different inflammatory conditions. Polycystic Ovary Syndrome (PCOS) is considered as a proinflammatory state. The aim of this study was to investigate the association between PTX3 and various metabolic and hormonal parameters in PCOS patients. This study included 64 new diagnosed PCOS patients who had been never treated previously with PCOS and 46 healthy controls with matched age and body mass index (BMI). PTX3, biochemical and hormonal parameters of both groups were measured. The patients were divided into obese and non-obese subgroups according to BMI (above or lower than 25 kg/m²). PTX3, HOMA-IR and high sensitive C-reactive protein (hs-CRP) levels of these subgroups were compared. Serum PTX3 (p=0.013), hs-CRP (p=0.015) and HOMA-IR (p=0.023) levels of PCOS patients were significantly higher than the control group. Serum PTX3 has been found to have negative correlations with BMI (r=-0.318, p < 0.001), waist circumference (r=-0.306, p < 0.001), HOMA-IR (r=-0.324, p < 0.001) and hs-CRP (r=-0.206, p=0.031). Subgroup analysis revealed PCOS women with obesity to have significantly higher serum PTX3 level than non-obese PCOS subjects (p=0.012), non-obese controls (p=0.015) and obese controls (p=0.002). Women with new diagnosed PCOS especially obese subjects had significantly lower serum PTX3 than the control group. PTX3 has been found to be negatively correlated with BMI and insulin resistance. Low PTX3 level may have a role in the etiology of PCOS and in the formation of atherosclerotic diseases by stimulation of chronic inflammation.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4238465PMC
November 2014

Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in patients with endometrial hyperplasia and endometrial cancer.

J Obstet Gynaecol Res 2015 Mar 3;41(3):445-8. Epub 2014 Nov 3.

Department of Obstetrics and Gynecology, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey.

Aim: Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and platelet distribution width (PDW) may indicate the systemic inflammatory response associated with various cancers. We aimed to investigate the relationship between NLR, PLR, PDW and endometrial pathologies including hyperplasia and cancer.

Methods: In this study, 472 cases who underwent endometrial biopsy were included. Three groups were constituted with respect to biopsy results: group 1, endometrial cancer patients (n = 54); group 2, endometrial hyperplasia patients (n = 152); and group 3, patients with normal biopsy results (n = 281). White blood cell and platelet counts as well as NLR, PLR and PDW recorded from complete blood counts obtained on the same day of biopsy were compared in the three groups.

Results: Endometrial cancer patients were significantly older than the cases in the other two groups (P < 0.001). The NLR in group 1 was significantly higher than group 3 (P = 0.02). However, there was no difference between the three groups with respect to PLR (P = 0.167). PDW was increased in group 1 compared to group 3 (P < 0.001).

Conclusion: Results of our study have shown that NLR, PLR and PDW are simple, readily available and robust inflammatory markers that may be used in the management of endometrial pathologies. However, the actual predictive potential of these biomarkers still warrants further trials.
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http://dx.doi.org/10.1111/jog.12536DOI Listing
March 2015

Chronic abdominal pain in a patient with escobar syndrome.

Gynecol Obstet Invest 2015 4;79(1):69-72. Epub 2014 Sep 4.

Department of Obstetrics and Gynecology, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey.

Escobar syndrome is characterized with multiple pterygia or webs of the skin and multiple congenital anomalies. We present a 15-year-old patient with Escobar syndrome who complained of persistent blunt abdominal pain for 1 year. Preoperative evaluation confirmed the diagnosis of imperforate hymen, and the patient underwent hymenectomy under intravenous sedation. The patient's postoperative course was uneventful and her complaints resolved completely. After a 3-month follow-up, she reported having normal menstrual bleeding intervals each month without any complications. Patients with Escobar syndrome may suffer from abdominal pain due to imperforate hymen. Careful evaluation of these patients must include a complete gynaecological assessment and, if indicated, surgical treatment must be performed without delay.
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http://dx.doi.org/10.1159/000365330DOI Listing
September 2015

Evaluation of female sexual function index and associated factors among married women in North Eastern Black Sea region of Turkey.

Turk J Obstet Gynecol 2014 Sep 15;11(3):153-158. Epub 2014 Sep 15.

Recep Tayyip Erdoğan University Faculty of Medicine, Department of Gynecology and Obstetrics, Rize, Turkey.

Objective: The aim of this study was detection of Female Sexual Function Index (FSFI) scores of married women living in North Eastern Black Sea region of Turkey and comparison with demographic data.

Materials And Methods: A cross-sectional, descriptive study conducted at a University Hospital, gynecology and obstetrics outpatient clinic. Married women between 18-50 years of age, without any complaint enrolled in the study and participants were asked to fill out the form of FSFI. Age, gravidity and number of living children, duration of marriage, education and income levels, employment status, and contraceptive methods has been questioned. Sexual desire, arousal, lubrication, orgasm, satisfaction, pain subscales, and total score of FSFI were determined and compared with demographic data.

Results: Lower FSFI levels were detected from 70.9% of the respondents. Age, duration of marriage and number of children were adversely affected the FSFI scores. Intermediate education level and usage of a contraceptive method were related with higher FSFI scores. Pain scores were high in all participants independently from other parameters.

Conclusions: For identification of women's sexual dysfunction, increasing the knowledge level and awareness about sexuality are required.
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http://dx.doi.org/10.4274/tjod.43815DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5558326PMC
September 2014

Impact of having a high-risk pregnancy on future postpartum contraceptive method choice.

Women Birth 2014 Dec 11;27(4):254-8. Epub 2014 Jul 11.

Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.

Background: To compare the knowledge and preference of preconceptional contraception to future postpartum contraceptive method choice in high-risk pregnancies.

Research Question: Does a high-risk pregnancy condition affect future postpartum contraceptive method choice?

Method: Women hospitalised at the High Risk Pregnancy unit of a tertiary research and training hospital were asked to complete a self-reported questionnaire that included demographic characteristics, presence of unintended pregnancy, contraceptive method of choice before the current pregnancy, plans for contraceptive use following delivery and requests for any contraceptive counselling in the postpartum period.

Findings: A total of 655 pregnant women were recruited. The mean age, gravidity and parity of the women were 27.48 ± 6.25 years, 2.81 ± 2.15 and 1.40 ± 1.77, respectively. High-risk pregnancy indications included 207 (31.6%) maternal, 396 (60.5%) foetal and 52 (7.9%) uterine factors. All postpartum contraceptive choices except for combined oral contraceptives (COCs) usage were significantly different from preconceptional contraceptive preferences (p<0.001). High-risk pregnancy indications, future child bearing, ideal number of children, income and education levels were the most important factors influencing postpartum contraceptive choices. While the leading contraceptive method in the postpartum period was long-acting reversible contraceptive methods (non-hormonal copper intrauterine device Cu-IUD, the levonorgestrel-releasing intrauterine system (LNG-IUS) (40%), the least preferred method was COCs use (5.2%) and preference of COCs use showed no difference between the preconceptional and postpartum periods (p=0.202). Overall 73.7% of the women wanted to receive contraceptive counselling before their discharge.

Conclusion: A high-risk pregnancy condition may change the opinion and preference of contraceptive use, and also seems to affect the awareness of family planning methods.
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http://dx.doi.org/10.1016/j.wombi.2014.06.006DOI Listing
December 2014

Response to: Platelet indices in patients with unexplained recurrent miscarriage; related factors should be considered.

Arch Gynecol Obstet 2014 Sep;290(3):409

Department of Obstetrics and Gynecology, Recep Tayyip Erdoğan University, School of Medicine, Rize, İslampaşa Mah, 53100, Turkey,

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http://dx.doi.org/10.1007/s00404-014-3301-xDOI Listing
September 2014

Effects of maternal ageing on ICSI outcomes and embryo development in relation to oocytes morphological characteristics of birefringent structures.

Zygote 2015 Aug 29;23(4):550-5. Epub 2014 May 29.

Gulhane Military Hospital IVF Center,Turkey.

The aim of this study was to determine the morphological characteristics of the older reproductive aged women's oocytes and to reveal the influence of these characteristics on intra-cytoplasmic sperm injection (ICSI) outcomes. The oocytes of women older than 35 years of age were evaluated retrospectively. Non-invasive polarization microscopy (PolScope) examinations of mature oocytes were performed by measurement of meiotic spindles' length, area and retardance and zona pellucida thickness and retardance. Fertilization and conception competence and the correlation with the birefringent structures were assessed. Two hundred and thirteen mature oocytes from 54 women were evaluated with a PolScope. Length of the meiotic spindle was shown to be related to fertilization success of women with advanced maternal age. In conclusion, the PolScope is a useful device used to identify the oocyte quality. Quantitative measurements of meiotic spindle parameters may be valuable for the selection of high-quality oocytes that have the potential for embryo development in the in vitro fertilization (IVF) laboratory of women older than 35 years of age who are mostly poor responders.
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http://dx.doi.org/10.1017/S0967199414000197DOI Listing
August 2015

Could platelet distribution width be a predictive marker for unexplained recurrent miscarriage?

Arch Gynecol Obstet 2014 Aug 12;290(2):233-6. Epub 2014 Mar 12.

Department of Obstetrics and Gynecology, Recep Tayyip Erdoğan University, School of Medicine, Rize, İslampaşa Mah, 53100, Turkey,

Purpose: The aim of our study was to evaluate the platelet function in unexplained recurrent miscarriage and to investigate whether any hematologic changes detectable by simple complete blood count have a diagnostic value for the prediction of unexplained recurrent miscarriage.

Methods: A prospective study based on the comparison of 74 patients with unexplained recurrent first-trimester pregnancy loss with 208 control subjects matched for age. The two groups were compared in terms of platelet indices.

Results: There was a significant difference in platelet distribution width in patients with unexplained recurrent miscarriage compared to healthy control subjects. Platelet distribution width values in the patient group were statistically higher (P < 0.001) than the control group.

Conclusion: Our study provides an evidence that platelet distribution width gradually increases in women with recurrent miscarriage compared to control group. Patients with unexplained recurrent miscarriage have significantly increased platelet aggregation. This data may provide an empirical rationale for the use of anticoagulants in the management of this clinical condition.
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http://dx.doi.org/10.1007/s00404-014-3192-xDOI Listing
August 2014

Management of cesarean scar pregnancy with suction curettage: a report of four cases and review of the literature.

Arch Gynecol Obstet 2014 Jun 25;289(6):1171-5. Epub 2014 Jan 25.

Department of Obstetrics and Gynecology, School of Medicine, Recep Tayyip Erdoğan University, İslampaşa Mah, 53200, Rize, Turkey,

Purpose: To present the outcomes of four cases of cesarean scar pregnancy treated with suction curettage.

Methods: Four patients were ultrasonographically diagnosed with cesarean scar pregnancies treated with suction curettage in a tertiary care center.

Results: Serum β-human chorionic gonadotropin levels ranged between 1,681 and 15,573 mU/mL, gestational sac diameter measured from 10 to 24 mm and scar thickness was between 4.7 and 6.8 mm. All patients underwent suction curettage under general anesthesia with transabdominal ultrasonography guidance. No complications were observed during or after operation.

Conclusion: Suction curettage is a viable alternative for conservative treatment in selected cases of patients who are diagnosed with CSP early in gestation and who have a myometrial thickness of more than 4.5 mm.
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http://dx.doi.org/10.1007/s00404-014-3143-6DOI Listing
June 2014

What is the success of ultrasonography of benign adnexal masses?

J Obstet Gynaecol Res 2014 Feb 22;40(2):473-8. Epub 2013 Oct 22.

Department of Gynecology and Obstetrics, Recep Tayyip Erdoğan University, Rize, Turkey.

Aim: To assess the diagnostic accuracy of the ultrasonographic discrimination of benign adnexal masses.

Methods: This was a prospective study, evaluating 245 consecutive cases using real-time gray-scale ultrasonography in a tertiary education hospital.

Results: Diagnostic accuracy was high for simple cysts and solid masses as κ-values of 0.824 and 0.816 and accuracy was moderate for endometriomas, dermoid cysts and cystadenomas as κ-values of 0.758, 0.689 and 0.627, respectively, and low for hemorrhagic cysts as a κ-value of 0.587. A logistic regression model was developed using ultrasonographic characteristics of the adnexal masses. Irregularity at lining of the inner wall, presence of solid component, papillary projections and echogenicity were shown to have a strong impact on the diagnosis of benign masses.

Conclusion: Although ultrasonography is a useful technique for the diagnosis of benign adnexal masses, it is limited in diagnostic accuracy. Pattern recognition is the most favored method for ultrasonographic diagnosis. Logistic regression analysis can contribute to diagnostic accuracy.
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http://dx.doi.org/10.1111/jog.12208DOI Listing
February 2014

Alterations of natriuretic peptides amino-terminal pro B-type natriuretic peptide and amino-terminal pro C-type natriuretic peptide during the pregnancy.

J Matern Fetal Neonatal Med 2014 Jul 5;27(11):1103-7. Epub 2013 Nov 5.

Department of Obstetrics and Gynecology and.

Objective: The aim of this study was to determine the plasma levels of natriuretic peptides amino-terminal pro B-type natriuretic peptide (NT proBNP) and amino-terminal pro C-type natriuretic peptide (NT proCNP) during pregnancy and any possible changes occurring in each trimester.

Methods: This was a prospective longitudinal case-control study conducted in a University Hospital antenatal outpatient clinic. Subjects were all healthy pregnant women without a history of previous cardiac disease, hypertension or preeclampsia, and each patient was assessed during every trimester, and blood samples were collected for the measurement of NT proBNP and NT proCNP levels.

Results: Twenty pregnant women were followed-up during pregnancy without any complications. We obtained longitudinal levels of natriuretic peptides in each trimester. The mean NT proBNP levels were 14.95 ± 16.8, 9.37 ± 10.76, 52.48 ± 126.65 pmol/ml and the mean NT proCNP levels were 44.64 ± 41.64, 45.70 ± 47.03, 47.22 ± 55.09 pmol/l, respectively. No statistically significant alteration of plasma levels of natriuretic peptides was detected between trimesters.

Conclusion: This is the first study evaluating the longitudinal levels of NT proCNP during the pregnancy, and demonstrates that NT proCNP remained constant, but NT proBNP levels do not significantly alter during pregnancy.
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http://dx.doi.org/10.3109/14767058.2013.850488DOI Listing
July 2014

Do quantitative birefringence characteristics of meiotic spindle and zona pellucida have an impact on implantation in single embryo transfer cycles?

Arch Gynecol Obstet 2014 Feb 15;289(2):433-8. Epub 2013 Aug 15.

Gulhane Military Medical Faculty, IVF Center, 06018, Etlik, Ankara, Turkey.

Objective: The aim of this study was to determine whether quantitative PolScope characteristics of meiotic spindle and zona pellucida could be used as a non-invasive marker to predict implantation success in elective single embryo transfer cycles.

Methods: Quantitative birefringence parameters; including mean retardance, area, length and polar body deviation angle of meiotic spindle and mean retardance and width of inner zona pellucida belonging to 53 transfer oocytes from elective single embryo transfer cycles were retrospectively analyzed. The relevant PolScope features were compared between 20 conception and 33 non-conception cycles.

Results: Meiotic spindle mean retardance, area, length and inner zona pellucida mean retardance and width did not reveal a statistically significant difference between transfer oocytes from conception and non-conception cycles. Deviation angle of the polar bodies was also comparable between the groups. Spindle and inner zona PolScope characteristics of transfer oocytes were not correlated with the maternal age.

Conclusion: Quantitative PolScope features of meiotic spindle and inner zona pellucida can not be used as a non-invasive marker to predict assisted reproductive technology success in elective single embryo transfer cycles.
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http://dx.doi.org/10.1007/s00404-013-2999-1DOI Listing
February 2014

Plasma lipids and lipoproteins during pregnancy and related pregnancy outcomes.

Arch Gynecol Obstet 2013 Jul 12;288(1):49-55. Epub 2013 Feb 12.

Department of Obstetrics and Gynecology, Recep Tayyip Erdoğan University School of Medicine, İslampaşa Mahallesi, Şehitler Caddesi, No.74, Rize, Turkey.

Purpose: To study the effect of maternal lipid profile changes in pregnancy in relation to fetal growth and development, prognosis, and complications of pregnancy.

Methods: One thousand pregnant women between 17 and 48 years of age were included in this prospective longitudinal and uni-center study. Lipid profile tests [triglyceride (TG), total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL)] were first requested as part of the routine pregnancy follow-up in first antenatal visit (<14 weeks) then repeated in the last trimester (>28 weeks). The analysis included the medical, social-demographic, and nutritional status of the women as well. Primer outcome measures were defined as the association of the pregnancy-related lipid profile change to neonatal weight, the weight of the infant in third month and pregnancy complications (preeclampsia, gestational diabetes mellitus, IUGR, and preterm birth).

Results: The levels of TG, total cholesterol, HDL, LDL increased significantly as pregnancy progressed. The percentage of the change in the TG levels were higher in patients with well nutritional parameters (p = 0.033). As the percentage of change in the TG levels increased, the neonatal weight increased (p = 0.033) but no effect on the placental weight and the third month weight of the infant was seen. As the percent change in TG levels decreased, the risk of the preterm birth significantly increased. In women who were positive in 50 g screening test, but were uncomplicated with gestational diabetes mellitus, the percent change in cholesterol was lower (p = 0.010), the percent change in LDL was lower (p = 0.015), and the percent change in TG was higher (p = 0.032).

Conclusion: In pregnancy, complex alterations occur in lipid metabolism. Percent change in TG is affected positively by the nutrition level. The neonatal weight also increases as well but postnatal weight is unaffected. Conversely TG levels significantly decrease in preterm birth. No association between preeclampsia and gestational diabetes mellitus with lipid profile changes were noted except in patients with glucose intolerance (>140 mg/dl in 50 g screening test) in which change in cholesterol, LDL was low and TG was high.
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http://dx.doi.org/10.1007/s00404-013-2750-yDOI Listing
July 2013

Postoperative medical treatment of chronic pelvic pain related to severe endometriosis: levonorgestrel-releasing intrauterine system versus gonadotropin-releasing hormone analogue.

Fertil Steril 2011 Feb;95(2):492-6

Department of Obstetric and Gynecology, Agri Patnos Public Hospital, Ministry of Health, Patnos-Agri, Turkey.

Objective: To compare efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS; Mirena) with depot GnRH analogue (GnRH-a; gosareline acetate; Zoladex) on endometriosis-related chronic pelvic pain (CPP) in patients with severe endometriosis during 12 months.

Design: Prospective, randomized, controlled study.

Setting: The reproductive endocrinology unit of a tertiary, research and education hospital.

Patient(s): Forty women with severe endometriosis (revised The American Fertility Society [AFS] classification >40) and endometriosis-related CPP and control groups were enrolled in the study.

Intervention(s): The patients were treated with either LNG-IUS (n = 20) or GnRH-a (n = 20). The GnRH-a dose was repeated every 4 weeks for 24 weeks.

Main Outcome Measure(s): Scores of CPP were evaluated using a visual analogue scale (VAS) and total endometriosis severity profile (TESP).

Result(s): The TESP score decreased in the LNG-IUS group at first, third, and sixth month follow-up visits, whereas at the 12th month follow-up visit, the TESP scores were increased to values similar to pretreatment values. Although the VAS score had no significant alteration during the follow-up period in the LNG-IUS group, the GnRH-a group showed a significant decrease in the VAS score and TESP score at the end of 1 year. The LNG-IUS treatment showed a lower patient satisfaction.

Conclusion(s): Both treatment modalities showed comparable effectiveness in the treatment of CPP-related endometriosis.
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http://dx.doi.org/10.1016/j.fertnstert.2010.08.042DOI Listing
February 2011