IVF outcomes after hysteroscopic metroplasty in patients with T- shaped uterus.

Background: T- shaped uterus may be associated with infertility and adverse pregnancy outcomes. Hysteroscopic metroplasty may improve the reproductivity for these cases. To our knowledge, there is no data in literature about the clinical consequences of in vitro fertilization (IVF) in patients undergoing hysteroscopic metroplasty for T-shaped uterus.

Acardiac twin pregnancy: successful intrauterine ablative treatment with alcohol at 14 weeks of gestation.

Twin reversed arterial perfusion (TRAP) sequence is a serious condition of monochorionic twin pregnancy, occurring in approximately one in 35,000 cases. First trimester treatment of TRAP sequence is controversial with higher incidence of procedure related complications. Present case demonstrates a TRAP sequence that was managed by intrauterine treatment with one-ml 100% pure alcohol injection into the abdominal part of the umbilical artery and obliteration of the acardiac twin at 14 weeks of gestation.

Fertility outcomes of patients with early stage endometrial carcinoma.

Aim: Three to five percent of endometrial carcinoma patients are younger than 40 years and may desire fertility. Conservative treatment can be employed in these cases. We aimed to review treatment outcomes of patients who were diagnosed with endometrial carcinoma and who wanted to preserve their fertility.

Are serum markers altered in first trimester screening in poor ovarian reserve patients?

Aim: To investigate whether serum biochemical markers were altered during first trimester screenings in patients who have diminished ovarian reserve.

Methods: One hundred and fifty-one women who conceived after intracytoplasmic sperm injection were enrolled during the 11- to 14-week scan between June 2006 and July 2008. The normoresponders (Group 1: 125 patients) had >6 oocytes and the poor responders (Group 2: 26 patients) had ≤6 oocytes in oocyte retrieval.

Low molecular weight heparin and first trimester maternal PAPP-A and hCG levels, fetal nuchal translucency in the first trimester of pregnancy.

Purpose Of Investigation: We studied the relation of first trimester nuchal translucency and first trimester biochemical markers using low molecular weight heparin (LMWH) at 11-14 weeks of gestation.

Methods: This retrospective study was conducted at our university between January 2007 and July 2009. Ninety-six patients were treated with low-dose LMWHs (enoxaparine 40 mg) from the beginning of pregnancy to 36 weeks of gestation and low-dose aspirin (100 mg) to 32 weeks (group 1) and 100 control subjects (group 2) were included in the study.

Isolated abnormal value during the 3-hour glucose tolerance test: which value is associated with macrosomia?

Objective: The aim of this retrospective review was to evaluate obstetric outcomes in patients with an isolated abnormal value on the oral glucose tolerance test (OGTT) at 0, 1, 2, and 3 h.

Methods: From January 2003 through June 2009, all consecutive pregnant women who presented to Baskent University were screened for gestational diabetes mellitus (GDM). Patients with one abnormal value based on findings of the OGTT were grouped according to increased levels of glucose at 0, 1, 2, and 3 h (Group 1  >  95 mg/dl for fasting glucose concentration, Group 2  >  180 mg/dl for the serum glucose concentration in the first hour, Group 3  >  155 mg/dl for the serum glucose concentration in the second hour, Group 4  >  140 mg/dl for serum glucose concentration in the third hour).

In vitro fertilization-intracytoplasmic sperm injection outcomes in single- versus double-lumen oocyte retrieval needles in normally responding patients: a randomized trial.

We compared the retrieval efficiency of single- (direct follicular aspiration) and double-lumen-needle (attained with follicular flushing) procedures in normal-responder IVF-intracytoplasmic sperm injection cycles. This prospective randomized study did not demonstrate a beneficial effect of double-lumen needle retrieval compared with single-needle retrieval in normal-responder IVF-intracytoplasmic sperm injection cycles in terms of retrieved oocytes, clinical pregnancy rates, and live birth rates.

Single versus double intrauterine insemination in multi-follicular ovarian hyperstimulation cycles: a randomized trial.

Background: The rationale for double insemination is to create the opportunity for a longer fertilization period as follicle rupture may occur over a wide interval (approximately 22-47 h) after hCG administration in ovarian hyperstimulation (OH) with intrauterine insemination (IUI) cycles. This randomized study evaluates the effectiveness of single versus double IUI in only OH cycles with multi-follicular development.

Methods: We conducted a single center trial, 228 eligible patients were randomized for this study on the day of hCG.

Pregnancy achieved by transfer of thawed day 3 embryos that had been frozen after assisted hatching: a case report.

Assisted Hatching (AH) is performed to increase implantation rates in assisted reproductive techniques, especially recurrent implantation failure and older age group. AH can be performed to four different techniques as laser, mechanical, enzymatic, chemical methods. In the literature, there is limited data about embryo freezing after AH.

Osseous metaplasia of the endometrium.

Osseous metaplasia of the endometrium is very rare finding, and usually these cases presented with secondary infertility. Other symptoms are pelvic pain, dyspareunia, menstrual irregularities, vaginal discharge and the passage of bony fragments in menstrual blood. Suspicious lesion could see by hysterosalpingography or by ultrasonography; however, conclusive diagnosis and treatment tool is hysteroscopy.

The effect of prior varicocelectomy in patients with nonobstructive azoospermia on intracytoplasmic sperm injection outcomes: a retrospective pilot study.

Objectives: To examine our retrospective data on the outcomes of intracytoplasmic sperm injection (ICSI) and to determine whether a history of varicocele repair in men with nonobstructive azoospermia (NOA) undergoing an ICSI cycle was optimizing or not.

Methods: This retrospective study was conducted on Baskent University Department of Obstetrics and Gynecology, IVF Unit, and Department of Urology. Infertile couples suffering from NOA scheduled to an ICSI cycle, which was controlled ovarian hyperstimulation with a gonadotropin or gonadotrophin-releasing hormone-agonist protocol, selected for the study were divided into 2 groups: group 1 (n = 31) included NOA patients who had undergone prior varicocele repair, and group 2 (n = 65) included NOA patients who had not undergone varicocele repair.

Premature progesterone elevation impairs implantation and live birth rates in GnRH-agonist IVF/ICSI cycles.

Introduction: Our aim was to investigate the clinical significance of premature elevated progesterone levels in women with good ovarian response treated with long gonadotropin-releasing hormone agonist (GnRH-a) cycles and IVF. Premature elevated progesterone levels refer to a rise in serum progesterone levels on the day of human chorionic gonadotrophin (hCG) administration for final oocyte maturation above a threshold level, which is usually arbitrarily defined.

Materials And Methods: This is a retrospective case study, which consists of 1,045 treatment cycles in women with low P/E2 [progesterone (ng/mL) x 1,000/estradiol (pg/mL)] on the day of hCG.

Sublingual misoprostol for cervical ripening before diagnostic hysteroscopy in premenopausal women: a randomized, double blind, placebo-controlled trial.

Objective: To evaluate the effectiveness of sublingual misoprostol for cervical ripening before diagnostic hysteroscopy in premenopausal women.

Design: Placebo-controlled, double-blind, randomized trial.

Setting: University hospital.

Metabolic and endocrine effects of metformin and metformin plus cyclic medroxyprogesterone acetate in women with polycystic ovary syndrome.

Objective: To evaluate the metabolic and endocrine effects of treatment with cyclic medroxyprogesterone acetate (MPA) plus metformin compared with metformin alone in women with PCOS.

Methods: In this prospective randomized study of women with PCOS, 20 women received 850 mg of metformin twice a day, and 20 women received 850 mg of metformin plus 5 mg of MPA twice a day. Body mass index, hormonal and lipid blood profiles, homocysteine blood level, and insulin sensitivities assessed by homeostasis model assessment (HOMA) were recorded at baseline and at 3 months.

Effect of cervical mucus aspiration before intrauterine insemination.

Objective: To determine whether cervical mucus aspiration before intrauterine insemination (IUI) has any effect on clinical pregnancy rates.

Method: The outcomes of 186 IUI cycles in 95 consecutive patients in whom mucus was aspired prior to IUI were compared retrospectively with those of 1057 IUI cycles in 505 women.

Results: The pregnancy rate was 15.

The impact of rescue in vitro fertilization converted from high-response gonadotropin intrauterine insemination cycles in terms of implantation and pregnancy rates as compared with matched controls.

Objective: To determine whether conversion of high-response gonadotropin/intrauterine insemination (IUI) cycles to "rescue" in vitro fertilization (IVF) yields a higher implantation and pregnancy rate as found in matched IVF controls.

Design: A prospective study with a retrospective controlled section.

Setting: Baskent University Department of Obstetrics and Gynecology.

Thoracic epidural anesthesia and analgesia for gastric resection at 26 week pregnant woman.

Anesthesia and surgery are required in up to 1.5% to 2% of all pregnancies. Alterations in maternal anatomy and physiology create potential risks for both mother and fetus.

How best is to discontinue postmenopausal hormone therapy: immediate or tapered?

Background: To evaluate the differences between the immediate and tapered cessation protocols of hormone therapy in terms of recurrence of menopausal symptoms.

Materials And Methods: In this prospective, randomized clinical study 70 consecutive patients in whom hormone therapy was no longer preferred were recruited from the menopause clinic of a university hospital and rank randomized into two groups. In group 1 (n=35) hormone therapy was immediately discontinued and in group 2 (n=35) the medication was tapered.

Impact of morbid obesity in surgical management of endometrial cancer: surgical morbidity, clinical and pathological aspects.

Objective: To evaluate the effect of body mass index (BMI) on clinical, surgical, pathologic features, and surgical morbidity in the management of patients with endometrial cancer.

Materials & Methods: All endometrial cancer patients who were surgically treated in our institution between January 1, 2003 and January 1, 2006 were eligible for the study. Forty-two out of 60 patients were included in the analysis from our cancer database.

Expression of survivin, PTEN and p27 in normal, hyperplastic, and carcinomatous endometrium.

We aimed to investigate if expressions of survivin and p27 proteins are involved in the development of endometrioid carcinoma, along with whether there are any correlations between these proteins and loss of wild-type PTEN that is found in up to 80% of endometrial carcinomas. We also studied their correlations with classical prognostic factors and survival in endometrial carcinoma. To our knowledge, this is the first time survivin expression is investigated in endometrial hyperplasia along with endometrioid adenocarcinoma.

Effects of aspirin on placenta and perinatal outcomes in patients with poor obstetric history.

Objective: The aim of this study was to compare a low-dose aspirin treatment on placental and perinatal effects in the patients with poor obstetric history such as preeclampsia, intrauterine growth retardation (IUGR) in previous pregnancy.

Study Design: This retrospective study of 86 pregnant women was conducted between April 2002 and June 2005. In this study period 364 placentas were examined and the patients with poor obstetric history such as IUGR and preeclampsia were selected.

A case of unicornuate uterus with ipsilateral ovarian and renal agenesis.

Objective: To present a case of a unicornuate uterus with ipsilateral ovarian and renal agenesis.

Design: Case report.

Setting: Baskent University Faculty of Medicine, Department of Obstetrics and Gynecology, Adana, Turkey.