Hasan Serdaroglu

Role of inflammatory mediators in patients with recurrent pregnancy loss

OBJECTIVE To examine interleukin-12 (IL-12), IL-18, IFN-γ, intracellular adhesion molecule-1 (ICAM-1), leukemia inhibitory factor (LIF), and migration inhibitory factor (MIF) levels in precisely-timed blood and endometrial tissue samples from women with idiopathic recurrent pregnancy loss (RPL). DESIGN Case-control study. SETTING University hospital. PATIENT(S) Twenty-one women with RPL and 20 women with proven fertility (controls). INTERVENTION(S) Primary endometrial cells and blood samples during the midsecretory phase (days 19-23). MAIN OUTCOME MEASURE(S) Detection of IL-12, IL-18, IFN-γ, ICAM-1, LIF, and MIF via enzyme-linked immunosorbent assay in both blood and endometrial tissue samples. RESULT(S) The blood and tissue levels of IL-12, IL-18, and IFN-γ were statistically significantly higher, and the blood and tissue levels of LIF and MIF were statistically significantly lower in patients with RPL. Only the level of tissue ICAM-1 was higher in patients with RPL. There was a strong correlation between blood and tissue level measurements of IL-12, IL-18, LIF, and MIF. CONCLUSION(S) Our findings support the hypothesis that inflammatory processes may contribute to pregnancy loss, possibly through their role in implantation. We found that blood and tissue levels of IL-18, LIF, and MIF, and tissue levels of IL-12, IFN-γ, and ICAM-1 have statistically significant prognostic relevance.

Effect of leukaemia inhibitory factor on long-term sperm motility and survival

Leukaemia inhibitory factor (LIF) is expressed at high constitutive levels in the human Fallopian tubal epithelium. In this study, the effect of human recombinant LIF on sperm motility and survival in vitro was investigated. Human spermatozoa were incubated in sperm washing medium that contained various concentrations of LIF at 37 degrees C and under 5% of CO(2) in air for up to 48 h. Sperm motion characteristics were measured using a sperm motility analyser. Sperm survival was determined by the hypo-osmotic swelling test. The effect of LIF on sperm motility was concentration-dependent and maximal effect was observed at a concentration of 5 ng/ml. Sperm motility was significantly higher after 24 h exposure to LIF compared with control (P < 0.001). Sperm survival was also prolonged in a concentration-dependent manner. LIF significantly enhanced sperm survival at higher concentrations (10 ng/ml) and the result was significant after 48 h exposure (P < 0.05). LIF increased long-term sperm motility and survival in vitro.

Multifetal gestations with assisted reproductive technique before the single-embryo transfer legislation: obstetric, neonatal outcomes and congenital anomalies

Abstract Objective: To compare perinatal, neonatal outcome and congenital anomalies of multiple gestations conceived by means of assisted reproductive techniques with spontaneously conceived multiples before the limitation of number of embryo transfer. Methods: Cases consisted of assisted reproductive technique (ART) multifetal gestations and control group comprised of spontaneously conceived multifetal gestations delivered in the same time period. Outcomes were perinatal, neonatal outcome, long-term outcomes and congenital anomalies of multiple gestations. There were 270 multifetal pregnancies for analysis, of which 137 were achieved by ART and 133 were spontaneous in this prospective study. Results: Incidences of preeclampsia, gestational diabetes, deep vein thrombosis, thrombocytopenia, intrahepatic cholestasis and preterm premature rupture of membranes were similar in ART and spontaneous groups. There was no difference in fetal malformation rates between ART and control group, but higher rates of central nervous system malformation were observed (4 (1.5%) in control, 0 in ART group, p = 0.04) in spontaneous group. No difference was seen in the perinatal mortality. Conclusions: Neonatal and maternal outcomes are comparable between ART and spontaneous multifetal gestations. Congenital fetal malformation rates between ART and spontaneous multifetal pregnancies were similar except central nervous system malformation that was more likely in spontaneously conceived ones.