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A Case Report: a Mother With Secondary Infertility
(Trakya Üniversitesi, 2018) Göztepe, Aslı; Güldağ, Mahmut Alper; Elter, Koray
Aims: Secondary infertility is a disease where women with a firstborn are not able to have a child again. In this casereport, we wanted to observe a whole process of a patient with secondary infertility and investigate the causes andwhether there are any solutions for it.Case Report:A 41-year-old female patient presented to the clinic with the complaint of not being able to get pregnant.First thoughts about the patient were focused on infertility however, she had a child before. Therefore, furtherinvestigations were needed. After the investigations, she was diagnosed with secondary infertility because no rationalreasons were able to clarify her disease.Conclusion: Nowadays, secondary infertility is still a major health problem and no medications or treatments areenough to resolve this problem. The most common theory is the H-Y antigen hypothesis, but still, there is not enoughevidence for this theory to be proven.
Menopoz sonrası kadınlarda hormon replasman tedavi süreci ve reprodüktif faktörlerin kemik mineral yoğunluğu üzerine etkileri
(2007) Balkanlı, Petek Kaplan; Özden, Gülşah; Tokuç, Burcu; Yüce, Ali M
Amaç: Menopoz sonrası kadınlarda hormon replasman tedavi (HRT) sürecinin ve parite, menopoz yaşı, menopoz süresi gibi reprodüktif faktörlerin kemik mineral yoğunluğu üzerine etkileri araştırıldı. Hastalar ve Yöntemler: Trakya Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Kliniği Menopoz Polikliniği'ne başvuran 322 menopoz sonrası kadının (ort. yaş 52.4±6.2; dağılım 38-76) yaş, reprodüktif öykü ve hormon replasmanı ile ilgili bilgileri arşivden çıkarıldı. Hastalar, östrojen kullanım süreleri ve halen kullanmakta olup olmadıklarına göre sınıflandırıldı ve bu özelliklerinin kemik mineral yoğunluğuna etkileri analiz edildi. Kadınların lomber vertebra, femur, trokanter ve wards kemik dansitometreleri DEXA (dual-energy X-ray absorpsiometri) yöntemiyle ölçüldü. Bulgular: Hormon replasman tedavisi kullanımı üç yıldan fazla olan menopoz sonrası kadınlardaki wards ve trokanter kemik mineral yoğunlukları, üç yıldan az olanlara göre anlamlı olarak yüksek bulundu. Vertebral kemik yoğunlukları, üç yılın üzerinde HRT kullananlarda hiç kullanmayanlara göre daha yüksek saptandı. Wards ve vertebral kemik yoğunluğu değerleri, halen HRT'yi kullanmakta olan ve üç yıldan daha uzun süredir kullananlarda hiç HRT kullanmamış kadınlara göre daha yüksek tespit edildi. Geçmişte HRT kullanıp sonradan bırakmış olan kadınlarda kemik mineral yoğunluğu değerleri hiç HRT kullanmamış olan kadınlardan farklı olmadığı bulundu.. Parite ve menopoz sonrasında geçen süre artışının kemik yoğunluğunu düşürdüğü görüldü. Sonuç: Vertebra ve kalça kemik mineral yoğunlukları, HRT kullanımının ancak üç yıl veya daha uzun süreli kullanımlarında ve HRT'nin kullanıldığı dönem içinde artmaktadır. Parite ve menopoz sonrası geçen süre ise osteoporoz riskini artıran faktörlerdir.
Erken evre endometrium kanserinde eksik cerrahi sonrası laparoskopik pelvik lenf nodu diseksiyonu: Olgu sunumu
(2005) Kaplan, Balkanlı Petek; Güçer, Fatih
Erken evre endometrium kanserinde geleneksel laparotomik cerrahi evrelemenin yerine laparoskopik yaklaşım, güvenli ve etkin bir seçenek olarak sunulmaya başlanmıştır. Bu yazıda, erken evre endometrium kanseri nedeniyle başka bir merkezde eksik cerrahi uygulanan, daha sonra merkezimizde laparoskopik pelvik lenfadenektomi yapılan 39 yaşındaki bir hasta sunuldu. Laparoskopik lenfadenektomi, lenf nodu diseksiyonu gerektiren jinekolojik maligniteler için teknik olarak geçerli ve güvenli bir yöntem olarak görünmektedir
The Use of Human Epididymis 4 and Cancer Antigen 125 Tumor Markers in the Benign or Malignant Differential Diagnosis of Pelvic or Adnexal Masses
(2017) Altıntaş, Zehra Nihal Dolgun; Kabaca, Canan; Karateke, Ateş; İyibozkurt, Cem; İnan, Cihan; Altıntaş, Ahmet Salih; Karadağ, Cihan
Background: Ovarian cancer is one of the highest mortality cancers in gynaecology. Discrimination of benign masses from malignant ones may sometimes become a challenge for the clinician since there is not a reliable tumour marker, thus some unnecessary, highly morbid operations can be performed. Aims: To explore the efficacy of human epididymis 4 (HE 4) and cancer antigen 125 (CA 125) markers in differentiating malignant and benign pelvic masses of ovarian origin and to identify the cut-off points for those markers. Study Design: Prospective study. Methods: Fifty-one patients who were diagnosed and planned to undergo surgery for ovarian mass between June 2008 and December 2008 were enrolled into this study. Preoperative venous blood samples were taken and frozen for marker investigation and final diagnoses were concluded by histopathological examination. After recruitment of all cases CA 125 and HE 4 levels were evaluated. Results: The statistical analysis did not indicate any statistically significant difference between the CA 125 levels of the patients with malignant and benign adnexal masses (p=0.105). The HE 4 levels of the patients with malignant adnexal masses were higher at a statistically significant level compared to the patients with benign adnexal masses (p=0.002). For HE 4 tumour marker and at the cut-off point of >25 pM, sensitivity was 1, specificity 0.40, positive cut-off value 0.19, negative cut-off value 1, accuracy 0.47 and positive likelihood ratio 1.65. Conclusion: Human epididymis 4 is a better diagnostic tool than CA 125 in benign-malignant discrimination of adnexal masses. The cut-off value of 25 pmol/L for human epididymis 4 will contribute to providing proper guidance to patients with adnexal masses and applying the proper treatment method.
Serum Oestradiol Pattern during Coasting is Different in Antagonist Cycles Compared with Long Agonist Cycles in In Vitro Fertilisation
(2013) Elter, Koray; Özay, Tijen Alev; Ergin, Elif; Özörnek, Murat Hakan
Background: GnRH agonists and antagonists have different mechanism of action, and therefore serum estradiol levels might differ during coasting in IVF. Aims: To compare the change in serum oestradiol levels after withholding the gonadotropins for coasting between long agonist and antagonist cycles. Study Design: Retrospective study. Methods: Antagonist and long agonist cycles, in which coasting was performed, were analysed in this retrospective analysis. Antagonist cycles (n=50) were compared with long agonist cycles (n=52) with respect to daily serum oestradiol levels following withholding of gonadotropins. Results: The pattern of change in serum oestradiol was different between groups; it increased on the first day by 11.2% and decreased thereafter on the second and third days in the agonist group. However, it began to decrease from the first day in the antagonist group. Therefore, peak serum oestradiol levels were significantly higher in the agonist group than in the antagonist group (mean±standard deviation; 5798±1748 vs 5104±1351 pg/mL). The duration of coasting was shorter in the antagonist group compared with that in the agonist group (mean±standard deviation; 2.60±1.40 vs 1.96±0.88 days). Conclusion: Serum oestradiol pattern during coasting is different in antagonist cycles compared with long agonist cycles in in vitro fertilisation.
A large posterior encephalocele associated with severe ventriculomegaly, cerebellar atrophy and transposition of the great arteries
(Wiley, 2018) Inan, Cihan; Sayin, Niyazi Cenk; Gurkan, Hakan; Erzincan, Selen Gursoy; Uzun, Isil; Sutcu, Havva; Atli, Emine Ikbal; Varol, Fusun
Posterior encephalocele is a neural tube defect, which is a sac-like protrusion of the neural tissue and cerebrospinal fluid through a defect in the occipital bone. This embryonic anomaly may coexist with cortical dysplasia, agenesis of the corpus callosum, hydrocephalus, microcephaly, craniofacial abnormalities, ventricular and atrial septal defect. We report a case of a large posterior encephalocele in a fetus accompanied by unexpected major abnormalities including transposition of the great arteries, severe ventriculomegaly and cerebellar atrophy. Postnatal surgical corrections of the posterior encephalocele and then of the transposition of the great arteries were performed but the neonate died 2 months after delivery.
Emergency cerclage in twins during mid gestation may have favorable outcomes: Results of a retrospective cohort
(Elsevier Masson, 2018) Cilingir, Isil Uzun; Sayin, Cenk; Sutcu, Havva; Inan, Cihan; Erzincan, Selen; Yener, Cem; Varol, Fusun
Purpose. - Cervical cerclage treatment for cervical changes at mid trimester is a very controversial topic in twins. The aim of the study was to present our maternal and fetal outcomes of mid-trimester cervical cerclage in twin pregnancies. Basic procedures. - This study was performed using data extracted from the medical files of the twin pregnancies whom performed emergency cervical cerclage between January 2012 and March 2018 at Trakya University, Facuty of Medicine, Department of Perinatology. Main findings. - Mean (min.-max.) gestational age at delivery was [27.3 (21-34) weeks]. The median time between cervical cerclage and delivery was 6.4 weeks, while the maximum prolongation of the pregnancy was 11 weeks. The median prolongation period of pregnancy was 4.1 weeks in patients with bulging membranes, but 10 weeks in patients with cervical effacement and cervical shortening. Eight infants died at the neonatal period. Two patients (20%) developed late abortions at 21 and 22 weeks of gestation, and 2 women (20%) delivered extremely premature neonates at the 24th weeks. Overall neonatal mortality rate was 40% (8/20 neonates). Twelve out of twenty were born alive (60%). Principal conclusions. - Despite the lack of randomized controlled trials, it seems reasonable to offer emergency cervical cerclage to twin pregnancies with cervical shortening (<15 mm). For the twin pregnancies with advanced cervical dilatation and protruding membranes, emergency cervical cerclage should be an option only for carefully selected patients after informing about the complications and low success rate. (C) 2018 Elsevier Masson SAS. All rights reserved.
The relation of fetal colon and rectum diameters with labor in healthy late-third trimester pregnancies
(Elsevier Science Bv, 2018) Inan, Cihan; Sayin, N. Cenk; Dolgun, Z. Nihal; Erzincan, Selen Gursoy; Uzun, Isil; Sutcu, Havva; Varol, Fusun
Objective: To investigate the associations of fetal colon-rectum diameters with labor and fetal distress or meconium passage in healthy pregnancies in the late 3rd trimester. Study design: A total of 162 healthy, singleton pregnant women at >= 36(0/7) weeks who were in the latent phase of labor (n = 69) or those not in labor (n = 93, controls) at the time of ultrasound examination were enrolled. Fetal colon (ascending, transverse, descending, sigmoid) and rectum diameters, Doppler indices of materno-fetal vessels were measured. Data were analyzed according to the mode of delivery. Results: Fetal colon-rectum diameters were smaller in women in labor compared to controls (p = 0.001). Positive correlations were observed between fetal colon-rectum diameters and interval between ultrasound and labor onset in the control group except for those who had scheduled cesarean sections (C/S) (p = 0.001). Similar colon-rectum measurements were obtained in fetuses delivered via cesarean section due to fetal distress or to other indications (p>0.05). In women who had uterine contractions during ultrasound examination; later delivered by vaginal route, no association was observed between Apgar scores and colon-rectum diameters during latent-phase (p > 0.05), and also there were significant positive correlations between different segments of colon-rectum diameters and duration of neonatal meconium passage (p < 0.05). Conclusion: Fetal colon and rectum diameters are smaller during labor and the measurements tend to diminish as the labor approaches, but do not indicate fetal distress. (C) 2018 Elsevier By. All rights reserved.

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