HELLP syndrome is characterized by hemolysis, elevated liver enzymes and thrombocytopenia. With a... more HELLP syndrome is characterized by hemolysis, elevated liver enzymes and thrombocytopenia. With a incidence of 0.1%-0.8% it is known to be effected by genetic predisposition. Unlike preeclempsia multiparity increases the risk of HELLP syndrome. Diagnosis is made by the classic clinical triad. Thrombocyte counts are especially important for classification of the disease. When making a diagnosis, severe preeclempsia, acute fatty liver of pregnancy, hemolytic ureamic syndrome and thrombocytopenic thrombotic purpura should be always be kept in mind for differential diagnosis. HELLP syndrome has several complications , including but not limited to; disseminated intravascular coagulopathy, acute renal failure, pulmonary edema, liver rupture and hematoma and retinal detachment. Suggested treatment modality consists, stabilization of blood pressure and magnesium sulfate infusion. Then evaluation of fetal status and planning delivery method and time if maternal status remains unstable. If pr...
Objective: The present study aims to assess the success of controlled ovarian stimulation in intr... more Objective: The present study aims to assess the success of controlled ovarian stimulation in intrauterine insemination cycles stimulated by recombinant-FSH and Clomiphene citrate for either mono- or bi-follicular development. Methods: We assessed 870 infertile patients treated with controlled ovarian stimulation in intrauterine insemination cycles at a university-based infertility clinic between January 2012 and December 2017. We compared the cycles stimulated by clomiphene citrate and recombinant-FSH in two set-ups; mono- and bi-follicular development. The main outcome measure was the clinical pregnancy rate per cycle. Results: The demographic and cycle parameters were similar between the groups, except for endometrial thickness on the day of hCG administration, which was higher in the recombinant-FSH group than the clomiphene citrate group. The overall clinical pregnancy rates in clomiphene citrate and recombinant-FSH groups were 9.8% and 10.3%, respectively (p=0.940). Regarding t...
Pompe disease is an autosomal-recessive disorder caused by acid alpha-glucosidase deficiency due ... more Pompe disease is an autosomal-recessive disorder caused by acid alpha-glucosidase deficiency due to mutations in the GAA gene. There are two forms of the disease: infantile-onset Pompe disease and late-onset Pompe disease. The worldwide incidence of both forms of the disease is commonly reported to be 1 in 40,000. Adult patients are affected by limb-girdle muscular weakness and respiratory insufficiency. Enzyme replacement therapy with alglucosidase-alpha is available since 2006. There is little knowledge about pregnant woman with Pompe disease. These women should be considered as high-risk pregnant women. Here, we aim to present Cesarean delivery and postpartum management of a case with an interrupted enzyme replacement therapy during pregnancy.
Triptorelin 0.2 mg and leuprolide 1 mg subcutaneous injections for triggering final follicular ma... more Triptorelin 0.2 mg and leuprolide 1 mg subcutaneous injections for triggering final follicular maturation were compared in patients with a high risk for ovarian hyperstimulation syndrome (OHSS). Infertile patients treated with GnRH antagonist protocol between January 2014 and March 2016 were recruited. Patients with high serum oestradiol levels on HCG day (>3000 pg/ml) indicating a risk of OHSS consisted of the study groups (A and B). Patients with serum oestradiol levels less than 3000 pg/ml consisted of the control group (C). A single injection of 0.2 mg triptorelin, 1 mg leuprolide and 10000 IU HCG were administered for final oocyte triggering in groups A (n = 63), B (n = 74) and C (n = 131), respectively. Demographic parameters were comparable between the groups. No cases of severe or moderate OHSS occurred in any group. The clinical pregnancy rates were 31.7%, 37.8% and 32.8% in groups A, B and C, respectively. Both injections had comparable efficacy in clinical outcome and OHSS risk. Regardless of preferred drug, GnRH agonist trigger for final oocyte maturation seems to be safe for patients with high OHSS risk, and can be safely used in fresh embryo transfer cycles.
Taiwanese Journal of Obstetrics and Gynecology, 2016
ABSTRACT Occult hernia is an under-diagnosed condition in women with chronic groin pain. Labium m... more ABSTRACT Occult hernia is an under-diagnosed condition in women with chronic groin pain. Labium majus is an important landmark for conditions of round ligament and direct inguinal hernias. The association of labia majora and abdominal structures through the round ligament should be considered while evaluating labial conditions.
The aim of the present study was to compare follicular fluid (FF) levels of norepinephrine (NE) a... more The aim of the present study was to compare follicular fluid (FF) levels of norepinephrine (NE) and dopamine (DA) in polycystic ovary syndrome (PCOS) and non-PCOS patients who underwent in vitro fertilization (IVF). Forty-seven PCOS patients (study group) and 61 patients with male factor infertility (control group) who underwent IVF using GnRH agonist protocol were recruited. Concentrations of NE and DA were measured in FF specimens of all patients. Demographic characteristics were comparable between the groups. Significantly higher levels of NE were measured in FF of PCOS patients (median: 61.05 nmol/l) compared to those with male infertility (median: 49.82 nmol/l). Similarly, significantly higher levels of DA were measured in FF of PCOS patients (median: 23.70 nmol/l) compared to those with male infertility (median: 18.28 nmol/l). In conclusion, the FF concentrations of both catecholamine are increased in PCOS patients when compared to non-PCOS patients.
Journal of Obstetrics and Gynaecology Research, 2015
The aim of this study was to assess the diagnostic accuracy of hysterosalpingography (HSG) on tub... more The aim of this study was to assess the diagnostic accuracy of hysterosalpingography (HSG) on tubal patency (TP) and to determine whether performing laparoscopy (LS) can change the original management strategy based on HSG findings. Records of all infertile couples (n = 1298) treated at a university-based infertility clinic between January 2002 and June 2010 were reviewed. All patients who had both HSG and LS testing (n = 264) were included in the study. HSG was performed in an attempt to rule out tubal and/or uterine pathologies. All patients included in the study were evaluated with LS not more than 12 months after HSG. The validity of HSG screening for TP was calculated as 84.1%. The positive and negative predictive values of HSG were 54.6% and 98.3%, respectively. The sensitivity of HSG was higher in patients with distal tubal occlusion than in patients with proximal tubal occlusion (69.8% [44/63] vs 46.7% [28/60], respectively; P = 0.011). The rates of management plan change in patients with bilateral TP, unilateral tubal occlusion and bilateral tubal occlusion were 2.8%, 12.2% and 32.4%, respectively (P = 0.000). Patients with both unilateral tubal occlusion and bilateral tubal occlusion on HSG should be reevaluated with LS to determine the appropriate management strategy.
HELLP syndrome is characterized by hemolysis, elevated liver enzymes and thrombocytopenia. With a... more HELLP syndrome is characterized by hemolysis, elevated liver enzymes and thrombocytopenia. With a incidence of 0.1%-0.8% it is known to be effected by genetic predisposition. Unlike preeclempsia multiparity increases the risk of HELLP syndrome. Diagnosis is made by the classic clinical triad. Thrombocyte counts are especially important for classification of the disease. When making a diagnosis, severe preeclempsia, acute fatty liver of pregnancy, hemolytic ureamic syndrome and thrombocytopenic thrombotic purpura should be always be kept in mind for differential diagnosis. HELLP syndrome has several complications , including but not limited to; disseminated intravascular coagulopathy, acute renal failure, pulmonary edema, liver rupture and hematoma and retinal detachment. Suggested treatment modality consists, stabilization of blood pressure and magnesium sulfate infusion. Then evaluation of fetal status and planning delivery method and time if maternal status remains unstable. If pr...
Objective: The present study aims to assess the success of controlled ovarian stimulation in intr... more Objective: The present study aims to assess the success of controlled ovarian stimulation in intrauterine insemination cycles stimulated by recombinant-FSH and Clomiphene citrate for either mono- or bi-follicular development. Methods: We assessed 870 infertile patients treated with controlled ovarian stimulation in intrauterine insemination cycles at a university-based infertility clinic between January 2012 and December 2017. We compared the cycles stimulated by clomiphene citrate and recombinant-FSH in two set-ups; mono- and bi-follicular development. The main outcome measure was the clinical pregnancy rate per cycle. Results: The demographic and cycle parameters were similar between the groups, except for endometrial thickness on the day of hCG administration, which was higher in the recombinant-FSH group than the clomiphene citrate group. The overall clinical pregnancy rates in clomiphene citrate and recombinant-FSH groups were 9.8% and 10.3%, respectively (p=0.940). Regarding t...
Pompe disease is an autosomal-recessive disorder caused by acid alpha-glucosidase deficiency due ... more Pompe disease is an autosomal-recessive disorder caused by acid alpha-glucosidase deficiency due to mutations in the GAA gene. There are two forms of the disease: infantile-onset Pompe disease and late-onset Pompe disease. The worldwide incidence of both forms of the disease is commonly reported to be 1 in 40,000. Adult patients are affected by limb-girdle muscular weakness and respiratory insufficiency. Enzyme replacement therapy with alglucosidase-alpha is available since 2006. There is little knowledge about pregnant woman with Pompe disease. These women should be considered as high-risk pregnant women. Here, we aim to present Cesarean delivery and postpartum management of a case with an interrupted enzyme replacement therapy during pregnancy.
Triptorelin 0.2 mg and leuprolide 1 mg subcutaneous injections for triggering final follicular ma... more Triptorelin 0.2 mg and leuprolide 1 mg subcutaneous injections for triggering final follicular maturation were compared in patients with a high risk for ovarian hyperstimulation syndrome (OHSS). Infertile patients treated with GnRH antagonist protocol between January 2014 and March 2016 were recruited. Patients with high serum oestradiol levels on HCG day (>3000 pg/ml) indicating a risk of OHSS consisted of the study groups (A and B). Patients with serum oestradiol levels less than 3000 pg/ml consisted of the control group (C). A single injection of 0.2 mg triptorelin, 1 mg leuprolide and 10000 IU HCG were administered for final oocyte triggering in groups A (n = 63), B (n = 74) and C (n = 131), respectively. Demographic parameters were comparable between the groups. No cases of severe or moderate OHSS occurred in any group. The clinical pregnancy rates were 31.7%, 37.8% and 32.8% in groups A, B and C, respectively. Both injections had comparable efficacy in clinical outcome and OHSS risk. Regardless of preferred drug, GnRH agonist trigger for final oocyte maturation seems to be safe for patients with high OHSS risk, and can be safely used in fresh embryo transfer cycles.
Taiwanese Journal of Obstetrics and Gynecology, 2016
ABSTRACT Occult hernia is an under-diagnosed condition in women with chronic groin pain. Labium m... more ABSTRACT Occult hernia is an under-diagnosed condition in women with chronic groin pain. Labium majus is an important landmark for conditions of round ligament and direct inguinal hernias. The association of labia majora and abdominal structures through the round ligament should be considered while evaluating labial conditions.
The aim of the present study was to compare follicular fluid (FF) levels of norepinephrine (NE) a... more The aim of the present study was to compare follicular fluid (FF) levels of norepinephrine (NE) and dopamine (DA) in polycystic ovary syndrome (PCOS) and non-PCOS patients who underwent in vitro fertilization (IVF). Forty-seven PCOS patients (study group) and 61 patients with male factor infertility (control group) who underwent IVF using GnRH agonist protocol were recruited. Concentrations of NE and DA were measured in FF specimens of all patients. Demographic characteristics were comparable between the groups. Significantly higher levels of NE were measured in FF of PCOS patients (median: 61.05 nmol/l) compared to those with male infertility (median: 49.82 nmol/l). Similarly, significantly higher levels of DA were measured in FF of PCOS patients (median: 23.70 nmol/l) compared to those with male infertility (median: 18.28 nmol/l). In conclusion, the FF concentrations of both catecholamine are increased in PCOS patients when compared to non-PCOS patients.
Journal of Obstetrics and Gynaecology Research, 2015
The aim of this study was to assess the diagnostic accuracy of hysterosalpingography (HSG) on tub... more The aim of this study was to assess the diagnostic accuracy of hysterosalpingography (HSG) on tubal patency (TP) and to determine whether performing laparoscopy (LS) can change the original management strategy based on HSG findings. Records of all infertile couples (n = 1298) treated at a university-based infertility clinic between January 2002 and June 2010 were reviewed. All patients who had both HSG and LS testing (n = 264) were included in the study. HSG was performed in an attempt to rule out tubal and/or uterine pathologies. All patients included in the study were evaluated with LS not more than 12 months after HSG. The validity of HSG screening for TP was calculated as 84.1%. The positive and negative predictive values of HSG were 54.6% and 98.3%, respectively. The sensitivity of HSG was higher in patients with distal tubal occlusion than in patients with proximal tubal occlusion (69.8% [44/63] vs 46.7% [28/60], respectively; P = 0.011). The rates of management plan change in patients with bilateral TP, unilateral tubal occlusion and bilateral tubal occlusion were 2.8%, 12.2% and 32.4%, respectively (P = 0.000). Patients with both unilateral tubal occlusion and bilateral tubal occlusion on HSG should be reevaluated with LS to determine the appropriate management strategy.
Uploads
Papers by rusen aytac