Ege Nazan Tavmergen Göker

Expression of interleukin-8 and monocyte chemotactic protein 1 in women with endometriosis

OBJECTIVE To investigate the expression and localization of interleukin-8 (IL-8) and monocyte chemotactic protein 1 (MCP-1) in women with and without endometriosis. DESIGN Comparative immunohistochemical study. SETTING Academic medical center. PATIENT(S) Ectopic (n = 24) and homologous eutopic endometrium (n = 24) from women with endometriosis and endometrium from women without endometriosis (n = 27) were used for immunohistochemical analysis of IL-8 and MCP-1. INTERVENTION(S) Tissue sections were immunostained with antihuman IL-8 and MCP-1 antibodies. MAIN OUTCOME MEASURE(S) Microscopic evaluation to assess the presence and localization of IL-8 and MCP-1 throughout the menstrual cycle in both eutopic endometrial and endometriotic tissues of women with endometriosis and comparison with normal endometrium. RESULT(S) In normal endometrium, secretory phase samples expressed higher levels of epithelial IL-8 than in proliferative phase samples. Epithelial MCP-1 expression was similar in both proliferative and secretory phases. Proliferative phase samples showed higher epithelial IL-8 and MCP-1 expressions in eutopic endometrium of women with endometriosis compared with that of normal women. Immunoreactivities of both chemokines were significantly increased in the epithelial cells of ectopic endometrial tissues compared with those of normal endometrium. CONCLUSION(S) These findings suggest that IL-8 and MCP-1 may be involved in the pathogenesis of endometriosis.

Premature luteinization defined as progesterone estradiol ratio >1 on hCG administration day seems to adversely affect clinical outcome in long gonadotropin-releasing hormone agonist cycles

Aim:  To examine the effect of premature luteinization on the outcomes in long gonadotropin‐releasing hormone agonist cycles.

Comparison of the ICSI outcome of ejaculated sperm with normal, abnormal parameters and testicular sperm.

OBJECTIVE(S) To compare fertilization rates, quality of embryos, pregnancy rates (PRs) and outcome of pregnancies in intracytoplasmic sperm injection (ICSI) using sperm from ejaculates of normal and abnormal semen and testicular sperm of non-obstructive azoospermia. STUDY DESIGN Four hundred fifty-four patients who underwent 454 ICSI cycles were evaluated retrospectively. Patients were divided into three groups according to the quality and source of sperm. Patients in group 1 underwent 133 cycles of ICSI using ejaculated normal semen, group 2 underwent 235 cycles using ejaculated abnormal semen, and group 3 underwent 86 cycles using testicular sperm. RESULTS The parameters were compared among the groups with respect to cycles induced by long (n = 160) and short (n = 294) protocol. In group 3, the fertilization and PRs were significantly lower than in all other groups (51.3 and 10.6% in the long protocol cycles, 53.3 and 5.1% in the short protocol cycles, respectively). There was no significant difference in the outcome of pregnancies in respect to abortion rates between different groups. CONCLUSION(S) The fertilizing ability of sperm in ICSI is highest with ejaculated sperm and lowest with sperm extracted by testicular biopsy. Also, the clinical PRs are significantly lower in ICSI with sperm from testicular biopsy. However, the outcomes of pregnancies are not affected by using surgically retrieved sperm from ejaculated semen.

Gluteal artery pseudoaneurysm, a rare cause of sciatic pain: case report and literature review.

This article describes a very unusual case of sciatic pain and motor dysfunction resulting from gluteal artery pseudoaneurysm. A 36-year-old woman with primary infertility sustained an iatrogenic injury to her left gluteal artery during transvaginal ultrasound-guided follicle aspiration. Twenty-five days after the procedure she developed severe left sciatic pain and motor dysfunction. Pelvic computed tomography and magnetic resonance imaging revealed a huge pelvic hematoma. Angiography demonstrated a gluteal artery pseudoaneurysm. Because endovascular occlusion of the aneurysm did not relieve the pain, the patient underwent surgery for evacuation of the hematoma and release of the lumbosacral plexus. This eliminated all her sciatic pain and restored her motor dysfunction completely. The English literature details only five other cases of sciatic pain resulting from gluteal artery aneurysm, and these reports are also discussed.

Long-term use of gonadotropin-releasing hormone analogues before IVF in women with endometriosis.

Purpose of review To discuss the relationship between endometriosis and infertility, the impact of endometriosis on assisted reproductive techniques and also the benefits of prolonged use of gonadotropin-releasing hormone analogue before IVF in women with endometriosis. Recent findings The available evidence suggests that endometriosis is strongly associated with infertility. Many studies indicate lower pregnancy and implantation rates even in assisted reproductive cycles in women with endometriosis. It is well known that medical suppression of endometriosis does not appear to be warranted for endometriosis-associated infertility. Prolonged pretreatment with gonadotropin-releasing hormone analogue before IVF has been reported to improve clinical pregnancy rates in infertile women with endometriosis. Summary Based on the recently published data, infertile women with endometriosis may benefit from long-term pretreatment of gonadotropin-releasing hormone analogue prior to IVF.

Unilateral Ectopic Twin Pregnancy Following an IVF Cycle

We report here a 37‐year‐old woman who underwent ovulation induction and in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment because of infertility who developed vaginal bleeding at the 6th week of gestation. Abdominal ultrasonography was insufficient to distinguish the intrauterine gestational sac. Subsequently, vaginal doppler ultrasonography detected two separate unilateral twin ectopic pregnancies with cardiac activity in both fetuses, which were operated on pelviscopically.

The outcomes of assisted reproductive technology cycles in patients with one or two ovaries

Aim: To provide a comparison between the follicular response to ovulation induction, and the pregnancy rate of women with a single or two ovaries, undergoing assisted reproductive technology.

The effects of female age on the outcome of testicular sperm extraction and intracytoplasmic sperm injection in infertile patient with azoospermia

Introduction: Testicular sperm extraction (TESE) is well-defined procedure for surgical sperm retrieval in obstructive and non-obstructive azoospermia. This study was focused on the effectiveness of testicular sperm extraction and intracytoplasmic sperm injection (ICSI) for azoospermic men with different female age subgroups.Materials and methods: A total of 107 men with azoospermia underwent TESE and ICSI treatment. The women were examined in three groups 20–29, 30–34 and 35 years or older. The main outcome in this study was fertilization and pregnancy rates with TESE and ICSI.Results: Spermatozoa were successfully retrieved during 97 of 107 (90.7%) TESE attempts, resulting in the fertilization of 286 of 563 (50.4%) injected metaphase II oocytes. Two hundred and fifty-five of them were transferred (89.8%). The clinical pregnancy rate and ongoing pregnancy rate per embryo transfer were 22.5% and 20.6% respectively. When comparing the fertilization and pregnancy rates, it was observed that women between the ages of 20–29 years had significantly higher pregnancy rates than women over 34 years of age (p < 0.05).Conclusion: The female age is a major factor in determining successful implantation in ICSI.

Effect of ovarian cysts detected on the beginning day of ovulation induction to the success rates in ART cycles

Aim:  In the present study, we examined the outcome of assisted reproductive technology cycles in patients with or without baseline ovarian cysts following gonadotrophin‐releasing hormone analogs administration.

COMET, TUNEL, and TEM analysis of an infertile male with short tail sperm.

Male infertility is correlated with sperm morphology and sperm DNA damage, which are completely different from that of fertile individuals. An accurate sperm DNA damage analysis and ultrastructural examination of the ejaculate provide important support in the clinical evaluation. It is supposed that in the near future, the fertilization rate, pregnancy rate, and miscarriages could be predicted using the combination of these types of tests in assisted reproductive technologies (ARTs). For this purpose, we report a very rare case of an infertile man having short tail sperm. The infertile man and his wife underwent in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI). During this process, we examined the ultrastructure of the ejaculated sperm with transmission electron microscopy (TEM) and calculated the sperm DNA damage with terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) and COMET assays. Then, we evaluated the association between sperm DNA damage and embryo quality.