The Role of Granulocyte-macrophage Colony Stimulating Factor in Recurrent Pregnancy Losses

Objective:A specific factor cannot be detected in approximately half of recurrent pregnancy losses (RPL). The aim of the present study was to investigate the role of a cytokine, granulocyte-macrophage colony stimulating factor (GM-CSF), in the etiology of recurrent pregnancy losses.Method:A total of 50 patients who had been admitted to the gynecology and obstetrics clinics of İstanbul University Medical School between January 1995 and September 2001 were included into the study and allocated to five groups including control and study groups. The study groups included 30 patients and the control groups included 20 patients. There were 3 study groups including non-pregnant women who had abortion (2 groups) and a spontaneous abortion group, which were selected among the recurrent pregnancy loss (RPL) subjects with unknown etiology. The spontaneous abortion, non-pregnant RPL group and pregnant RPL group were accepted as study group). These groups were compared with the control groups, which included pregnant and non-pregnant healthy women.Results:Moderate and severe GM-CSF activity was detected in the decidua of all cases in fertile and elective termination groups. However no significant difference was detected in the surface epithelium, gland epithelium and stromal GCSF activities. Endometrial GM-CSF activity was determined to decrease in spontaneous abortion and RPL cases.Conclusion:Reduced GM-CSF activity in the decidua may have a role in the etiology of RPL. Besides, the level and distribution of GM-CSF in different compartments of the decidua may be a determinant factor in the prognosis of pregnancy

BhCG as a Rupture Marker in Ectopic Pregnancy: A Retrospective Study

Objective:To find effective criteria in determining the risk of ectopic pregnancy rupture in patients with ectopic pregnancy.Method:The data of 101 patients who were hospitalized with the diagnosis of ectopic pregnancy in the tertiary center between January 2018 and January 2021 were analyzed retrospectively. Demographic data of the patients, the month of admission, the patients’ beta-human corionic gonadotropin (BhCG) values at the time of admission, blood type, endometrial thickness measured with transvaginal ultrasound, presence of adnexal mass suggestive of ectopic pregnancy and treatments applied to the patients were recorded. These data were compared between patients who had surgery for ectopic pregnancy rupture and those whose treatment was completed without it.Results:In the statistical analysis of the data, ectopic pregnancy rupture was found significantly more frequent for a threshold value of BhCG >4000 IU/L. Other data were not statistically significant.Conclusion:In cases of ectopic pregnancy, if the BhCG value at the time of admission exceeds the threshold value, the possibility of surgical approach increases. Medical treatment may be more successful at lower BhCG levels

Single-center Experiences of Ovarian Sex Cord Stromal Tumors

Objective:The aim of this study is to examine the sex cord stromal tumors of the ovary operated in our clinic in the last 4 years and to contribute to the literature on this rare tumor.Method:The clinical and laboratory findings of 34 patients with pathological diagnosis of ovarian sex cord stromal tumor, who were operated in our obstetrics and gynecology clinic between 2016 and 2020, were evaluated retrospectively. Pathological diagnoses were classified and other accompanying pathologies and complaints were evaluated for each type.Results:Ovarian sex cord stromal tumors usually attract attention with the peripheral effects of the hormones produced by the tumor tissue. They rarely come to very large sizes. They are mostly benign. When the hormone estrogen is produced, accompanying endometrial pathologies should not be overlooked. Hormonal complaints in patients improve dramatically after surgery both clinically and laboratory. Oncological follow-up is required following diagnosis in some malignant types.Conclusion:If ovarian sex cord stromal tumor is suspected, preoperative blood androgen levels, inhibin A, and alpha feto protein (AFP) should be evaluated. In addition, ultrasonographic and, if necessary, endometrial histopathological evaluations are important for patient follow-up as well as diagnosis. The patient's fertility desire and age should be considered during treatment

The Impact of COVID-19 Pandemic on Female Sexual Behavior

Objective:The Coronavirus disease-2019 (COVID-19) related isolation has resulted in economic damage, loneliness, fear of death, and depression all around the world. Self-isolation and social distance lead to unintended psychological effects and negatively affect sexual life. This study aimed to investigate women’s sexual behavior during the COVID-19 pandemic in our country.Method:This prospective, observational study was conducted in a tertiary referral hospital between June 27 and July 27, 2020. A questionnaire consisting of 13 questions regarding the sexual life during the COVID-19 pandemic was applied to 169 women aged 18-45 years. Demographic characteristics were recorded. The questions evaluating sexual behavior about the relationship with partner, sexual desire, frequency of intercourse, sexual satisfaction, and fertility desire were asked.Results:The mean age of the participants was 32.9±7.74 years (18-45). Regarding the per capita monthly income, 84 (60%) patients had a decrease, 53 (37.9%) of them remained stable, and only 3 (2.1%) of them had an increase during the pandemic. Sexual desire was decreased by 32.9% of the participants and remained the same in 58.6% of the participants. A higher rate of 40.5% was observed in the decreased group than in the stable income group with 22.7% (p=0.03). A statistically significant difference was found between the decrease in sexual desire rates. However, when the change in income level of the groups and their sexual satisfaction rates were compared, it was found that sexual satisfaction increased in those with a lower income level, and the difference was statistically significant (p=0.04).Conclusion:Acute stress caused by the COVID-19 pandemic negatively affected sexuality. The decreased income level reduces sexual desire, but we observed an increase in sexual satisfaction rates in this group