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Öğe The effect of mid-luteal estradiol level on the outcome of ICSI-ET cycles(2004) Aktan E.; Bozkurt K.; Ozer D.; Yucebilgin S.; Karadadas N.; Bilgin O.Methods: We investigated if mid-luteal estradiol levels could predict the outcome in intracytoplasmic sperm injection embryo transfer (ICSI-ET) cycles (n=231). Pregnant and non-pregnant women were compared regarding their peak estradiol levels on human chorionic gonadotropin (hCG) injection day, and mid-luteal estradiol levels on the 7th day following oocyte recovery. Pregnancy rates of the groups that were designed according to the "peak/mid-luteal estradiol level" and the mid-luteal estradiol levels were also compared. Results: Peak and mid-luteal estradiol levels in pregnant women were higher than in non-pregnant women in all patients, although the difference between peak and mid-luteal estradiol levels were similar in pregnant and non-pregnants. Pregnant women had higher mid-luteal estradiol levels in good responders, but the peak estradiol levels of pregnant and non-pregnant women were similar. In poor responders, pregnant and non-pregnant women were similar with respect to peak and mid-luteal estradiol levels. Both in all patients and good responders, women with mid-luteal estradiol levels <200 pg/ml had lower pregnancy rates than those with >2,000 pg/ml. Peak/mid-luteal estradiol ratios of pregnant and non-pregnant women were not significantly different in all patients, good responders and poor responders; although a tendency for a lower ratio in pregnants was encountered in good responders. Pregnancy rates of the groups according to the "peak/mid-luteal estradiol ratio" were similar; in all patients, good responders and poor responders. Conclusion: A relation between the mid-luteal estradiol level and the outcome is encountered only in good responders.Öğe Effects of coasting on the outcome of intracytoplasmic sperm injection-embryo transfer cycles(2004) Aktan E.; Bozkurt K.; Ozer D.; Yucebilgin S.; Karadadas N.; Bilgin O.Objectives: To determine the effects of 'coasting' on the outcome of controlled ovarian hyperstimulation (COH) and intracytoplasmic sperm injection-embryo transfer (ICSI-ET). Design: Retrospective study. Setting: IVF Centre, Ozel Ege Tup Bebek Merkezi, Izmir, Turkey. Sample: Twenty-six coasted and 52 non-coasted COH and ICSI-ET patients were enrolled in this retrospective study. Methods: Coasted patients were enrolled consecutively during the study period, and two non-coasted controls were selected from our database for each coasted patient. Coasting was decided when serum oestradiol level was ?4000 pg/mL. Groups were compared using x2 and Mann-Whitney U-tests for statistical analysis. Main Outcome Measures: Number of oocytes collected, metaphase II (MII) oocytes and cleaving embryos, the fertilisation rate and clinical pregnancy rate were the main outcome measures. Results: Number of oocytes collected, number of MII oocytes, number of cleaving embryos, fertilisation rate and clinical pregnancy rate for the coasted and non-coasted groups were 15.5 ± 5.2 and 14.0 ± 7.1, 9.7 ± 4.8 and 9.3 ± 3.9, 6.8 ± 3.9 and 5.8 ± 3.1, 0.85 ± 0.18 and 0.78 ± 0.18, 13/26 and 24/52, respectively; these differences were not statistically significant. None of the patients in the coasted group were hospitalised for signs or findings of severe ovarian hyperstimulation syndrome. Conclusions: Coasting does not adversely affect the number and the function of mature oocytes and the clinical pregnancy rate.Öğe The effects of different intraabdominal pressure protocols in laparoscopic procedures on oxidative stress markers and morphology in rat ovaries(Wroclaw University of Medicine, 2014) Biler A.; Yucebilgin S.; Sendag F.; Akman L.; Akdemir A.; Ates U.; Uyanikgil Y.; Yilmaz-Dilsiz O.; Sezer E.Background: To determine the effects of different intraabdominal pressure (IAP) on the ovaries in a laparoscopic rat model. Objectives: The aim of the study was to determine the effects on the ovaries of different intraabdominal pressures (IAP) in laparoscopic surgery in a rat model. Material and Methods: Thirty-two post-pubertal nonpregnant Sprague-Dawley rats were divided randomly into four groups. In the control group, no intraabdominal pressure (IAP) was applied. In Group Pp10 and Group Ppl5, an IAP of 10 and 15 mm Hg, respectively, were applied by carbon dioxide insufflation for 60 min, and a 30-min desufflation was carried out. In Group IPp15, a 15 mm Hg IAP was applied for 10 min, and then CO2 was desufflated for 10 min. After this ischemic preconditioning, IAP was established at 15 mm Hg for 60 min, after which CO2 was desufflated for 30 min. Erythrocyte and ovarian tissue malondialdehyde (MDA) and histopathologic damage scores were evaluated. Results: In Groups Pp10 and Ppl5, ovarian tissue MDA values were significantly increased compared to the control group. In Groups Pp10 and Pp15, erythrocyte MDA values were significantly increased when compared to Group IPp15 and the control group. Ovarian histopatological assesment scores were significantly higher in Group Ppl5 than in Groups Pp10 and IPp15. Conclusions: Pneumoperitoneum causes injuries to abdominal organ such as the ovaries. The ischemic preconditioning method is more effective in reducing oxidative stress due to laparoscopic pneumoperitoneum than lowpressure pneumoperitoneum methods.Öğe Recurrent uterine rupture after hysterescopic resection of the uterine septum(2013) Ergenoglu M.; Yeniel A.O.; Yildirim N.; Akdemir A.; Yucebilgin S.Introduction: Uterine rupture after hysteroscopic septum resection is a rare complication, and its frequency is reported to be approximately 1-2.7%. Uterine perforation and monopolar resection during hysteroscopy are well-known risk factors for subsequent uterine rupture during pregnancy. PRESENTATION OF CASE: We present a case of recurrent uterine ruptures during consecutive pregnancies in a patient who had undergone hysteroscopic septum resection for recurrent pregnancy loss. DISCUSSION: Recurrent uterine rupture due to hysteroscopic septum resection in pregnancy is a very rare condition. In the present case we noted that the first two uterine ruptures resulted from uterine contractions; however, the third rupture occurred spontaneously and earlier in gestation. As each uterine rupture occurred earlier than the rupture in the previous gestation, a history of uterine rupture during pregnancy should raise provider suspicion about the possibility of earlier uterine rupture recurrence. CONCLUSION: Uterine rupture may occur in pregnancies after hysteroscopic resection of the uterine septum. However, if a patient has a history of uterine rupture during previous pregnancies, the risk of uterine rupture may increase for earlier gestational ages in subsequent pregnancies. The patient must be informed about both the risks of uterine rupture during pregnancy after hysteroscopic septum resection and that recurrent ruptures may occur at earlier gestational weeks than during previous pregnancies. © 2012 Surgical Associates Ltd.Öğe Reproductive outcomes after hysteroscopic metroplasty for uterine septum(2010) Sendag F.; Mermer T.; Yucebilgin S.; Oztekin K.; Bilgin O.Purpose of Investigation: To evaluate reproductive outcome after hysteroscopic metroplasty. Methods: We analyzed the reproductive outcome of 30 patients with different degrees of septate uterus undergoing hysteroscopic metroplasty. In all cases the procedure was performed by resectoscope. Results: The patients had a total 74 pregnancies before metroplasty. Of these, ten (14%) were carried to term, six (8%) ended in preterm delivery, and 58 (78%) ended in spontaneous abortion. At least one year following hysteroscopic metroplasty a total of 20 pregnancies occurred. Of these, 11 (55%) were carried to term, two (10%) ended in preterm delivery, seven (35%) ended in spontaneous abortion. Conclusion: Correction of uterine septum significantly improves the prognosis of the pregnancies in patients with a history of severe obstetric problems. These results are similar to the results reported in the literature. Our data analysis suggests that hysteroscopic metroplasty for uterine septum improves pregnancy outcome of patients who come to us with a desire to conceive.Öğe Wernicke's encephalopathy: A case report and MRI findings(2010) Yucebilgin S.; Cirpan T.; Sanhal C.Y.; Ozan E.; Acar T.; Ozsener S.Wernicke's encephalopathy (WE) is a serious, potentially fatal acute or subacute neurological disorder caused by thiamine (Vitamin B1) deficiency. Although it is most frequently observed in patients who are chronic alcoholics, WE may also be associated with hyperemesis gravidarum. We report magnetic resonance imaging (MRI) and diffusion weighted imaging (DWI) findings in this case of WE in a pregnant patient with hyperemesis gravidarum. We conclude that DWI should be included in the imaging protocols of patients suspected to suffer from Wernicke's encephalopathy.
