Assessment of Serum and Follicular Fluid Total Oxidant andTotal Antioxidant Levels in In Vitro Fertilization (IVF) Cases

Objective: To assess the effects of serum and follicularfluid total oxidant (TOC) levels, total antioxidant capacity (TAC), and oxidative stress index (OSI) on oocytematuration, fertilization, embryogenesis, and clinicalpregnancy outcomes in In Vitro Fertilization (IVF) cyclesof infertile patients.Material and Methods: One hundred patients having infertility and underwent ART enrolled the study group andblood samples were collected on gonadotropin starting,oocyte pick-up (OPU) and embryo transfer (ET) days.Additionally, follicular fluid specimen obtained duringOPU was collected. TOC, TAC levels and OSI in serumsamples and follicular fluid specimens between clinicallypregnant and non-pregnant patients were compared.Results: No significant difference was noted between clinically pregnant and nonpregnant patients in terms of thewoman’s age, duration of infertility, ovarian reserve ornumber of transferred embryos. There was also no significant difference in TAC, TOC and OSI levels in serumsamples obtained during three phases of treatment cycle(basal gonadotropin starting day, OPU day and ET day)and in follicular fluid samples.Conclusion: TAC, TOC and OSI seem to be ineffective topredict clinical pregnancy as an outcome in patients whounderwent ART.Keywords: infertility, iotal oxidant capacity, total antioxidant capacity, oxidative stress index</p

Gebelerde Birinci Trimester Tiroid Fonksiyon TestiSonuçlarının Değerlendirilmesi

Çalışmamızın amacı birinci trimesterde tiroid disfonksiyonu sıklığını iki farklı referans aralığına göre ayrı ayrı değerlendirip sonuçları karşılaştırmak ve ülkemizdeki gebelerde tiroid disfonksiyonu gerçek prevalansını belirlemektir. Tersiyer merkez olan hastanemizin kadın hastalıkları ve doğum poliklinikleri’ne başvuran hastalara ait ilk trimester TSH, sT4 ve sT3 değerleri retrospektif olarak tarandı ve kayıt altına alındı. Sonuç olarak 647 olgu çalışmaya dahil edildi. TSH referans aralıkları ayrı ayrı 0.1-2.5 mIU/L ve 0.34-5.6 mIU/L olacak şekilde hastaların tiroid disfonksiyonu sıklıkları değerlendirildi. TSH referans aralığı 0.1–2.5 mIU/L olarak alındığında hastaların 525’i (%81.14) ötiroidik, 16’sı (%2.47) hipertitoidik, 106’sı (%16.38) hipotiroidik olarak saptandı. TSH referans aralığı 0.34-5.6 mIU/L olarak alındığında ise hastaların 582’si (%89.95) ötiroidik, 50’si (%7.72) hipertiroidik, 15’i (%2.31) hipotiroidik olarak saptandı. İki farklı referans aralığı kullanımında prevalans ve dolayısıyla klinik yaklaşım açısından anlamlı fark olacağı gözlendi. TSH için önerilen güncel referans aralığı kullanıldığında bölgemizdeki gebelerde tiroid disfonksiyonu prevalansını literatüre göre belirgin olarak yüksek oranda saptadık. Bu durum; bölgesel iyot eksikliği ile açıklanabilir. Ancak kanaatimizce; önerilen referans aralığının, ülkemizde yapılacak ve perinatal sonuçlar ile gebelikteki TSH değerlerini karşılaştıran uzun dönem izlem çalışmalarıyla tekrar gözden geçirilmesi uygun olacaktır.The aim of this study is to examine the frequency of thyroid dysfunction in the first trimester based on two different reference ranges, and to compare the results. To determine the exact prevalence of thyroid dysfunction among pregnant women in Turkey. We retrospectively reviewed and recorded first trimester TSH, fT4 and fT3 levels of patients, who were presented to the gynecology and obstetrics outpatient clinics of our hospital, which is a tertiary healthcare center. Totally 647 patients were included in the study. The frequency of thyroid dysfunction was evaluated based on two different reference ranges for TSH levels as 0.1-2.5 mIU/L and 0.34-5.6 mIU/L. Based on a TSH reference range of 0.1–2.5 mIU/L, 525 (81.14%) patients were euthyroid, 16 (2.47%) had hyperthyroidism, and 106 (16.38%) had hypothyroidism. Based on a TSH reference range of 0.34-5.6 mIU/L, 582 (89.95%) patients were euthyroid, 50 (7.72%) had hyperthyroidism, and 15 (2.31%) had hypothyroidism. The two different reference ranges yielded significantly different prevalences of thyroid dysfunction and hence, would lead to a significant difference in terms of clinical approach to patients. When we used the current recommended reference range for TSH, we detected a remarkably higher prevalence of thyroid dysfunction among pregnant women in our region in comparison to the literature. This condition may be explained with endemic iodine deficiency. However, in our opinion, it would be best to revise the recommended reference range for TSH for our country via long-term follow-up studies that compare perinatal outcomes with pregnancy TSH levels.</p