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    Can We Predict the Presence and Severity of Intra-Abdominal Adhesions before Cesarean Delivery
    (S. Karger AG, 2017) Taylan E.; Akdemir A.; Ergenoglu A.M.; Yeniel A.O.; Tekindal M.A.
    Aims: The study aimed to investigate whether we can predict the presence and severity of intra-abdominal adhesions before cesarean delivery using patient history, symptoms, and abdominal skin scar characteristics. Methods: In this prospective study, 143 pregnant women with history of previous abdominal surgery were included and they delivered by cesarean. Preoperative abdominal scar characteristics and symptoms as well as intraoperative abdominal adhesions were evaluated using the Manchester Scar Scale, a symptomatology questionnaire and the More Comprehensive Adhesion Scoring Method, respectively. Results: Patients with adhesions (n = 98) and without adhesions (n = 45) had similar baseline characteristics. In the adhesion group, abdominal scar scoring parameters were significantly increased. However, there was no significant correlation among total scar score, adhesion score, and symptom score. Conclusion: Despite the availability of many proposed methods, accurate prediction of the severity of surgery-related adhesions is beyond our current abilities. Therefore, as healthcare providers, obstetricians should avoid unnecessary use of the cesarean approach. This approach is more effective, beneficial, realizable, and reasonable than the prediction of surgery-related adhesions. © 2016 S. Karger AG, Basel.
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    In-vitro fertilization outcome predictors in women with high baseline follicle-stimulating hormone levels: Analysis of over 1000 cycles from a tertiary center
    (Sociedade Brasileira de Reproducao Assistida, 2021) Sahin G.; Akdogan A.; Aydın M.H.; Tekindal M.A.; Göker E.N.T.; Tavmergen E.
    Objective: The present study aimed to evaluate reproductive outcomes and determine the predictors of clinical pregnancy and live birth in women with elevated baseline follicle-stimulating hormone (FSH) levels, who have undergone intracytoplasmic sperm injection (ICSI) treatment. Methods: This retrospective study included 1011 ICSI cycles of women with high baseline FSH levels (> 10 IU/L), from a tertiary university IVF center between 2010 and 2015. Logistic regression analysis was performed to evaluate the prognostic factors of clinical pregnancy and live birth. Results: Among the 1011 ICSI cycles, the clinical pregnancy and live birth rates per oocyte retrieval were 19.5% and 14.3%, respectively. The live birth rates were 21.1% and 1.7% in women aged ?30 years and those aged ?40 years, respectively. In addition, the live birth rate was 1.47-fold higher in women from whom >3 oocytes were retrieved, compared to those from whom ?3 oocytes were retrieved (p=0.047). Logistic regression analysis indicated that the age categories ?30y, 36-39y and ?40y, level of baseline FSH (?20 IU/L) and the ovarian response (?3 or >3 oocytes retrieved) were significantly associated with live birth. Conclusions: Our study indicated that age, baseline FSH level, and ovarian response are independent predictive factors for clinical pregnancy and live birth among women with baseline FSH levels >10 IU/L. © 2021, Sociedade Brasileira de Reproducao Assistida. All rights reserved.