A Rare Case of Deep Pelvic Endometriosis Presenting with Serous Ascites and Infertility

In this study it is aimed to define a rare case of deep pelvic endometriosis with massive serous ascites and infertility. Literature search revealed sporadic cases of endometriosis presenting with bloody or brownish ascites, some had also pleural effusion and CA-125 levels were elevated in all cases. Our case had normal CA-125 level and normal looking ovaries. Besides classic endometriosis symptoms, our case was asymptomatic. Endometriosis is diagnosed postoperatively on the basis of histopathology. Management of infertility was IVF-ET, which resulted with a succesful pregnancy. This is the first case of deep pelvic endometriosis presenting with serous ascites and infertility. More reports are required to determine whether endometriosis with serous ascites has good prognosis in infertility or not

Effect of Initiation Day of Clomiphene Citrate Treatment on Endometrium and Cervical Mucus

Objective: To compare the antiestrogenic effects of clomiphene citrate (CC) on reproductive end organs in patients where CC was started on different days of the cycle. Patients and Methods: A total of 95 patients who underwent ovulation induction with CC were initially included in this prospective randomized controlled study. Patients were divided into two treatment groups: in day 3 group (n=52), CC was given from day 3 to 7 of the cycle for five days, whereas in day 5 group (n=43), CC was given on days 5 to 9. The antiestrogenic effects of CC in terms of endometrial thickness and cervical mucus quality, cycle characteristics, and treatment outcomes were assessed. To observe possible differences in antiestrogenic effects, only data from ovulatory cycles were analyzed. Results: Fourty-four patients in the day 3 group and 34 patients in the day 5 group were analyzed. Endometrial thickness was similar in both groups on the day of human chorionic gonadotropin (hCG). In the day 3 group, the mean cervical mucus score was lower (8.1±2.7 vs. 9.7±2.3, p=0.036). There were no significant differences between the groups in the mean serum estradiol (E2), progesterone levels, and the number of leading follicles on the day of hCG, and ovulation and pregnancy rates per cycle. Conclusion: Endometrial thickness does not differ whether starting CC on day 3 or 5 of the cycle. Nevertheless, poor cervical mucus quality may be more common in the patients where CC was started on day 3 of the cycle compared to day 5

Surgical approaches to recurring torsions and the effects of the attacks on the ovarian reserve: a case study in light of the literature

Objective: To report on the surgical approach in cases of ovary torsion that develop after preventive surgery and on the effects of the attacks on the ovary reserve Design: The presentation of the case. Setting: University Hospital. The patient: The sixteen-year-old girl, who had lost her right adnexa because of torsion, suffered successive torsion in the left adnexa after preventive surgery. Intervention: Through the laparoscopic method, the utero-ovarian ligament was shortened and ovariopexy was applied to the back of the uterus. The ovarian reserve between the attacks was monitored. Main Outcome Measure: The prevention of recurring torsions through the surgical method and thereby the preservation of the ovarian reserve. Result: The ovary must be protected under all circumstances during the treatment of torsion. More than one method of adnexa fixation may prove necessary to prevent further attacks. Conclusion: The case we present here is the only one in which the two sides were successively affected, despite the surgical intervention to prevent any recurrence, and also the only one in which the ovarian reserve between the attacks was monitored. Apparently, the ovarian reserve is affected badly by recurrent torsion attacks, though the reserve tests indicate some improvement in the months following the last attack

The Affect of Pentoxifylline on Sperm Parameters in Normozoospermic, Asthenozoospermic and Oligo-Asthenozoospermic Males

OBJECTIVE: To determine the affect of pentoxifylline (PTX) on sperm parameters in normozoospermic, asthenozoospermic, and oligo-asthenozoospermic males. STUDY DESIGN: Each semen sample collected from normozoospermic (n=20), asthenozoospermic (n=20), and oligo-asthenozoospermic (n=20) males was divided into two equal parts. One part of the semen sample washed using Puresperm only (NidaCon, Sweden) (After-wash category) and other part was treated with pentoxifylline after washing with Puresperm (PTX-treated category). The semen parameters of the after-wash and PTX-treated categories were compared. RESULTS: PTX-treated category was demonstrated significant increment of sperm concentration and rate of sperm with intact acrosome (SIA) when compared to after-wash group in both asthenozoospermic and oligo-asthenozoospermic males. In addition, PTX-treated group resulted higher sperm morphology in oligo-asthenozoospermic males when compared to after-wash group. However, PTX did not show any superiority on after-wash group in normozoospermic males. CONCLUSIONS: Pentoxifylline have beneficial effect on sperm parameters especially in oligo-asthenozoospermic and asthenozoospermic patients

The Effects of Once-Weekly Alendronate 70 mg, Risedronate 35 mg and Raloxifene 60 mg Daily in the Treatment of Postmenopausal Osteoporosis in Turkish Population

OBJECTIVE: We aimed to compare the efficacy and tolerability of once-weekly alendronate 70 mg/weekly, risedronate 35 mg/weekly and raloxifene 60 mg/daily in the treatment of postmenopausal osteoporosis. STUDY DESIGN: Retrospective case-control study. 216 aged matched postmenopausal women with osteoporosis who received alendronate (n=70), risedronate (n=74), or raloxifene (n=72) for 24 months were retrospectively evaluated. Additionally, all patients received 600 mg Calcium+ 400 IU Vit D daily. Bone mineral density (BMD) was measured by dual X-ray absorptiometry. T scores at baseline and 24 months were evaluated in the lumbar spine, total hip, femur neck, and trochanter. RESULTS: Baseline T scores of each region were not significantly different among three groups. T scores increased in the lumbar spine (p<0.01), femur neck (p<0.05), trochanter (p<0.01) and total hip (p<0.05) following 24 months of alendronate treatment. In the risedronate group, there was a significant increase in the lumbar spine only (p<0.01). Raloxifene treatment did not change T scores of any regions. There was only one case (1.4%) with fracture of forearm in the alendronate group. However, in the risedronate group, 5 cases (6.7%) with fracture (one case of elbow, two cases of finger, one case of hip and one cases of vertebral fractures) were seen during the treatment period. In the raloxifene group, 5 cases (6.9%) of bone fracture (including, three cases of fracture of forearm and one case of hip and one case of vertebral fracture) were seen. The rates of fracture and adverse effects in three groups were comparable. CONCLUSİONS: Alendronate 70 mg/weekly was well tolerated and produced significantly greater increases in BMD than other drugs with low fracture incidence