Hasan Ali Inal

Neuromuscular Morphometry of the Vaginal Wall in Women With Anterior Vaginal Wall Prolapse

The aim of this study was to compare the changes in hystomorphometry and innervation of the anterior vaginal wall in women with and without anterior vaginal wall prolapse.

Neuromuscular morphometry of the uterine ligaments and vaginal wall in women with pelvic organ prolapse

The aim of this study was to compare neuromuscular histomorphometry of the uterine ligaments and vaginal wall in women with and without pelvic organ prolapse.

Granulocyte colony-stimulating factor: A relation between serum and follicular fluid levels and in-vitro fertilization outcome in patients with polycystic ovary syndrome

Evidence is accumulating in the literature about the potential role of serum and follicular fluid (FF) granulocyte colony-stimulating factor (G-CSF) as a non-invasive biomarker of oocyte competence and embryo selection in in-vitro fertilization (IVF) cycles. In this study, we aimed to evaluate the effect of serum and FF G-CSF levels on IVF outcome in non-hyperandrogenic, non-obese patients with polycystic ovary syndrome (PCOS). Twenty-two patients with PCOS (Group I), and 22 patients with the etiology of male factor infertility (Group II) undergoing IVF treatment were included. Demographic features, controlled ovarian stimulation parameters, neutrophil count (NC), neutrophil/leukocyte (N/L) ratio, serum and FF G-CSF levels of the two groups were compared. Serum E2 level on the day of hCG (2982.5±171.4 vs. 2279.0±207.2 pg/mL), total number of retrieved oocytes (14.7±0.9 vs. 11.5±1.3) and mature oocytes (11.6±0.8 vs. 9.1±1.1) were significantly higher in group I when compared to group II (p<0.05). On the day of oocyte retrieval, both the mean serum (54.8±1.7 vs. 48.1±0.9 pg/mL) and FF G-CSF levels (48.8±1.4 vs. 44.1±0.5 pg/mL), NC (4.4±0.2×10(3) vs. 3.6±0.3×10(3)/μL) and N/L ratio (63.6±1.4 vs. 56.1±1.7) in group I were found to be significantly higher than group II ((p<0.05). Despite the increased levels of G-CSF both in the serum and follicular microenvironment in patients with PCOS, a relation between G-CSF and good ovarian response or clinical pregnancy rates could not be demonstrated in this study.

Follicular fluid total antioxidant capacity levels in PCOS

In this study, our aim was to assess total antioxidant capacity (TAC) levels in follicular fluid (FF) and their relationship to clinical pregnancy rates in PCOS patients undergoing assisted reproduction (ART). Twenty-two women with polycystic ovary syndrome (PCOS) (Group 1) and 41 women without PCOS (Group 2) were included in this study. Clinical and laboratory parameters and FF TAC levels were investigated. No statistically significant differences were found between the groups with regard to age and baseline parameters. Although we could not demonstrate a significant difference in FF TAC levels between the two groups (p=0.469), there was a significant positive correlation between FF TAC and clinical pregnancy rates, BMI, and the duration of infertility for the entire group (r=0.254, p=0.048; r=0.312, p=0.013; r=0.259, p=0.040; respectively). Owing to the correlation between FF TAC and the clinical pregnancy rates, further studies evaluating the impact of FF TAC levels on ART outcomes in patients with PCOS and other etiologies of infertility are needed.

Negative life events have detrimental effects on in-vitro fertlization outcome

Abstract The aim of this study was to investigate the effect of negative life events on in-vitro-fertilization (IVF) outcome. Depression and negative life events were measured using Beck Depression Inventory (BDI) and List of Recent Events in 83 women attending the IVF clinic of a tertiary research and education hospital with the diagnosis of unexplained infertility between January 2013 and August 2013. Demographic features, stimulation parameters, depression scores, and negative life events of pregnant and non-pregnant participants were compared and the relation between negative life events, depression scores, and IVF outcome was investigated. Women who did not achieve a pregnancy experienced more negative life events than women who became pregnant (77.2% vs. 23.1%) (p > 0.001). The number of patients with moderate-to-severe depression (BDI scores > 16) was higher in the non-pregnant group than pregnant group (49.1% vs. 26.9%), however the difference was not statistically significant (p = 0.057). Clinical pregnancy showed a significant moderate negative correlation with the number of negative life events (r = −0.513, p = 0.001), but the correlation between clinical pregnancy and BDI scores was not statistically significant (r = −0.209, p = 0.059). Stressful life events have a negative influence on the quality of life, which eventually affects in IVF outcome, possibly through maladaptive lifestyle behavior.

Maternal circulating levels of irisin in intrahepatic cholestasis of pregnancy.

Abstract Objective: Intrahepatic cholestasis of pregnancy (ICP), the most common liver disease in pregnancy, is characterized by elevated serum total bile acid levels and pruritus. It has become clear that bile acids are no longer labeled as simple detergent-like molecules, but also represent complex hormonal metabolic regulators. ICP has also been associated with increased incidence rates of gestational diabetes mellitus. Irisin is a newly discovered myokine that is able to regulate glucose and lipid levels, thus improving insulin sensitivity. In this study, maternal serum irisin levels were analyzed in order to provide a new perspective on the pathogenesis of ICP. Materials and methods: In this controlled cross-sectional study, 58 consecutive pregnant women with ICP (30 with mild and 28 with severe disease) and 30 healthy women with uncomplicated pregnancies (as the control group) were examined. The maternal irisin, fasting blood glucose, fasting insulin and homeostatic model assessment of insulin resistance levels of the two groups were compared. Results: Serum irisin levels were significantly higher in the severe ICP group than in the mild ICP and control groups (p = 0.005 and p < 0.001, respectively). At the best cut-off level of 908.875 pg/ml, irisin accurately predicted ICP [AUC = 0.827 (95% CI: 0.745–0.909; p < 0.001)] with sensitivity and specificity rates of 72.5 and 86.8%, respectively. There was a significant negative correlation between irisin and fasting blood glucose levels (r = −0.399; p = 0.021). Conclusion: The results of this study indicate that serum irisin levels were significantly higher in women with ICP compared to healthy pregnant controls. However, it is difficult to infer whether high irisin level is a cause or effect of ICP.

The effect of serum and follicular fluid amyloid-associated protein levels on in vitro fertilization outcome in patients with polycystic ovary syndrome

PurposeIn this study, we aimed to investigate serum and follicular fluid amyloid A protein levels in non-obese non-hyperandrogenic patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization (IVF) and IVF outcome.MethodsA total of 81 patients undergoing IVF treatment, 41 patients diagnosed as PCOS according to the Rotterdam criteria (group I) and 40 patients with the etiology of male factor infertility (group II), were included in the study. On the day of oocyte pickup, serum and follicular fluid samples were collected from all patients.ResultsSerum E2 level on the day of hCG (2849.93 ± 541.54 vs. 2494.28 ± 712.98) and total number of retrieved oocytes (13.73 ± 3.57 vs. 10.53 ± 4.07) were significantly higher in group I when compared to group II (p < 0.05). However, number of mature oocytes, fertilization rate, and clinical pregnancy rate did not differ (p > 0.05). No significant difference was found between two groups regarding the serum and follicular fluid amyloid A protein levels on the day of oocyte retrieval (p > 0.05).

Assessment of Endometrial Sampling and Histopathological Results: Analysis of 4,247 Cases

OBJECTIVE This study aimed to investigate the relationship between indications and histopathological results in patients undergoing endometrial sampling. MATERIALS AND METHODS Data of 4,247 patients undergoing endometrial sampling due to non-obstetric gynecological causes between January 2010 and October 2016 were retrospectively evaluated using the archives of the Gynecology and Obstetrics Clinic of Konya Training and Research Hospital. RESULTS The mean age of patients was 46.8 ± 8.22 years; the most common indication was menometrorrhagia/menorrhagia (70.66%), and the least common indication was cervical polyp (1.34%). The most common histopathological result was proliferative-secretory endometrium (63.62%); simple hyperplasia with atypia (0.56%) was determined to be the least common result. Endometrial cancer was observed more frequently in the post-menopausal bleeding and increased endometrial thickness group (23.11%). Of patients in whom biopsy was performed, 52.18% had undergone hysterectomy, as a result of which proliferative-secretory endometrium was most commonly (59.52%) and simple hyperplasia with atypia least commonly found as the histopathological diagnosis. CONCLUSION Although sampling should be performed following endometrial evaluation in patients with post-menopausal bleeding or increased endometrial thickness, according to the results of our study, routine endometrial biopsy should not be preferred in the other indications.

Investigation of cesarean sections at Konya Training and Research Hospital Obstetrics and Gynecology Department between 2010 and 2015

OBJECTIVE Analysis of the annual distribution of cesarean sections and indications between 2010 and 2015 in our clinic. MATERIAL AND METHODS Medical records of 10,437 cesarean section patients from a total number of 24,283 deliveries performed at Department of Obstetrics and Gynecology between 2010-2015 were evaluated retrospectively. The indications for Cesarean section were analyzed and compared based on years. RESULTS The lowest cesarean section rate was 18.67% in 2011 and the highest rate was 24.5% in 2013, and the annual rates were close to each other in this 6-year period (p > 0.05). History of uterine surgery was the indication with the highest rate of 49.52%, while fetal distress was the second most frequent with 12.53%; presentation anomalies were observed as the most frequent third indication with 7.55%, and umbilical cord prolapse was the least frequent indication with 0.33%. CONCLUSIONS Patient education about normal delivery and providing means for pain control during normal delivery, improvement in physical conditions of the clinics, frequent and regular training of the assisting staff with obstetrics physicians are important to diminish the rates of primary cesarean sections. In addition, a normal delivery after a previous cesarean section must be encouraged.

A study of serum Apo A-1 and Apo B-100 levels in women with preeclampsia

OBJECTIVE To investigate Apo A-1 and Apo B-100 levels and Apo B-100/Apo A-1 ratios in preeclamptic (PE) patients. MATERIALS AND METHODS Forty-eight PE and 48 without PE patients (healthy pregnancies) matched for gestational age were included. Maternal age, parity, gestational age at delivery, obstetrical complications including intrauterine growth restriction (IUGR) and gestational diabetes mellitus (GDM), serum Apo A-1 and Apo B-100 levels, and the Apo B-100/Apo A-1 ratio were compared. RESULTS Preeclamptic patients had significantly lower Apo A-1 levels (167.07mg/dl±14.61mg/dl vs. 244.37mg/dl±20.84mg/dl, p<0.001), higher Apo B-100/Apo A-1 ratio (0.63±0.07 vs. 0.42±0.05, p<0.001), but similar Apo B-100 levels (104.84mg/dl±7.05mg/dl vs. 102.39mg/dl±8.08mg/dl, p=0.118). Mean Apo A-1 and Apo B-100 levels and the Apo B-100/Apo A-1 ratio were similar in patients with severe PE, HELLP syndrome, IUGR, and patients requiring antihypertensive therapy compared to PE patients who did not have these complications (p>0.05). Apo A-1 levels had the best accuracy followed by the Apo B-100/Apo A-1 ratio in patients with PE. CONCLUSION Apo A-1 and the Apo B-100/Apo A-1 ratio may be useful markers in patients with PE. Further studies are required to elucidate this issue.