Aylin Pelin Cil

Age-specific probability of live birth with oocyte cryopreservation: an individual patient data meta-analysis

OBJECTIVE To estimate age-specific probabilities of live birth with oocyte cryopreservation in nondonor (ND) egg cycles. DESIGN Individual patient data meta-analysis. SETTING Assisted reproduction centers. PATIENT(S) Infertile patients undergoing ND mature oocyte cryopreservation. INTERVENTION(S) PubMed was searched for clinical studies on oocyte cryopreservation from January 1996 through July 2011. Randomized and nonrandomized studies that used ND frozen-thawed mature oocytes with pregnancy outcomes were included. Authors of eligible studies were contacted to obtain individual patient data. MAIN OUTCOME MEASURE(S) Live birth probabilities based on age, cryopreservation method, and the number of oocytes thawed, injected, or embryos transferred. RESULT(S) Original data from 10 studies including 2,265 cycles from 1,805 patients were obtained. Live birth success rates declined with age regardless of the freezing technique. Despite this age-induced compromise, live births continued to occur as late as ages 42 and 44 years with slowly frozen and vitrified oocytes, respectively. Estimated probabilities of live birth for vitrified oocytes were higher than those for slowly frozen. CONCLUSION(S) The live birth probabilities we calculated would enable more accurate counseling and informed decisions for infertile women considering oocyte cryopreservation. Given the success probabilities, we suggest that policy makers should consider oocyte freezing as an integral part of prevention and treatment of infertility.

Power Doppler properties of endometrial polyps and submucosal fibroids: a preliminary observational study in women with known intracavitary lesions.

To compare power Doppler flow mapping characteristics of endometrial polyps and submucosal fibroids and analyze whether two different power Doppler characteristics, single‐vessel pattern and rim‐like vessel pattern, can help to differentiate these focal endometrial lesions.

Myometrial involvement of tumor-like cystic endosalpingiosis : a rare entity

Endosalpingiosis is characterized by the presence of benign glands lined by tubal‐type epithelium involving the pelvic and lower abdominal peritoneum and pelvic and para‐aortic lymph nodes in women. Rarely, cystification can occur, resulting in a neoplasm‐like mass associated with clinical manifestations, an intraoperative abnormality, or a striking finding on gross examination. Here we report the transvaginal ultrasound, magnetic resonance imaging and histopathological appearance of an unusual case of cystic endosalpingiosis involving the right ovary and full thickness of the wall of the uterine fundus in a patient who presented with a 6‐month history of menorrhagia and pelvic pain. Clinicians should be aware of this type of uterine benign manifestation so as to refrain from overtreatment. Copyright

Staining characteristics of p16INK4a: Is there a correlation with lesion grade or high-risk human papilloma virus positivity?

Aim:  The aims of this study were to evaluate the efficiency of p16INK4a in showing cervical lesions and to determine any relationship between lesion grade and high‐risk human papilloma virus (HR‐HPV) infection and p16INK4a staining characteristics.

Childhood asymmetric labium majus enlargement: is a conservative approach available?

Unilateral vulva swelling during prepubertal period consists of a wide variety of inflammatory and neoplastic lesions. A group of labial lesions that showed normal radiologic, histopathologic and surgical findings are reported as childhood asymmetric labium majus enlargement. An 11-year-old girl with childhood asymmetric labium majus enlargement is presented to discuss the clinicopathologic features, differential diagnosis, and indications of conservative approach in the treatment of this rare entity.

Diagnosis and management of vaginal mullerian cyst in a virgin patient

Benign cystic lesions of the vagina are uncommon and may become symptomatic. We describe two symptomatic anterior vaginal wall cysts in a virgin patient and the usefulness of imaging modalities. A 36-year-old virgin woman presented with a complaint of vaginal bulging and pelvic pressure. Pelvic examination revealed a cystic mass protruding from the vagina surrounded by the intact hymen. The initial abdominopelvic ultrasound showed a hypoechoic cystic mass measuring 42 × 20 mm in the vagina. She then had a pelvic magnetic resonance imaging (MRI) that revealed two anterior vaginal wall cysts with no communication with the urethra or bladder. The cysts were excised and histologic examination with mucicarmine revealed mucin-secreting tall columnar cells consistent with a diagnosis of mullerian cyst. While both ultrasonographic examination and MRI are helpful in localizing vaginal cysts, MRI is superior in showing multiple cystic lesions of the vagina and their communication with the surrounding structures.

Who is the best candidate for oocyte cryopreservation research

Clinical studies of oocyte cryopreservation have gained momentum within the recent years; however, no guidelines have yet been established for patient selection. This article discusses the controversial aspects of selecting candidates for oocyte cryopreservation research.

Papillary adenofibroma of the cervix: a case report

Adenofibroma is an extremely rare benign biphasic neoplasm that is classified into the mixed epithelial and mesenchymal tumor group. It typically affects the endometrium, but may occur in the cervix or in an extrauterine location. Preoperative diagnosis of this tumor is usually difficult. We describe the case of a 55‐year‐old woman with papillary cervical adenofibroma, which appeared as a cervical mass containing multiple cystic components on transvaginal ultrasound. This lesion appears to be clinically and histologically benign but must be differentiated from malignant lesions of the uterus, particularly from adenosarcoma, which can be suggestive of adenofibroma. Accurate diagnosis of these benign tumors permits appropriate counseling of patients. Copyright

Outcome of vasectomies performed at a Turkish metropolitan maternity hospital

Objective To determine prospectively the outcome of vasectomies performed by two trained surgeons over a 9-month period at the Ministry of Health Ankara Etlik Maternity and Womens Health Teaching and Research Hospital Family Planning Centre. Methods The demographic data, source of information concerning the method, sexual function before and after voluntary no-scalpel vasectomy, compliance with the post-vasectomy follow-up program of men applying for a vasectomy were analyzed. All patients were contacted by telephone and invited for follow-up visits for counseling, inquiry regarding sexual dysfunction, and performance of a semen analysis. Results The patients were married men, mostly primary school graduates, with more than one child. Sources of information were health services and/or health personnel for 89% of the patients. Of the 279 men who underwent a vasectomy and who were later contacted by phone, 131 (47%) came for a follow-up assessment. There was only one post-vasectomy pregnancy (0.8%). The incidence of reported sexual problems did not change after the procedure. Vasectomy did not affect the sexual function of men in our study. Conclusion Compliance with follow-up after vasectomy, which is extremely important for assessment of its successful outcome, is low.

Breast cancer diagnosis following ovarian stimulation: Are the tumours different?

Demographic data and tumour characteristics of 18 patients (study group) diagnosed with breast cancer within 24 months of undergoing ovarian stimulation with either gonadotrophins or clomiphene citrate were evaluated and compared with similar 102 age-matched women diagnosed with breast cancer without prior infertility treatment (control group). Eight out of 17 (47.1%) patients in the study group and 35/95 (36.8%) patients in the control group had positive family history for breast cancer. Median tumour size was similar in the study and control groups (both 1.3 cm). Both groups were comparable regarding tumour histological types and oestrogen receptor, progesterone receptor and Her2/Neu expression status. Albeit not significant, stage 0 tumours were more prevalent in the study group compared with the control group (22.2% versus 10.5%), and there were no stage III tumours in the study group as opposed to 7/95 in the control group. In conclusion, breast cancer diagnosed within the first 2 years following infertility treatment is similar in tumour characteristics compared with those occurring in patients without prior infertility treatment.