COMPARISON OF THE EFFECTS AND UTILIZATION INCIDENCE OF HORMONAL TREATMENT AND OTHER ANTIRESORPTIVE AGENTS IN POSTMENOPAUSAL PATIENTS

Amaç: Bu çalışmada amaç kliniğimize başvuran menopoz hastalarının hormon tedavisi ve diğer antirezorbtif ajanları kullanım yaygınlığını araştırmaktır. Ayrıca hastaların kemik mineral yoğunlukları ve mamografi bulguları da değerlendirilmiştir. Gereç ve yöntem: Bu çalışma, Şubat-Aralık 2005 tarihleri arasında başvuran menopoz hastalarının dosyaları taranarak yapılan retrospektif bir araştırmadır. Hastaların demografik özellikleri, kemik mineral yoğunluğu ve dansiteleri, aldıkları tedaviler ve mamografileri incelenmiştir. İstatistiksel analizde t-test, tek yön ANOVA ve çift değişken korelasyon analizi kullanılmıştır (p 0,05). Hormon tedavisi alanlar ve almayanlar arasında mamografik bulgular açısından anlamlı fark saptanmadı (p>0,05). Sonuç: Kliniğimizde hormon tedavisi tercih edilen hasta grubunun büyük bir kısmını osteoporozu olmayan hastalar oluşturmaktadır. Osteoporozu olanlarda ise hormon tedavisi veya diğer antirezorbtifler hastanın kliniğine göre benzer oranda tercih edilmektedir. Hormon tedavisi almış olmanın mamografik bulgulara etkisi saptanmamıştır. Objective: The aim of the study is to investigate the utilization incidence of hormonal therapy and other antiresorbtive agents in postmenopausal patients appealed to our clinics. Bone mineral density and mammographic findings were also evaluated. Material and method: This study is a retrospective analysis of records of patients who were admitted to menopause outpatient clinic during February-December 2005. Demographic features, bone mineral densitometers, mammographies and prescribed medications were evaluated. One-way ANOVA, t-test, bivariate correlation analysis were used for statistical analysis (p 0.05). Hormone therapy, does not seem to affect the mammographic findings (p>0.005). Conclusion: In our clinic, osteoporosis was not determined in most of the patients in hormonal treatment group. Hormonal treatment or other antirezorbtive agents were preferred similarly according to clinical findings in osteoporotic group. It was not detected any effect of hormonal treatment on mammographic findings

Association of serum and follicular fluid leptin and ghrelin levels with in vitro fertilization success

 Objectives: The aim of this study was to evaluate the relationship between in vitro fertilization (IVF) cycle outcomes, serum and follicular fluid (FF) levels of leptin and ghrelin. Material and methods: Forty-four women who underwent intracytoplasmic sperm injection cycles (ICSI) were enrolled in the study. On the third day (D3) of the menstrual cycle, venous blood samples were drawn for serum measurements of leptin and ghrelin. The follicular fluid (FF) and the corresponding oocyte were obtained from a single dominant preovulatory follicle at the time of oocyte pick-up. The FF and D3 serum leptin and ghrelin concentrations were measured by enzyme-linked immunosorbent assay. The relationship between pregnancy rate and serum, follicular fluid levels of leptin and ghrelin were analyzed. Results: Of the 44 cases included, nineteen achieved clinical pregnancy (43.18%). Follicular fluid ghrelin levels were significantly lower in the pregnant group than non-pregnant group (p < 0.05) With respect to FF leptin, there was no statistically significant differences between the pregnant and non-pregnant women (p > 0.05). There was no statistically significant difference in D3 serum ghrelin between pregnant and non-pregnant groups (p > 0.05). However, D3 serum leptin levels were significantly lower in pregnant women than non-pregnant women (p < 0.05). Conclusions: Lower ghrelin levels in the follicular fluid were associated with higher pregnancy rates. Also, D3 serum leptin levels were inversely correlated with clinical pregnancy rates. These findings support the potential role of these molecules on IVF outcomes

The effect of follicular fluid levels of GDF9 and BMP15 on oocyte and embryo quality

Metot: Kontrollü over stimulasyonu uygulanan 97 hastadan folikül sıvısı alındı. Foliküler sıvı GDF9 ve BMP15 proform ve matur düzeyleri western blot yöntemi ile ölçüldü. Foliküler sıvı FSH, östradiol ve progesteron düzeyleri otomatik kemiluminesent enzim immunoassay ile ölçüldü. Sonuçlar: Toplam 97 hastaya ait oosit ve folikül sıvısı çalışmaya dahil edildi. GDF9 ve BMP15 propeptit formu tüm örneklerde saptanırken , GDF9 matur formu 88(%90.7), BMP15 matur formu ise 58(%59.8) örnekte mevcuttu. GDF9 matur düzeyleri ile oositlein nükleer maturasyonu arasında istatistiksel anlamlı korelasyon saptandı (p Yorum: Foliküler sıvı GDF9 matr düzeyi yüksek olan olgularda nükleer maturasyon, embryo kalitesi ve klinik gebelik oranları fazladır. Buna göre IVF kültür medyumlarına rekombinant GDF9 matur eklenmesiyle tedavi başarısının arttırılabileceği düşünülebilir. Methods: The levels of follicular fluid GDF9 and BMP15 propeptide and mature forms were estimated by western blot analysis. The levels of follicular fluid FSH, estradiol and progesterone were measured with automated chemiluminescent enzyme immunoassays Results: Ninety seven follicular fluid samples and oocytes were included to this study. The propeptide form of GDF9 and BMP15 were detected in all samples, however the mature forms were evident in 88 (90,7%) and 58 (59,8%) respectively. Mature GDF9 levels were significantly correlated with nuclear maturation of oocytes (p Conclusion(s): Higher mature GDF9 levels were significantly correlated with nuclear maturation, quality of embryos and clinical pregnancy rate. Treatment results may be improved with the usage of recombinant mature GDF9 in IVF culture medi

Gonadotropin-releasing hormone agonist triggering is effective, even at a low dose, for final oocyte maturation in ART cycles: Case series

OBJECTIVE: To investigate the efficacy of low-dose gonadotropin-releasing hormone (GnRH) agonist for final oocyte maturation in females undergoing assisted reproductive treatment (ART) cycles. MATERIAL AND METHODS: Nine females undergoing ovarian stimulation in a GnRH antagonist protocol who received triptorelin 0.1 mg to trigger final oocyte maturation were included. Treatment outcomes of these patients were compared with those of controls, matched for age and oocyte number (n=14), who received 0.2 mg triptorelin at the same time. The luteal phase was supported with vaginal micronized progesterone and oral estradiol hemihydrate 2 mg twice daily. RESULTS: The mean (±) numbers of retrieved, metaphase II, and fertilized oocytes were 15.66±7.82, 14±7.28, and 10.11±5.86, respectively. The implantation and clinical pregnancy rates were 46.1% and 71.4%, respectively. Of the pregnancies, 2 were live births, 1 was a preterm birth (twins), 2 are on-going, and 2 ended as miscarriages. No case of OHSS was encountered. On comparison of the results of these patients (fresh cycles; n=7) with those of matched controls, there were no significant differences in terms of retrieved mature oocytes, implantation rates, or clinical pregnancy rates (p>0.05). CONCLUSION: These findings suggest that low-dose GnRH agonist triggering has similar efficacy as standard doses in terms of retrieved mature oocytes and clinical pregnancy rates in in vitro fertilization cycles

Gonadotropin-releasing hormone agonist triggering is effective, even at a low dose, for final oocyte maturation in ART cycles: Case series

© 2015 by the Turkish-German Gynecological Education and Research Foundation.Objective: To investigate the efficacy of low-dose gonadotropin-releasing hormone (GnRH) agonist for final oocyte maturation in females undergoing assisted reproductive treatment (ART) cycles. Material and Methods: Nine females undergoing ovarian stimulation in a GnRH antagonist protocol who received triptorelin 0.1 mg to trigger final oocyte maturation were included. Treatment outcomes of these patients were compared with those of controls, matched for age and oocyte number (n=14), who received 0.2 mg triptorelin at the same time. The luteal phase was supported with vaginal micronized progesterone and oral estradiol hemihydrate 2 mg twice daily. Results: The mean (±) numbers of retrieved, metaphase II, and fertilized oocytes were 15.66±7.82, 14±7.28, and 10.11±5.86, respectively. The implantation and clinical pregnancy rates were 46.1% and 71.4%, respectively. Of the pregnancies, 2 were live births, 1 was a preterm birth (twins), 2 are on-going, and 2 ended as miscarriages. No case of OHSS was encountered. On comparison of the results of these patients (fresh cycles; n=7) with those of matched controls, there were no significant differences in terms of retrieved mature oocytes, implantation rates, or clinical pregnancy rates (p>0.05). Conclusion: These findings suggest that low-dose GnRH agonist triggering has similar efficacy as standard doses in terms of retrieved mature oocytes and clinical pregnancy rates in in vitro fertilization cycles

Serum Procalcitonin and Proinflammatory markers in Polycystic Ovary Syndrome

Objective: We evaluated levels of procalcitonin and proinflammatory markers in patients with polycystic ovary syndrome (PCOS) and compared them with controls in the Black Sea region of Turkey. Study Design: This prospective controlled study involved patients with PCOS (n=59) and healthy age-matched controls (n=26; total, n=85). Serum procalcitonin (PCT), white blood cells (WBCs), high-sensitivity C-reactive protein (h-CRP), homocysteine (Hcy) levels, insulin resistance, and lipid profiles were compared between the PCOS and control groups. The same parameters were also compared between overweight and normal-weight PCOS patients. Results: Serum PCT, Hcy, h-CRP, and WBC levels were similar in the PCOS and control groups. High-density lipoprotein (HDL) levels were lower in the PCOS group than in the control group (p <0.05). In a subgroup analysis of the PCOS group, there were no significant differences between overweight and normal-weight PCOS patients with regard to proinflammatory markers (serum WBC, h-CRP, Hcy, PCT levels). However, total cholesterol, LDL, and triglyceride levels were significantly higher in overweight PCOS patients (p <0.005). Serum HDL levels were significantly lower in the overweight PCOS group than in the normal-weight group (p <0.005). Fasting insulin and HOMA-IR levels were significantly higher in overweight PCOS than normal-weight PCOS patients (p<0.05). Conclusions: Serum PCT, h-CRP, WBC, and Hcy levels were within normal ranges in PCOS patients. These results may be related to the relatively young age and regional differences in the study group