Berna Seckin

Diagnostic value of sonography for detecting endometrial pathologies in postmenopausal women with and without bleeding

To investigate the diagnostic value of endometrial thickness measurement on sonography in predicting endometrial pathologies in postmenopausal women with vaginal bleeding and in those with asymptomatic thickened endometrium.

The reproductive outcome of women with hypogonadotropic hypogonadism undergoing in vitro fertilization

Abstract The aim of this study was to evaluate the reproductive outcome and assisted reproductive technology (ART) outcomes of patients with hypogonadotropic hypogonadism (HH) and to compare the results with male factor (MF) infertility patients. The reproductive outcome of 33 HH patients was evaluated retrospectively and compared with results of 47 patients with mild male factor infertility. For ovulation induction, human menopausal gonadotropin (hMG) was used in HH patients and recFSH was used in MF infertility patients. HH patients were divided into subgroups according to retrieved oocyte numbers and the groups were compared with each other. The main outcome measures were total gonadotropin dose used, duration of stimulation, human chorionic gonadotropin (hCG) day estradiol level and endometrial thickness, oocyte number retrieved, and rate of clinical pregnancy. ART outcomes and cycle characteristics of 33 HH patients were compared with 47 MF infertility patients. There was no difference in age and body mass index (BMI) between the groups, but mean follicle stimulating hormone FSH and luteinizing hormone LH levels were significantly lower in the HH group (p < 0.001). Duration of stimulation was 12.5 ± 2.06 days in the HH patients and 10.08 ± 1.62 days in the MF infertility patients and the difference was significant (p < 0.001). Total gonadotropin dose used was higher in the HH group than the MF infertility group (p < 0.001). However, there were no differences in hCG day estradiol levels, endometrial thickness on hCG day, total oocyte number retrieved, MII oocyte number, and pregnancy rate. In the HH subgroups, patient ages were significantly lower in the >15 oocyte retrieved group. Although patients with HH have a long-term estrogen deficiency, their response to controlled ovarian hyperstimulation treatment is similar to normal women. However, the HH group is heterogeneous and estimating the ovarian reserve before treatment is not always possible in this group.

Role of postprandial bile acids in prediction of perinatal outcome in intrahepatic cholestasis of pregnancy

The aim of this study was to investigate the role of fasting and postprandial total bile acids (fTBA, ppTBA) in prediction of adverse perinatal outcomes in intrahepatic cholestasis of pregnancy (ICP).

Usefulness of hematological parameters for differential diagnosis of endometriomas in adolescents/young adults and older women

Background Inflammatory processes have been considered to be involved in the pathogenesis of endometriosis. However, the predictive role of inflammatory hematological parameters in endometriosis is not clear. The aim of this study was to analyze the clinical value of hematologic markers in the differential diagnosis of endometriomas in younger and older reproductive age women. Materials and methods A retrospective chart review was done for 502 patients who underwent surgery: 267 with endometriomas (endometrioma group) and 235 with other benign adnexal cysts (control group). Patients were placed into subgroups as younger (adolescents/young adults, aged <25 years) and older (aged ≥25 years) women. Total and differential white blood cell count, neutrophil-to-lymphocyte ratio, platelet indices and platelet-to-lymphocyte ratio (PLR) were evaluated with receiver operating characteristic curve analysis for differential diagnosis of endometriomas. Results The mean serum levels of PLR, plateletcrit (PCT), platelet count and CA-125 (reference range below 35 IU/mL) were significantly higher in the endometrioma group (p < 0.001). The area under the curve (AUC) for CA-125 was 0.85 [95% confidence interval (CI), 0.82-0.88] (p < 0.001) for the entire group. However, platelet count, PLR, and PCT showed poor discriminative ability for detecting endometriomas with AUC values of 0.59 (95% CI, 0.55-0.65, p < 0.001), 0.58 (95% CI, 0.53-0.63, p = 0.002) and 0.61 (95% CI, 0.56-0.66, p < 0.001), respectively. In age-stratified analysis, these platelet indices had also low diagnostic performance in both age groups. Conclusions Hematologic markers do not adequately differentiate ovarian endometriomas from other benign cysts in neither adolescents/young adults nor older women.

First and Second Trimester Biochemical Markers in Maternal Epilepsy: A Case-Control Study

Abstract Background: Our aim is to investigate whether the maternal serum levels of first and second trimester serum analytes are altered in women with epilepsy in pregnancy. Methods: Maternal serum biochemical markers (estriol, alpha-fetoprotein [AFP], human chorionic gonadotrophin [hCG], free β hCG, pregnancy-associated plasma protein-A) were compared in a series of 122 pregnant women with epilepsy and in a cohort of 122 normal pregnant women. The serum samples were obtained between 11–13 6/7 weeks and 16–18 weeks gestation. Results: Second trimester serum estriol levels, expressed as multiples of the median (MoM), in the epileptic group (1.55 ± 0.77 MoM) were significantly higher than those in the control patients (1.13 ± 0.40 MoM) (p < 0.001). Of the women with epilepsy, 66.3% (n = 81) were exposed to antiepileptic drugs. Conclusion: Our study revealed that otherwise uncomplicated pregnant epileptic women had higher second trimester (18–20 weeks of gestation) estriol levels compared to non-epileptic pregnant women.

Age-stratified analysis of tumor markers and tumor characteristics in adolescents and young women with mature cystic teratoma

Background: Serum tumor markers are widely used for the preoperative evaluation of an adnexal mass. Elevations of cancer antigen (CA) 125 and CA 19–9 have been reported in patients with mature cystic teratoma (MCT). The aim of the study is to investigate the relation of serum tumor markers with tumor characteristics in young women with MCT. Methods: We conducted a retrospective review of 157 patients under the age of 35 who underwent laparoscopic surgery for ovarian MCT. Patients were divided into two age groups: Group I (n = 80): adolescents/young adults (aged 13–25 years) and Group II (n = 77): women aged 26–35 years. Data were analyzed for serum tumor markers, tumor size, and bilaterality. Results: The rates of elevated CA 125 and CA 19–9 were 10.7% and 31.5%, respectively, for Group I, and 13.9% and 26.5%, respectively, for Group II. The bilaterality rate was higher in Group II compared to Group I (19.5% vs. 8.8%, respectively, p = 0.04). Serum CA 125 and CA 19–9 elevations were not related to tumor size in Group I. In Group II, elevated levels of CA 125 were also unrelated to tumor size. However, significant elevation in CA 19–9 levels was observed when tumor size was larger than 4 cm in this age group (p = 0.004). Elevated CA 125 and CA 19–9 levels were not significantly associated with the presence of bilateral MCT in either group. Conclusion: The results of our study indicate that elevations of CA 19–9 are associated with larger tumor size in women aged 26–35 years, but not in adolescents/young adults. However, elevated serum CA 125 levels are not related to tumor size in either age group.