Do follicular fluid advanced glycation end products levels affect the ovarian response in unexplained infertility?

Objective: To compare the advanced glycation end products (AGEs) levels in follicular fluid according to the different ovarian responses of women who underwent controlled ovarian stimulation due to unexplained infertility and to examine the relationship between these levels and pregnancy outcomes. Methods: Sixty-three women who underwent fresh IVF/ICSI cycles with GNRH antagonist protocol were divided into 3 groups according to the number of retrieved oocytes as suboptimal (4–9 oocytes), optimal (10–15 oocytes) and high (>15 oocytes) responders. AGEs levels in follicular fluid were measured by ELISA method. Results: AGEs levels were 6.81 ± 2.20 mg/ml, 5.30 ± 2.01 and 6.44 ± 1.43 mg/ml in suboptimal, optimal and high response group, respectively. AGEs level was significantly higher in suboptimal response group than in optimal response group. The cutoff level of 6.19 mg/ml had a sensitivity of 59.3% and a specificity of 66.7% in distinguishing the suboptimal response group from the optimal response group. However, there were no statistically significant difference between AGEs levels and clinical pregnancy and live birth rates. Conclusion: Increased AGEs level in follicular fluid may be associated with decreased ovarian response during controlled ovarian stimulation in unexplained infertility case, however, it does not provide information about pregnancy outcomes

Severe Hematoma of Vulva after Vulvar Varicose Vein Surgery

Vulvar hematomas, causing serious morbidity and rarely mortality, usually occur after delivery. Non obstetric ones are rare conditions which is often seen after blunt trauma of vulva. Management of vulvar hematoma include conservative and surgical approaches. Surgical methods are prefered for great, complicated, expanding ones especially. We present a severe vulvar hematoma happened after vulvar varicose vein surgery and discuss the conservative approach for this case

Contraceptive choices of adolescents before and after the voluntary termination of pregnancy

In this retrospective study, we aimed to investigate the contraceptive choices before and after voluntary termination of pregnancy among adolescents. Seventy pregnant adolescents aged 17–19 and undergone voluntary pregnancy termination were included. Counseling about contraceptives was given before the procedure. Contraceptive choices before and after termination of pregnancy were evaluated. Before pregnancy termination, all of the adolescents reported the use of a contraceptive method. The most commonly used method was coitus interruptus (37.1%), followed by male condom (34.3%) and the rhythm method (18.6%). The use of oral contraceptive pills (7.1%) and intrauterine devices (IUDs; 2.9%) were very low. Implants and injections were not used. None of the methods used were dual methods (used with the male condom). After the termination procedure, IUD was main choice (54.3%) followed by oral contraceptive pills (31.4%). Four adolescents (5.7%) selected to insert subdermal implants and three adolescents (4.3%) preferred injections. All of these preferred methods were dual methods. The preference of male condom as a single method decreased by about 3%. The rhythm method and coitus interruptus were not preferred. As a conclusion, contraceptive choices of adolescents significantly change to more effective methods by sufficient counselling during the termination of an unintended pregnancy.Impact statement What is already known on this subject? Adolescent pregnancies are an important public health problem. The prevention of these pregnancies is important in this respect. However, especially in developing countries, adolescents do not have sufficient knowledge of effective contraceptive methods. What do the results of this study add? The contraceptive choices of adolescents significantly change to more effective methods by appropriate counselling during the termination of unintended pregnancies. What are the implications of these findings for clinical practice and/or further research? An unintended pregnancy termination may be an opportunity to provide appropriate counselling to prevent subsequent pregnancies in adolescents, especially in countries where the sexual and reproductive health or family planning services are inadequately used

Spontanous Vulvar Endometriosis: Report of A Case

Endometriosis is an ectopic occurrence of tissue morphologically and functionally resembling endometrial tissue outside the uterine cavity. Vulva is one of the rarest location of extrapelvic endometriozis. We report a case of a 44-year-old multiparous woman, referred to our clinic with the complaints of having a vulvar mass and cyclic swelling of the mass during menstruation. She had a history of 2 previous cesarean delivery and no history of previous vulvar or vaginal surgery. The mass was 3-4cm in diameter and localized on the upper-portion of the right labium minus. Complete surgical excision was performed with the suspicion of endometriosis. Final histopathology report confirmed the diagnosis of endometriosis. Three weeks after surgery there was no evidence of endometriosis. In conclusion whether or not having a history of a previous vulvar surgery, vulvar endometriosis should be considered as a part of differential diagnosis in evaluation of vulvar masses

Maternal Serum Nitric Oxide Levels in Adolescent Pregnancies

OBLECTIVE: We aimed to evaluate maternal serum nitric oxide (MSNO) levels in adolescent pregnancies. STUDY DESIGN: A total of forty five pregnancies were included to the study, of these eight were adolescent pregnancies (age range, 18-19 years old). Factors analyzed between adolescent pregnancies and reproductive age pregnancies (age range 20-35 years old) were; age, gravidity, parity, gestational weeks, umbilical and middle cerebral artery Doppler velocimetry values, birth weigts, APGAR 5. minute scores and MSNO levels. Statistical analyses were carried out by using the statistical packages for SPSS 15.0 for Windows (SPSS Inc., Chicago, IL, USA) with Chi-square (χ2) test and Student’s t test. The receiver operator characteristic (ROC) curve analysis was used to establish the cutoff values for MSNO levels. RESULTS: Demographic and clinical characteristics showed no statistically significant difference among the groups (p>0.05). MSNO levels were statistically significantly lower in adolescent age pregnancies.                                               CONCLUSION: According to current study, MSNO levels were statistically significantly different from reproductive age pregnancies. MSNO levels may be a discriminative marker in adolescent age pregnancies but further studies with larger participants are needed to get more definite results