Ethical and legal aspects of abortion

The Angels asked God: Is there a solution for the abortion debate? God: Yes, of course my Angels. It will be resolved. The Angels: When? God: Not in my lifetime. (Oktay Kadayifçi) The abortion debate is an emotional, sensitive and complicated issue that interests society and religion. Our intention is not to convince you to accept either side of the debate, but to help with an understanding of both sides. As a health care provider, our mission is to reduce unwanted pregnancies and provide a loving home for all children. Whatever our efforts as a medical health care provider, they have not been successful in meeting the needs. One of the available methods is pregnancy termination, but the main issue is whether pregnancy termination is a method or not. Pro-life and pro-choice proponents have their strong and reasonable views. In this paper, we try to clarify the claims of both sides without any intervention. © 2007 Published by Reproductive Healthcare Ltd

Unilateral laparoscopic tubal reversal versus IVF

PubMedID: 24001156Background: Tubal sterilization is one of the most important surgical techniques for sterilization. There is a dilemma for women who wish to undo this procedure in the choice between tubal reversal or in vitro fertilization (IVF). Patients and Methods: In this retrospective cohort study, 134 patients who had had tubal sterilization previously and wished to have another child were enrolled in this study. Primary outcome was clinical pregnancy. The outcomes of 58 women who had had laparoscopic unilateral tubal reversal (Group 1) were compared with those of 76 women who had had IVF (Group 2). Results: Clinical pregnancy rates were higher in the tubal reversal group (55.2% in Group 1 and 15.8% in Group 2). Ectopic pregnancy rates were similar (1.7% in Group 1 and 1.3% in Group 2) between the two groups. Clinical pregnancy rates were higher in all age, body mass index, and interval from ligation categories. Conclusions: Laparoscopic unilateral tubal reversal is an important alternative to IVF. However, this is an advanced laparoscopic operation, and more surgeons skilled in this microsurgical operation are still needed. © Copyright 2013, Mary Ann Liebert, Inc. 2013

The effect of age specific FSH levels on in vitro fertilization-intracytoplasmic sperm injection/embryo transfer outcomes in women with normal ovarian function [Normal Ovaryan Fonksiyonu Olan Kadinlarda Yaşspesifikfshseviyelerinin In Vitro Fertilizasyon-Intrasitoplazmik Sperm Enjeksiyonu/Embriyo Transferi Sonuçlari Üzerine Etkisi]

Objective: The objective of this study is to determine the effect of age specific follicle stimulating hormone (FSH) levels on the number of oocytes, the number of MII oocytes, fertilization, the number of grade 1 embryos and pregnancy rate in vomen with normal ovarian function for in vitro fertilization-intracytoplasmic sperm injection/embryo transfer cycles. Material and Methods: In this study 392 patients data were reviewed retrospectively between 01.01.2010-01.01.2014 at Çukurova University Faculty of Medicine Department of Obstetrics and Gynecology Assisted Reproduction Treatment Centre who used recombinant follicle stimulating hormone for controlled ovarian stimulation than performed in vitro fertilization-intracytoplasmic sperm injection/embryo transfer due to unexplained infertility. Patients were grouped as women of age 33 and lower, 33-37 and 38-41. Each age group were divided into two subgroups; premature ovaraian aging and control group. Subgroups in all age groups were compared in terms of baseline characteristics and in vitro fertilization (IVF) results. Results: In younger age group the total gonadotropin dose used and the duration of induction were detected statistically significantly higher than premature ovarian aging (POA) patients in control patients. (p=0.004, p=0.048) E2 level at hCG administration day, number of oocytes obtained and the number of MII oocytes were lower than the control group in POA patients (p=0,001, p=0.022, p=0.023 respectively). In the 33-37 age range, in the POA group E2 level at hCG administration day, number of oocytes and the number of MII oocytes retrieved was lower than the control group (p<0.0001, p=0.027, p=0.040 respectively). Conclusion: Interperation and consideration of age-specific FSH levels in treatment planning while taking into account the patient's age may contribute to optimize the IVF outcomes in patients undergoing controlled ovarian hyperstimulation. © Copyright 2016 by Türkiye Klinikleri

Açiklanamayan infertilite etiyolojisinde olasi risk faktörü olarak herediter trombofilinin yeri

Inherited thrombophilia as a potential risk factor in the etiology of unexplained infertility Objective: Unexplained infertility represents one of the most common diagnoses among infertile couples. In this study we investigated the impact of inherited thrombophilia as a risk factor in unexplained infertility. Material and Methods: In this study, genetic mutations of prothrombin gene G20210A, Factor V Leiden and methylene tetrahydrofolate reductase (MTHFR) C677T, as well as D-Dimer levels were investigated in 25 women diagnosed with unexplained infertility and 25 healthy fertile women. Results: In the present study, among unexplained infertile women and the control group, MTHFR C677T, prothrombin G20210A mutations and D-Dimer levels did not have a statistically significant difference (p>0.05). Factor V Leiden mutation was not observed in either group. Conclusion: Currently, there still are unclear points in the etiopathogenesis of unexplained infertility. As a result of our findings, although we did not observe a significant association between hereditary thrombophilia and unexplained infertility, the presence of a number of studies with contradictory findings demands future research with large sample sizes to clarify this issue

Comparison of lipid profiles in normal and hypertensive pregnant women

[No abstract available

The ultrastructural effects of surgical treatment of hydrosalpinx on the human endometrium: a light and electron microscopic study

PubMedID: 30966840Hydrosalpinx is a disease commonly observed in women and characterized by the obstruction which is in the shape of a fluid-filled sac at the distal part of tuba uterina closed to the ovary. In this study, we aimed to obtain endometrial tissue samples from the hydrosalpinx patients, before and after the surgical treatment and compare these endometrial tissue samples by using light and electron microscope. Endometrial tissue samples were obtained from the 24 women with bilateral hydrosalpinx range 19–46 years before and after the surgical treatment, and normal endometrial tissues were collected from five women without hydrosalpinx and evaluated as a control group. In endometrial samples of hydrosalpinx patients; it was observed that large and unregulated interstitial spaces representing the organellar destruction, membranous whorl structures associated with organelle destruction, thinning in the surface epithelium, decreasing in numbers of microvillus and pinopodes in microvilli cells, increasing in heterochromatin and picnotic changes in the nucleus, expansion, and vacuolization in the endoplasmic reticulum cisternae in the apical cytoplasm and intraepithelial macrophages and lymphocytes were rised in number. Although mild structural changes were observed in endometrial tissues obtained after surgical treatment of hydrosalpinx, surface epithelium, glandular and stromal cell structures were more similar to control endometrial specimens. In conclusion; serious structural changes have occurred in endometrial tissues of hydrosalpinx patients. These structural abnormalities have removed after surgical treatment so it is considered that surgical treatment is effective in patients with hydrosalpinx. © 2019, © 2019 Taylor & Francis Group, LLC.Firat University Scientific Research Projects Management Unit: EMK2017, TYL-2015-4528This study was supported by a grant from Cukurova University Scientific Research Projects Coordination Unit (Project number: TYL-2015-4528). This work was partially presented at the 23rd National Electron Microscopy (EMK2017) Congress in Antalya-Turkey

Ovarian pregnancy after intrauterine insemination: A case report [Intrauterin inseminasyon sonrasi ovaryan gebelik: Olgu sunumu]

Ectopic pregnancy is defined as implantation of a fertilized ovum in an area other than endometrial lining of uterus. The most common localization for ectopic pregnancy is the ampuller portion of the tuba uterina, but it can be to exist anywhere in the intraabdominal space. Ovarian pregnancy is a rare form of ectopic pregnancy and represents 1-3% of all the ectopic pregnancies. The incidence is 1 per 7000 to 1 per 60,000 deliveries Pregnancy was determined at the right ovary after intrauterine insemination(IUI). Laparoscopy performed and ectopic ovarian pregnancy was removed by protecting the ovary

Long-Term Outcomes of Laparoscopic Bean Vaginoplasty (Modified Vecchietti Procedure) for Mayer-Rokitansky-Kuster-Hauser Syndrome

PubMedID: 27120395Objective: The objective of our study is to evaluate the long-term results of laparoscopic bean vaginoplasty (LBV), which we previously described. Materials and Methods: From April 2002 to September 2013, 62 patients, who were diagnosed with Mayer-Rokitansky-Kuster-Hauser Syndrome and underwent LBV in Cukurova University School of Medicine Department of Obstetrics and Gynecology were included in the study. Operative data, complication rates, vaginal length, and sexuality of patients during the follow-up period were evaluated. Sexuality of the patients were evaluated using the Female Sexual Function Index (FSFI) questionnaire. The FSFI scores were compared with age-matched 65 healthy control subjects. Results: Mean age of patients in case and control groups were 23.9 ± 5.1 (18-32) and 25.1 ± 4.2 (18-31), respectively (P = .69). Median length of follow-up after surgery was 48 months (24-144 months). No complications occurred during the operations. No vaginal adhesions occurred during the follow-up periods. Median vaginal length during the last follow-up was 7 cm (6-9 cm). FSFI scores were similar with the control group. Conclusion: LBV is a successful modification of Vecchietti procedure, without any reported complication. However, the procedure should still be compared with the other methods in randomized trials. © Copyright 2016, Mary Ann Liebert, Inc

Removal of intra-abdominal intrauterine device by laparoscopy

PubMedID: 12041860Objective: In this study, we aimed to evaluate the cases in which intra-abdominal intrauterine devices (IUDs) were removed by laparoscopy. Methods: A retrospective study, from 1994 to 2000 was carried out with eight patients who underwent laparoscopy for the removal of an IUD. The patients admitted to our clinic with 'lost IUD' were examined by pelvic ultrasonography, X-ray and hysteroscopy. IUDs were found to be extrauterine but within the abdominal cavity. The IUDs were removed by operative laparoscopy. Results: The mean age of the patients was 31.5 years. The mean duration of usage of IUD was 5.5 years. The IUD was located in the cavity of Douglas in four cases, in the posterior wall of the uterus (perimetrium) in one case and in the conglomerated mass bordered by the intestines in three cases. The types of the IUDs were Cu-T 380A (n = 5), Multiload (n = 1) and Lippes-Loop (n = 2). The mean laparoscopic operation time was 25 min. No major complications (intestinal or vessel injuries) or minor problems occurred. Laparotomy was not necessary in any of the eight cases. All cases were treated as out-patients and discharged on the same day. After counselling, three women requested sterilization, which was performed at the same laparoscopy session by the administration of bilateral Yoon rings, and other family planning methods were chosen by five women. There were no problems when cases were followed at the 10th and 30th postoperative days. Discussion: Our results support the idea that, in cases of extrauterine but intra-abdominal IUD, laparoscopic removal of the IUD must be the first choice of therapy

Incidence and risk factors of ovarian hyperstimulation syndrome in cases subjected to controlled ovarian hyperstimulation [Kontrollü Overyan Hiperstimülasyon Uygulanan Olgularda Overyan Hiperstimülasyon Sendromu Görülme Insidansi ve Risk Faktörleri]

Objective: Objective: Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of ovulation induction applied with gonadotrophins. In this study, we aimed to determine the incidence and risk factors of OHSS for cases taken into IVF- ICSI/ET cycle and subjected to controlled ovarian hyperstimulation in our clinic. Material and Methods: IVF-ICSI/ET cycles subjected to controlled ovarian hyperstimulation in the Assisted Reproductive Treatment Center of Qukurova University were evaluated. Patients developing OHSS and patients not developing OHSS were set as two different groups. Patients' files were reviewed and their demographic features, examination data, laboratory findings, ultrasonography (USG) characteristics and treatment protocols were compared. Results: Number of cycles for the groups developing OHSS and not developing OHSS were 69 and 1373 respectively. Incidences of moderate and intense OHSS were determined to be 4% and 0.2% respectively. OHSS was more frequent in patients having high basal LH values, LH/FSH ratios and hCG day estradiol (E2) values. HCG day mature follicle numbers, aspired preovulatory follicle numbers, aspired small follicle numbers and collected oocyte numbers were higher in the OHSS developing group (p=0.0001). Risk of OHSS in patients with polycystic ovary syndrome (PCOS) was 7.6 times higher (95% CI 4.3-13.5) than the others. The comparison made between the antagonist protocol and long luteal agonist protocol showed that there was no statistically significant dif-ference between the two groups in terms of OHSS development (p=0.069). Conclusion: Multivariate analysis revealed that, pregnancy, >3000 pg/ml E2 values, >2 LH/FSH ratio and presence of PCOS were found to be an independent risk factors for OHSS. Treatment of the high risk cases should be individual. During the treatment process of these patients, follicular development should be closely monitored using ultra-sonography and E2 follow-up. Copyright © 2013 by Türkiye Klinikleri