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ABSTRACT: To assess the effects of endometrial thickness and echogenicity on pregnancy and implantation rates in cases using assisted reproductive technology (ART).
We retrospectively analyzed the data of 241 ART cycles performed at Istanbul Medical Faculty, Reproductive Endocrinology Unit. The cycles were classified into three groups according to ultrasonographic endometrial thickness measurements on the day of hCG application; 51 cases (group 1) < or =8 mm, 182 cases (group 2) between 8-14 mm, and eight cases (group 3) 14 mm. Also the cycles were grouped according to endometrial echogenicity as trilaminar, isoechogenic and hyperechogenic pattern.
There was no significant difference in pregnancy rates between the three endometrial thickness groups and echogenic patterns. When conception and non-conception cycles were compared, no significant difference in endometrial thickness was observed (9.88 +/- 1.83 mm vs 9.84 +/- 1.89 mm).
Ultrasonographic evaluation of endometrial thickness and pattern is not useful in predicting implantation and conception rates in ART cycles.
Clinical and experimental obstetrics & gynecology 01/2009; 36(3):145-7. · 0.43 Impact Factor
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ABSTRACT: To determine the prevalence, severity and predictability of psychiatric symptoms of infertile women and the effects of infertility on marital and sexual relationships.
A semi-structured interview form, symptom check list, Beck Depression Inventory, State-Trait Anxiety Inventory and the Maudsley Marrital Questionnaire were utilized for 50 infertile women and 40 healthy women as a control group.
Depression, anxiety and strength of psychological symptoms were significantly higher in the infertile group. Depression was decreased as the rate of employment, economic status and education increased. Infertility, infertility treatment, and marriage duration were positively correlated with depression and the strength of psychological symptoms. Sexual relationships were negatively affected the longer the duration of infertility treatment lasted.
Special attention must be given to identifying psychiatric problems in infertile women. Relationship and sexual difficulties also appear central to infertility-related stress; targeting problems in these domains will have maximal therapeutic benefit.
Clinical and experimental obstetrics & gynecology 02/2006; 33(1):44-6. · 0.43 Impact Factor
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ABSTRACT: Our aim was to determine whether serum leptin level is regulated by thyroid hormones, lipid metabolic products and insulin resistance status in women with polycystic ovary syndrome (PCOS). A prospective case-controlled study was carried out in Istanbul University, Cerrahpasa School of Medicine in 25 lean PCOS (L-PCOS) women, 19 obese PCOS (O-PCOS) women and 28 normal women. The diagnosis of PCOS was established according to the clinical, hormonal (elevated luteinizing hormone and serum androgens) and ultrasonographic findings. Fasting serum levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), fasting glucose, insulin, total cholesterol (TC), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), very low-density lipoprotein-cholesterol (VLDL-C) and leptin were measured and compared in the three groups and the correlations between serum levels of leptin and other parameters were evaluated. Serum leptin levels were higher in the O-PCOS group, while its level was comparable between the L-PCOS and control groups. Serum levels of FT4 were significantly lower in both L-PCOS and O-PCOS groups than the control group. Women in both L-PCOS and O-PCOS groups were found to be significantly hyperinsulinemic and insulin resistant. Serum levels of TC, VLDL-C and TG were significantly higher in the O-PCOS group, while serum HDL-C level was lower. There was a poor correlation between serum leptin, and FT4, TC, TG, HDL-C and VLDL-C levels. A significant correlation was observed between serum leptin levels and both BMI and insulin resistance status in PCOS. We believe that, although thyroid hormones and lipid metabolic products do not seem to participate in the regulation of serum leptin levels, BMI and insulin resistance status may have a key role in women with PCOS.
Gynecological Endocrinology 07/2003; 17(3):223-9. · 1.58 Impact Factor
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ABSTRACT: In this study, we aim to compare the surgeons' choice on the ectopic pregnancy cases during the last four years. The differences between laparoscopy and laparotomy cases and the factors which directed the surgeon to choose either of the surgical methods were evaluated.
Our study comprises 135 patients who were diagnosed as ectopic pregnancy and were hospitalized in the Gynecology Department of Istanbul Medical Faculty during 1996-1999.
During 1996-1999 a total of 118 cases had been diagnosed as tubal ectopic pregnancy and had been treated surgically. Seventy three patients (62%) had been treated with laparotomy while the rest 45(38%) had been treated laparoscopically. When compared, the amount of intraabdominal free blood volume was significantly higher in laparotomy group [270.45 +/- 466.72 mL laparoscopy group - 889.75 +/- 714 mL laparotomy group, (p = 0.0001)]. When we considered haemoperitoneum amount according to the patients' parity, intraabdominal blood volume was interestingly higher in multiparas [507 +/- 599.32 mL nulliparas vs. 768.68 +/- 749.15 mL mulltiparas, (p = 0.044)]. The percent of cases with ruptured tubes was 64% for the laparotomy and 38% the laparoscopic cases; and the difference between two groups was significant (p = 0.0013).
Our study implied that haemodynamic stability and less intraabdominal free blood affect the surgeons' decision between laparotomy and laparoscopy. Fewer multiparous patients are suitable for these criteria which leads to less laparoscopic surgery. These findings, which need to be clarified, lead to the idea of human factor affecting the surgeons' choice indirectly.
Archives of Gynecology and Obstetrics 05/2002; 266(2):79-82. · 1.28 Impact Factor
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ABSTRACT: Purpose:In this study, we aim to compare the surgeons’ choice on the ectopic pregnancy cases during the last four years. The differences
between laparoscopy and laparotomy cases and the factors which directed the surgeon to choose either of the surgical methods
were evaluated. Methods:Our study comprises 135 patients who were diagnosed as ectopic pregnancy and were hospitalized in the Gynecology Department
of Istanbul Medical Faculty during 1996–1999. Results: During 1996–1999 a total of 118 cases had been diagnosed as tubal ectopic pregnancy and had been treated surgically. Seventy
three patients (62%) had been treated with laparotomy while the rest 45(38%) had been treated laparoscopically. When compared,
the amount of intraabdominal free blood volume was significantly higher in laparotomy group [270.45±466.72 mL laparoscopy
group – 889.75±714 mL laparotomy group, (p=0.0001)]. When we considered haemoperitoneum amount according to the patients’ parity, intraabdominal blood volume was interestingly
higher in multiparas [507±599.32 mL nulliparas vs. 768.68±749.15 mL mulltiparas, (p=0.044)]. The percent of cases with ruptured tubes was 64% for the laparotomy and 38% the laparoscopic cases; and the difference
between two groups was significant (p=0.0013). Conclusion: Our study implied that haemodynamic stability and less intraabdominal free blood affect the surgeons’ decision between laparotomy
and laparoscopy. Fewer multiparous patients are suitable for these criteria which leads to less laparoscopic surgery. These
findings, which need to be clarified, lead to the idea of human factor affecting the surgeons’ choice indirectly.
Archives of Gynecology and Obstetrics 03/2002; 266(2):79-82. · 1.28 Impact Factor
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ABSTRACT: We evaluated the fertility promoting effect of metformin in infertile patients with polycystic ovary syndrome. Twenty-nine infertile patients with polycystic ovary syndrome (PCOS) are included in our prospectively designed study and 15 normal menstruating women served as controls for reproductive hormones and ovarian volumes. All PCOS patients received a total of 78 cycles of clomiphene citrate (CC) in the beginning, then patients who could not get pregnant were switched to metformin plus clomiphene citrate. PCOS patients served as their own controls for the ovulation and pregnancy rates. At the end of the CC cycles 4.2% of patients got pregnant and 65.2% of the remaining group got pregnant with metformin plus CC cycles (p=0.0001). We have not observed any serious side effects of metformin. The high pregnancy rate of our study population is consistent with the hypothesis that insulin resistance plays an important role in the pathogenesis of anovulation in patients with PCOS.
Archives of Gynecology and Obstetrics 09/2001; 265(3):124-7. · 1.28 Impact Factor
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ABSTRACT: To evaluate the long-term effects of metformin on biochemical variables and body weight in polycystic ovary syndrome (PCOS).
Fifteen obese PCOS patients that attended the university clinic were included to this prospective study. These patients used 1,500 mg of metformin daily for 12 months.
We found a statistically different decrease in mean body mass index (t:4,369), (p:0.0002) at the end of the 12 months. In contrast to that there were no statistical differences in fasting serum insulin and testosterone levels. Metformin improved menstrual patterns (60% of cases) in obese PCOS patients.
Hyperinsulinemia and androgen excess in obese non-diabetic women with PCOS are not improved by the administration of metformin. Metformin treatment may have improved menstrual patterns by a mechanism independent of and unrelated to insulin sensitivity or circulating insulin concentrations.
Clinical and experimental obstetrics & gynecology 02/2001; 28(4):212-4. · 0.43 Impact Factor
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B Baysal
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ABSTRACT: The purpose of this study was to compare the effectiveness of barrier agent Interceed (TC7) (Johnson & Johnson Medical, Inc) and preoperative use of commonly used progesterone, medroxyprogesterone acetate.
Forty-five Spraque-Dawley white rats of reproductive age (225-250 g) were employed as a model for postsurgical adhesion formation. Group 1 consisted of control rats, Group 2 consisted only of rats with Interceed applied to the denuded areas, Group 3 consisted of rats where preoperative MPA was used. Fifteen rats were exposed to daily IM injections of 15 mg medroxyprogesterone acetate (MPA) two weeks before the surgery.
The total adhesion score of the MPA group was significantly less than the control and Interceed group respectively (chi2=10.15) (p<0.001), (chi2=4.67) (p<0.03). There was no significant difference between the Interceed and the control group (p>0.05).
Preoperative long-term MPA treatment significantly decreases primary adhesion formation. It seems that there are some other mechanisms responsible for this effect rather than anti-inflammation and/or immunosuppression. It may be that the hypoestrogenic milieu depends on the use of progesterone.
Clinical and experimental obstetrics & gynecology 01/2001; 28(2):126-7. · 0.43 Impact Factor
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S Aksaray,
B DokuzoGuz,
E Güvener,
M Yücesoy,
N Yuluğ,
S Kocagöz,
S Unal,
S Cetin,
S Calangu,
M Günaydin,
H Leblebicioğlu,
S Esen,
B Bayar,
A Willke,
D Findik,
I Tuncer, B Baysal,
F Günseren,
L Mamikoğlu
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ABSTRACT: With the participation of eight major reference hospitals in Turkey, 749 aerobic Gram-negative isolates obtained from 473 intensive care patients in 1997 were tested for their susceptibility to 13 commonly employed antibacterial agents. The frequency with which species were isolated and resistance rates were compared with data from the previous 2 years. Imipenem was the most active agent against the majority of isolates (75%), followed by ciprofloxacin, cefepime and amikacin. The per cent susceptibility to all antibiotics declined from 1995 to 1996. With the exception of imipenem, for which there was no change in resistance, the per cent susceptibility somewhat increased in 1997. However, it was still lower than in 1995.
Journal of Antimicrobial Chemotherapy 06/2000; 45(5):695-9. · 5.07 Impact Factor
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Journal of Hospital Infection 12/1996; 34(3):235-7. · 3.39 Impact Factor
